BajaNomad

How's your Medical insurance covering you in Mexico?

EnsenadaDr - 6-20-2015 at 09:06 AM

Good Morning everyone yes it's been a while but between my work in the US and Mexico, haven't had much time for posting. Checked in this morning and it occurred to me how many of you are ready for a medical emergency South of the Border? The general consensus is that Medicare will cover all emergencies in Mexico. This is generally not the case. However, I would like to hear your experiences in getting reimbursed from Medicare and if any of you have had immediate coverage from a hospital in Mexico from your insurances. Kudos to those who are enrolled in the Mexican Health plans such as Seguro Popular or IMSS. Tenga un buen dia.





[Edited on 6-20-2015 by EnsenadaDr]

SFandH - 6-20-2015 at 09:44 AM

Quote: Originally posted by EnsenadaDr  
The general consensus is that Medicare will cover all emergencies in Mexico. This is generally not the case.


I was just reading about the coverage the Kaiser Permanente Senior Advantage San Diego HMO offers and it states:

"our plan covers emergency care anywhere in the world"

No extra monthly premium, you just keep paying the Medicare Part B premium

You need to live in San Diego county to enroll however.

[Edited on 6-20-2015 by SFandH]

soulpatch - 6-20-2015 at 10:01 AM

We have Seguro Popular for a back up but we just pay cash for everything including a recent surgery.
It is all very affordable.

reimbursed from Medicare??

durrelllrobert - 6-20-2015 at 10:40 AM

I guess so since Medicare part B pays the entire annual premium for Sr. Advantage at Kaiser but the reimbursement checks are sent from Kaiser. I have had out of country reimbusement from Kaiser 3 times, twice for emergency treatment in Mexico and once in Canada. I each case they reimbursed for everything except presciptions; of course I had to pay cash upfront in Mexico and using my Visa card in Canada. My wife and i are both enrolled in Seguro Popular also but I have never used it. In fact I cant even find my enrollment documentation; do you know how to get duplicate?

EnsenadaDr - 6-20-2015 at 10:49 AM

I am sure all of you know to receive Kaiser Sr. Advantage you must be living in the US a majority of the time so an American Address is needed. Is that right Bob?

EnsenadaDr - 6-20-2015 at 10:52 AM

The other problem is that you need to pay the medical bills up front which can be a burden for many.

durrelllrobert - 6-20-2015 at 11:16 AM

Quote: Originally posted by EnsenadaDr  
I am sure all of you know to receive Kaiser Sr. Advantage you must be living in the US a majority of the time so an American Address is needed. Is that right Bob?


I use my postal mail box in Chula Vista and I don't live in that.

SFandH - 6-20-2015 at 02:29 PM

EnsenadaDr, in reference to the Kaiser Senior Medicare Advantage Plan, it appears you are correct on both counts, your primary residency should be, in this case, San Diego County and Kaiser reimburses the expense after you pay for the emergency care at the Mexican hospital.

I'm new to Medicare so I've been reading about it, paying special attention to outside of the US medical emergencies.

Basic Part A and Part B does not cover medical expenses outside of the US except in very special cases. One being you're in Canada in transit between the lower 48 and Alaska and the other being it's an emergency near the border and a Canadian or Mexican hospital is closer than a US hospital.

However, many people buy Medigap or Medicare Advantage (Part C) insurance to cover what Medicare doesn't and many of those policies will cover medical emergencies while traveling abroad. I've read for up to 60 days abroad but there is probably differences from one policy to another.

Anyway, Medicare is new to me and I'm trying to learn about it, especially considering I spend a lot of time in Mex. and I need to be prepared for medical emergencies.

If this thread is to continue a distinction needs to made for full time Mexico residency and part-time residency.

DENNIS - 6-20-2015 at 02:33 PM

Quote: Originally posted by EnsenadaDr  
I am sure all of you know to receive Kaiser Sr. Advantage you must be living in the US a majority of the time so an American Address is needed. Is that right Bob?


Postal Annex, and others, have a street address. That satisfies the requirement.
It's a "Don't ask...Don't tell type of thing.

[Edited on 6-20-2015 by DENNIS]

SFandH - 6-20-2015 at 02:42 PM

Quote: Originally posted by DENNIS  
Quote: Originally posted by EnsenadaDr  
I am sure all of you know to receive Kaiser Sr. Advantage you must be living in the US a majority of the time so an American Address is needed. Is that right Bob?


Postal Annex, and others, have a street address. That satisfies the requirement.


