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She (finally!) acknowledges that she needs to live nearer an adult child. I am 500 miles away, in another state; my sister lives in Germany, my mother's country of origin & still home to many friends and relations. Said sister has a lovely AL facility nearby, so mom's ideal choice would be to go there. So AL facility is not an issue; medical insurance, however, is. Her Medicare Advantage will not apply to medical bills in Germany. Does anyone know of insurance, private or otherwise, that will? Thank you so much for your help.

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I think this is a question for your sister. Is ur Mom on a green card here? If so she is still a citizen in Germany. I agree, she Won't be able to use her insurance here in Germany. As far as I know, no insurance in the US will cover Mom in Germany. Basically because there is no way they will or can contract doctors and hospitals there. Visiting is one thing but she will again be a resident. Again, your sister will have to see what will be available in Germany.
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I would have your sister check to see what your Mom is eligible for in Germany. Did she ever work there? Is she still a German citizen? Having been born there she may be eligible for benefits there. The AL Facility may be able to answer some of the questions or direct your sister to someone that can. Wishing you all the best!
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Sob! Sniffle...

I hope reading this will not make you lose the will to live, but here is a link to the EU's own pdf introduction to social security rights in Germany...

ec.europa.eu/social/BlobServlet?docId=13751&langId=en

In particular, it includes links to local websites which your sister might find informative. It also mentions reciprocal arrangements with other countries, though I haven't been to look to see whether that includes the USA.

One thing to bear in mind is that Germany too is a federal state, so which state your sister lives in might make a difference. Could be, for example, "wir sind doch im Bayern..." and nothing is quite the same as anywhere else.

A great deal will of course depend on whether or not your mother remains a German citizen and how long your sister has been living (and working?) in Germany.
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Medicare does not cover long-term care, either assisted living or a nursing home, in the US or any foreign country. Pretty much all us insurances don't apply in other countries with the exception of emergency medical care. As others have noted, it depends on whether your mother is still a citizen of Germany or not as to whether she qualifies for any type of benefits in Germany.
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Does mom still speak German? Communication may be difficult.

This is something that sis needs to research knowing more about German laws and policy.
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Thank you all for taking the time to answer. Countrymouse, I especially thank you for the link.
Yes, my mother lived and worked in Germany; yes, she still speaks German -- her native language -- fluently; and as far as I know, she is still a citizen (green card in US).
I am grateful for the suggestions. Will post an update when there is one.
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Fitzgerald, only thought I have is to check with the American Embassy in Germany to see if they are aware of any programs. However, if she's still a citizen, then I would think she would be able to get German health care.

Good luck.
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Definitely something for your sister in Germany to look into. Germany has Socialized Healthcare, like much of the world. Whether or not your mother would be considered an immigrant for healthcare or a resident returning would be something to determine. She will eventually be covered by the German Healthcare system.

I do wonder how your mother will manage the flight? It is a long trip, could be made longer by connecting flights. Who will accompany her? Have you checked with the airlines about how they can accommodate her? My Dad and step-mother stopped taking long haul flights when they were 84. They had done them annually up until that point and were used to international travel, airport transfers and security checks.
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Finally someone mentioned the socialized German health care system -- the US, of course, is the only industrialized nation which relies upon private, for profit insurance –and even Medicare, Medicaid and Social Security have always been threatened with cuts, privatization or dismantling, the latter which is now more likely under the new budget, where Trump gave enormous tax cuts to billionaires and expanded the military budget, which will then siphon off moneys for social spending programs. I would think that she would be covered in Germany -- even more so likely because she is still a German citizen, despite having lived in the US for some time.
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Some caregivers on here have had successes with being an out of state caregiver, sending in hired caregivers to the home. This could provide care while you decide on a placement for Mom, or if you take her into your own homes-either in the U.S., or in Germany.

What is your Mother's second choice? Is she a healthy 90 y.o.?
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No one has mentioned health-care sharing organizations, which, as I understand, operate internationally. We are members of Samaritan Ministries, another is Medi-Share, and another has a name like Liberty or Freedom. These are open to Christians, and have requirements that one must meet involving Christian tenets.
It's my understanding that other religions have similar organizations.
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they don't cover pre-existing conditions
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Just call the German consulate in America , they will be able to answer your questions, my mom is a citizen of Switzerland and America , no Insurance with cover both places , however Swiss government takes care of their elder and the insurance isn’t so expansive plus much better , hopefully will be same in Germany. It’s great for people to go back to their Origins When older as most of their memories they are left with is from when they were younger
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Thank you so much, everybody. The lady has changed her mind altogether! She has decided upon a continuing care community in the US.
Sometimes these elders can by mighty "veraenderlich."
I am grateful for your thoughtful responses.
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