MEDICARE Health Insurance
Still Needed in Korea
Still Needed in Korea
March 22, 2024
BLUF: If you are a retiree living overseas, ANYWHERE overseas, none of these Medicare plans work since Medicare is not available overseas, BUT you must still enroll in Part B to keep TRICARE.
When living or visiting in the U.S. having Medicare is a huge advantage for retirees over 65, because Medicare is the first payer of medical bills (75%), and your TRICARE picks up the remaining 25%. This makes health care when stateside pretty much free.
However, with Medicare not allowed overseas, Medicare itself becomes kind of useless... BUT, is still necessary to keep TRICARE! When overseas, TRICARE becomes the first payer of medical bills and you pay the remaining 25%. Enrolling in Medicare Part B is required to keep your TRICARE For Life.
At 65 years old you must enroll in Medicare Part B in order to keep your TRICARE. Read More on our TRICARE page.
Veterans approaching that milestone 65th birthday face decisions impacting both their health and finances. If you are like most retirees, TRICARE is probably something you DON'T want to LOSE, and when turning 65 that relies on your Medicare enrollment.
In 2001 Congress rolled out TRICARE For Life (TFL), a Medicare wraparound program designed to ease the financial burden of the out-of-pocket costs associated with Medicare for older retirees.
Your TRICARE For Life DEPENDS on Medicare enrollment, specifically Part B even though Medicare is not available for use overseas. Without enrollment, you lose TRICARE.
Part A helps cover inpatient hospitals and skilled nursing home care, limited home health services and hospice. Enrolling in Part B automatically comes with Part A. You pay for Part B. Part A is no fee.
Medicare Part A Covers:
Part B helps cover services from doctors and other healthcare providers, outpatient care, home health care, durable medical equipment and many preventive services. Enrollment at age 65 is a must to retain TRICARE.
Medicare Part B Covers:
Do I Need Medicare Parts A and B?
An all-in-one plan which has all the benefits of Part A and B and is covered through a private insurer. Medicare Advantage IS NOT a substitute for enrolling in Part B. You may choose this Advantage plan after enrolling in Part B to help manage Medicare if in the U.S., but you must first enroll in Part B.
Part D helps cover prescription drugs, which as with all Medicare, not available for use overseas.
Sometimes TRICARE records get flagged showing Medicare Part A & B as "OHI" Other Health Insurance. IT IS NOT! This is an incorrect clerical annotation in the TRICARE record. If you have TRICARE For Life and are ever told by a network hospital, a provider who has always previously processed your TRICARE and billed them directly, that your record shows Medicare Part A & B as OHI, they WILL NOT bill TRICARE until that gets changed. You must call TRICARE Claims Processing at 080-429-0880 and have them correct this by either changing the question of "OHI?" from YES to NO, deleting that from the record, or coding it with something else, not OHI.
Inexperienced Claims Processors on the line with you at TRICARE may or may not know about this. The experienced folks do, what we call the "good ones", so if you get the run-around and the "it should be good" responses, ask for a supervisor.
Anyone who is eligible for premium-free Medicare Part A is eligible for Medicare Part B by enrolling and paying a monthly premium. If you are not eligible for premium-free Medicare Part A, you can qualify for Medicare Part B by meeting the following requirements:
* You must be 65 years or older
* You must be a U.S. citizen, or a permanent resident lawfully residing in the U.S for at least five continuous years
You may also qualify for automatic Medicare Part B enrollment through disability. If you are under 65 and receiving Social Security or Railroad Retirement Board (RRB) disability benefits, you will automatically be enrolled in Medicare Part A and Part B after 24 months of disability benefits. You may also be eligible for Medicare Part B enrollment before 65 if you have end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (also known as ALS, or Lou Gehrig’s disease).
Begin the process 3-6 months before you 65th birthday. If you are receiving retirement benefits before age 65, or qualify for Medicare through disability, generally you’re automatically enrolled in Medicare Part A and Part B as soon as you become eligible. Otherwise, enroll just before your 65th birthday.
