Spanish Medical Providers
Oct 21st, 2017, 02:31 AM
#41
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IMDonehere,
It is in the financial interests of the British government to pay Spanish providers to meet the health care needs of UK pensioners in Spain, since the cost of medical care in Spain is probably 2/3 or less than what it is in the UK. While it may be the case the UK pensioners contribute to the local Spanish economy and pay real estate or income taxes, it's not clear the Spanish economy gains enough to offset the high costs of providing medical in the last 20 years of life, and the financial blow to the UK of so many pensioners in need of serious medical care returning to the UK make it more in the UK's interest than the Spanish interest to keep the pensioners in Spain.
Nonconformist,
Some version of that seems to be where the negotiations presently sit, but with the twist that British pensioners will probably be required to buy into a separate British health insurance scheme, rather than having UK taxpayers at large foot the entire bill for health care of nationals living abroad. But nobody really know what the present British government is doing. It seems to be imagining all kinds of options that the EU is telling them no longer exist if they are unwilling to actually be in the EU.
It is in the financial interests of the British government to pay Spanish providers to meet the health care needs of UK pensioners in Spain, since the cost of medical care in Spain is probably 2/3 or less than what it is in the UK. While it may be the case the UK pensioners contribute to the local Spanish economy and pay real estate or income taxes, it's not clear the Spanish economy gains enough to offset the high costs of providing medical in the last 20 years of life, and the financial blow to the UK of so many pensioners in need of serious medical care returning to the UK make it more in the UK's interest than the Spanish interest to keep the pensioners in Spain.
Nonconformist,
Some version of that seems to be where the negotiations presently sit, but with the twist that British pensioners will probably be required to buy into a separate British health insurance scheme, rather than having UK taxpayers at large foot the entire bill for health care of nationals living abroad. But nobody really know what the present British government is doing. It seems to be imagining all kinds of options that the EU is telling them no longer exist if they are unwilling to actually be in the EU.
Oct 21st, 2017, 02:35 AM
#42
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By the way, a great many UK pensioners have retired to Catalonia, and while it is far from clear that the independence movement there will succeed, what the status of UK pensioners would be in an independent Catalonia -- in particular who pays for their health care -- seems even more unclear than the present situation regarding Brexit.
Oct 21st, 2017, 03:59 AM
#43
Massimop. I am waiting to see what Brexit does to all these UK citizens living in EU countries. We know a lot that live in Spain.
My one freind is attached to the US Embassy and she went on and on about their healthcare. She has to pay for scrips but was amazed at the price. Her husband has heart problems and she can't get over how well they are treated and the care they have received. She doesn't want to leave ever now.
My one freind is attached to the US Embassy and she went on and on about their healthcare. She has to pay for scrips but was amazed at the price. Her husband has heart problems and she can't get over how well they are treated and the care they have received. She doesn't want to leave ever now.
Oct 21st, 2017, 04:12 AM
#44
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My SIL contacted a number of Spanish healthcare companies and she will not be covered. The Spanish consulate will not accept healthcare with exclusions.
End of story.
Thanks for everyone's help.
End of story.
Thanks for everyone's help.
Oct 21st, 2017, 08:03 AM
#45
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I'm so sorry that she hit what looks to be a dead end.
Just for my own knowledge, how is a pre-existing condition defined? If someone has high cholesterol, would that be a pre-existing condition that would predispose someone for cardiac problems? Happily, I've never been a situation where any conditions disqualified me for insurance, but I do wonder...after a certain age, don't most people have some kind of "condition" that might necessitate medical care in the future?
Just for my own knowledge, how is a pre-existing condition defined? If someone has high cholesterol, would that be a pre-existing condition that would predispose someone for cardiac problems? Happily, I've never been a situation where any conditions disqualified me for insurance, but I do wonder...after a certain age, don't most people have some kind of "condition" that might necessitate medical care in the future?
Oct 21st, 2017, 10:51 AM
#49
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ekscrunchy, I do consulting to and deal with various insurers in the US and of course the term "pre-existing condition" can be anything that you are already being treated for or have had an occurrence of. This can range from fairly routine and minor (as you noted, many older folks may take statins or high blood pressure medication or a thyroid hormone) to more serious. Diabetes is more serious, as well as having has cancer, asthma, a heart attack or stent put it, let alone Crohns disease or something like that, an immune deficiency, AIDs, epilepsy, serious mental health issues, anorexia, lupus, arthritis, MS, a stroke, Parkinsons, etc.
