A question re medicare coverage [Dual U.S. / Canada Citizen]

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A question re medicare coverage [Dual U.S. / Canada Citizen]

Postby Norbert Schlenker » Sun Mar 24, 2013 11:43 am

I had an interesting question the other day from an acquaintance - let's call him Mr. X - and I can't be sure of the answer, so I'm asking the knowledgeable among you.

Mr. X is 58. He left the United States in his late 20's and has lived and worked in Canada ever since. Mr. X is a dual citizen and files both U.S. and Canadian tax returns every year. Mr. X's wife and children and grandchildren are in Canada, so he intends to remain in Canada for the remainder of his life, but he occasionally visits other relatives in the U.S. Like all Canadian residents, he is covered for medical expenses at home.

Before emigrating, Mr. X worked 39 quarters for purposes of Social Security. Paperwork from the SSA confirms that figure. 39 quarters is of course just short of the 40 quarters required to collect Social Security at retirement, but the totalization agreement between Canada and the U.S. suggests that SSA will pay him nevertheless, either directly or via agreement with the Canada Pension Plan (which he pays into while working in Canada).

Here's the wrinkle. Medicare entitlement isn't covered by the totalization agreement. So he's one quarter short of entitlement to U.S. medicare coverage at retirement. While he's satisfied with his health care coverage in Canada, there could be two benefits if he was also covered by U.S. Medicare: (1) quicker access to procedures via U.S. Medicare if his Canadian health care coverage imposes a wait, not uncommon with non life threatening issues, and (2) no need to buy travel insurance for trips to the U.S., which gets expensive as one gets older.

Google suggests that about $1200 in U.S. source wages, from which FICA is deducted, is sufficient to create one extra quarter of SS credit. (Presumably $1200 in self-employment income would do likewise.) Given that Mr. X is a U.S. citizen, there is no legal impediment to him earning income in the U.S.

If you were Mr. X, would you find a way to earn that extra quarter of Social Security credit?
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Re: A question re medicare coverage [Dual U.S. / Canada Citi

Postby obgraham » Sun Mar 24, 2013 2:04 pm

If you were Mr. X, would you find a way to earn that extra quarter of Social Security credit?
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Re: A question re medicare coverage [Dual U.S. / Canada Citi

Postby lawman3966 » Sun Mar 24, 2013 8:56 pm

Norbert Schlenker wrote:Here's the wrinkle. Medicare entitlement isn't covered by the totalization agreement. So he's one quarter short of entitlement to U.S. medicare coverage at retirement. While he's satisfied with his health care coverage in Canada, there could be two benefits if he was also covered by U.S. Medicare: (1) quicker access to procedures via U.S. Medicare if his Canadian health care coverage imposes a wait, not uncommon with non life threatening issues, and (2) no need to buy travel insurance for trips to the U.S., which gets expensive as one gets older.


I tend to agree that it's worth becoming eligible for U.S. Medicare, since you never know what your future plans may entail.

However, enrolling to get benefits, while still living in Canada, is another matter. Have you/he calculated the cost of the premiums and co-pays for Medicare and whether it's efficient to get Medicare instead of travel insurance or other alternative when visiting the U.S.?
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