Moving to a new country is challenging enough, and if you’re moving from a country with free healthcare, like the UK, to the US, it can be even more daunting when trying to understand how to access healthcare services.

So, what is Medicare?

Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). It is not free at the point of use, however it is subsidised.

I did say Medicare can quickly become complex, and that’s because it has four different parts to its coverage:

Medicare Part A

Also known as hospital coverage – Part A covers inpatient care at hospitals, nursing facility care, hospice care, and other limited home healthcare services. Part A is usually included without a premium as it’s covered through historic taxes paid toward Medicare.

Medicare Part B

Part B is the main coverage, the medical insurance part of Medicare. It covers the everyday doctor’s visits, preventative care and screenings, medical supplies and outpatient care. This part of Medicare is premium based – i.e. not free! You need to pay a monthly premium to receive Part B. The good news is that the premium is adjusted based on income.

Medicare Part C

Part C tends to be a more comprehensive coverage and therefore more expensive. You have access to prescription drugs (Part D) and additional coverage like vision and dental. However, you will have to access the plans through a private insurance company approved by Medicare, making the plans more costly.

Medicare Part D

Part D provides prescription drug coverage and can be accessed as a standalone plan or as part of a Medicare Advantage Plan. You do not need to enrol in Part D, but it’s highly encouraged as it could incur additional costs when accessed in the future.

If you’re moving to the US, how you access Medicare can be quite challenging. Eligibility is not automatic at 65 and will depend on a few factors. Typically, you need to have 40 Social Security credits to qualify for Medicare. However, you do not have to be a US citizen to access Medicare. If you or your spouse do not have 40 qualifying credits, you can still access Medicare after five consecutive years of residing in the US.

If you are eligible for Medicare and are ready to enrol, it’s vital you do so in a timely manner or you could end up with higher premiums for the paid parts of Medicare (Part B and D).

The Initial Enrolment Period (IEP) begins three months before your 65th birthday and ends three months after.

When you are enrolling, you will need to decide on what coverage works best for you. The options are complicated but often boil down to:

1. Original Medicare – Part A and B only
2. Original Medicare + standalone Part D
3. Part C (Medicare Advantage Plan)

Most will opt for option two, and some will opt for the convenience of option three. Whichever you decide, make sure you are considering Part D because overlooking coverage right now results in higher costs and potential penalties when trying to access it in the future.

Navigating healthcare as a UK expat in the US is challenging, but Medicare is meant to make things simpler and more accessible. Medicare is complex, but understanding the basics will help you select the right policy for you.

Remember, if you are not 65 or have qualifying medical conditions, Medicare is not an option for you. If you are under 65 and moving to the US, you will need to enrol in private healthcare through your employer or via the widely accessible marketplace at healthcare.gov

We highly recommend consulting with healthcare professionals and insurance specialists to help you through selecting the right policy for you, and making your time in the US simpler and hassle free!