What kind of medical events that may ruin your retirement?

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flyingaway
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What kind of medical events that may ruin your retirement?

Post by flyingaway » Sat Aug 18, 2018 3:53 pm

We are seriously considering retirement in 1, 2, 3, or more years. The most uncertain thing that prevents us from making a decision is health insurance and health care.
After one more year at work (at 55), I will be eligible for buying my current employer's group insurance at about $17,000 a year for a couple (2018 rate). We can plan $5,000 additional co-pay etc. Alternatively, we could also buy ACA at a much lower rate if we control our withdraw rate. The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
In fact, outside the U.S., we think that we may be able to pay for most medical events (for less than US$22,000 a year), except for probably cancer treatments and organ transplants. My question is what kind of medical events that you know which have ruined people's retirement, or bankrupted some people even before retirement? (with or without health insurance).

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dm200
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Re: What kind of medical events that may ruin your retirement?

Post by dm200 » Sat Aug 18, 2018 3:58 pm

flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
We are seriously considering retirement in 1, 2, 3, or more years. The most uncertain thing that prevents us from making a decision is health insurance and health care.
After one more year at work (at 55), I will be eligible for buying my current employer's group insurance at about $17,000 a year for a couple (2018 rate). We can plan $5,000 additional co-pay etc. Alternatively, we could also buy ACA at a much lower rate if we control our withdraw rate. The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
In fact, outside the U.S., we think that we may be able to pay for most medical events (for less than US$22,000 a year), except for probably cancer treatments and organ transplants. My question is what kind of medical events that you know which have ruined people's retirement, or bankrupted some people even before retirement? (with or without health insurance).
Suppose one of you encounters a modest medical condition that prevents you from such travel OR some other life event intervenes. You would need/want the US based insurance.

JoeRetire
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Re: What kind of medical events that may ruin your retirement?

Post by JoeRetire » Sat Aug 18, 2018 4:11 pm

flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
You plan to be out of the country for 5 straight years?

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Re: What kind of medical events that may ruin your retirement?

Post by LadyGeek » Sat Aug 18, 2018 4:14 pm

This thread is now in the Personal Finance (Not Investing) forum (retirement planning).

One significant event can wipe out your savings in a heart beat. Off the top of my head, here are a recent few events which happened to people I know (not me):

Billed costs (you can get a discount by using the insurance rates):

- Cardiac care unit, a few days stay, $200k + doctors and consultations
- Emergency orthopedic surgery (unplanned fall), hospital facility, $65k + several $$$k for all the doctors, home health care, follow-ups.
- Chronic medical condition, specialist consultations and tests, multi $$$k - on-going. The latest test was $3,000

The above is in the US. Consider the quality of care you will receive in the country you will be traveling in. Local residents may be treated differently than US citizens.
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Re: What kind of medical events that may ruin your retirement?

Post by Tdubs » Sat Aug 18, 2018 4:19 pm

If you are going to be abroad and traveling a lot for five years, isn't medical insurance a relatively minor expense in your budget and worth the peace of mind?

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dm200
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Re: What kind of medical events that may ruin your retirement?

Post by dm200 » Sat Aug 18, 2018 4:21 pm

Others might have information, but don't some US health insurance companies provide some degree of coverage in some countries?

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dm200
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Re: What kind of medical events that may ruin your retirement?

Post by dm200 » Sat Aug 18, 2018 4:24 pm

Alternately, might you spread the travel over a few more years - spending some time each year in the US? Get medical tests, non-emergency procedures, medical visits, etc.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sat Aug 18, 2018 4:39 pm

Tdubs wrote:
Sat Aug 18, 2018 4:19 pm
If you are going to be abroad and traveling a lot for five years, isn't medical insurance a relatively minor expense in your budget and worth the peace of mind?
Long-term travels and living in most countries are not expensive. Our minimum budget is $80,000 per year, $23,000 for health insurance will be a big part of it, especially we do not plan to come back to the U.S. often.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sat Aug 18, 2018 4:44 pm

JoeRetire wrote:
Sat Aug 18, 2018 4:11 pm
flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
You plan to be out of the country for 5 straight years?
I could not figure out other things to do in retirement. The only thing that I may want to do, but could not do with a job, is long-term travels (not vacations). We may come back to visit our sons twice a year for two months. This is just something that we are seriously considering at this time.

Jablean
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Re: What kind of medical events that may ruin your retirement?

Post by Jablean » Sat Aug 18, 2018 5:10 pm

Doubtful ACA insurance would be better unless you qualified for subsidy but could be something to come back to during the Fall sign up period if you did drop out. Assuming you'd still be filing US taxes will you get hit with the individual mandate? Maybe not now but would a change in administration put it back in play?

For events - Stroke, Las Vegas. Five days in hospital, bill before insurance was 100,000, continuing care and physical therapy totaled all pre-insurance to right around $200,000. With insurance, 6,000. Luekemia, unknown causes, in your 50s possibly curable with chemo, in your 70s expect short-term hospice for comfort care only. All together also about $100,000 for acute phase.

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Re: What kind of medical events that may ruin your retirement?

Post by jebmke » Sat Aug 18, 2018 5:28 pm

Strokes, dementia, renal failure ... there is a long list.
When you discover that you are riding a dead horse, the best strategy is to dismount.

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Re: What kind of medical events that may ruin your retirement?

