". . . renewal is not guaranteed . . ." Look, nothing is guaranteed, neither is your O visa guaranteed. If you plan to be an expat then you have the accept the impermanence and uncertainty inherent in that status. Yes, I am going to plan on my 10 year LTR status. Long stay visas change a lot less than tourist visas.
If Thailand actually does tax worldwide income, like the US already does, then that is what I will deal with. My Social Security is protected by the Dual Tax Treaty. I will remit my work pension to Thailand and it is exempt with the LTR visa. Any work pension left in the US would be a small amount and I will pay the tax, if any, on that small amount.
For health care I have a Thai policy and savings in the US set aside for that purpose.
As for meeting the requirements, the BOI decides, not you. If you want a discussion on that then you are going to have to reveal more information on that.
My federal US Social Security is protected by the Dual Tax treaty. My work pension is not. The portion of my work pension that I bring into Thailand is protected by my LTR. That leaves the portion of my work pension that remains in the US as potentially taxable in Thailand. I would pay Thai tax on that but I wouldn’t pay US tax on that money. It is not going to be a significant tax for me.
My US Social Security is not taxable according the the US-Thai DTA. My work pension is taxable according to my tax advisor. But, as I mentioned previously, I have an LTR visa and the money I bring into Thailand is not taxable.
Some of us are not digital nomads or want to take a Muay Thai class or bounce in and out every 6 six months. And we still don’t know how Immigration is going to treat DTV’s (90 day reports anyone?).
A pensioner LTR is about the same cost as an O and no money in the bank requirements and only 1 year reports. Of course you need the $80,000/year passive income which is why I said “if you qualify”.
If you are under 50 years old and can qualify as a digital nomad and want to put up with the border/immigration requirements then the DTV is a good choice. It is a good addition to the Thai visa options. Maybe for you. Not for me. We all have choices . . .
The Elite visa is so different from the LTR and other visas that it doesn’t belong in the conversation.
I got my LTR before there were any tax rule changes. Taxes were not a consideration in 2022. It turned out to be a side benefit recently. The cost over 10 years is low and the convenience factor is high.
Yes, federal pensions are not taxed depending on the dual tax treaty with your country. If you have any other types of income though then you might have considered the tax implications. For instance I have both a work pension (potentially taxable) and US Social Security (non taxable). I certainly don’t know the OP’s full financial circumstances.
The LTR is still a good visa and I am suggesting it as something to look into. If it doesn’t apply then there are other alternatives.
I’ve heard others say that they have some type of Medicare supplemental insurance that they can use overseas. I don’t know the details myself. I only have Medicare Part A and I can’t use this outside the US.
I used to have an OA visa but I got it in 2017 before there was an insurance requirement. I don’t know what insurance is acceptable when getting an OA in your home country but I highly doubt Medicare or any supplement would qualify. I have Thai insurance, Pacific Cross. They want you to have insurance you can use in Thailand. Eventually you have to get 1 year extensions of your OA and then you will need Thai insurance to do that. To use non-Thai insurance for the 1 year extensions you have to get your insurance company to sign a document that says their policy conforms to the Thai requirements. Mostly I hear that insurance companies will not sign the form.
I would not count on Medicare helping you with regards to meeting any immigration requirements or paying for any medical treatment in Thailand. If you want health insurance in Thailand you need to pay for it yourself or self insure.