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Old 16-02-2018, 21:12   #16
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Re: Medical insurance for US 'resident' long-term cruisers

Sham residency?How would some one be doing something illegal if they are USA citizen and establish residency because I am sick. In any event I have expat Health coverage for Latin America and in the USA provided by Allianz. I pay a huge amount of US income taxes, US property taxes and 1% property taxes on a boat valued at $500K that is rarely in US waters. I do not even live in the USA and payed a huge amount of USA Fed income taxes, State income Taxes before I moved overseas. Would you like to argue the relative fairness of all that. LOL
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Old 17-02-2018, 07:46   #17
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Re: Medical insurance for US 'resident' long-term cruisers

https://healthisinternational.com/
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Old 17-02-2018, 12:43   #18
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Re: Medical insurance for US 'resident' long-term cruisers

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Old 17-02-2018, 12:44   #19
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Sorry, that didnít work the first time

https://www.azimuthrisk.com/index.php
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Old 17-02-2018, 20:08   #20
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Re: Medical insurance for US 'resident' long-term cruisers

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Sham residency?How would some one be doing something illegal if they are USA citizen and establish residency because I am sick. In any event I have expat Health coverage for Latin America and in the USA provided by Allianz. I pay a huge amount of US income taxes, US property taxes and 1% property taxes on a boat valued at $500K that is rarely in US waters. I do not even live in the USA and payed a huge amount of USA Fed income taxes, State income Taxes before I moved overseas. Would you like to argue the relative fairness of all that. LOL
I am sure you don't believe that it's fair to those who are paying premium in good faith to make them pay for emergent care for those who game the system. How would you look at it if someone was trying to insure a boat with known defects with your insurance company and your rates were raised thereafter?

As for US taxes, there is always a solution if you feel you are paying too much.
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Old 17-02-2018, 20:32   #21
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Re: Medical insurance for US 'resident' long-term cruisers

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Have you used this plan? It seems to have a liberal pre-existing conditions policy, no max coverage caps and decent pricing.
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Old 17-02-2018, 21:05   #22
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Re: Medical insurance for US 'resident' long-term cruisers

Per ACA, regardless of pre-existing condition, health coverage is available to all USA citizens. If a USA citizen decides to move back to the USA because they are sick so they can meet the requirement to live in the country so they can receive health care per ACA how is that gaming the system? It is right to get health care per ACA. It is the law. ACA defines what it means to be resident and therefore be covered by ACA.

So what are you proposing? Any citizen of the USA who is living overseas then relinquishes the right to be covered by ACA when they return to the USA?

You suggest that it is OK for a USA citizen to legally find a way to pay less taxes(which I agree with), but that it is NOT OK for a USA citizen and tax payer to find a way to legally to get covered by ACA or Medicare just because they happen to be living overseas when the get sick. What is the difference??????

I assume for practical reasons having to do with administering citizens that choose to get medical care outside the USA, USA citizens living overseas are not covered by ACA or Medicare. However, if USA citizens were given the incentive to get the health care they need at the lowest price possible anywhere in the World it would save all of us, as USA tax payers, in a big way. As has been well documented health care in the USA costs at least double compared to anywhere in the world and often is not as good as medical treatment that can be found overseas. As long as adequate treatment is available in Guatemala, I would much prefer to be treated in Guatemala. There are not very many illnesses that you cannot get adequate treatment in Guatemala for a fraction of the price in the USA.

In any event I am covered by Allianz Expat / Latin America with a rider that allows me to get reimbursed for treatment in the USA if I decide to go to the USA to get treated. The USA rider only costs $30 more per month because Allianz knows since my country of domicile is in Latin America I am not likely going to seek the more expensive treatment in the USA unless adequate coverage is not available where I live or in a country closer than the USA. Plus my Allianz policy has $20K deductible.

As a USA taxpayer I have no problem with some one who lives overseas returning to the USA to legally get covered by ACA and have no problem with any USA taxpayer legally pay as little taxes as possible.
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Old 17-02-2018, 21:43   #23
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Re: Medical insurance for US 'resident' long-term cruisers

Quality health care is a basic human right that should be available for all citizens of a nation as wealthy as the US.

If some "gaming" is required for us to work around the current scam setup, more power to you, game on!
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Old 18-02-2018, 12:45   #24
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Re: Medical insurance for US 'resident' long-term cruisers

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Quality health care is a basic human right that should be available for all citizens of a nation as wealthy as the US.

