US Health Insurance Issues for Expat-Retirees to consider
By Maria Thermann

US Health Insurance Issues for Expat-Retirees to consider

Unlike the UK or EU countries, national health insurance in the US does not exist in the same or similar form. Ex-President Obama tried to correct this thorny issue with his Medicare system, but at the time of writing it is far from clear for how long this arrangement will stand under the current Republican Administration under President Trump. If you are planning to retire to the US, sorting out your expatriate health insurance is essential. New immigrants moving to the US without having worked there before for at least 40 quarters are not eligible for the Medicare health insurance scheme when they are 65 .

You will need to arrange for overseas health insurance before relocating to the US, as there is no nationwide system of government-owned medical facilities that can be accessed by the general public. GPs and hospitals are, generally speaking, funded by payments made by patients directly and by insurance companies. There is a basic provision of outpatient care in emergency rooms, but US hospitals are predominantly providing inpatient care that is not funded by a nationwide scheme like the National Health Service in the United Kingdom for example.

If you are still of employment age, and relocate to the US, it is likely your employer will be offering a private health insurance scheme for you and your whole family as part of your remuneration package. For retirees, however, an overseas health insurance policy will be expensive and also problematic to find. Irritatingly, if you do fall ill in the US or need any kind of treatment, you will have to find a hospital or doctor that will actually accept your particular type of insurance policy. Visiting medical facilities that fall outside the insurance policy you are covered by could mean having to pay for all treatments yourself.

When you read through the fine print of your overseas health insurance policy, be sure to check that dental and vision care are included. Not every insurance company covers all aspects. In some cases you may have to take out separate dental and vision care insurance, which are often sold separately in the US. In the United States prescription drugs are also often handled separately from medical services. Prescription drugs are expensive, and not all of it may be covered by insurance.

At the very least, the expat health insurance you choose should include cover for hospital stays and treatments and have an annual benefit limit of at least US$ 1,000,000 and include cancer treatment.

Some overseas health insurance companies offer three types of cover. A more comprehensive policy would typically come with an annual benefit limit of US$2,000,000, include cancer treatment and might even include inpatient maternity care for family members. Top of the range insurance policies come usually with an unlimited annual benefit limit, mental health care and cancer care, too. You may not need any of these types now - but it is better to be fully prepared.

If you want to buy a property in the US and only use it for part of the year as your retirement home, you should consider carefully what type of travel insurance you sign up for. Your travel insurance for the USA should not have an upper age limit and should cover most types of pre-existing health conditions, including cancer treatment you might have had or are still receiving.

Repatriation costs and full medical costs should also be included in your travel insurance policy, or you may find that you are billed for thousands of dollars, if repatriation to your home country is the only way to get better after falling ill in the United States.

The policy should carry an upper limit of benefits of at least US$ 1,000,000 and cover your maximum allowed stay in the US of 90 days for a single trip. Some insurers even go beyond this, offering a total of 104 days for a single trip to the US (your tourist visa will only allow a 90-day stay, however, for a single trip). If you are travelling to the US with other people, your travel insurance should also cover every member of your family.

For further information about Medicare for retirees and international health insurance issues, please visit for up-to-date details. The following insurance companies offer comprehensive cover:

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