On Medicare: Should you keep Medicare when moving overseas?

Dear Toni: My husband and I are enrolled in Medicare with a supplement and Part D prescription coverage, and we will be moving to Italy, then returning to the United States in a few years. I understand that there is no coverage from Medicare for overseas expenses and that we should seek a medical plan in Italy if we have health issues there.

Is there a way to suspend our Medicare coverage while we are overseas and reinstate it without a penalty when we return? It’s a large expense to have to pay Medicare Part B, a supplement and Part D premiums and not be able to use the benefits. If we were to cancel our coverage, what would we have to do when we return to Texas? — Sandy, Houston

Dear Sandy: This is a great question because there are different situations when someone is living overseas.

If you or your husband will be working with employer benefits, then you can delay Part B until you return to the United States without receiving a penalty.

If neither of you will be working full time with group health benefits, then I would advise you both to remain enrolled in Medicare and keep your supplemental plan, because you never know what will happen with your health. If you drop your Medicare supplement and then return to the United States later, you and your husband will be subject to underwriting when you reapply for a new supplement.

I’ve encountered people who moved overseas, stopped their Medicare Part B coverage and then developed serious health issues. Upon returning to the United States, they re-enrolled in Part B only to discover that their penalty goes all the way back to the day they turned 65 — a 10 penalty penalty for each year since age 65 or when their Medicare Part A began.

Let’s say you and your spouse are 75 years old and your Medicare Parts A and B began when you turned 65. When you return to the States and re-enroll in Medicare, that penalty would equate to 10 years times 10 percent — a 100 penalty each month for the rest of your Medicare enrollment.

Sandy, here’s what the Toni Says team would advise you to do when moving overseas:

— Do not disenroll from Medicare because you and your spouse will have to re-enroll and may receive Part B and Part D penalties.

— If you cancel your Medicare supplement and Part D prescription drug plan, then when you return to the U.S. you can reapply for a new supplement, which will involve underwriting questions, and enroll in a stand-alone Part D plan with additional Part D penalties.

— Another option, if you have health issues upon your return and cannot qualify medically for a Medicare supplement, would be to enroll in a Medicare Advantage plan with a Part D prescription drug plan.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.