If some "gaming" is required for us to work around the current scam setup, more power to you, game on!
Every game has winners and losers. Would you feel the same if you were on the losing end?
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Old 18-02-2018, 13:29   #25
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Re: Medical insurance for US 'resident' long-term cruisers

John-
"Quality health care is a basic human right"

I think Robert Heinlein was one of the folks who said that one can judge a civilization by the care it takes of those who cannot care for themselves. The feeble-minded, the crippled, the aged and infirm. Akin to the many cultures that have a special regard for the insane as being "special" to their gods.

But really? Health care, a commercial market product, is a human RIGHT?

Uh, no. No way, no how.

If you need something that someone else has to make a specific effort to give you, as opposed to some liberty or ability to gather and do things unobstructed on your own, that's not a RIGHT that's at best a courtesy and social consideration. You're not "entitled" to it. The most basic human right is the right to hang out in the wind, until dried out and starved.

You may have the right to go pick wild fruit--but you don't have the right to order me to go cultivate it and deliver it to you. And that's medical care: A cultivated, picked, and delivered service.

You trip on a curb and crack your head, I'll be glad to put a bandage on the wound, or give you a ride to the hospital, but don't expect me to pay your bills out of my own pocket, or to run the MRI machine.

Human right? Hell no. But there are many folks in places like Scandanavia and Singapore and other spots who have decided that's a HUMANE thing to do, and if it means putting up with higher taxes....well, at least they can largely agree it is the right thing to do.

But please, let's not confuse humane with human rights. Maybe there's a charter for some government somewhere that recognizes, promises, or establishes medical treatment as a "right", I just don't know of *one*.
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Old 18-02-2018, 13:43   #26
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Re: Medical insurance for US 'resident' long-term cruisers

IMO in more civilized developed nations, there should not be any for-profit activity in health care, K-12 education or housing.

Yes these are human rights for our citizens, just a few less civilized nations haven't fully implemented effective mechanisms for delivering them effectively where most needed.

In the meantime, will have to make do with means testing and subsidies.
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Old 18-02-2018, 17:33   #27
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Re: Medical insurance for US 'resident' long-term cruisers

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IMO in more civilized developed nations, there should not be any for-profit activity in health care, K-12 education or housing.

Yes these are human rights for our citizens, just a few less civilized nations haven't fully implemented effective mechanisms for delivering them effectively where most needed.

In the meantime, will have to make do with means testing and subsidies.
You are most correct. The US system is in a downward spiral. Too much utilization and the prices are insane. A client showed me a bill from a 4 hour procedure, $246,000, no joke. The dr ended up getting $68,000. No where else does this occur. Highly skilled practitioners with a high level of responsibility should be well paid, but I happen to know those Dr owns a $10 million condo. Thus runs through the system. Cost of insurance is the symptom of this and gets worse every year. Our politicians have not a a clue how to fix it.
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Old 18-02-2018, 17:53   #28
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Re: Medical insurance for US 'resident' long-term cruisers

One of my employees and his family are in Antigua, Guatemala. We shopped insurance through our regular insurance broker and went with IMG. They have gotten a number of procedures, including cervical spine surgery. They are happy with the insurance. I am happy that is less than half of our US based medical policies.

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Old 18-02-2018, 18:45   #29
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Re: Medical insurance for US 'resident' long-term cruisers

Just for future reference. I lived in Guatemala for many years and like some other posters, really like the healthcare system there. We now live in Panama, and while good affordable healthcare/insurance is available, we still prefer the healthcare in Guate. In fact we've timed our visits back to Guate so we could continue to do all our regular exams there.
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Old 20-02-2018, 10:46   #30
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Re: Medical insurance for US 'resident' long-term cruisers

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Just for future reference. I lived in Guatemala for many years and like some other posters, really like the healthcare system there. We now live in Panama, and while good affordable healthcare/insurance is available, we still prefer the healthcare in Guate. In fact we've timed our visits back to Guate so we could continue to do all our regular exams there.
BelizeSailor, that is really good to know. We are planning on spending the 2018 hurricane season there. We are not spring chickens any longer, but we also have no major health issues. But you never know when something could happen. We do have international health insurance through IMG, but it will be hard for us to even reach our deductible, as it stands right now. I've heard other good things about healthcare in Guatemala. This is very encouraging. Thanks.
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