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Georgia

Nov 6, 2007, 3:51 PM

Post #26 of 50 (3699 views)

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Re: [lmaxine] Effect of insurance on medical costs

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Add to this the fact that Medicare Part B has a very high(by Mexican standards) deductible before the benefits kick in. I simply don't see a benefit to it. I have Medicare and Medicare Part B "por si acaso" -- just in case I develop dimentia or something and my kids drag me kicking and screaming back to the US for care.

Jerry@Ajijic

Nov 6, 2007, 9:15 PM

Post #27 of 50 (3675 views)

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Re: [Georgia] Effect of insurance on medical costs

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One possible benefit of allowing Medicare in Mexico is to give the medical establishment NOB some competition. If Medicare was allowed in Mexico it would be based on paying the going rates paid by the locals (Mexicans). This is the same as NOB where medical care is much cheaper in small communities than large and Medicare pays accordingly. Assuming Medicare does the same (paying the going local rate) it would same Medicare billions. It would also give the NOB come competition which would help lower prices NOB. Of course the odds of the NOB medical profession allowing this to happen are pretty high.

macmember

Nov 6, 2007, 9:44 PM

Post #28 of 50 (3671 views)

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Re: [Georgia] Effect of insurance on medical costs

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As hard as it is for Medicare to monitor the crooked hospitals in the USA, how hard do you think it would be for them to keep the Mexican system LEGAL and above board????????????

If I ran Medicare I would never consider paying claims from another Country where there is no fear factor for fraud. In the USA they place huge Civil Money Penalties on the Drs and Hospitals that try and cheat the system. They have to pay or have their licenses revoked. In Mexico they would have no recourse.

Make sense?

windknot

Nov 7, 2007, 5:39 AM

Post #29 of 50 (3661 views)

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Re: [Jerry@Ajijic] Effect of insurance on medical costs

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Jerry, I couldn't disagree with you more. When is the last time you saw medical prices DROP????? If anything, Medicare will only serve to raise the prices in Mexico! Add to the fact that I have never been in any medical facility anywhere...where the staff and doctors didn't wish for at least a slightly lighter case load. Medical care is just one of those things that people have to have....no matter the cost.

IMHO, if you are of good health generally, you don't want Medicare......Come and enjoy the great prices here, and the good doctors. (which I admit may take some searching for, depending on where you live) However, if you have some chronic condition, I can assure you that the treatment here is much cheaper. If you can afford that treatment out-of-pocket, or with private insurance (also considerably cheaper here....at least until Medicare comes) then fine. If not, I suggest you review your options and consider staying NOB and using your Medicare there.

lmaxine

Nov 7, 2007, 6:36 AM

Post #30 of 50 (3647 views)

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Re: [windknot] Effect of insurance on medical costs

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In Reply To

It's foolish to think that if you enjoy good health you will be able to afford medical care here. Yes, that's true for minor illnesses, but even young, healthy people are in terrible accidents, have heart attacks, and get cancer. No one EXPECTS to become in need of serious medical care, but when it happens, you'd better have a very large nest egg to wipe out, even at Mexican prices. Georgia posted somewhere (maybe on another site, I don't remember) about a mutual friend who was in a horrific accident, nearly died, needed several surgeries and intensive care for months-certainly not expected. Anyone who comes here without some kind of medical insurance for major medical issues has his/her head buried in the sand.
"He upon whose heart the dust of Mexico has lain will find no peace in any other land." Malcolm Lowry

Jerry@Ajijic

Nov 7, 2007, 6:38 AM

Post #31 of 50 (3648 views)

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Re: [macmember] Effect of insurance on medical costs

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FYI Medicare does pay claims in Canada and has for years. It only does this under very special conditions but they can do it. As for policing the Mexican claims I do not see that this would be any different from policing claims in the US or Canada. Blue Cross and many other insurance companies pay claims in Mexico and Medicare would not be any different. The only major different is that BC and other insurance companies pay much lower claims than they would for claims originating NOB and Medicare would do the same.

windknot

Nov 7, 2007, 6:43 AM

Post #32 of 50 (3644 views)

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Re: [lmaxine] Effect of insurance on medical costs

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That's what the Mexican private insurance is for!!! Please read the post before you go shooting off your mouth.