Post by bankle » Sat Aug 18, 2018 9:16 pm

From personal experience: Leukemia at age 53 while actively working. (AML with a certain unfavorable genetic mutation). The initial 6week hospitalization, including ER, "standard" first round chemo, resulting kidney failure/dialysis, transfusions, etc. came to a "list" price of almost $1mm. Fortunately I had good employer coverage, plus coverage thru DH's union - so minimal cost other than deductibles. The rest of the year was spent in and out of hospital for further chemos, infections, and an eventual bone marrow transplant (another 7 weeks). Fungal pneumonia caught during transplant meant over a year doing nightly at-home antifungal infusion - "list" price for monthly home delivery of IV meds and supplies = $15k. Now I take the latest generation of oral antifungal - "list" for 30 days is $4.7k. Plus about 17 other prescription meds currently. Etc etc.

Current insurance covers everything (deductibles and copays of course) - but have had more than a few tussles with one of the companies - stressful and a big energy suck.

Though generally, and fortunately, I am doing quite well, I haven't returned to work. Had been planning to continue until FRA - good work environment, swell bonuses, 401k matches, decent raises. Nope. While our assets were and are in good shape, they would only, hopefully, have gotten better with a few more years of work. Retirement is not destroyed, but we would have had just that much extra, ya know?

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Re: What kind of medical events that may ruin your retirement?

Post by 47Percent » Sat Aug 18, 2018 9:25 pm

flyingaway wrote:
Sat Aug 18, 2018 4:39 pm
Tdubs wrote:
Sat Aug 18, 2018 4:19 pm
If you are going to be abroad and traveling a lot for five years, isn't medical insurance a relatively minor expense in your budget and worth the peace of mind?
Long-term travels and living in most countries are not expensive. Our minimum budget is $80,000 per year, $23,000 for health insurance will be a big part of it, especially we do not plan to come back to the U.S. often.
If you are not planning to come back to the US often, then there won't be any copay. So the $23k figure is moot. You should be using the $17k figure for budgeting for US insurance as a fall-back.

If something does happen that necessitates you coming back and exercising the US insurance, then that $23k would look like a bargain anyway.

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Re: What kind of medical events that may ruin your retirement?

Post by 123 » Sat Aug 18, 2018 9:50 pm

With the general exception of pregnancy virtually any medical event or condition that can happen before age 65 can also happen at age 65 or greater. This includes all types of accidents.
The closest helping hand is at the end of your own arm.

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Re: What kind of medical events that may ruin your retirement?

Post by randomguy » Sat Aug 18, 2018 10:09 pm

Jablean wrote:
Sat Aug 18, 2018 5:10 pm
Doubtful ACA insurance would be better unless you qualified for subsidy but could be something to come back to during the Fall sign up period if you did drop out. Assuming you'd still be filing US taxes will you get hit with the individual mandate? Maybe not now but would a change in administration put it back in play?

For events - Stroke, Las Vegas. Five days in hospital, bill before insurance was 100,000, continuing care and physical therapy totaled all pre-insurance to right around $200,000. With insurance, 6,000. Luekemia, unknown causes, in your 50s possibly curable with chemo, in your 70s expect short-term hospice for comfort care only. All together also about $100,000 for acute phase.
There are multiple questions here
a) what to do for insurance when overseas. Paying out of pocket for most things is great. Nobody cares about most things. They are cheap. There are not a lot of >10k+ bills for most people. It is your legs are shattered by a car and you spend 3 months in the hospital type bills that keep you up at night.

b)What do you do when you come back to the US to visit? You want coverage in case one of those things happen

I know there are plans for americans living abroad who are visiting the US and plans for US citizens going abroad. You need to find some combo that matches your needs. First google hit I get is

https://www.gninsurance.com/outreach-in ... lth-plans/

which sounds like about what you need 10 months of overseas coverage, 2 months us. I know no details (coverage, costs, and so on) but this seems like something where finding an insurance salesman might be the right way of going. Or hit up one of the retire overseas boards.

Right now in the US, if you hit something serious, you could probably rigg some qualifying event to get ACA coverage in a couple months.

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Re: What kind of medical events that may ruin your retirement?

Post by AlohaJoe » Sat Aug 18, 2018 10:33 pm

You can buy "anywhere but the US" global medical insurance for $2,000 or so for a couple your age.

If you're going to be in the US for two months a year you'll need to check whether that means you owe penalties for not having ACA compliant health care.

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Re: What kind of medical events that may ruin your retirement?

Post by jacoavlu » Sat Aug 18, 2018 11:20 pm

The answer to your question is essentially infinite, without insurance. At your age, top causes in no particular order are going to be heart attack, stroke, cancer, trauma. I see these things every day, in a medium size non academic non metro hospital, in people your age and younger. Don’t go without insurance.

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Re: What kind of medical events that may ruin your retirement?

Post by celia » Sun Aug 19, 2018 12:28 am

flyingaway wrote:
Sat Aug 18, 2018 4:44 pm
JoeRetire wrote:
Sat Aug 18, 2018 4:11 pm
flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
You plan to be out of the country for 5 straight years?
I could not figure out other things to do in retirement. The only thing that I may want to do, but could not do with a job, is long-term travels (not vacations). We may come back to visit our sons twice a year for two months. This is just something that we are seriously considering at this time.
You plan to travel just because you can't think of anything else to do???? What happens when you get tired of traveling and want to feel "grounded", "at home", talk to people you've known a long time?

I predict that you will get tired of "traveling" in a lot shorter time than 5 years. And I hope you find something (hobby, activity, group) you can gravitate towards in retirement rather than something you want to distance yourself from. Start looking now!

And to answer your question about medical issues, I would say anything that is a "terminal" illness, a surgery with a long recovery time, or causes cognitive decline may cut short your travels. And these can happen at any time, without warning.

