“Both terrorism and insurance sell fear — and business is business” ― Liam McCurry,
The greatest fear of mine is a slow, painful, and expensive death from a catastrophic illness or accident. Living abroad poses many health risks, especially living on a tropical island with limited access to quality health care. After a painful bout with Chikungunya, it became necessary to research our options for international health insurance.
I suppose there are pros to being uninsured in Nicaragua. Health care is cheaper. We don’t have to see a doctor to get antibiotics or other prescription medications. We can usually self-diagnose if the illness is small and uncomplicated. For serious illnesses, Vivian Pellas hospital and the new Militar hospital in Managua offer excellent care. But, without health insurance, a catastrophic illness or accident can be expensive.
I’ve written posts about the need to have emergency medical funds when living abroad. If an expat goes to Vivian Pellas for an emergency medical procedure, before anything happens…anything! VP swipes your credit card. Do you know what your credit card limit is? How will you afford an emergency $16,000 stent or two?
Therefore, because of my fears and “business is business”…we purchased international health insurance. Part One covered our exploration into the world of international health insurance policies. Now….
Welcome to the world of two happy, healthy insured expats!
I. Worldwide Expatriate Association (WEA) Signature Plan
1. We chose WEA for our health care needs because
- International health insurance since 1965
- WEA (Worldwide Expatriate Association) is part of the PA Group
- Backed by Lloyds of London
- Great option for Canadians and U.S. citizens (can pay lower premium of not including U.S. coverage and still have coverage in Canada.)
- If over the age of 65, can keep beyond age 74
2. WEA Signature Care Plan excluding the U.S. and Canada
We chose the Signature Care Plan excluding the U.S. with a maximum lifetime coverage of $1,000,000 for each person covered in the policy. $1,000,000 will go far in Nicaragua because the health care costs are about 1/4 of the U.S.
We excluded coverage in the U.S. making our premiums affordable. Our premium cost in the 60-64 year age group is $2365.48 annually with a $250 deductible for each policy holder. We chose the option to pay the full amount annually, however we could pay monthly $197.12. That is coverage for BOTH of us. Very affordable!!!
3. Process of applying
The application form can be submitted online. You must give your credit card information as part of the application process. In addition, you must have a foreign mailing address. Thus, our need to open a PO Box on Ometepe Island ( I’ll save that for a Let’s Get Real about Nicaraguan Post Offices blog post.)
Once WEA receives your application, it takes 2-4 days for the underwriter to review the application. In our case, we didn’t have any pre-existing conditions except for an eye operation to repair a hole in the retina 7 years ago. WEA contacted us for more information about the retina surgery, we submitted the information, and one day later we were approved. Because we are both under 65 years of age, we didn’t need to have any thorough exams for insurance purposes.
WEA gave us a policy number and their membership website information. WEA Direct
We logged in with our policy number and voilà! Our detailed policy, personal information, payment options, place to send claims….everything is at our fingertips.
4. There is no waiting period. Our policy takes effect immediately. We can go to any hospital, of which the definition is:
HOSPITAL Means an institution that:
1. Is operated in accordance with the laws pertaining to Hospitals of the area in which the Hospital is located;
2. Which, for compensation from its patients and on an inpatient basis, is primarily engaged in providing surgical and medical diagnosis, treatment, and care of injured and sick persons;
3. Is under the supervision of a staff of duly licensed doctors of medicine;
4. Which continuously provides twenty-four (24) hours a day nursing service by registered nurses (R.N.); and 5. Which is not mainly a place for rest, for the aged, for addicts, for alcoholics or a nursing or convalescent home or institution;
6. Makes charges.
5. We are in the AXA Network, but if a hospital does not have our AXA Network listed as a service provider, we can still go anywhere and the PA group can call the hospital direct and work out payment. WEA does this often.
Hospitals in Nicaragua in the AXA Network.
So, we are happy campers now that we have affordable health insurance in Nicaragua. It is reassuring to know that we have our catastrophic health care needs met in Nicaragua and when we travel to any other country except the U.S. or Canada.
II. Health Coverage in the U.S.
1. Affordable Care Act
We thoroughly investigated our options for ACA and came to the conclusion that the plans were too expensive with high deductibles. Since we still have a residence in the U.S. we qualified for ACA with a $1,000 credit, but since we don’t plan on living in the U.S. again, it seemed to us like a costly idea.
In a couple of years, we will qualify for medicare. We explored both plans for medicare and our needs will be met with the Original Medicare Plan.
Part A of our medicare plan is premium-free because we already get Social Security benefits, which we EARNED and were deducted from our 30 years of employment.
Part B will automatically be deducted from our Social Security checks, unless we request that we don’t want it. Presently $104 is deducted from Medicare eligible SS benefits.
Our plans are to receive the Original Medicare Parts A and B when we are eligible. They will just send us our cards and automatically deduct Part B from our SS benefits when we are 65 years old.
NOTE: In most cases, you cannot use medicare abroad.
Check out this case that I helped to uncover in Nicaragua. I was subpoenaed to testify in this case, but fortunately they pled guilty and I didn’t have to testify.
Rare Medicare Fraud Case linking Miami to Nicaragua ends with 10 convictions
3. Travel Insurance for coverage in the United States
Until we are 65 years old and receive medicare, we will continue to buy travel insurance that will cover us in the United States when we rent a car and visit with family and friends.
In May 2015, we bought the travel insurance policy below for $171.70 to cover us for three weeks in the states.
Safe Travels USA from Trawick International – Policy Coverage Limits
This information is in the full policy certificate.
|Trip Cancellation||No coverage|
|Trip Interruption||$5,000 per person, Return transportation only|
|Emergency Medical||$50,000 per person, Primary coverage|
|Pre-Existing Condition||$1,000 per person Emergency Medical for Unexpected Recurrence|
|Co-Insurance||Plan pays 80% of first $5,000 after deductible, then 100%|
|Medical Deductible||$250 per person|
|Home Country Coverage||Not selected|
|Medical Evacuation & Repatriation||$2,000,000 per person|
|Non-Medical Evacuation||$25,000 per person|
|Baggage Delay||Not selected|
|Baggage & Personal Items Loss||$1,000 per person, $75 per item, Checked luggage only|
|24 Hour AD&D||$25,000 per adult, $10,000 per child|
|Hazardous Sports||Not selected|
|Amateur Sports||Not selected|
|Money Back Guarantee||Up to the day before effective date|
|24 Hour Assistance Service||24 hour assistance provided|
|Renewable Policy||Renewable up to 24 months|
Here is a great website where you can compare 132 travel insurance policies from 22 providers. Squaremouth
We are finally insured and reassured. Retiring abroad is never easy, but we have our health care needs met and my fears have subsided in the case of a catastrophic accident or illness while living abroad, traveling the world, or returning to the U.S. to visit family and friends.