This thread is about Medicare....NOTHING ELSE Of course you want some kind of health insurance!....just not Medicare.

tonyburton / Moderator

Nov 7, 2007, 6:55 AM

Post #33 of 50 (3641 views)

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Re: [windknot] Effect of insurance on medical costs

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Please let's keep this discussion civil. If you want to attack, then attack the message, not the messenger. Tony.

NEOhio1

Nov 7, 2007, 7:02 AM

Post #34 of 50 (3641 views)

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Medicare and incomes

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This push to bring Medicare to Mexico doesn't have anything to do with providing you and me, as expatriates, medical care thru a US entitlement program. Its does have to do with Mexican physicians and institutions wanting parity with US physicians and institutions for medical SERVICES, which has no connection to care or who gets it, just a connection to money. Once they get that their prices to ordinary Mexican citizens and expatriates will increase substantially. Now the physician and you can negotiate your care costs, with a set fee schedule he won't be able to do that with you. At this point the expatriate isn't even a big part of the pie, they want to tap into the Mexican national population who is legally eligible for SS and Medicare from the US. And there is a lot of foresight being used here to get this in place to be able to get paid from Medicare in the future should the Mexican citizens presently in the US legally return to Mexico in the future. Then you have the potential for a whole mass of eligible people if the millions of Mexican citizens in the US illegally gain by decree, be it work permits, etc... their subsequent eligibility for SS and Medicare.

The oversight problems are immense, the licensing and reimbursement rules beyond anything Mexico has seen to date, and it would be a political nightmare to any US politician who would sponsor such a proposal. Can't you imagine the hue and cry from US voters .. and frankly I would be one of them, the US entitlement programs have no business being beyond the borders of the US. One of my biggest objections has nothing to do with thinking that just those in the US should be able to use those entitlement programs, but that those programs are so fraught with stupidity and corruption that they should not be imported to other countries to ruin their system of care too.

Jerry@Ajijic

Nov 7, 2007, 8:34 AM

Post #35 of 50 (3618 views)

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Re: [NEOhio1] Medicare and incomes

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You are right, the problems would be great BUT Blue Cross, AIG, and many other international insurance companies as well as a multitude of Mexican companies are and have been for years coping with these problems. I understand that Medicare has problems but they would have no more here than they do NOB. The insurance companies that do serve Mexico figure out what is the local rate for medical care just as Medicare does NOB. As a example I believe that one insurance company will pay 100% of your bill at some Mexican hospitals but a lot less at some of the higher priced (gringo priced) ones.

Oscar2

Nov 7, 2007, 10:22 AM

Post #36 of 50 (3601 views)

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Re: [Jerry@Ajijic] Medicare and incomes

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Being that the subject matter is somewhat the same, yesterday I just received a nay vote (shot down) against my John Hancock long term care insurance request to extend any future long term care I may need too Mexico.

The policy specifically names about 16 other worldwide countries including Israel, Malaysia, Greece, New Zealand, Lebanon, Hong Kong, the Netherlands, and most other major countries in the world but Mexico was conspicuously excluded.

With all the chaos and turmoil occurring in Israel and a number of other nearby countries in that part of the world, why would they not even consider trusting Mexico as a viable good neighbor, especially with the accrued savings long term care would provide them.

Their guidelines and policies were written in earlier times but now seem nonsensically entrenched in unfavorable and volatile times in parts of the world seemingly less favorable then Mexico. Since 9-11, climates are changing in those parts of the world they once considered viable. With the fall of the dollar and rise in cost of living abroad, one would think Mexico would be a welcomed affordable alternative.

Luckily, my health is good right now and with time I’ll keep plugging away and write letters and speak to most anyone within the John Hancock system making it hopefully clear that times are changing and long term care in Mexico would be an excellent choice.

robrt8

Nov 7, 2007, 7:33 PM

Post #37 of 50 (3548 views)

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Re: [NEOhio1] Medicare and incomes

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I'd like to add to #34's post. In addition to her great post, there is also the factor of litigation that may tag along. God forbid the door is left open in Mexico as it is NOB. My Dad retired years ago and couldn't volunteer because of the threat of litigation (he couldn't work for free).

