My Medicare Nightmare

Pattern US Medicare Card (Wikimedia Commons)

article prime

Creator’s Be aware: It’s been a reasonably tough couple of years for me health-wise, however fortunately I’m nonetheless right here, having survived the newest shut scrapes with dying. Certainly, I’m questioning once I might finally run out of ‘cat lives’!  After going off my bike and breaking my hip in March 2021, then surviving a blood clot in my lung (pulmonary embolism) that almost killed me, and this previous 12 months 2022, coping with an evolving kaleidoscope of unusual and troubling systemic signs (suspiciously coinciding with my mRNA pictures, which on the time I used to be grateful to get as my lung was nonetheless recovering from the embolism.)  And simply once I thought I may lastly get nationwide healthcare protection within the USA (I turned 65 in January) the system was complicated and worldwide mail was a difficulty, so my authorities medical insurance was cancelled. However not earlier than I ran up some horrendous medical payments whereas within the USA – on a regular basis, being instructed I used to be coated, which, due to failed communication in a really advanced bureaucratic system, turned out to be false! And but, one way or the other, I survived – once more!

As a retired American residing in Asia for over 30 years, I routinely get pleasure from reasonably priced state-of-the-art healthcare in Thailand, which has included life-saving procedures in some situations. At any time when I journey to the USA, I buy medication and medical provides in Thailand, the place the similar merchandise are a fraction of the prices within the USA. Certainly, most journey insurance coverage insurance policies provide well being care protection globally, ‘besides within the USA.’ So, once I turned 65 in January 2022, which is the eligible age for US authorities medical insurance Medicare, I used to be excited to lastly have assured healthcare protection within the USA, like my pals from international locations all around the world take with no consideration.


President Lyndon B. Johnson signing the Medicare modification, July 30, 1965. Former President Harry S. Truman (seated) and his spouse, Bess, are on the far proper. (Wikimedia Commons)

The USA is the one industrialized nation on the earth that doesn’t have some type of government-guaranteed or ‘common’ healthcare protection for all of its residents. Greater than 30 million Individuals don’t have medical insurance and hundreds of thousands extra are underinsured. 68,000 Individuals die yearly as a result of they’re uninsured or under-insured. Moreover, even with insurance coverage, medical prices are so excessive that medical payments trigger chapter for half one million individuals every year within the USA, the primary explanation for chapter [1].  Even in Thailand, the federal government offers common healthcare by way of the general public well being system to the entire nation’s residents. And healthcare prices in Thailand’s personal hospitals, that are extra like 5-star lodges than hospitals, are considerably lower than the prices within the USA [2].

In early February 2022, shortly after I utilized for Medicare protection, I used to be contacted by the Federal Advantages Unit (FBU) on the American Embassy in Manila, Philippines, which offers providers for the SSA and different profit businesses to clients in over 40 international locations within the Asia-Pacific area. They needed to substantiate my mailing handle in Thailand, and knowledgeable me that every one documentation needed to be despatched by postal mail from SSA headquarters in Maryland, USA. Prior to now, I’ve obtained an annual assertion by postal mail from SSA headquarters in Maryland, so clearly, that they had my right mailing handle.

Entrance entrance to Bumrungrad Worldwide Hospital, Bangkok, Thailand

By July, I used to be getting ready to journey to the USA for seven months of seasonal work, and I nonetheless had not obtained any data from SSA to clarify how my new Medicare protection labored. I used to be, nevertheless, in a position to entry my on-line SSA ‘Profit Verification Letter’ which acknowledged clearly that I used to be coated underneath each Half A (hospitalization) and Half B (medical). However even this on-line ‘verification’ letter made no point out of the required month-to-month premiums for Half B protection, nor was there any point out of the 20% ‘co-pay’ duty for each Half A and Half B healthcare payments. Solely Individuals know what a co-pay is. In different developed international locations the place common entry to healthcare is the norm, that is extraordinary! Given the extraordinarily excessive healthcare prices within the USA, a 20% coinsurance expense generally is a substantial out-of-pocket value. The stunning racist origins of the 20% ‘co-pay’ necessities for Medicare are defined in “The Racist Historical past of American Healthcare” [3] whereby the co-pay was supposed to disclaim entry to African Individuals, who have been deemed unlikely to have the ability to afford it.

