Which state?

You are not obligated to pay tax in any state in which you are not a tax resident. Somewhere your state tax board lists the criteria they consider when determining whether you are tax resident. If you have a home and/or business in the state then you are very likely a tax resident.

I stopped paying California taxes in 2019. This year the CA Franchise Tax Board sent me a letter saying that they noticed that I had not filed CA taxes in 2019 and that they estimated that I owed them $6,000. I sent them a copy of my Thai drivers license, My Thai pink ID card, and a copy of my passport showing that I had not been in the US more than a few weeks in the past 4 years. They sent me another letter saying they no longer considered me a tax resident.

I'm not sure if you consider yourself to have left that state but that is my recent experience.

@Greg *******

I was expecting the worst and was pleasantly surprised.

Long term visas are cheaper. That’s about it . . .

@Roger ******

If you have some kind of private Medicare supplement then it is likely they will cover you on a reimbursement basis.

There is no simple answer to insurance costs. It will depend on your age, health status, amount of coverage, and the deductible.

I am 68 and my policy costs about $2,300 per year with $300,000 coverage and a $1,200 deductible. This is probably excessive coverage considering costs in Thailand.

@Tomasz *******

I have Pacific Cross. Their website is very good for showing their range of plans and deductibles and estimated costs. They have great customer service but I’ve never made a claim so I can’t comment on that.

I’m aware that there are international insurance plans out there because there are plenty of people that have worked internationally all their lives.

One thing for sure is that whenever a particular company is mentioned you will hear from people that like that company or hate that company. Insurance is a triggering topic for many people.

Look for a policy with a large(ish) deductible. This will lower the cost. Pay for routine care out of pocket. Get enough coverage for a catastrophic event.

I’ve been here 7 years. My policy has a 40,000 baht deductible. The highest medical bill I ever had was 20,000 baht and that was once earlier this year.

@David *************

I came on an OA in 2017. They added a health insurance requirement to this visa in 2019 so most people avoid it these days. Once you start doing 1 year extensions it is no different than the O visa except for the insurance requirement.

@Roger ******

Medicare cannot be used overseas. I didn’t even sign up for Part B.

I have Thai health insurance and savings to use for any medical expenses not covered by my insurance (pre-existing conditions). Also healthcare here is very good and very inexpensive so some degree of self insurance makes sense here when it doesn’t make sense in the US.

@Roger ******

Once every year or two US Social Security sends me a letter to verify my address and ask if my eligibility has changed. Social Security has my address as being my Thai address but my SS benefit is deposited to a US bank. I don’t know it they do this to SS recipients in the US. If you don’t return the letter then they will suspend your SS benefit deposits to your bank. You can reinstate your benefits but you have to contact Social Security and the process could take months.

I had moved from Bangkok to Sisaket province two years ago. When I got the letter it said that it was their second attempt to contact me. I returned the form using Express Mail Service and never saw an interruption of my benefits.

@Paul ******

On the flip side, I become a tax resident by living in Thailand more than 180 days. It didn’t matter before but this year it does due to some new interpretations of the tax rules. The US and Thailand have a tax treaty the prevents double taxation but exactly how this is going to play out is still not known.