In the US right now, you cannot be denied coverage due to that nor charged more due to the ACA, but in the old days you could, but most insurers I know would not refuse to write insurance policies just because someone was taking a statin, if they had never had a heart attack or stent put in, etc. In fact, I have never heard of an insurer doing that if that were the only problem you have (back in the old days), denying coverage just because you were taking a statin.
I do not think that was the issue here given what IMDonehere has said, that she was denied insurance just because of that.
In the US right now, you cannot be denied coverage due to that nor charged more due to the ACA, but in the old days you could, but most insurers I know would not refuse to write insurance policies just because someone was taking a statin, if they had never had a heart attack or stent put in, etc. In fact, I have never heard of an insurer doing that if that were the only problem you have (back in the old days), denying coverage just because you were taking a statin.
I do not think that was the issue here given what IMDonehere has said, that she was denied insurance just because of that.
Oct 21st, 2017, 11:22 AM
#50
Unfortunately, the pre-existing condition coverage mandated by the ACA does not apply to people over 65. While you cannot be refused for Medicare, if you wnat a Medigap supplement plan and do not sign up in the initial period, you can be denied coverage. Not sure whether this is also true for Medicare Advantage, but would expect so.
Oct 21st, 2017, 10:24 PM
#51
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It is a real pain when things do get to a false stop. No movement what so ever.
I also do not understand what Brexit has to do with this situation.
None of those who have commented about various tax and health care rules presently live in Spain thus they do not understand fully what is going on.
I am not willing to go into all the ins and outs, but in the past Spain was not applying it's own regulations regarding movement of people. Now they are "harder" and keeping more inline with that.
I have been doing some looking around for you (SIL) a lot of forums about moving to Spain are aimed at other Europeans.
This one is not necessarily so and I found this argument about health care.
It does not help this situation, but it suggests the situation is not so easy.
http://www.expat.com/forum/viewtopic.php?id=589321
There has been an up take in Americans wanting to live in Europe since that election. There must be some way of taking that step.
I also do not understand what Brexit has to do with this situation.
None of those who have commented about various tax and health care rules presently live in Spain thus they do not understand fully what is going on.
I am not willing to go into all the ins and outs, but in the past Spain was not applying it's own regulations regarding movement of people. Now they are "harder" and keeping more inline with that.
I have been doing some looking around for you (SIL) a lot of forums about moving to Spain are aimed at other Europeans.
This one is not necessarily so and I found this argument about health care.
It does not help this situation, but it suggests the situation is not so easy.
http://www.expat.com/forum/viewtopic.php?id=589321
There has been an up take in Americans wanting to live in Europe since that election. There must be some way of taking that step.
Oct 22nd, 2017, 12:21 AM
#52
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So as it stands now, can the SIL not live in Spain legally even if she agrees to pay her own medical costs, either with private Spanish doctors or by leaving the country and seeking care elsewhere?
How do these rich celebrity types move from country to country even when they are elderly? Or even non-celebrity but very rich people??
If Dustin Hoffman wants to pick up and move to Spain, for example, would he be prohibited from doing so legally if he had a pre-existing condition, or is there a work-around if one has lots of cash?
What percentage of persons over 65 have NO pre-existing conditions? My guess is that the percentage would be in the single digits, no? I know I sound very uneducated about all this but this thread has been an eye opener for me..
I think many Americans (me, included) labor(ed) under a fantasy that they can just pick up and move to Europe if and when they can afford to do so, without any limitations...
How do these rich celebrity types move from country to country even when they are elderly? Or even non-celebrity but very rich people??
If Dustin Hoffman wants to pick up and move to Spain, for example, would he be prohibited from doing so legally if he had a pre-existing condition, or is there a work-around if one has lots of cash?
What percentage of persons over 65 have NO pre-existing conditions? My guess is that the percentage would be in the single digits, no? I know I sound very uneducated about all this but this thread has been an eye opener for me..
I think many Americans (me, included) labor(ed) under a fantasy that they can just pick up and move to Europe if and when they can afford to do so, without any limitations...
Oct 22nd, 2017, 12:48 AM
#53
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You need to prove you have health insurance that will pay your foreign medical bills if you want permission to stay long term in a country with a publicly-funded health system. You cannot obtain a visa to enter and stay without documented proof of a valid insurance policy.