Quickly after arriving within the US, I contacted SSA to request data and documentation explaining about my new Medicare protection, a Medicare card, something – at which level they instructed me that my Half B protection had been cancelled on account of non-payment of the month-to-month premiums. I knew nothing of this – having obtained no invoices, nor the quantity due, how and the place to pay, and many others. I puzzled if this was due to my Thailand handle, which was confirmed quite a few instances by e-mail and phone with the FBU subject workplace on the US Embassy in Manila. I nonetheless, sixteen months later, haven’t obtained any documentation from SSA.

However the SSA consultant instructed me to not fear and that Half A would cowl any hospitalization, together with ER visits (as this may be ‘technically getting into the hospital’). Crucially, this recommendation turned out to be incorrect, and I came upon solely after I had run up 1000’s of {dollars} in ER payments at hospitals in New York and Colorado that this was coated solely underneath Half B.

Nevertheless, SSA knowledgeable me I may back-pay the Half B premiums for all of 2022 which might reinstate my protection retroactively for your complete 12 months.  SSA cashed my test for $2,000 in October and my Half B protection was lastly reinstated (5 months later!) in March 2023. Throughout this time, I wanted some expensive diagnostic exams (which I used to be instructed solely a medical specialist may order – which, in fact, added one other layer of value within the ‘for-profit’ American Healthcare System technique). So, after three months ready to see a medical specialist, I used to be instructed by that workplace that since my Half B was nonetheless not reinstated, I must pay the session charge of $472 (no testing included) money up entrance. I used to be given the choice to reschedule a later appointment when my Half B may be reinstated. However the subsequent obtainable appointment was one other three months wait!! Fortunately, I used to be not coping with an aggressive most cancers – I’d be lifeless, simply ready to get some medical consideration!!!

So, after seven slightly sickly months in in any other case pleasurable seasonal jobs at YMCAs in upstate New York and the Colorado Rockies, educating yoga and meditation and supporting the worldwide seasonal employees program as earlier than, I used to be trying ahead to ‘escaping’ from the USA – thanks to my nightmare dealings with the severely under-funded Social Safety providers [4], the ‘for-profit’ American Healthcare System and the terrifying and outrageously excessive prices of healthcare there.

The entrance foyer of Bumrungrad Worldwide Hospital, one of many many worldwide personal hospitals in Bangkok, with a soothing ambiance extra like that of a five-star resort!

Thank goodness I dwell in Thailand, the place I’ve quick access to environment friendly and reasonably priced, state-of-the-art healthcare (to not point out no mass shootings, pure, unprocessed meals, low value of residing, a respectful, non-confrontational tradition, and many others.) So, I left my job in Colorado sooner to be able to return to Thailand to get the mandatory (and reasonably priced!) well being care I wanted. I contacted my private doctor in Bangkok who, inside a single week or so, had organized appointments with three prime medical specialists, who scheduled the diagnostic exams, follow-up appointments, and therapy. All of this value far lower than the US coinsurance funds I’d be accountable for, even after my Medicare protection was reinstated. Seven months within the USA was greater than sufficient for me. It was time to go away, and certainly a aid to return to Thailand. 

Although I’m nonetheless ready for all of it to be resolved, the SSA workers I’ve contacted a number of instances over these many months have been useful, given the amount of enrollees. Whereas I used to be lucky sufficient to have had elsewhere to go for healthcare, I can’t assist however marvel in regards to the hundreds of thousands of Individuals who don’t have some other choices.



Please be happy to contact Jim on Fb or by e-mail at 

You possibly can learn extra about Jim’s backstory,  right here and right here.