Health insurance for Americans

[Stu Jackson]

Originally Posted by Stu Jackson

If you're on Medicare and overseas or even in Canada, you will not be covered. My wife found a policy for us for our next European trip (for a month next month) for like $78 for full coverage. I'm sorry she's out of tthe house now, but I'll find out what it is and post it later. I had a TIA in Canada last December and it cost us $5K!!!

OTOH, if you're not in a "developed" country, your choice to go uninsured. I wouldn't call Europe and "undeveloped" country.

Your life, your choice. Good luck.

I've checked, but you have to come back to the States every three months, so wouldn't work for a circumnavigation, sorry.

[Paul L]

This is a very well researched article in Time magazine disecting the costs of the US health care system. The shocking numbers to me was that Medicare is about the only portion of the US system that is run cost effectively.
Bitter Pill: Why Medical Bills Are Killing Us - TIME

[Therapy]

Originally Posted by Paul L

This is a very well researched article in Time magazine disecting the costs of the US health care system. The shocking numbers to me was that Medicare is about the only portion of the US system that is run cost effectively.
Bitter Pill: Why Medical Bills Are Killing Us - TIME

Must subscribe to read.

[Paul L]

Originally Posted by Therapy

Must subscribe to read.

The sign up is free, I believe.

[rognvald]

Originally Posted by David_Old_Jersey

Whilst I am sure Zee won't by shy in responding , my guess is that she has previously paid into the system that now provides her healthcare - and that part of the deal then was that the cost later drops. Whether that deal ever made financial sense is a separate matter, but it's the deal both sides freely made. Zee stuck to her side of the bargain.........

David, by plucking the above quote out of my previous response without the explanation that followed makes one think that I believe Zee is not entitled to her benefits under Medicare. I never said that. What I did say is that $100. per month compared to what most working Americans pay for health care is not a bad deal. And, the fact that most Americans have paid into the system throughout their lives does not discount the fact that the system is broken and what they have paid will not even remotely cover the cost of their health care until they die-- let alone for the coming generations. The abuses of the system by patients, doctors, hospitals, government mismanagement, unnecessary medical procedures, abortions as a means of birth control among America's poor, health care and emergency services for illegal aliens and a shrinking tax base ensures a bankrupt system for future generations. We Americans are statistically the most generous nation in the world and we have an unconscionable debt as proof. No decent civilization should ever deny its needy help but you can't feed your children from an empty cupboard. Europeans have discovered this sad reality in recent years and we're next. Good luck and good sailing and all due respect to Zee as I originally intended.

[DotDun]

Originally Posted by Therapy

Must subscribe to read.

Same article here for free.

TIME: Why Medical Bills Are Killing Us

[svmariane]

Originally Posted by robertsapp

So just asking a question, as I don't know the answer - if you live on your boat and are cruising the world and therefore don't have a fixed foreign address, will the IRS accept the fact that you are not a permanent resident of the US?

Sorry for the long post... But if you are a US citizen and live overseas the following might be helpful.

SHORT VERSION: If you don't already know about these, you should. Instructions for Form 2555 (2012) and Publication 54 (2012), Tax Guide for U.S. Citizens and Resident Aliens Abroad

I've been doing this for years and yes, the IRS has established ways to prove you've been out-country. You need to be proactive on this. I've used form 2555 from 1983 through 2004 - it's not complicated. With the advent of the ACA (Obama Care) I'll recommence using the 2555 not because of income exclusion but again to prove my being outside of the USA

Note: I've "income" from a US based retirement source and as a US Cit needs must file with the IRS. I carry a Washington state DL and a US passport.

Since retiring in 2004 I've used a different foreign address each year on form 1040. Sometimes a marina, sometimes a local pub/bar, sometimes a friend's home address - depends. I did not NEED to do this, but now with the ACA I'm glad I did - because I know that the IRS accepted my yearly tax paperwork using this method.

If unsure (ahem) of the reliability with the local mail service, I've enclosed the completed return in a sealed envelope with the local address on the tax forms and on the outside of the sealed envelope - then used DHL or FedEX to get the packet to a family member in the States who takes the interior envelope to a US post office, pays postage, and there it goes.

Note this: I've also attached a short memo to the 1040 stating that I'm travelling on my sailboat for an extended cruise and if the IRS wishes to make contact to do so at the following ... and then provided my sister's address. If you use a Mail Forwarding Service such as St. Brendan's Isle, you might make pre-contact and see if they will mail your stuff. (Maybe have to pre-pay them?? Ask.)