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Re: What kind of medical events that may ruin your retirement?

Post by Watty » Sun Aug 19, 2018 12:57 am

Just FYI, for extended travel you may need visas and you may be required to have medical insurance to get a visa.

AlohaJoe wrote:
Sat Aug 18, 2018 10:33 pm
You can buy "anywhere but the US" global medical insurance for $2,000 or so for a couple your age.
Be sure to read all the fine print on those, some of them apparently exclude things like chemotherapy.

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Re: What kind of medical events that may ruin your retirement?

Post by AlohaJoe » Sun Aug 19, 2018 1:08 am

Watty wrote:
Sun Aug 19, 2018 12:57 am
Just FYI, for extended travel you may need visas and you may be required to have medical insurance to get a visa.

AlohaJoe wrote:
Sat Aug 18, 2018 10:33 pm
You can buy "anywhere but the US" global medical insurance for $2,000 or so for a couple your age.
Be sure to read all the fine print on those, some of them apparently exclude things like chemotherapy.
The plan I quoted includes chemotherapy but it is a good point that, like all contracts really, one should read the details carefully so you get what you think you are getting.

What's more, you should think about how insurance like this fits into your overall plan. If you get disagnosed with cancer while traveling in Croatia are you going to stay there for chemotherapy or are you going to fly back to America? Will that pre-existing condition cause issues with getting new insurance after 2 or 3 years out of the country? And so on.

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Re: What kind of medical events that may ruin your retirement?

Post by mouses » Sun Aug 19, 2018 1:24 am

Jablean wrote:
Sat Aug 18, 2018 5:10 pm
Luekemia, unknown causes, in your 50s possibly curable with chemo, in your 70s expect short-term hospice for comfort care only. All together also about $100,000 for acute phase.
What? A 70 year old is thrown into the bit bucket for something possibly curable when they may live 20-25 years additional?

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Re: What kind of medical events that may ruin your retirement?

Post by Jablean » Sun Aug 19, 2018 2:18 am

mouses wrote:
Sun Aug 19, 2018 1:24 am
Jablean wrote:
Sat Aug 18, 2018 5:10 pm
Luekemia, unknown causes, in your 50s possibly curable with chemo, in your 70s expect short-term hospice for comfort care only. All together also about $100,000 for acute phase.
What? A 70 year old is thrown into the bit bucket for something possibly curable when they may live 20-25 years additional?
If they had diagnosed it a week or two earlier, maybe chemo would have helped but at diagnosis time my mom was given three weeks. She did a week of chemo with no changes in her labs so went home. The most common form for that age has a 10-20% cure rate and no known cause.

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Re: What kind of medical events that may ruin your retirement?

Post by Gnirk » Sun Aug 19, 2018 2:28 am

Sad story, BIL retired, no medical insurance because he was very healthy and figured he’d wait until Medicare. Diagnosed at 63 with Gioblastoma ( nasty, aggressive brain cancer). Had to declare bankruptcy due to $million plus medical bills, and passed away before he was eligible for Medicare.

Wife ended up working at McDonalds at the age of 61.

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Re: What kind of medical events that may ruin your retirement?

Post by daveydoo » Sun Aug 19, 2018 2:46 am

flyingaway wrote:
Sat Aug 18, 2018 3:53 pm

In fact, outside the U.S., we think that we may be able to pay for most medical events (for less than US$22,000 a year), except for probably cancer treatments and organ transplants. My question is what kind of medical events that you know which have ruined people's retirement, or bankrupted some people even before retirement? (with or without health insurance).
Kinda hard to sum up all of medicine for this. Google what people die from and what bankrupts people. All the new billion-dollar drugs that get people excited about biotech on this forum cost a lot. Some drugs are $500,000 a year. "Personalized" medicine is already mindbogglingly expensive -- if someone needs to engineer a therapy based on your cells or genetic information. You will generally not get that outside the US.

Even "regular" drugs are expensive. Look up the Medicare Part D drug-spending dashboard -- you can sort them by cost per beneficiary and see how folks use them (https://www.cms.gov/Research-Statistics ... PartD.html). Many are not commonly used but plenty of even commonly-used ones cost $10,000 per year. Every year.

Even if you travel, I presume that you will get the bulk of your routine medical care at home. Or maybe you really want to get your screening colonoscopy in Paris? Ooh-la-la! And when they find something...?

Medical care can be inexpensive overseas. Often that's because there's very little of it. Many threads on here about that. Do not rely on WHO "ranking" of countries since this seems to be mostly public health-related.

It's easy to comparison-shop when you know what part you need. Most medical care is not like an oil change -- "Doc, I'm here for my ______ ." The tricky part is when you don't know what's wrong or don't even know that there is something wrong.

You will need a smart internist to help coordinate your care, provide continuity ("You had a problem with this drug/symptom/specialist before"), to actually track what works for you, and to know when you need to see a specialist.

I really don't think health insurance is like a land-line -- something you outgrow when you're busy, savvy, and/or well-off.

Spouse and I have careers in this field, and we find the prospect of not having health insurance terrifying. Our most significant conversations about how long to work, etc., center around access to excellent health insurance. They do not center around money. This is a strange land.

Sounds like you have never been ill -- congratulations and may it continue indefinitely.
"I mean, it's one banana, Michael...what could it cost? Ten dollars?"

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 8:48 am

Watty wrote:
Sun Aug 19, 2018 12:57 am
Just FYI, for extended travel you may need visas and you may be required to have medical insurance to get a visa.

