Ex-pats returning to U.S. for health care

Charlene – Thailand: I have lived outside the U.S. for more than 10 years and have kept my Part B all this time and have never used it. Now, I may be facing some serious back surgery, and would like to return to the U.S. this summer and have the surgery done near Portland, Oregon. How should I proceed to make sure I am covered?

Phil Moeller: You should have a legal U.S. address to make sure your Part B will cover you for care when you return. Having a P.O. box does not qualify. If you have friends or family in the Portland area, perhaps you can rent a room or co-sign an apartment lease. I am NOT an expert on establishing a legal residence but have been told by Medicare and insurance companies that this is what is required for them to honor medical claims.

In the meantime, I’d find a Portland doctor or medical practice that accepts Medicare and is willing to take you on as a patient. Once you’ve done that, I assume this doctor would be willing to accept any needed medical records from your doctors in Thailand.

Part A of Medicare does a good job of covering all hospital expenses once its annual deductible has been met. Part B, however, only pays 80 percent of covered expenses. You can cover that gap with either a Medicare Advantage plan or a Medigap plan. These are both sold by private insurers and, again, you need to be a U.S. resident to qualify. This could take a lot of lead time, so I’d urge you to get started ASAP if you want to supplement your Part B coverage.