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pauldavidmena
Super Nomad
Posts: 1687
Registered: 5-23-2013
Location: Centerville, MA, USA
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Just got a reply from my inquiry to Blue Cross / Blue Shield. Basically they asked me to call an 800 number to locate a "participating provider" where
I will be traveling, and that "the plan pays for covered emergency services at the In-Network benefit level of coverage and all other covered
non-emergency services at the Out-of-Network benefit level. Show your ID card to the participating provider and they will coordinate your care and
claim submission. You will be responsible for any out-of-pocket expenses (non-covered services, deductible, copayment and coinsurance) that you would
normally pay for in the United States."
Based upon what I'm reading on this forum and elsewhere, it might be too good to be true.
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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Okay, Blue Cross Blue Shield pays a percentage of what is set on Medicare reirmbursement. If you travel outside of the US, all of the Blue plans that
I sold had you pay for the service and then submit a bill when you returned. Emergency services mean that whatever is needed to keep you alive and
not losing life or limb. I had a client that was in Cabo who had an appedix rupture and the Blues were only to happy to pay for the emergency
surgery since it was less than it would have been in-network.
Once you go out of network, they normally pay with a higher deductible and pay only reasonable and customary.
I have never seen a hospital, except for a few on the border in Tijuana who would directly bill Blue Cross.
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pauldavidmena
Super Nomad
Posts: 1687
Registered: 5-23-2013
Location: Centerville, MA, USA
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I decided to call the 800 number, and as expected, got a friendly but unconvincing response. It seems prudent to have a credit card with a deep credit
limit in the event of an emergency, and to file with BCBS after the fact and hope for at least partial reimbursement. My "BLUE CARE ELECT PREFERRED
VALUE PLUS" plan should reimburse for emergency care overseas - if the full-color brochures are to be believed.
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Alm
Ultra Nomad
Posts: 2716
Registered: 5-10-2011
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You are worried about coverage now - you should better worry about getting a proper treatment on time. 2-3 hours for local Red Cross to arrive, even
when you are 15 miles from their base. Then God knows how long to get to a real hospital - not a small clinic nearby.
Evac plan requires you to go to some medical facility first, and only then they will airlift you to a big city in Baja or NOB, and it may take hours
to get to the airport where this evac service is flying from. Few more expensive services are "evac and rescue", meaning they will pick you up the
place of accident.
Border formalities at the airport take precious time, and if you go to Mexican hospital don't expect them to speak English. More and more of them do,
as time goes by, but don't count on it, especially in public hospitals and small towns.
FYI, you get irreversible brain damage after stroke if not treated within 4 hours.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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I totally agree with Baja Guy, have an emergency exit plan, medjet seems like a good alternative!!
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pauldavidmena
Super Nomad
Posts: 1687
Registered: 5-23-2013
Location: Centerville, MA, USA
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| Quote: | Originally posted by EnsenadaDr
I totally agree with Baja Guy, have an emergency exit plan, medjet seems like a good alternative!! |
There seem to be a number of companies competing in this space, and I think it's a good idea to have this type of contingency plan in one's pocket
just in case. Perhaps it's worthy of its own topic?
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Pompano
Elite Nomad
Posts: 8194
Registered: 11-14-2004
Location: Bay of Conception and Up North
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Mood: Optimistic
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I've heard of a good medical plan...
Tongue in cheek naturally, but this might just happen with the present state of affairs. 
I do what the voices in my tackle box tell me.
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CaboMagic
Super Nomad
Posts: 1103
Registered: 4-30-2005
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With his experience in the industry, Pescador is one to listen to ..
There are so many variables ..
Not to put any sort of damper in your plans or enthusiasm pauldavidmena but keep in mind that Cabo is still part of Mexico, even tho it does create,
or follow, its own rules/laws .. Might want to check if (your) insurance provider considers Mexico 'abroad' ..
20 yrs ago, living in Cabo, required emergency medical attention - Kaiser Permanente did reimburse, but advised it was because it was emergency
medical attention, or it would have been refused.
Many friends/clients/acquaintences from BajaSouth do not live there year round, and travel NOB for health issues .. not to say there aren't those
whose dedication to health and their studies thereof are not admirable .. nor is it a 'sure thing' that care provided NOB would be "perfekt"
Wish you the best in all you do, Lori
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