AlohaJoe wrote:
Sat Aug 18, 2018 10:33 pm
You can buy "anywhere but the US" global medical insurance for $2,000 or so for a couple your age.
Be sure to read all the fine print on those, some of them apparently exclude things like chemotherapy.
This is what I am worried about. I read many people in expat forums talking about travel insurance outside the U.S., I have et to see a case with successful claim related to a serious illness.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 8:49 am

Gnirk wrote:
Sun Aug 19, 2018 2:28 am
Sad story, BIL retired, no medical insurance because he was very healthy and figured he’d wait until Medicare. Diagnosed at 63 with Gioblastoma ( nasty, aggressive brain cancer). Had to declare bankruptcy due to $million plus medical bills, and passed away before he was eligible for Medicare.

Wife ended up working at McDonalds at the age of 61.
I am convinced that health insurance is necessary in the U.S.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 9:02 am

celia wrote:
Sun Aug 19, 2018 12:28 am
flyingaway wrote:
Sat Aug 18, 2018 4:44 pm
JoeRetire wrote:
Sat Aug 18, 2018 4:11 pm
flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
You plan to be out of the country for 5 straight years?
I could not figure out other things to do in retirement. The only thing that I may want to do, but could not do with a job, is long-term travels (not vacations). We may come back to visit our sons twice a year for two months. This is just something that we are seriously considering at this time.
You plan to travel just because you can't think of anything else to do???? What happens when you get tired of traveling and want to feel "grounded", "at home", talk to people you've known a long time?

I predict that you will get tired of "traveling" in a lot shorter time than 5 years. And I hope you find something (hobby, activity, group) you can gravitate towards in retirement rather than something you want to distance yourself from. Start looking now!

And to answer your question about medical issues, I would say anything that is a "terminal" illness, a surgery with a long recovery time, or causes cognitive decline may cut short your travels. And these can happen at any time, without warning.
Sorry, maybe I did not express my idea clear. I am teaching at school, so I have summer and winter breaks to do many things and have been doing those things, such as visiting all 50 U.S. states and 47 other countries and areas. The only thing that we could not do and may want to do (after reading many blogs and watching many youtube videos, you know) is long-term travel around the world.
Financially, we are now on borderline ($80,000 a year). So insurance cost of $23,000 is a big part of it, which could enhance our travel a lot, if somehow we are convinced it is not necessary.
We are also afraid that it would be too late to wait until 65 to do those travels, when we have more money and medicare.
You are absolutely correct that we may become tired about travel after a few years. My wife's backup plan is to come back to take care of grandkids. (Our sons do not have girlfriends yet, lol).

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dm200
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Re: What kind of medical events that may ruin your retirement?

Post by dm200 » Sun Aug 19, 2018 9:42 am

flyingaway wrote:
Sun Aug 19, 2018 9:02 am
celia wrote:
Sun Aug 19, 2018 12:28 am
flyingaway wrote:
Sat Aug 18, 2018 4:44 pm
JoeRetire wrote:
Sat Aug 18, 2018 4:11 pm
flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
You plan to be out of the country for 5 straight years?
I could not figure out other things to do in retirement. The only thing that I may want to do, but could not do with a job, is long-term travels (not vacations). We may come back to visit our sons twice a year for two months. This is just something that we are seriously considering at this time.
You plan to travel just because you can't think of anything else to do???? What happens when you get tired of traveling and want to feel "grounded", "at home", talk to people you've known a long time?

I predict that you will get tired of "traveling" in a lot shorter time than 5 years. And I hope you find something (hobby, activity, group) you can gravitate towards in retirement rather than something you want to distance yourself from. Start looking now!

And to answer your question about medical issues, I would say anything that is a "terminal" illness, a surgery with a long recovery time, or causes cognitive decline may cut short your travels. And these can happen at any time, without warning.
Sorry, maybe I did not express my idea clear. I am teaching at school, so I have summer and winter breaks to do many things and have been doing those things, such as visiting all 50 U.S. states and 47 other countries and areas. The only thing that we could not do and may want to do (after reading many blogs and watching many youtube videos, you know) is long-term travel around the world.
Financially, we are now on borderline ($80,000 a year). So insurance cost of $23,000 is a big part of it, which could enhance our travel a lot, if somehow we are convinced it is not necessary.
We are also afraid that it would be too late to wait until 65 to do those travels, when we have more money and medicare.
You are absolutely correct that we may become tired about travel after a few years. My wife's backup plan is to come back to take care of grandkids. (Our sons do not have girlfriends yet, lol).
I suppose it may depend on all the details, but folks in general good health should be able to do such travel well into their 60's and 70's. I know a lot of them.

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midareff
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Re: What kind of medical events that may ruin your retirement?

