Does Medicare work overseas?

I got a phone call yesterday from Germany. I think it’s pretty cool that someone in Germany found my blog – though I have also been contacted by Americans  living in France, Costa Rica, and Mexico.  Jeff, who lives in Germany, was calling to ask why he can’t use Medicare in Germany.

Jeff has a German accent, but he lived and worked in the United States for 45 years. He is an American citizen and a veteran.  He served in the Navy during the Vietnam War.

Jeff was a police officer for 20 years and when he retired he got health insurance through a company that services retired firefighters and police officers. When he moved to Germany this health insurance covered him. But when her turned 65 he was informed that his coverage would end and his only choice for health insurance coverage was Medicare.

Jeff told me he is upset that he paid Medicare taxes for 45 years and now cannot use his Medicare because he lives in Germany. I told him he is not alone.  Hundreds of thousands of Americans live in Mexico and they can’t use their Medicare either. There has been some lobbying to get Medicare to do a demonstration project with hospitals in some locations in Mexico where lots of older Americans reside.  There has been talk, but no action on this idea.

Jeff returns to the U.S. every so often and has gone to a doctor. I informed Jeff that he has Medicare Part A (hospitalization), but if he isn’t paying the Medicare Part B premium, he is not covered for many medical services.  Part B covers emergency room services, doctor visits, labs, chemo and radiation, and most services that are not “in-patient hospital care”.

Because Jeff is a veteran, I told him he should talk to the VA about getting signed up for VA health care benefits – in case he needs care when he is visiting the U.S..  Jeff said he is a “Vietnam Veteran”, but he was in the Navy and off the coast of Vietnam, but never in the country. This is important because veterans who served in Vietnam are automatically accepted into the VA health care system.  I told Jeff to talk about this with the VA to see if he qualifies as a “Vietnam Vet”.

Long story short: Jeff is paying $600 per month for health insurance in Germany, and it is very unlikely he will ever be able to use his Medicare there.  I didn’t tell Jeff that, because he has not been paying his Part B premium, he would face a “late-enrollment penalty” if he signs up for Part B in the future.  I figured I wouldn’t add to his frustrations about Medicare.