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Medicare (B) services in US if you have a Mexican address

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RVGRINGO
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Post by TrueBrit Thu Feb 25, 2016 10:55 am

I have my Mexican address on file with most state and US government agencies (I didn't want jury duty etc).  I have had no problem - I receive my Social Security.  I currently receive Blue Shield health insurance as part of a retirement package but when I turn 65 next week I will be eligible for Medicare and things change.  I have opted to sign-up with Medicare Part B and my current Blue Shield Health Insurance converts to a Medicare Part B supplemental insurance.  Now I know that Medicare does not cover services outside the USA.  I have separate health insurance coverage for Mexico.  However, in calling my ex-employee, Blue Shield, Medicare and the Social Security Administration, no-one can give me a definitive answer to this question.

If I have an address outside of the USA on file with SSA and I visit the USA, while INSIDE the USA can I take advantage of Medicare, i.e. will Medicare cover me for services performed in the USA by a doctor who accepts Medicare?

I have called the above several times and often get conflicting answers.  No-one can point me to any regulations that definitively answer this question.  Having the SSA agent tell me "I think so" is not very comforting.  Some have told me 'no' - with a Mexican address, Medicare will not cover you for anything inside or outside the US.  Even the gentleman giving the emergency medical flights presentation lakeside in the coming weeks could not answer it - and you think the success of his company would depend on knowing the answer to this question.

So, is anyone else in this situation?  And has had experience with Medicare inside the USA?  Is it worth keeping Medicare Part B? (as it is not free)

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Post by gringal Sat Feb 27, 2016 10:53 am

The long answer is already on TOB.

To answer your question about my experience with Medicare through an HMO in the states:  It was not only disappointing but health-threatening.  I escaped over-treatment including surgeries by just saying NO.

In Mexico, I don't have to wait in paper 'garment' in a cold room to see a doctor who is looking at his watch every 30 seconds.  I am content with the care right here.  I cancelled Part B Medicare years ago.

The person who didn't know all the answers to your question re airlifting people to the states so that they could have care under Medicare either didn't know the answer and didn't want to tell you.  It's his/her job to know.

My advice here, as it was on TOB. Read your Blue Cross/Blue Shield policy, especially the fine print.

You may wish to find a Mexican insurance policy.   Sounds like you're still young enough to do so.  
Good luck.  I know this can be confusing. scratch

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Post by Ojalero Sat Feb 27, 2016 11:15 am

Medicare is your right, but you can have not get a Medicare Advantage Plan using a Mexican address.

I would scrap the Part B coverage as it it is for routine care, something not worth traveling NOB for. Part A covers the real expensive stuff and is an entitlement for those 65 no matter where they live, you just need to get the services in the US or US territory.

I personally would never voluntarily get any procedure done in Mexico that requires anesthesia. The dead are not able to council you on this matter.

See this for more info about your insurance situation:  http://www.fool.com/retirement/general/2014/03/14/social-security-and-medicare-for-expatriates-what.aspx
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Post by gringal Sat Feb 27, 2016 12:21 pm

"I personally would never voluntarily get any procedure done in Mexico that requires anesthesia. The dead are not able to council you on this matter."

I have a number of friends and acquaintances who have had surgery with  anesthesia in Mexican hospitals and are now well and happy with the care, myself included.  Since the U.S. hospital system doesn't rate well on the world wide scale, what do you base this blanket condemnation on?

BTW, The Motley Fool's brief statement you referred to is not enough to base a decision on, as opposed to the official sites from the SSA.

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Post by David Sat Feb 27, 2016 1:01 pm

I find the medical care here to be superb, efficient, and very personal. I had spinal surgery in Guadalajara at Angeles del Carmen hospital in 2013. The care was excellent and the outcome was successful. The facilities were what you would expect to find in the USA, and the care much better. As for anesthesia, the anesthesiologist who assited the surgeon was well educated, bi-lingual, and visited me twice each day I was in the hospital. I choose Mexico for all of my medical care.
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Post by Ojalero Sat Feb 27, 2016 7:17 pm

I am glad that people are happy with their surgical results in Mexico. I said that I personally would not. Why do I need to defend my personal opinion? I did not say that I recommend anything. I personally believe that if one thinks that the care, outcome, and legal protections of Mexico equals that of the US is delusional, but that is my personal opinion also.
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Post by gringal Sat Feb 27, 2016 10:09 pm

Ojalero wrote:I am glad that people are happy with their surgical results in Mexico. I said that I personally would not. Why do I need to defend my personal opinion? I did not say that I recommend anything. I personally believe that if one thinks that the care, outcome, and legal protections of Mexico equals that of the US is delusional, but that is my personal opinion also.