Post by midareff » Sun Aug 19, 2018 10:16 am

flyingaway wrote:
Sat Aug 18, 2018 3:53 pm
We are seriously considering retirement in 1, 2, 3, or more years. The most uncertain thing that prevents us from making a decision is health insurance and health care.
After one more year at work (at 55), I will be eligible for buying my current employer's group insurance at about $17,000 a year for a couple (2018 rate). We can plan $5,000 additional co-pay etc. Alternatively, we could also buy ACA at a much lower rate if we control our withdraw rate. The problem is that we plan to travel around the world at least for the first 5 years in our retirement and will spend very little time in the U.S. Having a U.S. based medical insurance seems to be a waste of money.
In fact, outside the U.S., we think that we may be able to pay for most medical events (for less than US$22,000 a year), except for probably cancer treatments and organ transplants. My question is what kind of medical events that you know which have ruined people's retirement, or bankrupted some people even before retirement? (with or without health insurance).
We have traveled lots outside the US in the last 8 years. I was able to put my wife on my former employer's health plan at their cost which is near near $7K this year and will probably be slightly over next year. I'm Medicare + AARP United Plan F. About 8 years ago when I was on the insurance she has now I needed a hospital check in Bankok and had several tests and saw several physicians in the course of a day. The bill was about $250 US which was the plan deductible for emergency out of US. Last month in the Ukraine I was hospitalized in Odessa for three days with the services of a cardiologist and ENT. They gave us a room and my wife stayed in the next bed. Including emergency transport from the ship, return to the ship, multiple blood works, IV's, X-Rays and cardiograms, and three days of service (near full time) of an interpreter the bill was roughly $1750. United picked up 80% of the over $250 deductible. Medical insurance for the trip would have cost the same for me. I suggest you consider your medical insurance options carefully. AFAIC, there are not good dental insurance options. Cancer treatment for me cost $80.... that was $2 a day for the valet to keep it out front so I could leave quickly after my 40 treatments being radiated. I believe the insurance paid about $170K. Many medical events can ruin your retirement.. there are many cancers that are life ending, there are diseases that are debilitating and of course the coronary big one that leaves you not OK for most activities. You can't plan for these, all you can do is insure for them.

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Re: What kind of medical events that may ruin your retirement?

Post by Traveler » Sun Aug 19, 2018 10:40 am

I would go without auto (collision/comp) and home insurance long before I'd go without health insurance. At least the car and home have limits on potential loss.

letsgobobby
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Re: What kind of medical events that may ruin your retirement?

Post by letsgobobby » Sun Aug 19, 2018 10:57 am

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Last edited by letsgobobby on Sat Apr 27, 2019 11:27 pm, edited 1 time in total.

Topic Author
flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 11:57 am

midareff wrote:
Sun Aug 19, 2018 10:16 am

We have traveled lots outside the US in the last 8 years. I was able to put my wife on my former employer's health plan at their cost which is near near $7K this year and will probably be slightly over next year. I'm Medicare + AARP United Plan F. About 8 years ago when I was on the insurance she has now I needed a hospital check in Bankok and had several tests and saw several physicians in the course of a day. The bill was about $250 US which was the plan deductible for emergency out of US. Last month in the Ukraine I was hospitalized in Odessa for three days with the services of a cardiologist and ENT. They gave us a room and my wife stayed in the next bed. Including emergency transport from the ship, return to the ship, multiple blood works, IV's, X-Rays and cardiograms, and three days of service (near full time) of an interpreter the bill was roughly $1750. United picked up 80% of the over $250 deductible. Medical insurance for the trip would have cost the same for me. I suggest you consider your medical insurance options carefully. AFAIC, there are not good dental insurance options. Cancer treatment for me cost $80.... that was $2 a day for the valet to keep it out front so I could leave quickly after my 40 treatments being radiated. I believe the insurance paid about $170K. Many medical events can ruin your retirement.. there are many cancers that are life ending, there are diseases that are debilitating and of course the coronary big one that leaves you not OK for most activities. You can't plan for these, all you can do is insure for them.
Did you mean United Airlines? Are these travel insurance easy to claim? (doctor's statements, document translations, many proofs, etc.)

reggiesimpson
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Re: What kind of medical events that may ruin your retirement?

Post by reggiesimpson » Sun Aug 19, 2018 12:00 pm

Take a look at "Audre and Dimitris traveling love affair". Serious world travelers for years with the knowledge and experience to advise you effectively.

getthatmarshmallow
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Re: What kind of medical events that may ruin your retirement?

Post by getthatmarshmallow » Sun Aug 19, 2018 12:38 pm

Keep in mind that the rates that people see on bills are negotiated rates, and without insurance you may pay higher rates.

My grandmother was in a car accident that shattered her leg at age 80. The bill for just the emergency care was 93,000. Rehab and followup surgeries were more. She was and is in excellent health.

$0.02: buy the insurance and scale back the travel plans a bit.

StealthRabbit
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Re: What kind of medical events that may ruin your retirement?

Post by StealthRabbit » Sun Aug 19, 2018 1:28 pm

Many (any) Health events may get you broke in USA W/O insurance!

But... life does not END with employment... tho I'm at great heredity risk for early demise.. I use alternatives to USA HC insurance, and a I travel a LOT.

BTDT for the last 14 yrs (Left workforce at age 49, no HC insurance, no pension, travel 50%+ and some yrs 100% out of USA (election yrs for SURE!)) ~ $40- 60k / yr to travel / live overseas (Cheaper than staying home in USA...)

EZ to travel 5+ yrs (been traveling extensively so for 50 yrs and not tired of traveling yet). Nice to get 'retirement' gigs that PAY you to travel / live overseas. (I take them as often as possible)

1) While in USA can use HC medical cost sharing plans (legal alternative to ACA) ~ $300 / month for 2; https://www.kitces.com/blog/healthcare- ... are-plans/
2) Travel HC insurance is very inexpensive (<$2000/ yr) but is not gonna cover cancer / brain surgery... but will usually cover medical evac if required.
3) Medical rates and care outside USA is quite excellent and affordable
4) Procedure / hospital Rates IN USA are VERY inflated and quoted that way because they expect you to have insurance (which will NOT pay the posted amounts, but usually a lessor negotiated rates).
5) Some USA Cost sharing plans will help you negotiate CASH rates. ~ 30- 50% of posted rates (foreign countries ~ 10 - 20% of USA posted rates)

You have several options, See what best fits your needs.

