Health insurance for elderly Americans

Matilda

RIP Lindsay
Sep 13, 2006
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I am receiving more and more emails from elderly Americans (70-85) who can no longer afford health insurance in the United States as the cost for them is prohibitive. They feel they have no choice but to leave, and come to the DR when not only the cost of health care is cheaper but so is the cost of health insurance.

I have followed the threads trying to find information about which insurance companies offer health insurance to newly registered elder people, but can't actually work out if it is available for those over 70, 75, 80 or 85 or at what cost. And there is little information on line and (what a surprise) no one appears to answer the phone.

However, given the relatively cheap cost of medical care here compared to the US, might it not be an idea to self insure and just put aside x a month which would cover many things apart from catastrophes?

What advice would you give Americans in this situation who want to move here as they cannot afford U.S. healthcare?

Matilda
 

Matilda

RIP Lindsay
Sep 13, 2006
5,485
338
63
I'm confused. Medicare is too expensive?

No idea as I don't understand the US health system at all - they just say they cannot afford the Health insurance. Is Medicare free? Does everyone get it?

Matilda
 

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
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No idea as I don't understand the US health system at all - they just say they cannot afford the Health insurance. Is Medicare free? Does everyone get it?

Matilda
Medicare Part A is "free*" when you apply for Social Security. Part B costs $134 a month, deducted from your SS funds.

Many opt for a supplemental policy which pays for all deductibles. I have no idea how much they are.










*Really, one paid for it over decades
 

SantiagoDR

The "REAL" SantiagoDR
Jan 12, 2006
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I'm confused. Medicare is too expensive?

Same here, how could they not afford it, but yet want to move here and pay for insurance here.

My U.S. cost for Medicare Part B is about $13.50 a month from my Social Security pension, the carrier I have reduces my Medicare premium to that amount. That includes Part-D (Prescriptions coverage), $20 PCP visits, $25 Specialists. I pay nothing for the supplement plan.
 

cavok

Silver
Jun 16, 2014
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Cabarete
I am receiving more and more emails from elderly Americans (70-85) who can no longer afford health insurance in the United States as the cost for them is prohibitive. They feel they have no choice but to leave, and come to the DR when not only the cost of health care is cheaper but so is the cost of health insurance.

I have followed the threads trying to find information about which insurance companies offer health insurance to newly registered elder people, but can't actually work out if it is available for those over 70, 75, 80 or 85 or at what cost. And there is little information on line and (what a surprise) no one appears to answer the phone.

However, given the relatively cheap cost of medical care here compared to the US, might it not be an idea to self insure and just put aside x a month which would cover many things apart from catastrophes?

What advice would you give Americans in this situation who want to move here as they cannot afford U.S. healthcare?

Matilda

First of all, I don't know of any insurance company here that will offer insurance to someone over 69. Second, Medicare and Medicaid is pretty cheap and if you had any really major operation or medical condition, I thinkMedicaid/Medicare would cover it better and for less than any reasonable policy down here - especially if you needed skilled nursing care.
 

windeguy

Platinum
Jul 10, 2004
42,211
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Medicare starts at 65 for most people, but does not cover everything, to my understanding.

https://www.cbo.gov/publication/44661

There was a thread that said what I have also heard. In order to be insured in the DR, by a DR insurance company, you have to apply before you turn 65. Someone disputed that, but I don't know of any certain way to get insurance here past 65. So unless and until we discover a plan and its pricing for those over 65 it is unlikely to exist. Also, any plan that does exist here is certain to exclude any pre-existing conditions, making it much less attractive to an elderly person. I see there is a response about 69 being the cut off, I had been told 65 is the cut off.
 

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
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Medicare starts at 65 for most people, but does not cover everything, to my understanding.

https://www.cbo.gov/publication/44661

There was a thread that said what I have also heard. In order to be insured in the DR, by a DR insurance company, you have to apply before you turn 65. Someone disputed that, but I don't know of any certain way to get insurance here past 65. So unless and until we discover a plan and its pricing for those over 65 it is unlikely to exist. Also, any plan that does exist here is certain to exclude any pre-existing conditions, making it much less attractive to an elderly person. I see there is a response about 69 being the cut off, I had been told 65 is the cut off.
We have a member in out group that turned 70, and the premiums doubled. That's still a great deal.
 

windeguy

Platinum
Jul 10, 2004
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We have a member in out group that turned 70, and the premiums doubled. That's still a great deal.

Yes, but they almost certainly had that insurance coverage in force before they turned 65. I was indeed told that the premiums go up substantially as you age, but it is true they are not much compared to US plans outside of Medicare.

From what I read into the initial question, it makes no sense for people of advanced age to retire here because insurance in the US is too expensive for them.
 

cavok

Silver
Jun 16, 2014
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Medicare doesn't - it only covers 80%. You need to buy "Medigap" to cover the other 20%. Cost depends on how thoroughly you want to cover the other 20%. For about $250/mo you can just about everything covered with no deductibles.

There are also Medicare Advantage plans. I pay zero/mo. The only downside is in the case of something major, I could have up to a maximum of $6500 out of pocket expenses. That's fine with me - others maybe not(?). You can reduce that by paying extra per month, but very reasonable.

A friend of mine just checked recently. Both Universal and Palic would accept up to 69 - all others that I know of won't go above 65.
 

SantiagoDR

The "REAL" SantiagoDR
Jan 12, 2006
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There may be a back door to the over 65 problem.