Some countries allow long-term residents to buy into the national health service, paying yearly premiums. You can also buy private insurance in America that will cover you abroad no matter how old you are and no matter how many pre-existing conditions you have, but the premiums/monthly payments get higher and higher the older you are, and if you want pre-existing conditions covered, you must pay for it. (Obamacare will not pay for foreign care -- which is actually not cost-effective for the American taxpayer).
I don't know how much money Dustin Hoffman has, but it's possible paying $2,500 per month in health insurance premiums would not be a dealbreaker for him if he wanted to live in Spain long-term. So yes, there is a "work-around" if you have enough money.
Some countries allow long-term residents to buy into the national health service, paying yearly premiums. You can also buy private insurance in America that will cover you abroad no matter how old you are and no matter how many pre-existing conditions you have, but the premiums/monthly payments get higher and higher the older you are, and if you want pre-existing conditions covered, you must pay for it. (Obamacare will not pay for foreign care -- which is actually not cost-effective for the American taxpayer).
I don't know how much money Dustin Hoffman has, but it's possible paying $2,500 per month in health insurance premiums would not be a dealbreaker for him if he wanted to live in Spain long-term. So yes, there is a "work-around" if you have enough money.
Oct 22nd, 2017, 01:35 AM
#54
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Just to add: Most people do not have pre-existing conditions that would require premiums of $2500 per month. The OP posted this his SIL was quoted that amount by an insurance company, but if you read the link that ribieraacra posted, you will see discussion of cost of private insurance premiums for those with pre-existing conditions was about $3000 per year, which is less than $300 per month.
Some people would not find those premiums unaffordable. In fact, many Americans, before reaching age 65 paid several thousand a year for health insurance. So even if they are not Dustin Hoffman they might not find it unaffordable to continue to pay that amount for health insurance, especially if they move to a country where prescription drugs are cheaper along with other out-of-pocket expenses for dental care & basic needs.
Some people would not find those premiums unaffordable. In fact, many Americans, before reaching age 65 paid several thousand a year for health insurance. So even if they are not Dustin Hoffman they might not find it unaffordable to continue to pay that amount for health insurance, especially if they move to a country where prescription drugs are cheaper along with other out-of-pocket expenses for dental care & basic needs.
Oct 22nd, 2017, 01:52 AM
#55
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Clarification, so no one is misled:
The cost of a private insurance plan for an individual with a pre-existing condition is determined by individual insurers, so I am not saying that anybody can get private insurance for $3000 per year. What I was trying to say is that some people would do a cost-benefit analysis of the per diem cost of private health insurance and make their own calculus about whether living abroad was worth the premium.
$3000 per year is less than $300 per month and thus less than $10 per day. Some people would find that both affordable and attractive if living in Europe is their dream.
However, one also needs to be clear about the costs of tax obligations & other expenses one might not face living in the US. In the end, it's very much a question of trade-offs. Some people can find a way to make the trade-offs work within a budget (i.e., they offset the higher costs of health care & taxes by living with cheaper rent & other economizing in shopping, etc) while other people just pay the extra costs as an investment in personal happiness, safety, etc.
The cost of a private insurance plan for an individual with a pre-existing condition is determined by individual insurers, so I am not saying that anybody can get private insurance for $3000 per year. What I was trying to say is that some people would do a cost-benefit analysis of the per diem cost of private health insurance and make their own calculus about whether living abroad was worth the premium.
$3000 per year is less than $300 per month and thus less than $10 per day. Some people would find that both affordable and attractive if living in Europe is their dream.
However, one also needs to be clear about the costs of tax obligations & other expenses one might not face living in the US. In the end, it's very much a question of trade-offs. Some people can find a way to make the trade-offs work within a budget (i.e., they offset the higher costs of health care & taxes by living with cheaper rent & other economizing in shopping, etc) while other people just pay the extra costs as an investment in personal happiness, safety, etc.
Oct 22nd, 2017, 07:24 AM
#59
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Yes, you mentioned that above. Every individual case is different depending on age, overall health issues & destination.
Missionaries and academics often go abroad for longer periods of time than tourist travel insurance will cover and they purchase private health insurance (probably most often from US-based insurance companies like Blue Shield, etc.) Whether it's possible for individual travelers to obtain such coverage at prices they can afford -- again, that depends on the individual's circumstances
Missionaries and academics often go abroad for longer periods of time than tourist travel insurance will cover and they purchase private health insurance (probably most often from US-based insurance companies like Blue Shield, etc.) Whether it's possible for individual travelers to obtain such coverage at prices they can afford -- again, that depends on the individual's circumstances
Oct 22nd, 2017, 07:57 AM
#60
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