We need to be careful with that trick. The post office now has a database that distinguishes between residencial and commercial addresses. A bank (Citibank) refused to take a PMB (private mailbox) address as my residencial address once. I was on the telephone and the bank person told me that the address I gave them (a street address PO Box operation like Postal Annex) as my residence was a commercial address and they couldn't accept it a residence. Effing computers.

bajaguy - 6-20-2015 at 02:46 PM

Quote: Originally posted by SFandH  
EnsenadaDr, in reference to the Kaiser Senior Medicare Advantage Plan, it appears you are correct on both counts, your primary residency should be, in this case, San Diego County and Kaiser reimburses the expense after you pay for the emergency care at the Mexican hospital.

I'm new to Medicare so I've been reading about it, paying special attention to outside of the US medical emergencies.

Basic Part A and Part B does not cover medical expenses outside of the US except in very special cases. One being you're in Canada in transit between the lower 48 and Alaska and the other being it's an emergency near the border and a Canadian or Mexican hospital is closer than a US hospital.

However, many people buy Medigap or Medicare Advantage (Part C) insurance to cover what Medicare doesn't and many of those policies will cover medical emergencies while traveling abroad. I've read for up to 60 days abroad but there is probably differences from one policy to another.

Anyway, Medicare is new to me and I'm trying to learn about it, especially considering I spend a lot of time in Mex. and I need to be prepared for medical emergencies.

If this thread is to continue a distinction needs to made for full time Mexico residency and part-time residency.





I have a Medigap Plan "F" supplemental policy through United Healthcare that allows me to go to any Doctor/Facility that accepts Medicare (no US geographical limitations). It will also cover emergency treatment outside of the US.

I also have two worldwide medical evacuation plans, one through my life insurance policy and one through my SPOT subscription.

Just learned that Good Sam (the RV people) have a medical evacuation policy called Travel Assist. The Travel Assist Premier plan will also cover family members and looks like it will cover even with pre-existing conditions for $140 a year.

https://www.goodsamtravelassist.com/default.aspx



[Edited on 6-20-2015 by bajaguy]

redmesa - 6-20-2015 at 02:48 PM

I travel with my British Columbia Medical Plan (only reimburses what same would have cost in Canada)and and BCAA worldwide travel insurance. The BCAA is the insurance that reimbursed me when my husband died in Hawaii. I always have a huge line of credit to draw on if necessary.

SFandH - 6-20-2015 at 02:53 PM

Quote: Originally posted by bajaguy  

Just learned that Good Sam (the RV people) have a medical evacuation policy called Travel Assist. The Travel Assist Premier plan will also cover family members and looks like it will cover even with pre-existing conditions for $140 a year.

https://www.goodsamtravelassist.com/default.aspx



[Edited on 6-20-2015 by bajaguy]


Interesting, thanks.

I suppose there are also US based insurance plans designed for expats. Another angle to look into.

EnsenadaDr - 6-20-2015 at 11:24 PM

Quote: Originally posted by durrelllrobert  
I guess so since Medicare part B pays the entire annual premium for Sr. Advantage at Kaiser but the reimbursement checks are sent from Kaiser. I have had out of country reimbusement from Kaiser 3 times, twice for emergency treatment in Mexico and once in Canada. I each case they reimbursed for everything except presciptions; of course I had to pay cash upfront in Mexico and using my Visa card in Canada. My wife and i are both enrolled in Seguro Popular also but I have never used it. In fact I cant even find my enrollment documentation; do you know how to get duplicate?
Bob just go into your local office in Maneadero and ask the admin to assist you with it, at the Seguro Popular section.

medigap policy coverage

john68 - 6-21-2015 at 07:57 AM

here's the foreign coverage that medigap policies provide--

http://www.medicare.gov/supplement-other-insurance/medigap-a...


SFandH - 6-21-2015 at 08:35 AM

Thanks John. Just sat down for another day of reading about Medicare coverage. I still haven't decided between a Medicare Advantage Plan or a Medigap plan but I'm leaning towards the San Diego County Kaiser Senior Advantage Plan, a HMO. It's wide open because I don't have any doctor loyalties now.

Opinions welcome, I suspect there are many on this message board who are using Medicare. I know it's not exactly on topic, except for the coverage in Mexico aspect.

john68 - 6-21-2015 at 09:04 AM

Good luck.

I was a tax lawyer for over 30 years and had some experience reading and understanding complex laws. I found the Medicare process almost incomprehensible. The drug coverage under Part D is equally difficult to understand. I finally gave up and listened to friends who had had good results with USAA medicare supplement. We chose plan F.

I read somewhere that Obamacare would eliminate Medicare Advantage policies in the near future. I didn't follow up on that issue because our doctors in Colorado wouldn't accept Medicare Advantage.

EnsenadaDr - 6-22-2015 at 09:52 AM

Thanks for all the info and keep it coming. Good to hear from Bob that he was reimbursed for emergencies out of country. Please continue to contribute to the discussion. Thank you Bajaguy for the info on other health insurance options.