BUSINESSWEEK ONLINE : JULY 17, 2000 ISSUE
COVER STORY Medicare Stops at the U.S. Border Retired American Max Riedl, 74, and his wife, Hermine, 72, live happily in Bad Worishofen, Germany. But one thing bugs them. ''We have paid into the [Medicare] system for 45 years, but we are not covered,'' says Riedl, a former director at Optical Filter in Natick, Mass. What's more, insurers in Germany rejected them when they turned 70. After talking to several U.S. companies and insurance info sources, they got a policy from Britain's Goodhealth International Healthcare. Lack of access to Medicare is a hot-button issue for retirees abroad. Medigap, the supplemental insurance to cover some costs not covered by Medicare, pays for emergency care overseas--but only the first 60 days you're outside the U.S. This leaves long-term retirees overseas with only three options: buy private coverage individually or through a group, pay into the government-sponsored system in the country where you live, or go without coverage. Gilbert Wells, 74, opted for his host government's plan. A patent lawyer from Washington, he now lives in Portugal and pays $100 a month--for no-deductible hospital care and $1.50 doctor visits. ''But there is a lot of waiting in line,'' he says. ''Many complaints I've heard about HMOs in the U.S. sound like problems in Portugal.'' However much you hate HMOs, remember that health-care standards overseas vary widely. And unless you know the local language, communicating with care providers can be a nightmare. Some expats return to the U.S. for just these reasons. Others are satisfied with the low-cost care they get abroad. Bob Miller says expats in Costa Rica may choose from two state health plans. One, for people 55 and over, pays for designated doctors and hospitals and costs $37 per month for a couple. The other lets you choose your own providers for a higher price. American Citizens Abroad and the Association of Americans Resident Overseas, two organizations that represent the interests of Americans living overseas (table), offer group insurance to their members and lobby in Washington to get Medicare extended to expat Americans. Retiring overseas doesn't stop you from claiming Medicare coverage when you're back in the U.S. If you start getting Social Security benefits when you turn 65, the government enrolls you in Medicare automatically. While living abroad, you may not want to pay the $45.50 monthly premium for outpatient care in the U.S. But if you return to the U.S. with a medical emergency and need coverage, you could have a problem if you didn't enroll during the annual January-March signup period. Planning ahead is your best medicine. By Ellen Hoffman _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BACK TO TOP					RELATED ITEMS Taking It with You Abroad TABLE: Charting Your Course Medicare Stops at the U.S. Border TABLE: Before You Go... INTERACT E-Mail to Business Week Online

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