ACA/Obamacare for American Cruisers Abroad MERGED THREADS

[belizesailor]

As requested by the OP, please dont hijack this thread into a pointless political debate.

[zeehag]

if you truly believe your visa status is not known by both usa and mexican govts while cruising here, you are most mistaken. you are tracked. you leave a trail and it is followed when necessary.
if you actually believe usa govt doesnt have a clue where you are mistaken.
also, go out of mexico then comeback to renew a visa not allowing multiple entry mebbe you should watch in imigracion a few hours as folks pull all kinds of bs ont the clerks there..is fun to watch. someone even was sent out of mexico while i sat there listening andwatching-- yes they do know what you do here and in usa. it is only naive to think otherwise.

[Paul L]

Originally Posted by Kenomac

I stated what I plan to do as a cruiser. Leave the country, Pay cash for care & take out a catastrophic health policy. Isn't that what the op asked for? Or, did you want my answer more sugar coated.

When you check the price of catastrophic health insurance policy, you may find that a policy from the Exchanges is significantly cheaper, assuming you qualify.

[Evenstar]

So I had a text chat with someone from the Healthcare.gov, very friendly woman named Mira.

The gist of it was...she was puzzled. Puzzled and envious...but she didn't know for sure if we'd be a slam dunk for an exemption.

She agreed that foreign residency would be, but wasn't clear about the IRS rules as to how they would apply.

Two things:

1) There WILL be an "Exemption Application" showing up on Healthcare.gov at some point. So I think all of us will have to fill that out to at least claim exempt status.

2) She's going to submit this up the chain for review, as there is NOT a clear ruling/guideline that she could see. I got the impression she had a few people looking over her shoulder trying to answer it as well. So the case of the "I'm out of the country all year but don't live anywhere" people like us hopefully will be addressed.

I gave them my e-mail address and told them they could contact me if they wanted to know more information or had questions.

Apparently everyone in the office with her was very excited that someone could live such a lifestyle.

[CaptTom]

Good discussion, and thanks to (almost) all for keeping it non-political!

My own limited, or rather VERY limited, knowledge on this suggests that the penalty the first year is either nill or minimal, and it goes up over several years. If you're OK now, it may make sense to do nothing until this whole thing becomes clearer. Again, I'm not claiming to know the details, just offering an option you may want to consider.

[goboatingnow]

Just speculating , surely if you cannot establish a residence elsewhere , You will be regarded as being at your previous one , or certainly , still resident in your own country. Most countries require proof of residency abroad to eliminate it at home. This is what trips up cruisers. In essence youre just on a long vacation as far as they are concerned.

Dave

[Ocean Girl]

I really appreciate the thoughtful posts trying to provide hard facts about this.


Since I have a history of brain tumors, we cannot go without insurance. Last I heard, my husband plans on catastrophic insurance while we cruise, cash for everyday stuff. But it is so early, will take a harder look when it gets closer for us to head out and the information is spelled out a little clearer.

Thanks to the OP Evenstar and Rebel Heart for trying to get this discussion into our cruising community forum, lots of Americans here

[Doodles]

Originally Posted by belizesailor

What specific provisions of, the as yet not implemented, Obamacare are effecting your premiums now?

Re your plan, not a bad option. I carried USA based catastrophic coverage up until a few years ago ($10,000K annual deductable, international coverage). When I turned 50, no change in my good health status and no claims (ever), they jacked up the premium to $650 per month. I cancelled and picked up coverage through G & T in Guatemala. Its a PPO network type plan, Q2,500 ($335) deductible, Q1,800 ($240) per month...for "full" coverage. Their network is of course mostly in Central America, but the plan also covers me internationally, including the USA, but at out of network rates. My experience with G & T has been good. I also still have a HSA account. This combination works for me.

Healthcare in Guate, and a few other CA countries, is excellent and reasonably priced (even without insurance).

I have legal residency in Guatemala, and rarely return to the USA (and then only for a few days), so as I understand it will be exempt.

Currently in Panama, another good option for your plan, and much less "wild west" than Guatemala can be...your wife may be more comfortable with that.

We've found the same in Thailand, excellent care and very cheap. Medical tourism is big business here so the facilities and personnel are first rate and the costs are very reasonable.

[Doodles]

........

Come on the OP asked nicely ... can't we keep this non-political? Jeez ..

Otherwise, you provide some useful information.

[Stu Jackson]

S

Originally Posted by Boatguy30

I for one would be 100% behind true market based healthcare. I'd love to see the average 70 y/o cruiser with say melanoma history and maybe say diabetes go into the "marketplace" and try to get coverage.

My understanding is that the new exchanges and the limits on denying coverage are supposed to address this issue.

I'm on Medicare & Advantage. Had a TIA in Canada over last Xmas, not covered, $6K out-of-pocket.

It appears that improvements may be gradual, but the majority of folks polled like the "features" of the new plan, just got "twisted crazy" with the lies and distortions. Not political, just reality. For example, our post-college age son who is less than 26 is now covered under our health insurance. Would not have happened without the new law. Saves us bundles PER MONTH on premiums.

Like everything else in boating, there are options, and you have to do research and homework to find the ones that suit you best.

[Dulcesuenos]

Going to ask a question please dont lambaste my ignorance on this, isnt healthcare in other countries so affordable compared to the US that you really dont need coverage unless it were something incredibly catastrophic? I know thats not the point of the OP's question but still curious?

[Stu Jackson]

Please see Reply #38 above. Depends on what country.

[avb3]

The OP asked that there not be any political comments made in this thread. Numerous posts have been deleted that either were political or responded to those that were. Anymore and this important thread will be closed.

[rebel heart]

Originally Posted by Dulcesuenos

Going to ask a question please dont lambaste my ignorance on this, isnt healthcare in other countries so affordable compared to the US that you really dont need coverage unless it were something incredibly catastrophic? I know thats not the point of the OP's question but still curious?

To that end, if you spend more than 330 days out of the USA you are excluded from the individual mandate.

But take a very real scenario like a US sailor who's cruising full time in Mexico and then gets diagnosed with cancer or another serious illness. Chances are they'll want to be back with their family and back with, frankly, superior medical care in a lot of arenas.

[svmariane]

Found this ACA Subsidy Calculator | The Henry J. Kaiser Family Foundation

Hope that calculator helps somebody.

As for me, I've been a resident of Austria since 1992 and have documents to so prove. Gonna be a bear, though, if I need to get them "officially" translated into English.