On Form 2555, here's what you're seeking: Part III, Physical Presence Test

"To meet this test, you must be a U.S. citizen or resident alien who is physically present in a foreign country, or countries, for at least 330 full days during any period of 12 months in a row. A full day means the 24-hour period that starts at midnight.

To figure 330 full days, add all separate periods you were present in a foreign country during the 12-month period shown on line 16. The 330 full days can be interrupted by periods when you are traveling over international waters or are otherwise not in a foreign country. See Pub. 54 for more information and examples."

Essentially, you'll list the start date for your travels, note that you're still outside the USA, and list all the countries you've been in / passed through.

IF you don't meet the 330 day requirement this time around you'll need to file without the exemption... BUT in the next year you'll use it, and you can also file a 1040X amended return for the prior year to get at least a few months of the exemption.

Note: Although I mention forms 1040 and 1040X, you might use other forms such as the EZ line but the same principle applies.

I'm still trying to get things to work with efile electronic filing. Last time around it wouldn't accept foreign zip codes. Go figure...

Also: Although Congress and/or the IRS might change things around between now and April 15th, what I've noted is applicable as of the now.

Good luck to all of us....

James

[Therapy]

Originally Posted by DotDun

Same article here for free.

TIME: Why Medical Bills Are Killing Us

Good!
Thanks.

While I still have a few pages left to read it is very informative.

It has some inaccuracies that I can easily pick out but overall conclusions seem pretty accurate. Except for him thinking Medicare payments are enough to pay costs of course. And he does not know that many things in the OR cannot be "reused" (for a number of reasons). But even with those Medicare payments (not the drugs) doubled there is an awful lot of room for reductions.

It is a racket for sure. I am part of it but unfortunately, a very small cog not smart enough to make the "real" money some are making.

[David_Old_Jersey]

Originally Posted by rognvald

David, by plucking the above quote out of my previous response without the explanation that followed makes one think that I believe Zee is not entitled to her benefits under Medicare. I never said that.

It is what I read, but I accept that not your intention .

The USA can afford even it's current "Broken" Healthcare system, it's just that folks have decided to spend the money on other stuff - mostly it seems on things that favour friends and family of the politicos who write the cheques, and then for the populace to feed off the crumbs from the rich mans table (with varying degrees of success)......but clearly that is choice that the voters are happy with, or at least have been. Methinks the USA lives in interesting times, plenty of hard choices yet to be made - with a bit of luck (including for me!) they (you!) will also make a few smart ones

But obviously I am drifting well away from the thread topic - someone earlier made a comment well worth investigating, that if visiting the EU the Schengen visa requires folks to have own healthcare......not sure if that is true, seems too sensible to be true!

[rognvald]

Originally Posted by David_Old_Jersey

It is what I read, but I accept that not your intention .

The USA can afford even it's current "Broken" Healthcare system, it's just that folks have decided to spend the money on other stuff - mostly it seems on things that favour friends and family of the politicos who write the cheques, and then for the populace to feed off the crumbs from the rich mans table (with varying degrees of success)......but clearly that is choice that the voters are happy with, or at least have been. Methinks the USA lives in interesting times, plenty of hard choices yet to be made - with a bit of luck (including for me!) they (you!) will also make a few smart ones

But obviously I am drifting well away from the thread topic - someone earlier made a comment well worth investigating, that if visiting the EU the Schengen visa requires folks to have own healthcare......not sure if that is true, seems too sensible to be true!

As Civilization declines . . . the Shaman becomes king.

[SVNeko]

Thanks for the info, James. Sounds like a PITA.

[Therapy]

Originally Posted by Paul L

This is a very well researched article in Time magazine disecting the costs of the US health care system. The shocking numbers to me was that Medicare is about the only portion of the US system that is run cost effectively.
Bitter Pill: Why Medical Bills Are Killing Us - TIME

Paul,

Thanks.

That should be required reading for all, Americans (that can read).

While I will disagree with some particulars and question a good many numbers he provides, there is no question that as usual, the rich hold the power, defend their "business" and get richer.

[sailorboy1]

You know I don't really want to read anything about how the American health care system works for Americans living at room. I want to read more stories of how Americans are dealing with health insurance/care when outside the US.

Part of the reason I decided to get into cruising was that I knew I was needed to get out o the US or work till I was really to drop, because of health care costs.

[sailpower]

Originally Posted by Don L

Part of the reason I decided to get into cruising was that I knew I was needed to get out o the US or work till I was really to drop, because of health care costs.

Hey, didn't you get the memo? That's all been fixed now.

[sailorboy1]

Originally Posted by sailpower

Hey, didn't you get the memo? That's all been fixed now.

I must not have. The one I got read like it didn't matter if I left the US or not, I was going to pay either way.