Gringal

Nov 8, 2007, 9:11 AM

Post #38 of 50 (3506 views)

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Re: [robrt8] Medicare and incomes

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Good point, Hopako. That's just all we need. One of the top reasons for the high doctor and hospital fees in the states is the cost of carrying malpractice insurance. In some specialties, obstetrics, for example, the cost is eye-popping.

Sometimes I scratch my head wondering why people come to Mexico to retire and then can't accept that they will have some wonderful new things, but not everything they had NOB, including Medicare. If low cost medical care was such a big issue, why didn't they find a nice place to settle down in the states? They knew what the situation was in Mexico before coming here.

Some people with some very serious medical problems that will cost a bundle in care post on this forum with questions about the care here, and come anyway. It is as though their "Mexican Dream" must be fulfilled, no matter what condition they are in. I feel empathy for them, but there is no magic bullet to cover their situation. Sometimes, it wanders into the field of "dark humor", like a person who has six (always well behaved) pit bulls, 4 cats, and wants to find a furnished rental for the winter with wheelchair access, in a quiet neighborhood.

Esteban

Nov 23, 2007, 4:55 AM

Post #39 of 50 (3426 views)

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Re: [Gringal] Medicare and incomes

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I've been sworn to secrecy but I happen to know there are doctors and hospitals, in Mexico, going through the Medicare certification process as we speak. I don't know how many facilities have applied but it's the real deal. I've been watching this for quite sometime because of my involvement with Grupo Inbursa, selling their health care insurance, a few years ago. I'm not sure about the timetable but I suspect, if all goes well, things may start happening next year.

Esteban

NEOhio1

Nov 23, 2007, 6:33 AM

Post #40 of 50 (3412 views)

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Re: [Esteban] Medicare and incomes

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It will be incredible if Congress will take the political hit necessary to make Medicare available in Mexico as the perception that they are giving Medicare services to Mexicans who worked in the US, whether legally or illegally, will be too much to overcome. Not to mention the idea of selling to millions of US citizens the thought that some citizens have moved or retired to Mexico by choice and want to have the services available - I can hear it now, "enough to move away, enough to pay your way". US citizens here availing themselves of the program doesn't bode well for Mexico by having it become the nursing home of the US. If many of the boomers that are expected can make the move on a shoe string because medicare is available I can hear the talking heads now, and it becomes "enough to move away but not enough to pay their way, so they want you to". Then they will get started on the legalization of migrants in the US illegally and their eventual entitlement to the service. Nope just can't see it. Its too hot.

Ivester

Nov 24, 2007, 7:06 AM

Post #41 of 50 (3357 views)

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Re: [NEOhio1] Medicare and incomes

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The only way I can see this happening is if private insurance companies in the US figure out a way to make money from it. That is, if Blue Cross or Aetna can funnel Medicare money through their operations into Mexico, then Congress will vote for it overwhelmingly and any US president will support it. Doesn't matter if it's Dems or Reps; both parties are wholly owned subsidiaries of the insurance companies. The public will hate it, but they'll have nowhere to go politically, as usual.

Bloviator

Nov 24, 2007, 11:35 AM

Post #42 of 50 (3328 views)

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Re: [Esteban] Medicare and incomes

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I sincerely hope you are right. It would save me a lot of money or a lot of travel or both. However, with the massive amount of fraud in Medicare NoB, I can't see them trying to export it and deal with the potential fraud involved.

A whole bureaucracy would have to be set up to deal with this. Also, once Mexico is included in Medicare, others would have to be included also. Thus providing even more opportunities for fraud.

Can't you see Russian hospitals salivating at the prospect of all that money. As it is, there is massive fraud from Russians in the US. If they don't have to leave home to benefit, I'm sure they would love it.

