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gbatrucks


Jun 21, 2007, 4:38 PM

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Medicare or Local Medical Care # 2

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I'm wondering if one should opt of of the medicare deduct from your social security benifit? Even the SSA recommends considering this on their web site. If we have no plans to ever move NOB & it's damm doubtfull the the policitians will ever extend Medicare benifits outside the US, and with IMSS coverage, what about just dropping out of the Medicare program altogether?
"The trouble with life is there's no background music."



jennifer rose

Jun 21, 2007, 4:49 PM

Post #2 of 36 (3128 views)

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Re: [gbatrucks] Medicare or Local Medical Care # 2

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See http://mexconnected.com/...;;page=unread#unread

By now means should that thread limit discussion here; it was referenced, well, only for a point of reference.

Now, even though I'm too old for men to care and too young for Medicare, if I were to make that decision today or tomorrow, I'd opt for opting out.


Don


Jun 21, 2007, 6:07 PM

Post #3 of 36 (3115 views)

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Re: [gbatrucks] Medicare or Local Medical Care # 2

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I hope you have read the "Forum String" in Jennifer's post.

My post is there and I have coverage with Medicare in the U.S. and IMSS in Mexico. Since I posted that post, I have had follow-up care in Mexico and just returned fron the U.S. for visits and a medical checkup. All I can say at this point is than the premiums I paid for coverage in both countries was one of the best decisions I have made. The amounts my coverage paid in both countries for medical care and medicines was far, far, far more than what I paid in premiums.

But only you and your doctors know your needs now and possible furture needs. Only you can make that decision what coverage to maintain.


RickS


Jun 21, 2007, 7:29 PM

Post #4 of 36 (3098 views)

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Re: [gbatrucks] Medicare or Local Medical Care # 2

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I had (have) friends who moved to Ajijic to retire years ago. We all thought that they would NEVER move back to the US. But, alas, life changes and circumstances change, even for those who think they are settled in for the long haul. A spouse dies or a situation comes up that makes living abroad not a choice.

For me, should I move to Mexico, I would look at the Medicare Part B coverage just like it was an insurance policy... and a pretty cheap one at that. It isn't beyond possibilities (but maybe not probabilities) that Medicare will be extended beyond US borders at some level (think of all the other things that politicians have done that seemed incredible just a few years before!).

In the end, it's a personal choice. What works for me (and Don) doesn't work for JR and others.


Gringal

Jun 22, 2007, 7:17 AM

Post #5 of 36 (3057 views)

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Re: [jennifer rose] Medicare or Local Medical Care # 2

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"Now, even though I'm too old for men to care and too young for Medicare, if I were to make that decision today or tomorrow, I'd opt for opting out. "

That one is worthy of "Maxine".

I think it's really a matter of how well one sleeps with or without insurance for contingencies. After a few years of doing without Part B, one would have a substantial "medical savings account" to help cover a major illness. If something happens that slingshots a person back to the U.S. for care, there is still the major Medicare coverage.

I have to admit remaining in a quandary over IMSS coverage. From the stories I've heard, it's sounds like an HMO from Hell. One local woman described the process of being handed from one doctor to another, depending on who is on duty. Not a happy thought. On the other hand, one would be spared the enormous expense of a major illness.
As in most government programs, the recipient is definitely not in charge of the care. So ???


lmaxine

Jun 22, 2007, 3:41 PM

Post #6 of 36 (3010 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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I have to chime in again on this topic. I have Medicare Part B and Mexican private major medical insurance, and IMSS as a last resort back-up. Why? A couple came here to live "forever" and had an excellent Mex. private major medical policy. The husband had NO risk factors for a stroke-but had one that affected his right side and his language centers of his left side of the brain. He had excellent and wonderful medical care in Guadalajara, as well as physical therapy here in Ajijic. But, he needed speech and language therapy, as he could not speak except gibberish, couldn't process what was being said, and lost his ability to read. There was no English-speaking speech and language therapy available here. He had not taken Part B when he turned 65 here, so had to buy back in, pay fines and wait for a few months for it all to kick in, and they moved back to the US where they could get the help he needed. So much time had passed that although he was helped somewhat, too much time had passed for a full recovery of his ability to speak. That's when I decided that when I turned 65, I would take PartB. I have NO plan to return to the US, expect to spend the rest of my life here, but YOU NEVER KNOW.
I don't believe that the money saved by not paying in to that program would cover the expenses of a serious disease. For example, I understand that chemo can cost almost 20,000 US Dollars per treatment.
And, we have many people here without adequate medical coverage and their friends have to hold fundraisers to help them out. That's kind of not fair to those here who are living on limited incomes but have managed to get themselves decent medical coverage, for "in case..."

