International Health Coverage

I am recently retired, looking to select a health plan that will work for my wife and I. Both of us have selected Medicare A and B. The past 10 years we have had our health plan with Kaiser. However my wife is from UK London, plus we own a house in Canada so this will allow us to travel and spend time overseas. Our total retirement income will be $110,000. What health plan would you recommend?

Kaiser (and any other plan) will cover you for emergency care anywhere in the world. Assuming that your trips are relatively short—weeks not months—and that neither of you requires something like daily physical therapy, there is no reason to change health plans if you are satisfied with Kaiser. It is an excellent buy. If, on the other hand, your trips are relatively long and you will need routine medical care while abroad, you should consider Blue Cross Basic, GEHA Standard, and, if you are eligible, Foreign Service. Read the "overseas" section in the Blue Cross Brochure. BCBS Basic is a much better buy in your situation than BCBS Standard. Another angle may be whether you both can be covered by the British health system while in London. Finally, there is the "pop back" from Canada to the DC area where you could use Kaiser for your routine care.

I am planning to retire abroad. Which plan would cover me best?

Four of the plans have extensive preferred provider networks worldwide, or give you preferred provider rates abroad. These are Blue Cross Standard, Blue Cross Basic (which covers out of network care abroad), Compass Rose (if you are eligible), and Foreign Service (if you are eligible). You should look at those brochures. You should also contact Americans living abroad wherever you are planning to go to see what they do and what they recommend. For example, in many countries paying cash is inexpensive and in many others there are national health plans that would cover you at low or no cost as a legal resident. But details vary immensely from place to place. Some FEHB plans may work better in country X than others. The local expats will know all these answers. Finally, all FEHB plans will cover emergency care abroad, but that is not the same as routine or extended care.

I will be starting work with the Department of State as a Foreign Service Officer in January. Since my family and I will be abroad about 2/3 of my career, should we just forget using an HMO?

You are the classic case of a family that needs to be in a broad PPO/FEE plan, though in the periods you are in the U.S. there may be a year here or there when you could switch to an HMO. There are four plans you should consider: Blue Cross Basic, Foreign Service, Blue Cross Standard, and Compass Rose. The first two are considerably less expensive. All four will serve you well both stateside and abroad and BCBS Basic doesn’t hold you to its U.S. network. Which is best abroad may depend on the country in which you are posted. A good way to scout things out is to talk to employees already stationed in that country.