If you do not enroll during your initial enrollment period, and do not qualify for a special enrollment period, you can also sign up during the annual General Enrollment Period, which runs from January 1 to March 31, with coverage starting July 1. You may have to pay a late enrollment penalty for not signing up when you were first eligible.
If you’re not automatically enrolled, you can apply for Medicare through Social Security in person at a local Social Security office, through the Social Security website, calling 1-800-772-1213, or for us in Korea, contact the SSA office in the Philippines.
YES, but...
Because Medicare Part B comes with a monthly premium, some retirees choose not to sign up. If you change your mind and decide later to sign up, there will be a penalty fee added to your monthly premium. There is a grace period before this happens, which is about 12 months. Read more in the FAQ "Are there Penalties When Declining Part B?"
Generally YES there is a penalty if you miss your window of opportunity at 65.
But, also NO there is not a penalty if you are still working for the DOD as a civil service employee. Once you retire from civil service there is a grace period of 12 months to purchase Medicare Part B without penalty.
So, assuming you are retired, if upon turning 65 you decide to decline purchasing Medicare Part B, there is a price to pay if you change your mind later. The penalties for declining Part B and trying to signup for it later can be quite astounding. So much so, of you are contemplating this course of action, think very very hard of the eventual outcome should you change your mind later. Medicare Part B can at times cost as much as 2-4 times more if you wait to long.
Some retirees feel that since Medicare isn't available for use overseas, it makes no sense to pay for it, even if it means losing TRICARE. Each person has their reasons for their decisions, and if purchasing local Korean insurances is a better fit for a particular person, good on them.
Yes it's true Medicare is not available for us overseas, however we must keep in mind Medicare isn't designed to work overseas. Medicare is not a global program, it's not even a military program. Medicare is designed to support every American, military or not, living in the US. Our choice to retire and live overseas, is just that, our choice. Our decisions usually come with concessions, one of them being our decision to live outside of the infrastructure Medicare was designed to support us in.
This means not having Medicare as the first payee to pay that 75% of medical bills, with TRICARE paying the remaining 25% if you live in the states. Living overseas, TRICARE is the first payee of that 75%, and the 25% comes out-of-pocket. So, another concession is knowing if I don't purchase Medicare I lose my TRICARE and then end up paying 100% of everything out-of-pocket, or with whatever local insurance I can find.
Bottom line is you pay for Medicare Part B even if you live in the US, so the amount actually in question, the amount to use when comparing with other plans, is that 25% amount.
Food for thought when contemplating not purchasing Medicare Part B
No
Medicare Part B premiums may change from year to year, and the amount can vary depending on your situation. For many people, the premium is automatically deducted from their Social Security benefits.
Using 2021 as an example, the standard monthly Part B premium: $148.50 in 2021.
If your income exceeds a certain amount, your premium could be higher than the standard premium, as there are different premiums for different income levels.
See the charts on the Medicare website for the current Medicare Part B premium.
If you are receiving Social Security, Railroad Retirement Board, or federal retirement benefits, your Part B premium will be deducted directly from your monthly benefit. If not, you will be sent a bill every three months.
The chart below shows the Medicare Part B monthly premium amounts, based on your reported income from two years ago (2019 in this example). These amounts may change each year. A late enrollment penalty may be applicable if you did not sign up for Medicare Part B when you were first eligible. Your monthly premium may be 10% higher for each 12-month period that you were eligible, but didn’t enroll in Part B.
Sure, you can decline, but you will lose all your TRICARE benefits, and if you change your mind later and want Medicare Part B, there will be a heavy penalty to pay as stated in another FAQ.
Unlike living CONUS where you have Medicare as your first payee and TRICARE as your second, which leaves you pretty much without a bill to pay, overseas your TRICARE is first payee... period. You end up paying the 25% TRICARE doesn't pay, because there is no Medicare to use. You must decide at a financial level if saving on the cost of Medicare and losing TRICARE is worth what you might get from Korean insurance.
And if you decide at a later date you want TRICARE back, there is a financial penalty that will make your Medicare Part B fee much higher.
Read about Penalties on the Medicare page.