"He upon whose heart the dust of Mexico has lain will find no peace in any other land." Malcolm Lowry


RickS


Jun 22, 2007, 4:53 PM

Post #7 of 36 (2999 views)

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Re: [lmaxine] Medicare or Local Medical Care # 2

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At the current monthly premium of $99/mo. a partial list of what one gets is:

Part B: Medical Insurance
Part B coverage includes physician and nursing services, x-rays, laboratory and diagnostic tests, influenza and pneumonia vaccinations, blood transfusions, renal dialysis, outpatient hospital procedures, limited ambulance transportation, Immuno-suppressive drugs for organ transplant recipients, chemotherapy, hormonal treatments such as lupron, and other outpatient medical treatments administered in a doctor's office.
Part B also helps with durable medical equipment (DME), including canes, walkers, wheelchairs, and mobility scooters for those with mobility impairments. Prosthetic devices such as artificial limbs and breast prostheses following mastectomy, as well as one pair of eyeglasses following cataract surgery, and oxygen for home use is also covered.

In 15 years or so from now, one will have probably payed in around $20-25k. What do you suppose dialysis or chemo will cost per month 15 years from now!?! And that's just a couple of the many things that could go wrong as we age. When I move to Mexico you bet I'll continue my Part B coverage.


(This post was edited by RickS on Jun 22, 2007, 4:55 PM)


jennifer rose

Jun 22, 2007, 8:18 PM

Post #8 of 36 (2966 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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The current issue of Inside Mexico has a thoughtful piece on this topic. See http://www.insidemex.com/...sues/imx07-issue.pdf


thriftqueen

Jun 22, 2007, 8:19 PM

Post #9 of 36 (2966 views)

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Re: [RickS] Medicare or Local Medical Care # 2

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We've lived in Mexico for ten years and we will never cancel our Medicare. As the others have said so many things can change and it's wonderful to know we have that coverage. Call it peace of mind. We are 69 and 72 and in reasonably good health.We do not use Mexican doctors. Any care we need we return to the states to US doctors. Regardless of what I've read on the Mexico forums one will never convince me that the level of expertise is the same here in Mx as in the US. The level of care both in patient care and doctors caring is probably better in Mexico.


Gringal

Jun 23, 2007, 8:21 AM

Post #10 of 36 (2923 views)

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Re: [jennifer rose] Medicare or Local Medical Care # 2

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Thank you for passing this article on, Jennifer. It covered the issue very well. In an ideal situation, we expats would be able to use Medicare in Mexico. As I read some posts, I find that not everyone is being realistic about the most likely probabilities in their personal medical future.

Like the person described in the article whose wife needed an emergency appendectomy, many of us do not have a real choice about where to have our medical care. A heart attck or stroke does not wait for us to make arrangements for travel to the U.S. to our doctor. It occurs suddenly. What happens in the next minutes or hours makes a huge difference in the outcome. Those who eschew Mexican doctors and hospitals will very likely be calling the local Cruz Roja ambulance and heading for the nearest emergency room. I, personally, had an emergency situation last fall that required very prompt intervention. I could not have been more satisfied with both the expertise and the attention of the Mexican medical care I received. I paid out of pocket. Plus, I'm still here to tell about it.

An historical note: There was a time when people had no medical coverage whatsoever. 1965 brought the first Medicare coverage to older Americans, according to the article Jennifer linked to.
Since that time, medical costs have skyrocketed, along with the cost of drugs. I suspect that there is an unholy connection between these facts. I don't have the data and can only speculate, but when I went to my medical group in the U.S for a checkup before moving here, there were threee doctors in the practice and at least 8 people working in the office. Hmmmm. When I went to a Mexican gynecologist last year for a mammogram, sonogram and nice long office visit plus exam, I was charged the grand total of $190 US for everything. There were two doctors and one person working in the office. Again, hmmm.

I expect to die in Mexico, hopefully much later. If I live long enough, I'll need some help. There is no way I could afford or would accept the "nursing home" type of care in the U.S. available to people who are not very, very rich. Here, I can look forward to decent care before I croak. That is important to me. The question is: do those people who intend to return to the U.S. for medical care also intend to return there for nursing home care? There's a thought to curdle your crema.


Rolly


Jun 23, 2007, 8:46 AM

Post #11 of 36 (2914 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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Giggle of the day: "There's a thought to curdle your crema."

I agree with you, Gringal. I recently had a major medical emergency for which I received excellent care in a first-rate facility for a very reasonable cost.

I am committed to life in Mexico for the long term, so it's Mexican medical care for me all the way to the end. I dropped Part B a long time ago. But I agree that if your commitment to Mexico is not firm, it might be wise to keep Part B, although it sure is a lot of money each month.

