Expat health insurance plan dies, but proponents pass on useful advice

A dream of an insurance program which would provide affordable overseas coverage for U.S. Medicare-eligible and covered residents in Panama has died.

The plan, developed by financial consultants Albert Rojas and Mark Scheinbaum, ended when a Panamanian banking group that was, in the words or its proponents: “enthusiastic and encouraging”, withdrew.
In the current economic environment the bank did not want to take on a new line of business.

In a memo to expats who had expressed interest in the plan Scheinbaum said it began as a response to inquiries from friends and colleagues
“We made no attempt to re-invent Medicare supplements, or to pose as some type of government program. We simply tried to construct a framework of affordable premiums for retired people 65 or 68 or 78 many of whom are healthy, or perhaps long-ago cured, recovered, or in remission from various illnesses and conditions which kept them from other coverage.

During his investigations he got to know “some of the horror stories and absolute deficiencies of health care in the United States first hand “. He also had experienced his own problems. “Three years too young for Medicare, and living in a State with few surgeons, three surgeries in one calendar year and huge medical bills hardly covered by insurance, made me understand many health issues up close and personal.” He wrote.

“As a financial advisor and money manager for 27 years, it is ironic that even I could not properly defend my family against catastrophic medical bills met with huge deductibles, co-pays and ‘out of network’ insurance loopholes.”

“…. Sadly, an estimated 27% cost of living inflation in Panama over a four year period, places many of us in the same economic crunch which faces many retirees or soon-to-be retirees in the USA.”

While Panama based Albert Rojas is investigating other ways to resurrect the program, Scheinbaum took time to pass on some information to those who had expressed interest.

1. Travel Insurance polices from your credit card or labor union or club are rarely comprehensive enough to protect you from significant medical expenses which are large enough to hurt your budget but perhaps not bad enough to force you to buy a ticket to Houston or Miami.
2. Don’t overlook the affordable ($150 or so per year) "emergency medical transport" policies from American Express and others which along with your
credit card could get you to a major USA medical facility in a dire, emergency.
3. There have indeed been some special Medicare Advantage pilot programs, and special Medicare HMO "demonstration projects" in Miami and elsewhere, which have extended some limited coverage to U.S. retirees in Mexico or in other special situations. These are rare and are under the knife in Congress..
4. In a difficult situation you take what you can: some reputable Panama institutions such as Santa Fe Hospital have a form of HMO for as little as $30 a month which gives reliable and peace of mind care to those of you in Panama City or close enough to the City to take advantage of this.
5. Some other clinics, "consultative clinics," and hospitals have , or will soon offer programs similar to Santa Fe. They are worth a look. Many of the doctors you will meet in Panama are caring, excellent, and from the "old school" where they actually “care” about you and your family and your future..
6. Be careful when salesmen, AARP mail brochures, or some of the "big name" insurers make vague reference to "coverage wherever you are." When coverage is extended overseas read the small print.
7. International Health Insurance is and has always been available to business executives, and people buying from European and other underwriters. Premiums are often extremely expensive; deductibles can be high, and there can be age limits above 60 or 65 where coverage is eliminated or sharply reduced. Pre-existing conditions are often cause for being "rated" for higher premiums or declined entirely.

Mark Scheinbaum is based in the United States but is currenly teaching two courses at the University of Louisville campus in Panama.