Handling Medicare for Expats from the United States

    10/25/23  Every US Medicare-eligible expat has ongoing decisions to make about maintaining coverage or not while living overseas.  I found this article a good brief summary and evaluation of the issues:
https://creativeplanning.com/internatio … -s-expats/

As a reminder, Social Security/Medicare questions for US expats in Brazil are handled by the Federal Benefits Unit (FBU) at the US Embassy in Lisbon, Portugal.  They're very responsive, and have special phone hours for Brazil residents.  Here's their contact info:

https://pt.usembassy.gov/u-s-citizen-se … -security/-@abthree

What you pay for maintain Part B is almost the equivalent to foot the cost of medical insurance here. 

I do not recommend you qualify for SUS ( Single Payer Health Care in Brazil ), as delivered quality might not be up to standards, depending upon where you are.  And it gets worse if you are to live in one of those beach side communities. 

Start thinking about purchasing coverage..

And remember folks, Medicare and Social Security are not rights guaranteed by  Constitutional Law. They are entitlements. They came upon being during FDR's New Deal.  Before then, it was everyone on their own .

In accounting parlance, Entitlements are classified under Unfunded Liabilities . Which is odd, if you think about your years paying for Social Security and Medicare through payroll deductions.   

What most Americans are unaware of is... The entire lump sum of these deductions are invested into US Debt Securities, such as Notes, Bills, and Bonds.   In  short, they take your contributions and syphoned into Government I.O.U.s     Which is fine for as long as the US Government makes good on its issued debt obligations ( they are often rolled into a new one ).

If you ever hear specialists on Entitlement Programs funding, they will all agree that your Social Security stash is fully funded , currently at about 100%, with some forecast to a slight  decline in the coming years.  Its funding levels only take second place to the US Postal Service Retirement Fund, which, by law, is supposed to maintain funding levels at 200% of projected disbursements ( not sure on 200%, but it is pretty high ).

Another fact to weigh in , and worthy of  consideration, is that the estimated sum between Social Security and Medicare entitlements, at present value, and to be disbursed over the next 30 years is somewhere north of USD 100 Trillion . This is not much of an heralded fact, as the US Government does not follow Standardized GAAP Accounting procedures, so this amount is hidden under the rug. 

So everyone talks about the 34 Trillion Dollar Debt,, year to year surplus deficits, but no one pays attention the the 800 pound gorilla in the room. 

You are looking at a third of the US annual Federal Budget, alone on Medicare and Social Security Disbursements to the largest retirement generation in years, Baby Boomers. 

All of this to arrive at the conclusion that, over time, your entitlement benefits will get diluted. So embrace your new reality, and focus on getting value medical care coverage, whenever it might be.