Rolly Pirate


Brian

Jun 23, 2007, 10:41 AM

Post #12 of 36 (2897 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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In Reply To

I expect to die in Mexico, hopefully much later. If I live long enough, I'll need some help. There is no way I could afford or would accept the "nursing home" type of care in the U.S. available to people who are not very, very rich. Here, I can look forward to decent care before I croak. That is important to me. The question is: do those people who intend to return to the U.S. for medical care also intend to return there for nursing home care? There's a thought to curdle your crema.


I don't think anyone "intends" to get medical care other than routine checkups. Unfortunately, other things do crop up from time to time some of which can be better handled by US standards. No one ever plans to need nursing home or in-home care due to disability. Wise people do, however, prepare for the possible need for such services and insure themselves to receive the very best care. Long term disability insurance is now a staple of any responsible retirement planning. The premiums are cheaper the earlier one makes the decision to begin paying for it.


Gringal

Jun 23, 2007, 11:40 AM

Post #13 of 36 (2879 views)

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Re: [Brian] Medicare or Local Medical Care # 2

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And about that curdled crema: a couple I knew in the states moved into the only kind of long-term care facility I would consider acceptable. Your sojourn there starts in the residential independent facility with a private apartment, maid service and the availability of an elegantly appointed dining room with a real French chef. You bring your own funishings. The rooms have a view of either San Francisco or the Bay. Some, on the higher floors, of the Golden Gate. A shuttle takes the residents to desired entertainments in the City. In the event of disability, there is a medical care wing available to the subscibers at no additional cost.

One little catch: The initial deposit is $300,000 US per person, and the monthly fee is $3500 US. Sounds nice, but I don't think it's covered by long-term care insurance, so I'll pass and settle for the live-in with a drivers license here in Mexico. Our new guest room with bath will do nicely.


Bill in NC

Jun 23, 2007, 7:54 PM

Post #14 of 36 (2825 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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When my mom died last year (after almost 6 years in a private geriatric clinic in Guadalajara), her final expenses were less than US$700.

That included the late night ambulance ride to the hospital, and her overnight stay (she died early the next morning)

Cremation/shipping to me here in the U.S. (took nearly 2 weeks for her to arrive, thanks to Homeland Security) was about US$650.

I would never have brought her back to a U.S. nursing home, having had more than enough experience with them over the course of her illness.


In Reply To
When I went to a Mexican gynecologist last year for a mammogram, sonogram and nice long office visit plus exam, I was charged the grand total of $190 US for everything. There were two doctors and one person working in the office. Again, hmmm.

I expect to die in Mexico, hopefully much later. If I live long enough, I'll need some help. There is no way I could afford or would accept the "nursing home" type of care in the U.S. available to people who are not very, very rich. Here, I can look forward to decent care before I croak. That is important to me. The question is: do those people who intend to return to the U.S. for medical care also intend to return there for nursing home care? There's a thought to curdle your crema.



(This post was edited by Bill in NC on Jun 23, 2007, 7:56 PM)


Gwynne


Jun 24, 2007, 9:07 AM

Post #15 of 36 (2780 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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This is good reading. However, don't forget that Medicare only pays about 80% of ALLOWABLE expenses. (That's why Medigap policies are such big business.) That $60,000.00 hypothetical bill mentioned in the article would still set the patient back $12,000.00. What's not allowable? We can start with a wheelchair with upper body support that was denied my mother-in-law who couldn't sit upright due to a stroke.

Now let's look at the doctors.....if you can find one. My husband's good GP in Dallas sent a form letter saying he was no longer welcome there since they don't accept Medicare. They did recommend several Medicare doctors. One of them had been assigned to my mother-in-law and I knew he didn't speak English. The others were also foreign: African, Indian, and Korean. How do I know? I called and asked.

My husband broke his right fibula in a cycling accident 4 years ago. The total bill was a little over $7,000.00. After deductibles and un-allowables (private insurance) we paid $1,500.00. (This was in the US) Two months ago he stepped in a hole here in Mexico and broke the left fibula. Our total outlay for an excellent bone doctor who came out of his office to help my husband out of the car, was $590.00.

We have looked at our experiences NOB and our experience SOB and have done the math. We're opting for quality medical care by caring doctors here in Mexico. My husband opted out of plan B and I will also.

