Answered2 years ago
How does US Medicare Advantage coverage work for medical expenses incurred in Thailand?
In telling of my experience, others will learn some valuable information. Unfortunately, this information will not help some of the audience here.
I have a US passport, 68 yo, United Healthcare Medicare Advantage plan, no Thailand Health Insurance, Non-O marriage visa, live in Ratchaburi for 6 months each year.
Starting in mid-December I contracted a medical condition that sent me to the ER 5 times. 3 visits to Bangkok Hospital Ratchaburi, 1 visit to Ratchaburi Hospital and 1 visit to Bamrumgrad Hospital.
All of the claims that I submitted electronically to my US health insurance were paid. Some were reimbursed 100% and others around 80%.
Most US Medicare Advantage plans will reimburse you if you are overseas, except Puerto Rico and a few other exceptions. Care on a cruise ship is covered the same way. You are not covered if you are outside the US for longer than 6 months in that year.
I researched this in July 2024 and used it in December 2024 and January 2025.
I have a US passport, 68 yo, United Healthcare Medicare Advantage plan, no Thailand Health Insurance, Non-O marriage visa, live in Ratchaburi for 6 months each year.
Starting in mid-December I contracted a medical condition that sent me to the ER 5 times. 3 visits to Bangkok Hospital Ratchaburi, 1 visit to Ratchaburi Hospital and 1 visit to Bamrumgrad Hospital.
All of the claims that I submitted electronically to my US health insurance were paid. Some were reimbursed 100% and others around 80%.
Most US Medicare Advantage plans will reimburse you if you are overseas, except Puerto Rico and a few other exceptions. Care on a cruise ship is covered the same way. You are not covered if you are outside the US for longer than 6 months in that year.
I researched this in July 2024 and used it in December 2024 and January 2025.
Answer summary
The author shares their experience using a US Medicare Advantage plan while living in Thailand on a Non-O marriage visa. They provide details about multiple ER visits and hospital claims in Thailand, noting that while some reimbursements were full, others were partial. The conversation highlights concerns about coverage limitations for US citizens abroad, with several comments discussing various aspects of health insurance for expats, including the potential risks of exceeding the allowed time outside the US and the quality of care in Thai hospitals.
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Terary **********
"You are not covered if you are outside the US for longer than 6 months in that year"
How do you get around that part? My US job provides insurance which I think is 100% useless to me. Currently, if I take ill and need serious medical help, I will have to travel back to the US and pretend I got ill there.
How do you get around that part? My US job provides insurance which I think is 100% useless to me. Currently, if I take ill and need serious medical help, I will have to travel back to the US and pretend I got ill there.
Matthew *********
@John ********
that is great advice many will be on plan B and like you so many Americans escape winter. This great information. And for me and other veterans Bangkok hospital knows how to fill out the foreign medical form and submit to VA. The VA pays if it service connected or of 100 percent disabled. I wish someone had told me this last year
David *****
I’m honestly shocked they paid at all. I wonder if they’ll come back later and ask the refund from you. United doesn’t want to pay claims for visits to hospitals in the US that they’re in network with let alone visits outside the country. But otherwise, good for you.
John *********
OP@David ****
I read the “Terms and Conditions”. I am not shocked that they paid because they established the rules. They won’t ask for a refund because I am following the rules set forth by the insurance company. The difference is that I actually read the fine print.
Joseph *******
Good read. Regarding your “how would they know” comment, I believe anyone trying to skirt the 180-day rule would be committing insurance fraud which is a felony.
John *********
OP@Joseph ******
thankfully, I am not committing insurance fraud.Kevin **********
Thanks for sharing. I have Medicare traditional. I will have to check if it covers me while in Thailand over the winter.
John *********
OP@Kevin *********
you need to do your own research. For me the research was worth a few thousand dollars.