Topic Author
flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 1:33 pm

reggiesimpson wrote:
Sun Aug 19, 2018 12:00 pm
Take a look at "Audre and Dimitris traveling love affair". Serious world travelers for years with the knowledge and experience to advise you effectively.
If I remembered correctly, they did not have health insurance in their early years.

Topic Author
flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 1:44 pm

StealthRabbit wrote:
Sun Aug 19, 2018 1:28 pm
Many (any) Health events may get you broke in USA W/O insurance!

But... life does not END with employment... tho I'm at great heredity risk for early demise.. I use alternatives to USA HC insurance, and a I travel a LOT.

BTDT for the last 14 yrs (Left workforce at age 49, no HC insurance, no pension, travel 50%+ and some yrs 100% out of USA (election yrs for SURE!)) ~ $40- 60k / yr to travel / live overseas (Cheaper than staying home in USA...)

EZ to travel 5+ yrs (been traveling extensively so for 50 yrs and not tired of traveling yet). Nice to get 'retirement' gigs that PAY you to travel / live overseas. (I take them as often as possible)

1) While in USA can use HC medical cost sharing plans (legal alternative to ACA) ~ $300 / month for 2; https://www.kitces.com/blog/healthcare- ... are-plans/
2) Travel HC insurance is very inexpensive (<$2000/ yr) but is not gonna cover cancer / brain surgery... but will usually cover medical evac if required.
3) Medical rates and care outside USA is quite excellent and affordable
4) Procedure / hospital Rates IN USA are VERY inflated and quoted that way because they expect you to have insurance (which will NOT pay the posted amounts, but usually a lessor negotiated rates).
5) Some USA Cost sharing plans will help you negotiate CASH rates. ~ 30- 50% of posted rates (foreign countries ~ 10 - 20% of USA posted rates)

You have several options, See what best fits your needs.
These were what I was considering in my mind. Getting some "alternative" insurance or travel insurance and paying most medical costs in other countries in cash. But the previous discussions have me think the real medical problems may ruin our retirement portfolio very quickly.

RudyS
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Re: What kind of medical events that may ruin your retirement?

Post by RudyS » Sun Aug 19, 2018 1:47 pm

flyingaway wrote:
Sun Aug 19, 2018 9:02 am
Sorry, maybe I did not express my idea clear. I am teaching at school, so I have summer and winter breaks to do many things and have been doing those things, such as visiting all 50 U.S. states and 47 other countries and areas. The only thing that we could not do and may want to do (after reading many blogs and watching many youtube videos, you know) is long-term travel around the world.
Financially, we are now on borderline ($80,000 a year). So insurance cost of $23,000 is a big part of it, which could enhance our travel a lot, if somehow we are convinced it is not necessary.
We are also afraid that it would be too late to wait until 65 to do those travels, when we have more money and medicare.
You are absolutely correct that we may become tired about travel after a few years. My wife's backup plan is to come back to take care of grandkids. (Our sons do not have girlfriends yet, lol).
[ quote fixed by admin LadyGeek]

Generally, Medicare doesn't cover outside of the US. But many medigap policies will. Need to check all the details.

daveydoo
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Re: What kind of medical events that may ruin your retirement?

Post by daveydoo » Sun Aug 19, 2018 2:03 pm

reggiesimpson wrote:
Sun Aug 19, 2018 12:00 pm
...Serious world travelers for years with the knowledge and experience to advise you effectively.
n=1. Wonder what they invested in. :D
"I mean, it's one banana, Michael...what could it cost? Ten dollars?"

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midareff
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Re: What kind of medical events that may ruin your retirement?

Post by midareff » Sun Aug 19, 2018 2:44 pm

flyingaway wrote:
Sun Aug 19, 2018 11:57 am
midareff wrote:
Sun Aug 19, 2018 10:16 am

We have traveled lots outside the US in the last 8 years. I was able to put my wife on my former employer's health plan at their cost which is near near $7K this year and will probably be slightly over next year. I'm Medicare + AARP United Plan F. About 8 years ago when I was on the insurance she has now I needed a hospital check in Bankok and had several tests and saw several physicians in the course of a day. The bill was about $250 US which was the plan deductible for emergency out of US. Last month in the Ukraine I was hospitalized in Odessa for three days with the services of a cardiologist and ENT. They gave us a room and my wife stayed in the next bed. Including emergency transport from the ship, return to the ship, multiple blood works, IV's, X-Rays and cardiograms, and three days of service (near full time) of an interpreter the bill was roughly $1750. United picked up 80% of the over $250 deductible. Medical insurance for the trip would have cost the same for me. I suggest you consider your medical insurance options carefully. AFAIC, there are not good dental insurance options. Cancer treatment for me cost $80.... that was $2 a day for the valet to keep it out front so I could leave quickly after my 40 treatments being radiated. I believe the insurance paid about $170K. Many medical events can ruin your retirement.. there are many cancers that are life ending, there are diseases that are debilitating and of course the coronary big one that leaves you not OK for most activities. You can't plan for these, all you can do is insure for them.
Did you mean United Airlines? Are these travel insurance easy to claim? (doctor's statements, document translations, many proofs, etc.)
No, it was American Airlines who is basically our last choice for air travel. Sometimes you just have to go with the carrier the cruise lines books you on and on top of that they were so messed up at MIA it took them almost two hours to get the luggage to the carousel. The luggage agents were not helpful, would not get someone from management and in fact their lack or service or attempted service resulted in a pretty hostile crown after the first hour. The Ukrainian to English translator furnished by the medical service made all arrangements for full line by line documentation translated into English when we arrived in Kiev, our last stop in the Ukraine. I paid by cc and called AARP United the day after we got home. They said put your member number on every page and mail it in. I did and it took about 4 weeks for a correct check to show up in the mail. Easy as it could be.

