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To move or not to move ?

Locomotionone

I have been planing for a while to move to Dominican republic this month ,I am a disabled cancer survivor ,I just recently found out if I stay in a foreign country more than 30 days I could lose my benefits,any suggestions ?

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色花堂Rusher

Without knowing more details, it is impossible for anyone to offer any detailed advice.聽 However, I'll try to provide a general overview of medical care options that are available to US Military disabled veterans and US Military retirees.聽 Other options will have to be provided by other expats in the forum.


Medical insurance is a very real concern, no matter where you live.聽 You are wise to investigate this before your move.聽

  1. Only YOU can determine what your insurance covers, or not.聽
  2. However, you say you "could" lose your health insurance.聽 Is it "could" lose coverage, or is it more accurately "will definitely" lose your coverage?聽


If you're a retired US military type, TRICARE for LIfe or TRICARE WILL cover you anywhere overseas, except for a few countries that you should check out on their websites.聽 However, that TRICARE coverage is subject to the standard deductible limits, and you'll probably need to PAY UPFRONT for medical services and then FILE your TRICARE claims for reimbursement.聽 I believe they normally cover 25% of approved medical services.聽


If you're a disabled US Military veteran, you may qualify for coverage of your "VA-rated" service-connected disabilities/issues.聽

  1. You must ALREADY have a VA disability rating for something for this to apply, and if you only are rated for, say, a bad knee, then that is the only thing the clinics can treat you for.聽
  2. The DR has several clinics in multiple areas that operate in conjunction with the VA's Foreign Medical Program (FMP), which you must sign up for.聽 I'm personally aware of one such clinic on the main drag in Punta Cana Village, although the name escapes me at the moment.


I haven't utilized the VA FMP avenue in the DR, yet, but they have very nice clinics and seem like classy operations.


My wife and I HAVE utilized the TRICARE reimbursement for medical costs overseas, both in Panama and the DR.聽 The process is a little cumbersome, but it DOES WORK and we did receive reimbursements (at 75% level) about six weeks.聽

  1. We had no problems getting our reimbursements from TRICARE.聽 聽We got the forms online, filled them in, sent them away and eventually got paid.
  2. However, I've read posts from military retirees who received medical care out in the hinterlands (away from Panama City in Panama, or Santo Domingo/Punta Cana/Santiago in the DR) that had issues.聽 The problem seems to be that the hinterland hospitals/doctors/etc. either don't use or used different-from-US-standard "medical codes" for your treatment -- and this causes HUGE problems.聽
  3. TRICARE simply won't reimburse unless the medical codes make sense to them, in their US-treatment mindset.聽
  4. Sometimes you can get this fixed by persuading the providing healthcare facility or provider to change the "correct" medical codes.聽 Sometimes, they won't.聽 You have no way of forcing them to do it.
  5. You should keep in mind that TRICARE DOESN'T cover every procedure in the world.聽 Or, they may not cover certain treatments if you have certain pre-existing conditions, such as cancer (this has impacted me) or heart problems.聽 IT IS UP TO YOU TO DETERMINE COVERAGE BEFORE YOU RECEIVE TREATMENT.聽


Okay -- that's enough for a top-level view of like coverage available to military retirees and/or disabled veterans.聽


Best of luck in figuring it out.聽 I hope it all works out for you.


Jim

色花堂Rusher

planner

Great post and info assuming the poster is a disabled vet.


We need more info here!聽 What benefits do you think are at risk?聽 The more specifics we have the more we can help.

wondering9

The answer will聽 vary depending on the specific benefit and which country you are coming from.

If you are coming from the United States, then for sure

(1) you will not lose Social Security

(2) you will not be able to use Medicare outside of the US at all (but you may want to keep paying for it anyway, because they charge extra if you stop it and then start it up again later).


I say "for sure" but to be safe you should check directly with the agencies that handle the benefits you're worried about -- or with a disability lawyer. Everybody's case is different, and you definitely don't want any surprises!


The rest of this post is about places you could go for reliable information.


One reason to get advice from a lawyer is that with all the US federal layoffs, it can be even harder now to get the help and information you need directly from the agency. Employees are trying really hard to step up IMO, but sometimes seem a bit overwhelmed. If money is an issue you might be able to get the advice you need -- at least the"yes/no" on "will I be able to keep X benefit"? -- from a legal aid program; also, state bar associations often have a program where lawyers give one very affordable introductory session. Elder aid or disability aid programs might also be able to point you to someone who can help you figure it out (though they may not be used to questions that involve other countries).


Again, you should check separately for every benefit you're concerned about, because the rules can be different for each.


Social Security can be especially hard to get ahold of (I've had phone waits of >3 hours, and that was before the layoffs started!) -- and I didn't find their level-1 help-desk people very well informed on questions that involved other countries -- so that can get frustrating. A helpful forum member here has suggested in the past that the Miami office might be more experienced with international issues.


Regarding Medicare, there is a large organization of well-trained volunteers who help people figure out benefits (google SHINE + Medicare + your state name). If the benefit is health-related, even if it is not Medicare per se, they might know who you should contact.


Even your local librarian might have some good ideas on how to look up the answers you need.


If you can give specifics, such as your country and the specific benefits, people might be able to give more specific answers.


There is a lot of misinformation floating around online so be careful what sources you trust!


Good luck.

Locomotionone

@色花堂Rusher

Thanks for response but I am not ex military I'm just on disability and my health insurance is a part of that this is crazy because on my income it is very hard to afford a place here but I had found several places there in my range also want to get better quality of food 馃う馃従鈥嶁檪锔

planner

Be careful of anything you see online. You need someone to confirm by actually going and seeing the places.

snowinpalm

@Locomotionone

Hi.聽 What kind of benefits are you receiving? Am also a cancer survivor and recipient of a double hip replacement.聽 No difficulties living here.

Locomotionone

Ssi disability do to the diabetics I got after chemo and really bad neuropathy ,not being able to do my old electrical maint job

Tippj

@Locomotionone

Are yer sure it SSI or SSDI , there鈥檚 a big difference as far as losing benefits , check your status , I thought

the same

wondering9

SSI or SSDI , there鈥檚 a big difference as far as losing benefits - @Tippj

Social Security has a brochure about this here:

ddmcghee

@Tippj

Exactly - SSDI will usually continue, but SSI does not if you are outside the US for more than 30 days.

planner

You also need to factor in your costs of health care. Depending on your age, you may not qualify for much. If under聽 65 you have options but all pre existing conditions will not be included.聽 Medications here are much less expensive then in the USA but you need to factor them in.