Dave *********
@Kevin *********
what he is saying is he has Medicare with an advantage planKevin **********
@Tony *********
thanksTony **********
@Kevin *********
it does notJohn *********
OP@Tony *********
United Healthcare Medicare advantage plan covers me worldwide. In my case, I paid the Thai hospitals when leaving the hospital. A few days later I submitted my online reimbursement claim. About 3 - 4 weeks later, the reimbursement check arrived in the mail at my US home. November to January for the hospital visits and all have been reimbursed to me as of February 11th.Tony **********
@John ********
Medicare will not cover any hospitals outside the USA except under a very few specific situations. The nearest coverage from Thailand is Guam.Tony **********
@John ********
maybe, have to check your policy for restrictions on it if country coverage. Some don't offer it and others require t you too pay and they reimburse if they approve.John *********
OP@Tony *********
You are correct. So in that case, a Medicare advantage plan would be better for US citizens that travel abroad.
Andy *********
Looking at the different plans, all the ones offered (to me) show a lifetime $50k coverage for 'emergency' medical services out of country.
Randall *******
Thank you for the information. I am researching thai health care now, for a living situation I hope will be similar to yours.
John *********
OP@Randall ******
happy to give you some insight.
Michael ***********
Did u submit your claims when you got back? Did u pay up front and then submit?
Looking to do the same as you have. I have been married to a Thai lady for 35 years, retiring this year, spending the winter in Thailand.
Looking to do the same as you have. I have been married to a Thai lady for 35 years, retiring this year, spending the winter in Thailand.
John *********
OP@Michael **********
I paid the hospital at the end of each hospital visit. I submitted my claims a few days after leaving the hospital while still in Thailand. I got paid by the my Medicare advantage plan while still in Thailand. They sent a check to my US residence and my daughter deposited it in my checking account for me. I have been married to my Thai wife for 38 years and we have been spending the 6 cold months in Thailand for 3 years.Michael ***********
@John ********
thank you. I will need to call my carrier.
Wylie *******
I believe the vast majority of plans will only cover for 30 to 180 days of consecutive travel outside of the covered area, with 90 days being the most common. You're playing with fire counting on it.
Todd **********
@Wylie ******
Who cares, if you live permantly in Thailand it doesn’t matter!! 🖕🏼the US and there govtJohn *********
OP@Wylie ******
I stated quite clearly what my research has found. Not speculation or guesswork. I actually read the “Terms and Conditions”. My Medicare advantage plan will cover me for up to 6 months outside the US. I’m not playing with fire, I am following the rules. The difference is that I know the rules because I did the research. I live in Thailand with my Thai wife to avoid the cold 6 months in the US.
Wylie *******
@John ********
No need to be so defensive when I was only trying point out some of the fine print that so many who think they did their research always seem to miss.Matthew *********
You paid taxes and pay for the plan during your life time, shouldn't matter if outside the country. In reality your doing them a favor by using better doctors and a fraction of the cost. I would take those 2 hospitals over 99 percent of the hospitals in the united states. Top hospital in Dallas, southwest medical is one of the top hospital and couldn't properly identify a brain tumor. Bangkok hospital caught on the first try in under a couple hours. I am thankful that I'm covered for foreign medical thru the VA
Lam ************
@Matthew ********
.US insurance company should very happy to have you get medical treatment oversea .. save the tons of cost if take place in US .Tony **********
They're going to eventually figure out that you're not really residing in USA and may demand back payment. I Believe if you read the policy, the coverage is for temporary travel like travel insurance.
John *********
OP@Tony *********
I live in the US from May to October. I am a US citizen, US resident, US homeowner and US taxpayer. I live in Thailand from November to April in my home in my Thai wife’s village. The insurance company determines the rules, I comply with the rules.
Nongnuch ********
@Tony *********
I remember having read reports that somebody had to show flight tickets to prove his time outside of the U.S. . . I guess this is very rare, probably only raised when in doubtJohn *********
OP@Nongnuch *******
that was not a question to answer on the claim reimbursement form.Activity
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