Hey there......you made a very strong "personal" statement in a highly dramatic way which was likely to scare the bejeesus out of the OP.  

Others' "personal" opinions came out in rebuttal, which is normal on these boards.
If you check the statistics of where U.S. medical care ranks among other countries, It may surprise you, even if it doesn't shake your "personal" opinion.


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Post by slainte39 Sat Feb 27, 2016 11:18 pm

Why does either side of this debate have to defend their personal opinion? Put it out there and let others just agree or disagree. Just because someone disagrees with your opinion doesn't mean you have to defend it....unless you are really looking for converts. Very Happy

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Post by TrueBrit Sat Feb 27, 2016 11:29 pm

Blue Shield were very clear about their Part B supplemental insurance. If I had an address outside the USA, they would cover me for 6 months and then....nothing. That made my mind up regarding the usefulness of Part B for me.
I still haven't heard from anyone who has successfully claimed against Part B for services performed in the USA with a foreign address on file with SSA. Fortunately I now don't have to test the system to see if it works.

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Post by Ojalero Sun Feb 28, 2016 12:15 am

slainte39 wrote:Just because someone disagrees with your opinion doesn't mean you have to defend it....unless you are really looking for converts. Very Happy

I was refering to gringals question, sorry I wasn't more specific. I am not "looking for converts", just stating my personal opinion based on my personal experiences. Sorry that I ruffled a few, but I would actually say that there is no way in hell I would let any surgeon in Mexico cut on me unless I can not get NOB, but again it is my personal opinion. To me, the most important insurance to have is an air evacuation policy for an American citizen over 65.
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Post by slainte39 Sun Feb 28, 2016 12:45 am

Ojalero wrote:
slainte39 wrote:Just because someone disagrees with your opinion doesn't mean you have to defend it....unless you are really looking for converts. Very Happy

I was refering to gringals question, sorry I wasn't more specific. I am not "looking for converts", just stating my personal opinion based on my personal experiences. Sorry that I ruffled a few, but I would actually say that there is no way in hell I would let any surgeon in Mexico cut on me unless I can not get NOB, but again it is my personal opinion. To me, the most important insurance to have is an air evacuation policy for an American citizen over 65.

....OK

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Post by Ojalero Sun Feb 28, 2016 1:15 am

gringal wrote:If you check the statistics of where U.S. medical care ranks among other countries, It may surprise you, even if it doesn't shake your "personal" opinion.

I did ma'am, US #31, Mexico #60. SOURCE:  https://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health_systems_in_2000

Of course there are other lists quite different, but I am not talking about "health care" in general. Primary care is great in Mexico. Please show me, a sincere request, the rankings of countries by sick care. I do not see any sultans of the middle east going to Mexico for bypass surgery like they go to John Hopkins, Cleveland Clinic, Mayo Clinic etc.
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Post by Lady Otter Latté Sun Feb 28, 2016 5:11 am

How many Medicare patients do you suppose are treated at Johns Hopkins, Cleveland Clinic and Mayo Clinic, etc.?
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Post by Ojalero Sun Feb 28, 2016 9:03 am

Lady Otter Latté wrote:How many Medicare patients do you suppose are treated at Johns Hopkins, Cleveland Clinic and Mayo Clinic, etc.?