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dm200
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Re: What kind of medical events that may ruin your retirement?

Post by dm200 » Sun Aug 19, 2018 3:05 pm

RudyS wrote:
Sun Aug 19, 2018 1:47 pm
flyingaway wrote:
Sun Aug 19, 2018 9:02 am
Sorry, maybe I did not express my idea clear. I am teaching at school, so I have summer and winter breaks to do many things and have been doing those things, such as visiting all 50 U.S. states and 47 other countries and areas. The only thing that we could not do and may want to do (after reading many blogs and watching many youtube videos, you know) is long-term travel around the world.
Financially, we are now on borderline ($80,000 a year). So insurance cost of $23,000 is a big part of it, which could enhance our travel a lot, if somehow we are convinced it is not necessary.
We are also afraid that it would be too late to wait until 65 to do those travels, when we have more money and medicare.
You are absolutely correct that we may become tired about travel after a few years. My wife's backup plan is to come back to take care of grandkids. (Our sons do not have girlfriends yet, lol).
[ quote fixed by admin LadyGeek]

Generally, Medicare doesn't cover outside of the US. But many medigap policies will. Need to check all the details.
I also think some Medicare Advantage plans might be helpful - BUT always check the details.

masteraleph
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Re: What kind of medical events that may ruin your retirement?

Post by masteraleph » Sun Aug 19, 2018 3:10 pm

My mother was diagnosed with MS at 60. She very quickly lost function- her last vacation was a year later, her last visit to family a year and a half after that, and by three and a half years in basically spent every day in a specialized recliner, occasionally being hoisted into a wheelchair to go out to lunch every few weeks or to the doctor.

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cockersx3
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Re: What kind of medical events that may ruin your retirement?

Post by cockersx3 » Sun Aug 19, 2018 3:50 pm

Jablean wrote:
Sat Aug 18, 2018 5:10 pm
Five days in hospital, bill before insurance was 100,000, continuing care and physical therapy totaled all pre-insurance to right around $200,000. With insurance, 6,000.
Just wanted to take a moment and reflect on how absolutely insane this is. Unfortunately it is also very true in the US...have regularly seen 90+% markups on physician and hospital bills back when I was sick. Yet people just accept this as normal.

To me this is the primary reason for having health insurance in this country. Not because you expect the health insurance company to pay most of the cost, but simply to have access to the steep discounts off of list price that the insurance provider has negotiated. Any payments made by the insurance company are a bonus in my opinion.

When I retire early, my plan is to move abroad and pay for expat health insurance, and (when needed) get riders to cover the infrequent trips we'd make back to the USA. The absence of stable, financially viable options for non-employer-provided health insurance unfortunately makes it very difficult to retire early and stay in the USA.

drawpoker
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Re: What kind of medical events that may ruin your retirement?

Post by drawpoker » Sun Aug 19, 2018 3:52 pm

RudyS wrote:
Sun Aug 19, 2018 1:47 pm

Generally, Medicare doesn't cover outside of the US. But many medigap policies will. Need to check all the details.
That is a silly statement. Needs correction.

Medigap policies only work in tandem with Medicare. Medigap provides supplementary coverage to treatment that is covered by Medicare.

If it not covered by Medicare, then it is not covered by any Medigap policy either.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 4:04 pm

cockersx3 wrote:
Sun Aug 19, 2018 3:50 pm
Just wanted to take a moment and reflect on how absolutely insane this is. Unfortunately it is also very true in the US...have regularly seen 90+% markups on physician and hospital bills back when I was sick. Yet people just accept this as normal.

To me this is the primary reason for having health insurance in this country. Not because you expect the health insurance company to pay most of the cost, but simply to have access to the steep discounts off of list price that the insurance provider has negotiated. Any payments made by the insurance company are a bonus in my opinion.

When I retire early, my plan is to move abroad and pay for expat health insurance, and (when needed) get riders to cover the infrequent trips we'd make back to the USA. The absence of stable, financially viable options for non-employer-provided health insurance unfortunately makes it very difficult to retire early and stay in the USA.
This is essentially this thread about, retiring abroad (or travel around the world) and paying for expat health insurance (or paying by cash with self insurance). My concern is how to pay for some serious medical problems, such as cancers, organ transplants, or many other serious problems discussed above that will need more than $200,000 a year. I am not sure any of those expat health insurance will pay for those things.

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flyingaway
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Re: What kind of medical events that may ruin your retirement?

Post by flyingaway » Sun Aug 19, 2018 4:06 pm

midareff wrote:
Sun Aug 19, 2018 2:44 pm
flyingaway wrote:
Sun Aug 19, 2018 11:57 am
midareff wrote:
Sun Aug 19, 2018 10:16 am

