# Cancel Medicare?



## JCheeverLoophole

Now that we have French health insurance and we are about to sign up for a mutuelle (top-up insurance), I am thinking of canceling Medicare. I contacted them to ask about the penalty "that may be applied" when signing back up again in the event of returning to the US. This is the response from the Medicare chat line:

Me: How is it decided whether or not the penalty is applied? 
Medicare: If you decline coverage and you don't have creditable coverage outside of Medicare.

Does anyone have any advice here?


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## jweihl

I honestly can't wait for medicare to kick in (three more years), so that I don't have to worry about taking out travel health insurance when visiting the US. My understanding is that the french system and my mutuelle will only reimburse up to what they would in France (if anything), which for a US hospital bill would be nothing. So, I'll at least be keeping Part A as there won't be a premium for that. My guess is we'll take a look at the premium for Part B, and if it's not too expensive, pay for that too.


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## 255

@JCheeverLoophole -- This is, of course, a personal decision. In order to avoid the penalty (10% additional premium per year,) you need to have "Credible Coverage," essentially coverage that mirrors the benefits provided by Medicare Part B (or Part D, if applicable.) In the U.S. a "Notice of Credible Coverage" is routinely provided to employees still working and over 65 for large companies (over 20 employees,) governments and private "group" plans. This subject has come up, in the past, and the combination of French health cover and a supplemental plan should serve -- but I don't remember a case where a member has "reported back" success in avoiding the penalty. I believe you have eight months to restart after loosing your French cover. Since you won't have a "Notice of Credible Coverage," it would be on you, to make your own case to Medicare to avoid the penalty.

I know a lot of folks, in Mexico, maintain Medicare, "just in case," since insurance coverage for those 70+ is cost prohibitive there. They go "naked" and routinely keep a medical emergency fund for emergencies. Medicare Part B is only $170.10, for the lowest income tranche -- so pretty cheap. A lot of permanent travelers maintain the coverage, so they have heath care when they return home to visit family.

If you plan to renounce and never return to the U.S., why keep it? On the flip side, I know a couple in their late 80s that returned to the U.S. after over 50 years in France (I do not know when they signed up for Medicare) -- it was significantly cheaper back then.) They had never envisioned ever moving back, but when one got sick -- their children persuaded them to return to the States. As an aside, when the sick husband died, the widow moved back to France!

I'd suggest comparing your French Health Cover plus your supplemental plan with what Medicare Part B provides -- perhaps in a spreadsheet. You might try to get an advance "opinion" and if not convince yourself of the equivalence. You might also want to "play with the numbers." Basically, a 10 year absence would be double the fee, if you fail in your appeal. Also, consider your Stateside travel plans, to visit children/grandchildren, siblings, etc. How significant is it in your budget? Can you afford a more expensive payment, if you return? Just consider some contingency planning.

I'm not in France yet, we've got one and a butt years before our move -- but we are planning on maintaining Medicare Part B and do not currently plan to return to the U.S. permanently.. Cheers, 255


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## Bevdeforges

Just one further factor "for your consideration" (in the words of Rod Serling). Don't forget that Medicare does you absolutely NO good unless you are in the US. There is a very limited "border area" in Canada and another in Mexico where you could use your Medicare cover if you were to be taken in an emergency situation and a hospital in that area was the nearest available facility. But otherwise, to use your Medicare cover while resident outside the US you would have to be in the US (on a visit) or travel to the US to receive medical treatment.

That said, some folks do retain their Medicare cover precisely in order to do that - get treated in the US rather than getting treatment in France. Just remember that, in an urgent situation you might not be able to return back to the States or you may required medivac services in order to do so. 

If you will be travelling regularly back to the US, retaining your US Medicare could be worth your while. If you'll be using your Medicare coverage only on occasional "visits" back to the US, you may first want to consider travel cover for just the dates of your visits. If you are only back in the States for a few weeks a year, this might be adequate, though travel cover gets more expensive the older you are. And some insurers won't insure anyone for travel cover after the age of 65, 70 or 80.


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## Chrissippus

I have been retired in Thailand for 10+ years and maintain Medicare Part B, because I could never be sure that I wouldn't find it necessary to return to the US at some point in the future. After the move to France and if we like it there, maybe after five years we would become French citizens with a permanent right to live there and then I would drop Part B.


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