Medicare costs are the same if the patient goes to one of them or to a 25 bed rural hospital. On checking Johns Hopkins I see that they even have their own Medicare Advantage health plan for their locals. http://www.hopkinsmedicare.com/

The reputation of a hospital has no bearing on the cost of care to the Medicare recipient. Medicare requires that an ambulance take you to the closest hospital, not to the hospital of your choice for reimbursement (been there, done that). Nobody passes one of those institutions with chest pains to shop for perceived cheaper services. I know that the Cleveland Clinic has a floor of suites for the ultra rich where I would guess the Medicare patient would not get at the regular costs.

The law in the US is that any hospital that receives federal funding, virtually all them, must treat anyone with non elective surgery without the ability to pay.

The major reason that many Medicare patients do not use the sited institutions is they are not located near them.

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Post by David Sun Feb 28, 2016 9:12 am

IMHO, I would not go the USA for any medical issues, the waiting time alone could kill you!
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Post by Ojalero Sun Feb 28, 2016 9:38 am

Wait times? The US isn't Canada and even their times are highly exaggerated by those opposed to a single payer system.

How long does one wait at a Mexican hospital before the ability to pay obstacle is overcome, David?


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Post by Trailrunner Sun Feb 28, 2016 9:49 am

I'm with you, David.

I do respect your decision, Ojalero, but let me ask you. . .

What would you do if you got hit by a car or were in a motor vehicle accident and were bleeding internally at the Cruz Roja clinic, emergency surgery was needed, and the CR doc was setting up the surgery and ambulance transfer to Guad?

You wake up early one morning with crushing chest pain and it feels like an elephant is sitting on your chest. You go to one of the clinics and they administer nitroglycerin, get your blood pressure down a bit, and the pain temporarily goes away. The doctor reading your EKG says you are infarcting, you need an emergent cath lab and probable stent, and is making the arrangements for your transport to Guad to a cath lab.

What would you do, call the airlines?
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Post by Ojalero Sun Feb 28, 2016 10:40 am

Trailrunner wrote:What would you do, call the airlines?

I said early on that I would not seek voluntary surgical services in Mexico. I really think that answers your questions, right?
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Post by RVGRINGO Sun Feb 28, 2016 10:55 am

3rd most frequent cause of death in the USA: Medical errors!

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Post by Ojalero Sun Feb 28, 2016 11:04 am

RVGRINGO wrote:3rd most frequent cause of death in the USA:  Medical errors!

I spit my coffee all over my monitor when I read that statement.

Number of deaths for leading causes of death
Heart disease: 611,105
Cancer: 584,881
Chronic lower respiratory diseases: 149,205
Accidents (unintentional injuries): 130,557
Stroke (cerebrovascular diseases): 128,978
Alzheimer's disease: 84,767
Diabetes: 75,578
Influenza and Pneumonia: 56,979
Nephritis, nephrotic syndrome, and nephrosis: 47,112
Intentional self-harm (suicide): 41,149

SOURCE:  http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Your reference please sir.
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Post by Trailrunner Sun Feb 28, 2016 11:06 am

Not exactly what you said, what you said is: "I personally would never voluntarily get any procedure done in Mexico that requires anesthesia." In those 2 scenarios I mentioned, IF YOU WERE CONSCIOUS, you would always be asked for consent. IF YOU WERE UNCONSCIOUS, your surgery would be done under implied consent. So, would that conscious consent be "voluntary" by your definition?

Or, is it more like. . .if I decided to have a boob job or a face lift I would never let a Mexican surgeon cut on me etc.
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Post by Ojalero Sun Feb 28, 2016 11:14 am

Trailrunner wrote:So, would that conscious consent be "voluntary" by your definition?

There is a world of difference between elective surgery and emergency surgery. I would, if conscious and have time to be evacuated to the US, do so. I have done so in the past and hopefully would again if the situation allows it.
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Post by Trailrunner Sun Feb 28, 2016 11:19 am

Good. That's what I wanted to hear your definition to be.
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Post by gringal Sun Feb 28, 2016 11:48 am

My "personal" opinion of those ads from more than one of those air evac companies strike me a fear-based.
If that's the motivation for signing up, it probably is a good idea.

My "personal" take on U.S. medical care is rather poor, and is "experience based".  








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Post by Trailrunner Sun Feb 28, 2016 12:06 pm

Ditto what Gringal said.
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