I don´t know all the details, but it´s something like, if you have your own business, you can get a plan that allows you to add family members (Husband/Wife, parents, etc.), even if they are over 65.

That will need some investigation on your part with the insurance companies.


Just be aware that insurance companies here tend to deny coverage if you have too many of the same medical problem visits, not just pre-existing conditions.
 

windeguy

Platinum
Jul 10, 2004
42,211
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I had not heard of a denial for chronic conditions so that is news to me. There is a also a lifetime limit on how much the plans will pay out.

A back door for older people? Perhaps, but I have not heard about it.
 

Cdn_Gringo

Gold
Apr 29, 2014
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Living here, applying for residency, learning Spanish, dealing with the heat, the driving etc is enough to turn my hair gray. The hair of anyone over 80 just might fall out completely. There is much more to consider with a plan to relocated to a third world country solely to get cheaper medical insurance (if possible) that has yearly limits and restricted coverage for at least the first year.

At least in the US, if someone has a stroke, medical care will be provided and paying for it is something to deal with if you survive. Here, not so much. Moving to the DR and getting set up is not exactly cheap. Might that money be better spent going towards a US solution in a lot of cases?
 

Abuela

Bronze
May 13, 2006
1,952
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"What advice would you give Americans in this situation who want to move here as they cannot afford U.S. healthcare?"
My best advice would be self insured is possible if the person is relatively healthy. If they come here with pre-existing conditions,they might not even be able to pass the medical tests for residency or insurance. They would be wise to visit and check on availability of any medications they need and choose an area close to medical care they might require for their issues. Some may have health issues which would be aggravated by the climate, so location would be important for this choice as well. So all in all I would say it must be a case by case decision based on all the above factors and more. 
 

cavok

Silver
Jun 16, 2014
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There is one here for those 60-75 cost is RD$1,700 a month so around US$36. I haven't gone into the small print.

http://www.arscmd.com.do/plan-voluntario-alta-salud-mayor-de-edad/

Matilda

That's the first plan I've heard of offering insurance to someone over 69. The thing is - I've never heard of that insurance company. What you need to find out is just how widely that insurance company is accepted.

Also, I do not see what the maximum limit of coverge is for the plan(?). Important. Another is that the "medicamento" coverage is only RD$3000/yr. That only $60 USD for medications. That is very little for people over 70. Some medications are very reasonable, but not reasonable enough that $60/yr will even remotely cover you. Plus, if any of the medications have not gone generic, you will pay almost the same as in the US - could very easily run you more than $100/mo for medications. Easily.

Unless you are in very good health, have travelled widely, and speak Spanish a little, I would never recommend that someone over 70 come here because they think Medicare is too expensive.
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Medicare Part A is for inpatient hospital services and there is a yearly deductible which goes up every year. For 2017 it is $1316.00. However the deductible is payable every period. Meaning if a person is admitted to the hospital then the deductible is due. If the person then stays out of the hospital for over 60 days and lets say on the 61st day the person is then again admitted to the hospital they pay the deductible again. Medicare Part B (2017 $134.00) which pays 80% covers all outpatient services, doctors visits, ER visits, etc... Medicare Part A also has limitation on days etc....(can be a bit complicated). There is always the HMO Medicare replacements which differ between plans. Medicare also has certain drugs and procedures that are not covered and these change yearly. Medicare supplement plans can help with the non-covered items but many times if Medicare does not cover it neither will the supplement. While your Part A is free for those who are entitled (Part B at a min cost) it still can be costly especially for those who are more sickly.

Not surprised there are people inquiring about insurance in the DR Matilda.
 

cobraboy

Pro-Bono Demolition Hobbyist
Jul 24, 2004
40,964
936
113
There may be a back door to the over 65 problem.

I don´t know all the details, but it´s something like, if you have your own business, you can get a plan that allows you to add family members (Husband/Wife, parents, etc.), even if they are over 65.

That will need some investigation on your part with the insurance companies.


Just be aware that insurance companies here tend to deny coverage if you have too many of the same medical problem visits, not just pre-existing conditions.
This is correct and what we did through one of our companies. In addition to the premium (Palic) we also pay the state-required health insurance amount.

I put out on DR1 an offer to have folks join our group. We had one person who was declined for pre-existing conditions.

I think the cut-off for joining our group is 69, but I'm not 100% sure.

Just be aware that while physicians will accept insurance, they are also free to charge more. When I broke my jaw, insurance covered it but I still had to pay the surgeon an additional $700 which included titanium hardware and screws.
 

Derfish

Gold
Jan 7, 2016
4,441
2
0
Medicare Part A is "free*" when you apply for Social Security. Part B costs $134 a month, deducted from your SS funds.

Many opt for a supplemental policy which pays for all deductibles. I have no idea how much they are.










*Really, one paid for it over decades

The figure $134 is pretty liquid also. I opted out when I turned 65 due to the fact that I was not physically in the USA, and last Feb I contacted them about how much it would be if I wanted in now. It came to $178. My brother on the other hand has had Medicare since he turned 65 and it was $104 at that time, and there is a clause that medicare will not go up faster than the COLA raises (cost of living allowance raises). So since such raises for the last several years have been minimal he is paying less than the $134.00.
On the other hand the supplemental insurance can be very cheap. My sister in law pays $8.50 per month and according to her "Everything is covered." She even goes to a podiatrist to get her toenails cut since she has had problems with them over the years that $40 is paid by her supplemental policy.
Der Fish