GueroPaz

Nov 24, 2007, 4:02 PM

Post #43 of 50 (3302 views)

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Re: [Bloviator] Medicare and incomes

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Imagine the clerk/officer at your congressperson's office, with a checklist of the 89 most important constituent issues, getting a request for overseas Medicare legislation. It's not on the list. Nobody is paying campaign donations for expatriates, are they? We are in the general category of citizens (largely, non-voting ones) who have had the gall to leave the land of the free. UK citizens receive no COLA's in their govt. pensions while living overseas. Canadians have to return and live in Canada for six months of the year to remain eligible for NHS medical care. So I understand, from the English and Canadian expats here in Thailand. So it's never going to show up favorably on the political radar for Medicare to be included.

My federal pension's medical insurance now covers me overseas as if I'm in a PPO, so my copay is only 10% for inpatient procedures. My office visits run as low as $3 or $11 to see a surgeon, dermatologist, heart specialist, etc., so I never bother to claim those visits. When I do submit an inpatient claim, the gals down at the claims office probably laugh how cheap it is.

So, I doubt that the Congress is likely to include overseas Medicare coverage.

jennifer rose

Nov 27, 2007, 6:37 AM

Post #44 of 50 (3234 views)

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Re: [Esteban] Medicare and incomes

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And perchance would the company operating under a cloak of secrecy be Ambassador Care, http://www.ambassadorcare.com/home.html?

Just because it mentions Medicare and Social Security on its website, selling insurance to seniors, doesn't mean Medicare is coming to Mexico. It isn't.

On its website, the same company offers a network of veterinarians, makes loans to physicians, promotes housing developments abroad, and seeks relationships with retailers wishing to market to an international clientele.

(This post was edited by jennifer rose on Nov 27, 2007, 12:50 PM)

ncferret

Nov 29, 2007, 8:40 AM

Post #45 of 50 (3173 views)

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Re: [jennifer rose] Medicare and incomes

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I feel obliged to post regarding misinformation that has been given on two forums in the past 2 weeks regarding healthcare coverage.

First, a person on one forum posted wanted to know if BCBS covers claims in Mexico. There were various answers, some with very misleading information. Generally, BCBS does not cover claims outside the US except on an emergency basis. Health care providers (doctors and hospitals) will not accept your BCBS card in Mexico.

Will the providers (especially a hospital or clinic) file a claim for you? Maybe, since that costs the provider very little. Will BCBS pay the claim – that depends on many provisions in your Summary Plan Description. BCBS has tens of thousands of provisions in their contracts. Every state and every federal plan is different as are most private plans.

If the provider does file a claim for you, most likely, you will have to pay the entire bill and wait for reimbursement from BCBS. Why, because there are no BCBS approved health care providers in Mexico (at least none that I am aware of). BCBS only reimburses providers directly (its called accepting assignment) for providers that have gone through a stringent review process called accreditation.

Second, recently 2 people posted on two different forums and claimed that Medicare is going to start paying claims in Mexico. One post claimed, “Medicare will now pay medical bills in Mazatlan”. Nothing could be farther from the truth! For Medicare to pay providers directly in Mexico, a change in law would be required by Congress (or these providers will have to bill fraudulently). Personally, I doubt I will see Medicare paying claims in Mexico in my lifetime, although I certainly hope I’m wrong since the quality of health care here is excellent based on my experience and the US needs to save every dollar they can these days.

Here’s the truth about the claim made above. Years ago, HMO’s were permitted to bring Medicare recipients into their health care networks (Medicare Advantage) as a cost saving measure for the US government. There are a few HMO’s setting up coverage “across the border” and an individual HMO could possibly accredit any provider - including a hospital or doctor outside of the US.

One such HMO that resides in Southern California (Ambassador Care) has decided to provide a plan that covers you “internationally”. Sadly, the details of the plan are sorely lacking. For example, there isn’t even a list of approved providers. Meaning, you might get coverage or you might not when outside of the US since the plan has strict penalties for out of network claims. Before you sign up for coverage with any insurance company or HMO in the US, you should check with the Insurance Commissioner’s office for the state in which the company or HMO is licensed.

