ACA and living overseas

Health, Fitness, Food, Insurance, Longevity, Diets,...
Post Reply
WFJ
Posts: 416
Joined: Sat Apr 24, 2021 11:32 am

ACA and living overseas

Post by WFJ »

Does anyone have ACA while living in a foreign country? ACA premiums are very low (for those with ERE income), but plans do not cover international travel/living. I'm curious if there are any major medical plans that consider any non-emergency medical situation will be covered by ACA as soon as one returns to the US. The insurance would only need to cover major emergencies, even less exposure than a typical short-term medical plan.

User avatar
Seppia
Posts: 2016
Joined: Tue Aug 30, 2016 9:34 am
Location: South Florida

Re: ACA and living overseas

Post by Seppia »

Could you consider a travel insurance? These are usually fairly cheap.
I just ran a simple simulation starting from here: https://www.forbes.com/advisor/travel-i ... insurance/

40yo
NY Resident
Trip fully booked
Traveling to Italy from Sept 1st to Dec 31st
Covering only medical expenses

$130 gets you $250k per person primary coverage for medical + $1M Medical evacuation. With those amounts in Italy you could pay for heart surgery in a top private clinic a couple times over

RealPerson
Posts: 875
Joined: Thu Nov 22, 2012 4:33 pm

Re: ACA and living overseas

Post by RealPerson »

There are companies that offer so-called expat insurance. You can buy this with or without US coverage. With US coverage, you must be out of the US at least half of the year.

For most countries, I suggest self insuring. I have catastrophic (high deductible) insurance through ACA for the US, and in other countries I pay out of pocket. The cost of health care is so low in most countries that it probably does not make sense to buy insurance. A notable exception is Switzerland but most of the rest of Europe is very affordable.

Another issue is China, where they will let you bleed to death in a hospital if it is not clear that you can pay. Seriously. At least it used to be that way but I would check into that before travelling to China.

Unlike the ACA, expat plans exclude preexisting conditions.

WFJ
Posts: 416
Joined: Sat Apr 24, 2021 11:32 am

Re: ACA and living overseas

Post by WFJ »

Thanks for the link. Some countries are now requiring proof of international health insurance before allowing entry after several expats have left the countries with huge medical bills left behind. ACA will cover all US based expenses but need a policy that only covers non-US based expenses, if there is any convergence of coverage, the insurance companies will fight to the death to not pay and put the expense on the other company. Plan to be out of the US for 10-11 months a year, but will return to the US for any serious/chronic medical conditions. Maybe Joe will include a $100,000 foreign emergency medical care for Hunter's adventures in China and Ukraine???

More than just China, I've seen tourists with broken bones turned away from Thai hospitals without insurance or payment upfront and heard of several similar cases in Vietnam.

User avatar
Ego
Posts: 6359
Joined: Wed Nov 23, 2011 12:42 am

Re: ACA and living overseas

Post by Ego »

WFJ wrote:
Fri Jun 18, 2021 12:37 pm
Some countries are now requiring proof of international health insurance before allowing entry after several expats have left the countries with huge medical bills left behind.
You can purchase this the day before entering the country online or simply print out a... ahem.... proof of coverage to get through the border.
WFJ wrote:
Fri Jun 18, 2021 12:37 pm
ACA will cover all US based expenses but need a policy that only covers non-US based expenses,
Are you sure about this? Most health insurance policies cover the person for emergencies while outside their area of coverage.

ETA.... I just checked and was surprised to find that I am not covered outside the US, Canada and Mexico. Surprise!

WFJ
Posts: 416
Joined: Sat Apr 24, 2021 11:32 am

Re: ACA and living overseas

Post by WFJ »

Currently, ACA does not cover anything outside of the US. I would not just have a piece of paper as an insurance policy in a foreign country as not only might you be prosecuted for violating their laws, you could be have permanent damage caused by delay in care or even die. Hospitals in most foreign countries will let you bleed out a die if you can't pay (and people wonder why healthcare is more expensive in the US???).

jacob
Site Admin
Posts: 15907
Joined: Fri Jun 28, 2013 8:38 pm
Location: USA, Zone 5b, Koppen Dfa, Elev. 620ft, Walkscore 77
Contact:

Re: ACA and living overseas

Post by jacob »

I've never heard of a "national" health insurance that worked outside the country of domicile, that is, on a global basis. That's why "travel insurance" exists. This is also why non-tourist visas/residence permits usually require proof of health insurance, which is almost always obtained locally, usually within 30 days of arriving. Whether or not the local services will leave you to bleed out on the doorstep or turn away a broken arm, patch you up and send you on your way, or give you the same service as the locals really depends on the social consciousness of the given country. There's a wide range.

chenda
Posts: 3289
Joined: Wed Jun 29, 2011 1:17 pm
Location: Nether Wallop

Re: ACA and living overseas

Post by chenda »

RealPerson wrote:
Thu Jun 17, 2021 11:19 pm
A notable exception is Switzerland but most of the rest of Europe is very affordable.
I'm not sure about that, it won't necessarily be cheap for a non-national whose not entitled to use a state system or similar.

User avatar
Ego
Posts: 6359
Joined: Wed Nov 23, 2011 12:42 am

Re: ACA and living overseas

Post by Ego »

jacob wrote:
Sun Jun 20, 2021 1:24 pm
I've never heard of a "national" health insurance that worked outside the country of domicile, that is, on a global basis.
My perspective is skewed Californian. California Blue Shield and Kaiser Permanente cover emergency treatment and even urgent care anywhere in the world. We've also got some unusual HMOs here on the border that provide coverage in both countries and encourage treatment in Mexico for obvious reasons.

We always operate on the assumption that we will pay cash in case of emergency while traveling.

Years ago we had a Signature Visa credit card. If we booked our tickets with it we received evacuation insurance, emergency medical and dental coverage up to $2500. But the coverage lasted for only 30 days per trip. At that time if we bought a bus ticket across a border with the card it constituted a new trip. Not sure if they still do this.

Travel medical insurance is strange because it usually combines two things, medical coverage and evacuation. They often do not cover pre-existing conditions and the cover ends the moment you are repatriated. So, basically, their coverage is limited to the cost of medical care in country or the cost of a flight home, whichever is less.

Post Reply