Medical Care and Social Security while Cruising

[butterchurn]

My wife and I are planning to do the Great Loop when we retire in a couple of yeara and we have some medical and retirement questions.

If you take prescrition meds, how do you handle getting them while traveling from place to place?

What about medical care if you are a water gypsy and you need folow-up appointments for chronic conditions (non-serious)? We will have TriCare.

What about Social Security if your address is your boat which moves from state to state? Same goes with my daughter who will be with us and she receives SSI?

How about taxes?

We plan on selling or land based residence and moving aboard a trawler which will become our home.

Thanks ahead of time for your advice!
Ron

[CharleyAnna]

Hi there, and congratulations on living your dream. We are still a few years away.....
I am a nurse practitioner in family practice, and have many TriCare patients (my office is 2 mile from Ft. Knox). One bit of advice--find a provider before you leave, that is willing to work with you. I have several patients who do travel a lot. They have my home number for questions while on the road (although they never call). Also, I have ordered labwork and mailed them the orders with request on the orders to send the results to my office. And, I have refilled their meds at pharmacies such as Wal-Mart--I can call the meds in to our local store, and the patient can pick them up at any Wal-Mart. Luckily these guys are healthy enough to only physically have to come into my office either once yearly, or twice yearly. Now of course if you have a chronic condition like diabetes, it might not work as well. But, I do have one patient that travels around the U.S. on motorcycle, who is insulin dependant diabetic. He calls me in his readings every couple of weeks, and we adjust insulin as needed over the phone.
Good luck to you guys!!
Anna

[doug86]

Originally Posted by butterchurn

My wife and I are planning to do the Great Loop when we retire in a couple of years...
Same goes with my daughter who will be with us and she receives SSI?

So...is that two of you, or three?

How about taxes?

paying.. or receiving?

[Kettlewell]

I am not an expert on the traveling Meds. thing, but I will add that I don't see why you can't bring written prescriptions with you to get filled wherever you are in the USA. Once outside the country there will be a problem with that.

However, on the address thing, most of us establish a "permanent" address somewhere that is our legal address for things like your driver's license, voting registration, boat registration, taxes, etc. Many find a place that has a favorable tax climate for their particular situation, like in Florida, which has no income tax. There is a mailing service there called St. Brendan's Isle that specializes in providing a home base for travelers like you. Others use a trusted relative, or sometimes pay a local accountant to handle everything. There are too many things you need this fixed address for to avoid this, IMHO, though some manage to do so. I personally would not want to give up a driver's license or the right to vote, for example.

[donradcliffe]

Social Security payments can be direct deposited into any checking account, and both sides prefer it that way. A debit/ATM card will let you access the money, and you can also set up online banking with billpay.

Medicare care is trickier--I'm not sure what tricare is, but if you get the classic Medicare Part B with a supplement, you can find a doctor almost anywhere. If you go for the cheaper plans with a "network" you may be stuck going back home for treatment. Prescriptions can be sent to friends/marinas/yacht clubs, etc.

[Unicorn Dreams]

Ditto on the SS payments as SS doesn't like to send checks by mail.

As for meds, as long as you are in the US, have your prescription filled at Wal Mart then you are good all over the US .I'm onsulin dependent and have no problem. When overseas, I just have it shippped cold pack..

[SaucySailoress]

Just be careful, though... on a recent visit to the UK a private hospital (where I wanted some blood tests doing) refused to fill the prescription I had brought from Kuwait. They insisted I went to my local GP - who hadn't seen me for fifteen years!!

It might be better to get enough meds for your entire trip whilst you're guaranteed access to them!

[Sunspot Baby]

We do our prescriptions by mail order, 3 months at a time. I think when it is time to refill, you can just give them a new shipping address. Don't know how they would feel about sending into Canada.

We have them sent to a daughter-in-law and she then sends them to us where ever we tell her.

We have a Humana plan that covers foreign travel medical coverage, but be prepared to pay the full load at the time of treatment, then submit or reimbursement.

George

[djmarchand]

Here is how we dealt with those issues:

1. Residence- Established our legal residence address in Texas which has no income tax. Used my daughters address for our tax returns. Filed our tax return along the way. Today do it electronically. Got our drivers license there and set up our bank account there.

2. Mail- Used St Brendan's Isle to collect and forward to a future marina along the way.

3. Health Care- Pick an insurance plan that has coverage everywhere like Medicare Supplement, not a Medicare Advantage which may limit you to a specific network. Ordered meds by mail and St Brendan's collected them for us and forwarded with other mail. As others have said, establish a relationship with a PC physician somewhere particularly if you have on going issues.

4. Communications- You didn't ask about this one but used a Verizon air card. Today would have done that with a mifi device so we could connect both of our PCs wirelessly. Verizon has pretty good coverage along the ICW, except for parts of Ga.

Do it, cruise, enjoy your life.

David

[Hud3]

We worked with our doctor and prescription drug insurance company to get a six months supply of my wife's prescriptions. It was not a problem after they understood that we'd be off cruising. Our doctor made himself available by email to advise us on any medical issues, and also gave us prescriptions for antibiotics, and other medications that we might need and not be able to easily obtain.

You should be able to find "walk-in" urgent and non-urgent health care clinics in most towns and cities. Our medical insurance covers all of our health care costs here in Nevis as "out of network", so we pay a higher co-pay. The local providers don't accept our insurance, so we have to file a claim ourselves to get reimbursement.

If you have taxable income, you'll have to pay taxes. It doesn't matter to the federal and state governments whether you're cruising or not. I use TurboTax and file electronically. I pay my quarterly estimated taxes electronically. I have any refunds electronically deposited to my bank account.

It's pretty important to have a fixed address in the States from which mail can be forwarded to wherever you will be. We use a mail forwarding service (St Brendans Isle), but you could have a trusted relative or friend handle it for you. Either can weed out the junk mail. The USPS will forward mail for up to one year, but not beyond.

Our credit card companies, our banks, and our investment firm all require that we have a fixed address in the US. The IRS and Social Security will want a valid mailing address, as well. All of our financial needs are easily handled with a mail forwarding service, Internet banking and investment management accounts, autopay on credit cards, electronic payment options for our checking account, direct deposit for Social Security benefits, and ATM cards for cash.

It takes a bit to set all this up, but once set, it's all very easy to maintain.

[butterchurn]

Originally Posted by doug86

So...is that two of you, or three?



paying.. or receiving?

Receiving we have covered. I was thinking about paying.

[butterchurn]

Thanks everyone for the very helpful replies! We can do this!

BTW, for those who do not know, TriCare is a plan for the retired military and their dependents. It is good almost anywhere.