I am on Medicare but when I am out of the US, I usually just pay out of pocket in the host country as the costs are so low compared to the US. If I need to buy insulin, for example, $300 of insulin at US list price costs about $30 depending on the exchange rate out of country and interestingly, both US and foreign supply often come out of the same factory.
Yes because cutting taxes to the point where they want to take almost $1 trillion out of Medicare and lack of regulations on the pharmaceuticals are working out so well.
They don’t use Medicare when they are in the Dominican Republic. They come back to the US for a couple of weeks every other year and get their checkups, tests, etc. done and then go back to the DR.
I have had type 1 diabetes since 1983, have been on a pump since the early 1990s and have been retired for 4 years. Medicare plus my supplement pay for all of my pump supplies and insulin. (If you are on a pump, the pharmacy can bill the insulin as a “durable medical supply). Last year, my Endocrinologist outlet on a continuous glucose monitor. Medicare paid for it and all of the supplies needed for its use. So, except for the cost of the supplement, my diabetes supplies have not been a burden for me. You may not have to leave to country to afford your supplies if you are on a pump. If you are not on a pump, your costs will be much more, since you will have to pay for the exorbitant cost of insulin.
You are making a gross error in your calculations. What you are paying in your Medicare plus supplement premiums and co-pays are several times more than the cost of insulin in other countries. If you use $10,000 per year of insulin at MSRP in the US, that same insulin from the same manufacturer will cost you about $1,000 in other countries. That means that your combined Medicare + Supplement + CoPays (If you are MDI rather than pump) or Medicare + Supplement if pumper quarterly payments need to be less than $250 in the US. Not going to happen.
This is a great conversation and I’m learning a lot about what to expect when I reach retirement and Medicare. Thanks everyone for the input. What about retiring to Europe? Is there any where there that is easy and inexpensive? I’m thinking along the lines of Spain or Portugal, but I’m open to other suggestions.
Yes, Portugal, Spain, South of France, UK are all great options
Try Iceland Once you become a citizen. You go on their socialized med. if hospitalized it would be clods to 300K per day. Which is equal to about 2.35 US.
They all speak English and at least two Luther languages. You’ll never learn Icelandic Only thing expensive there is gas.
And you can buy insulin cheap and make money by mailing it to people stuck in America paying full price.
Put ads on craigs list coast to coast lol
Maybe I should move to Belize ! How much for that villa and how close is the pharmacy and post office ?
Sorry the risk is not worth the reward. Would not like to face extradition charges living in another country and do want to be able to freely visit US from overseas to see my family and grand children from time to time and not from behind bars. If you want to smuggle drugs into US, I think you will find some much more profitable options.
I am not messing with the cartels, no thanks but anyway the Canadian pharmacies don’t get in trouble for mailing it here why would I ?
I am not doing it anyway but obviously putting the idea out there for others and entertaining discussion.
Look at those numbers buy for $1000 what sells for $10,000 It should be possible to triple your money on every transaction.
Canada pharmacies have gotten trouble for shipping drugs into the US and many have stopped sending in even insulin. On top of that insulin can go bad if it sits in customs for too long so you will find that the Canada pharmacies that do ship into the US will not help you out if the insulin you receive is bad and they do that in violation of US law.
I am sure you can get away by having a friend send you some insulin from Canada a couple of times or I could sell you insulin I bought there and legally brought back but it is illegal to do that and if caught, the consequences are not worth the reward. Federal and state agencies do follow CL and conduct sting operations so not for me.
What about Medicare part D? Doesn’t that cover insulin if you are on MDI?
I’m on MDI and do pretty well with it. I wasn’t planning on going on a pump, ever. I’d like to keep doing what I’m doing.
Retirement is still a few years away for me but I’m already getting concerned. My plan was to get part D, but I now wonder if that’s going to be enough.
Wasn’t planning to move to another country either.
Is there anybody out there who is able to mange with part D?
Yes, I am on Part D. Many people don’t realize that insurance is just a drug dealing middleman so the real problem is the cost of the insulin which under part D quickly currently puts you in the donut hole making you actually fully pay for the real cost of the insulin + the insurance markup. I have not moved to another country but have been driving and buying my insulin in Canada because I buy roughly $8000 at US list price at a time in Canada and it costs me $800 which is far cheaper than my Part D insurance premiums + Co Pay. That way I take a very low cost ($14/Month) Part D supplemental insurance. Each person is different so a lot depends on how much you medication you use to determine best, most affordable way to go.
The FDA allows personal importation of up to a 90-day supply of prescription drugs (including insulin) with some fairly obvious and reasonable restrictions. The full details are at this link.
I read one report that the Canadian export mail order pharmacy market is valued at $1B/year
The key key is finding a pharmacy you can trust (there are some shady actors out there). Get a recommendation from your doctor if possible. I get my anti-seizure meds from Canada. In the US I’d pay upwards of $35,000/year. From Canada I pay $3000/year and it’s perfectly legal for both myself and the pharmacy.
It’s a great point about shipping risks with insulin. All the packages must go through customs and it’s possible they’ll get held up. Sometimes my seizure meds will be in transit for 2 weeks. Most of the pharmacies I’ve checked with won’t ship insulin. Others will, and I don’t know how (or if) they address the issue.
The online ones I have researched say if the insulin is a problem, it is your problem, not theirs which is why I drive to the border and pick mine up. Funny, the pharmacy I use is no more than about 800 ft. from the border and it takes me about 2 1/4 hours to drive up to the border from MA.
In general, I’d say, the more benefits a country provides to residents, the harder it is to obtain residency. So, lets say you wanted to go to the Nordic countries, where there are lots of diabetics. Sweden looks like five years, as a frame of reference.
Be aware that I have purchased insulin in both China and France and I paid exactly the same as I do in America. The US insurance agreements held. Note: I went to Expat hospitals to obtain at their pharmacy.
I’m too far from the border to take advantage of the drive in approach. But a funny story about Tandem -
Last week I was talking to the local Tandem rep about problems I’m having using Fiasp with my T-Slim:X2. The conversation drifted into Fiasp costs. My insurance stopped covering it this year. She told me that because Tandem’s headquarters is in San Diego, some of their T1D employees (they have quite a few of them) drive the short distance to Mexico to get Fiasp. Hard to believe that even one of the major pump manufacturer’s insurance doesn’t cover it!
Not hard for me to believe. At some points, my wife’s insurance wasn’t very good and she is a health care professional–namely a registered operating room nurse.