Just one opinion.
Gwynne


scubabride

Jun 24, 2007, 4:28 PM

Post #16 of 36 (2741 views)

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Re: [Gwynne] Medicare or Local Medical Care # 2

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I currently recieve all my medicalcare in the states from Veterens Administration. I will be eligable shortly for medicare based on disabilty. I plan on opting out of part B since I can use the VA if need be. I plan on looking into ING, but thier web site is all in apanish, so what do I do.


jerezano

Jun 25, 2007, 8:19 AM

Post #17 of 36 (2688 views)

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Re: [scubabride] Medicare or Local Medical Care # 2

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Hello scubabride,

You said:>> I currently recieve all my medicalcare in the states from Veterens Administration.

Better check what is involved in going back to the States to the nearest Veteran's Administration Clinic.

From here in Zacatecas the nearest one is McAllen, TX and driving costs from here to there including tolls and gasoline are about $200 usd round trip. Of course, buses are cheaper if you can get the Old Age card.

Also, services in that McAllen clinic are limited.

Adiós. jerezano.


Jerry@Ajijic

Jun 25, 2007, 9:23 AM

Post #18 of 36 (2675 views)

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Re: [jerezano] Medicare or Local Medical Care # 2

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You might check to be sure you can really get what you need from The Veterans Administration. I thought after serving 4 years in the navy during the Korean war I was eligible for VA coverage but when I asked to be certified for VA hospital help they wrote back that by executive order I could get nothing as we had too high income. I felt bad that I could not get any coverage thanks to El President but it was nice that for the first time somebody said we has too much income. We had always though we did not have enough.


jerezano

Jun 25, 2007, 10:32 AM

Post #19 of 36 (2667 views)

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Re: [Jerry@Ajijic] Medicare or Local Medical Care # 2

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Hello,

I'm in the same boat as Jerry@ajijic. The VA refuses to help me. They will take me for a first time emergency visit and then "You're on your own buddy. So long!"

That ain't what I was told when I joined the army way back when.

Adiós. jerezano.


Jerry@Ajijic

Jun 25, 2007, 1:24 PM

Post #20 of 36 (2642 views)

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Re: [jerezano] Medicare or Local Medical Care # 2

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Jerezano, at least we had the pleasure of someone telling us "we had too much income". Made us feel downright rich.

I have to stop now. It is time to heat up the beans and frijoles.


scubabride

Jun 25, 2007, 3:45 PM

Post #21 of 36 (2621 views)

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Re: [Jerry@Ajijic] Medicare or Local Medical Care # 2

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Luckily at the time I applied to be a VA pt,there was room for me. Once a pt, they can't stop treating me, soI am ok there In fact they did my triple bypass on my heart almost 3 years ago and they were great.

I am taking out an emergency evac policy to be taken back to the states in an emergency, and I have someplace to stay stateside if I need to return for serious treatment.

I just plan to pay my regular dr's care as needed in Mexico as I do not think I will qualify for the Mex soc security health ins, due to my healt record.

I also will be going back to the states at least 2x a year to visit family and will get my regular appointments at the VA then.


Gringal

Jun 26, 2007, 4:06 PM

Post #22 of 36 (2548 views)

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Re: [scubabride] Medicare or Local Medical Care # 2

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Be sure to check the fine print on the evac. policy. I've heard (unsubstantiated rumor) that they will go to great lengths to avoid taking you where you really want to go. Hope that's not true in your case.


Don


Jun 27, 2007, 7:55 AM

Post #23 of 36 (2506 views)

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Re: [Gwynne] Medicare or Local Medical Care # 2

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I can't speak for Dallas, but almost all the doctors and hospitals in the S.F. Bay Area accept Medicare. I was sent by my Mexican doctor, the director of the hospital, to the U.S. for treatment, which he felt couldn't be properly handled here. I was assigned a team of doctors in S.F. and some were born in foreign countries. My surgeon was an Iraqi and he did an excellent job. I have full coverage in both countries with IMSS and Medicare and will continue to do so. IMSS in Mexico is a major backup as I pay to see my private doctor here in Mexico.


lmaxine

Jun 27, 2007, 2:28 PM

Post #24 of 36 (2469 views)

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Re: [Gringal] Medicare or Local Medical Care # 2

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Some time ago, I attended a meeting offered by a med evac company. It all sounded great, but then came the small print-if you are living in Mexico, it will only take you from Mexico to the US IF you have a condition that can not be treated anywhere in Mexico. That leaves only something rare and unusual if it can't be treated somewhere in Mexico. And, if it does take you, it doesn't take you where you want to go, it takes you to the nearest US hospital capable of treating you-so most likely somewhere in TX or AZ.
Be careful, check out the small print.
"He upon whose heart the dust of Mexico has lain will find no peace in any other land." Malcolm Lowry


scubabride

Jun 27, 2007, 10:11 PM

Post #25 of 36 (2432 views)

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Re: [lmaxine] Medicare or Local Medical Care # 2

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Thanks for the heads up, I will be sure to double check before buying.
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