We have traveled lots outside the US in the last 8 years. I was able to put my wife on my former employer's health plan at their cost which is near near $7K this year and will probably be slightly over next year. I'm Medicare + AARP United Plan F. About 8 years ago when I was on the insurance she has now I needed a hospital check in Bankok and had several tests and saw several physicians in the course of a day. The bill was about $250 US which was the plan deductible for emergency out of US. Last month in the Ukraine I was hospitalized in Odessa for three days with the services of a cardiologist and ENT. They gave us a room and my wife stayed in the next bed. Including emergency transport from the ship, return to the ship, multiple blood works, IV's, X-Rays and cardiograms, and three days of service (near full time) of an interpreter the bill was roughly $1750. United picked up 80% of the over $250 deductible. Medical insurance for the trip would have cost the same for me. I suggest you consider your medical insurance options carefully. AFAIC, there are not good dental insurance options. Cancer treatment for me cost $80.... that was $2 a day for the valet to keep it out front so I could leave quickly after my 40 treatments being radiated. I believe the insurance paid about $170K. Many medical events can ruin your retirement.. there are many cancers that are life ending, there are diseases that are debilitating and of course the coronary big one that leaves you not OK for most activities. You can't plan for these, all you can do is insure for them.
Did you mean United Airlines? Are these travel insurance easy to claim? (doctor's statements, document translations, many proofs, etc.)
No, it was American Airlines who is basically our last choice for air travel. Sometimes you just have to go with the carrier the cruise lines books you on and on top of that they were so messed up at MIA it took them almost two hours to get the luggage to the carousel. The luggage agents were not helpful, would not get someone from management and in fact their lack or service or attempted service resulted in a pretty hostile crown after the first hour. The Ukrainian to English translator furnished by the medical service made all arrangements for full line by line documentation translated into English when we arrived in Kiev, our last stop in the Ukraine. I paid by cc and called AARP United the day after we got home. They said put your member number on every page and mail it in. I did and it took about 4 weeks for a correct check to show up in the mail. Easy as it could be.
Thanks. I understand you are talking about United Health with AARP, not United Airlines with travel insurance.

drawpoker
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Re: What kind of medical events that may ruin your retirement?

Post by drawpoker » Sun Aug 19, 2018 4:10 pm

flyingaway wrote:
Sun Aug 19, 2018 4:04 pm

This is essentially this thread about, retiring abroad (or travel around the world) and paying for expat health insurance (or paying by cash with self insurance). My concern is how to pay for some serious medical problems, such as cancers, organ transplants, or many other serious problems discussed above that will need more than $200,000 a year. I am not sure any of those expat health insurance will pay for those things.
Well, if that is your primary concern, those kind of things are just as likely to hit you no matter where you are living. U.S. or traveling abroad. So, logically, you would carry the type of health insurance that would give you that type of coverage for catastrophe type medical issues.

That was easy :wink:

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cockersx3
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Re: What kind of medical events that may ruin your retirement?

Post by cockersx3 » Sun Aug 19, 2018 4:10 pm

flyingaway wrote:
Sun Aug 19, 2018 4:04 pm
cockersx3 wrote:
Sun Aug 19, 2018 3:50 pm
Just wanted to take a moment and reflect on how absolutely insane this is. Unfortunately it is also very true in the US...have regularly seen 90+% markups on physician and hospital bills back when I was sick. Yet people just accept this as normal.

To me this is the primary reason for having health insurance in this country. Not because you expect the health insurance company to pay most of the cost, but simply to have access to the steep discounts off of list price that the insurance provider has negotiated. Any payments made by the insurance company are a bonus in my opinion.

When I retire early, my plan is to move abroad and pay for expat health insurance, and (when needed) get riders to cover the infrequent trips we'd make back to the USA. The absence of stable, financially viable options for non-employer-provided health insurance unfortunately makes it very difficult to retire early and stay in the USA.
This is essentially this thread about, retiring abroad (or travel around the world) and paying for expat health insurance (or paying by cash with self insurance). My concern is how to pay for some serious medical problems, such as cancers, organ transplants, or many other serious problems discussed above that will need more than $200,000 a year. I am not sure any of those expat health insurance will pay for those things.
Here's a link to the very first Google hit I got on expat health insurance. No costs on the web site, but they appear to cover transplants, cancer care, etc.

https://www.cignaglobal.com/internation ... ance/plans

My understanding from reading various expat blogs is that expat health insurance like this is much less expensive than the USA, but I guess you'd have to call and confirm.

RudyS
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Re: What kind of medical events that may ruin your retirement?

Post by RudyS » Sun Aug 19, 2018 5:07 pm

drawpoker wrote:
Sun Aug 19, 2018 3:52 pm
RudyS wrote:
Sun Aug 19, 2018 1:47 pm

Generally, Medicare doesn't cover outside of the US. But many medigap policies will. Need to check all the details.
That is a silly statement. Needs correction.

Medigap policies only work in tandem with Medicare. Medigap provides supplementary coverage to treatment that is covered by Medicare.

If it not covered by Medicare, then it is not covered by any Medigap policy either.
You didn't understand. Your statement needs correction too.
See here for a detailed discussion: https://medicare.com/medicare-supplemen ... gn-travel/
I myself have a medigap policy. For domestic, it only supplements what medicare pays, like you said. Outside of USA, my medigap policy covers many situations.

drawpoker
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Re: What kind of medical events that may ruin your retirement?

Post by drawpoker » Sun Aug 19, 2018 5:25 pm

RudyS wrote:
Sun Aug 19, 2018 5:07 pm
You didn't understand. Your statement needs correction too.
See here: https://medicare.com/medicare-supplemen ... gn-travel/
I have a medigap policy. For domestic, it only supplements what medicare pays, like you said. Outside of USA, my medigap policy covers many situations. It's plan N if that matters.
I think you are confusing the "foreign travel" rider that many Medigap policies offer.

If you have Medigap Plan C, D, E, F, G, H, I, J, M or N, your plan:

Covers foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn't otherwise cover the care.


This does not cover "many situations" . It is restricted to emergency care only, subject to $250 deductible, and will only pay out if emergency occurs within the first 60 days of travel.

https://www.medicare.gov/supplement-oth ... ravel.html

Clearly, it is not something for the OP to consider. Unless he decides to cut his trip to 60 days. Instead of 5 years.

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