The list of complaints against HMO’s in the US is extensive. Services obtained (other than for emergency care) outside of the HMO will usually be denied coverage. More importantly, with the aforementioned plan, you have to be a resident of certain Southern California counties (because the HMO license is only valid in their area of coverage). That means you have to set up residence in CA (pay taxes?) to take advantage of this plan. As Jennifer mentions, the company’s entire website makes the operation look very shady.

Traditional Medicare does not provide coverage outside the United States for any period of time – including Canada. Medicare HMO's may provide coverage for emergency care outside the country but you must retain residence in the HMO’s coverage area. If you live in Mexico and claim residence in an HMO’s coverage area, you may be committing fraud.

If you really want to know the details simply go to Medicare’s (the government's official site) site and read the pamphlet that specifically answers the question concerning coverage outside the US –

http://www.medicare.gov/Publications/Pubs/pdf/11037.pdf

Please don’t take anyone’s advice on ANY forum about your health care coverage – including mine. Don’t ask for anecdotal advice about healthcare coverage on a forum where numerous details may have been left out about a single person’s experiences. For example, “BCBS paid all my bills for a claim I had in Mexico”. Oh yeah, after the person paid the claims on his credit card and was able to prove that the care was an emergency. CALL YOUR INSURANCE COMPANY!!! Get the answers to your questions AND in writing if possible.

(This post was edited by ncferret on Nov 29, 2007, 8:43 AM)

Bloviator

Dec 5, 2007, 8:01 AM

Post #46 of 50 (3089 views)

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Re: [windknot] Effect of insurance on medical costs

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Friday when I went to see my urologist, he mentioned that when I had been under anesthetic for kidney stone removal, he had told me that I owed him $10,000 pesos for his services - in addition to the $15,000 pesos (paid at the time of the service) for the clinic and $2,000 for the anesthesiologist.

Considering that his services have been most economical before and that as far as I could tell, the only thing he had to do was watch the ultrasound machine pound the stone to dust, I couldn't figure why it was so expensive. I'm still nonplussed, but figure that the low cost of all the other services he has provided including a house call from Guad to Ajijic that may have saved my life, preclude any complaint. Therefore, I'm not complaining, just puzzled.
This whole episode has made me careful to check the total costs here and then consider whether it is better to use local care or Medicare, NoB.

I'm of the school that doesn't believe that it is practical in any way to provide Medicare here, primarily because of the danger of fraud, the bureaucracy involved, and the cost of extensive usage of such services.

Another thing I have learned from this is that there are greatly varying costs depending on the hospital or clinic providing the services. Puerta de Hierro is a wonderful facility with the most up-to-date equipment and the costs are consistent with the quality of facility and equipment. Other facilities are much more economical. I'm careful now to discuss all the local possibilities with my doctor before getting treatment/procedures/surgery.

(This post was edited by Bloviator on Dec 5, 2007, 8:03 AM)

esperanza

Dec 5, 2007, 8:27 AM

Post #47 of 50 (3082 views)

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Re: [Bloviator] Effect of insurance on medical costs

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He told you this while you were under anesthetic? Is he nuts? He expected you to remember this?

http://www.mexicocooks.typepad.com

bournemouth

Dec 5, 2007, 10:32 AM

Post #48 of 50 (3060 views)

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Re: [Bloviator] Effect of insurance on medical costs

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If this fellow is serious and thought that you ought to know what he told you under anesthetic, I think I'd be looking for a new urologist very fast. I see that as basically fraudulent.

Bloviator

Dec 6, 2007, 4:39 AM

Post #49 of 50 (3006 views)

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Re: [bournemouth] Effect of insurance on medical costs

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Sorry folks. Evidently my posting was misleading. I was coming out of anesthesia and do have some vague recollection of the discussion, though very vague. As mentioned above, his service has been excellent, generally economical, and professional.

Marlene

Dec 8, 2007, 2:35 PM

Post #50 of 50 (2926 views)

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Re: [Bloviator] Effect of insurance on medical costs

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It would have been professional of him to discuss it with you prior to the procedure when you had a clear head.

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