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Providers in Lake Chapala accepting Medicare?


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Speaking of Medicare scams, when I lived in San Miguel there was  group promising Medicare coverage.  It turned out they were doing treatment in Mexico and billing it through a place in California as though the treatment had taken place in CA.  It was discovered and ended badly.  No surprise.  I keep wondering about that statement about Medicare on the sign out in front of the new hospital. What's that about?  Hmmm?

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2 hours ago, gringal said:

...I keep wondering about that statement about Medicare on the sign out in front of the new hospital. What's that about?  Hmmm?

Possibly, just possibly, they are serving those  who are domiciled in the U.S. and living part-time in Mexico. Some Medicare Advantage (Part C) plans allow for  "out of network" providers. I have been assured by my Medicare Advantage provider that "out of network" includes coverage when I am outside of the U.S. This is only! only! only! for the part-timers who are spending the majority of their time at their U.S. domicile. Medicare Advantage is Medicare administered through a private insurance provider so there can be significant differences between plans.

Or, I could be wrong. But, really, what are the chances of a stranger on a webboard being wrong?

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My husband has Medicare for the US and Seguro Poular here.  Our intent is to treat any serious illnesses in the US, and Seguro Popular for emergencies.  If there is an accident--say, a fall and a broken hip--we would have SP stabilize, then hire a private driver to get us to Texas.  Or possibly just pay out of pocket--depends upon the situation.

I'm still in the process of investigating evacuation insurance.  I would prefer a company that repatriates globally, not just from Mexico to the US.  Any suggestions? 

 

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I'm up North right now for a short visit, so I do not have the data with me; it's in Ajijic.  The insurance I have is SkyMed. What it does is in case of a medical emergency, is evacuate me by plane and medical aid from Mexico and perhaps more countries to the hospital where I live or visit up north which happens to be, in my case, Swedish Hospital in Seattle, WA. You might want to check them out.

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SkyMed is global. You decide where you want to be evacuated "to." For the past several years, while we were traveling a lot, we had Guadalajara as our "evacuation to" point. We'll change that to a spot in the US sometime this year, once we pick a doctor/hospital there. No charge to change.

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Skymed is often mentioned, but I do not recall anyone every reporting that they actually used it.  The reality is that one must be stabilized to be transported, and that will be done in a Mexican hospital.  If an evacuation plan will only take you to the nearest hospital with qualified services to treat your condition, it is likely that you will be hospitalized in Mexico.  In any case; once you are stabilized, you may be well enough to return to your home for recovery, and no longer need "evacuation".  Read the fine print very carefully. It may explain why we have not read reports from satisfied customers who actually used the service.

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On ‎6‎/‎9‎/‎2019 at 10:54 AM, gringal said:

Speaking of Medicare scams, when I lived in San Miguel there was  group promising Medicare coverage.  It turned out they were doing treatment in Mexico and billing it through a place in California as though the treatment had taken place in CA.  It was discovered and ended badly.  No surprise.  I keep wondering about that statement about Medicare on the sign out in front of the new hospital. What's that about?  Hmmm?

I wish you would quit insinuating that they accept Medicare, when they do not.  Go back and read this sign, that you keep referring to, more carefully,  It states that they accept Medicare Advantage (if it covers you in Mexico), no more no less. I have talked to the Hospital administration people and they will not have anything to do with US Govt. Medicare, only Medicare Advantage, and other certain private insurers from the US, as well as, of course, Mexican private insurers.

 

You have brought this up on several occasions without obviously having read the sigh correctly

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This plan is strictly for travelers, not for permanent Mexico residents.  I haven't stopped to read the fine print on the sign (if there is any). I would like to hear directly from those advertising, what they have to say about what services they offer.  Do you have definite knowledge of this?  If so, by all means share.

Here is what Medicare advantage does and does not cover:

https://medicarepartc.com/medicare-advantage-traveling/

 

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1 hour ago, gringal said:

This plan is strictly for travelers, not for permanent Mexico residents.  I haven't stopped to read the fine print on the sign (if there is any). I would like to hear directly from those advertising, what they have to say about what services they offer.  Do you have definite knowledge of this?  If so, by all means share.

Here is what Medicare advantage does and does not cover:

https://medicarepartc.com/medicare-advantage-traveling/

(and

Of course, there are many people travelling and visiting Mexico and they do not claim that they can extract insurance payments for people who are not qualified. I can certainly agree you haven´t stopped to read the fine print, because there isn´t any, and doesn´t appear you have read the large print either.

I mentioned in my post who I talked to, so go back and read it, and then go to the Hospital and talk to (and hear) DIRECTLY from the same people I mentioned. Make an appointment with the Hospital Administrator.  After you have checked it out and you want to complain or raise questions on this forum then i will listen.

 

Different states have different Medicare Advantage conditions, not all are the same.

I shared but you want to hear DIRECTLY, so go for it.

 

I am closely acquainted with several of the principals of this Hospital and found your remarks about their handling of insurance claims and procedures, disingenuous and slyly implying some kind of fraud. Hmmm?

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1 hour ago, slainte39 said:

Of course, there are many people travelling and visiting Mexico and they do not claim that they can extract insurance payments for people who are not qualified. I can certainly agree you haven´t stopped to read the fine print, because there isn´t any, and doesn´t appear you have read the large print either.

I mentioned in my post who I talked to, so go back and read it, and then go to the Hospital and talk to (and hear) DIRECTLY from the same people I mentioned. Make an appointment with the Hospital Administrator.  After you have checked it out and you want to complain or raise questions on this forum then i will listen.

 

Different states have different Medicare Advantage conditions, not all are the same.

I shared but you want to hear DIRECTLY, so go for it.

 

I am closely acquainted with several of the principals of this Hospital and found your remarks about their handling of insurance claims and procedures, disingenuous and slyly implying some kind of fraud. Hmmm?

Don't you think this should be laid to rest about now?   I'm not about to talk to the Hospital Administrator.  I'll take your word for it.

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Sure do as I didn´t want to disturb "this´s" rest in the first place.

 

I just thought I saw you going in the wrong direction with your suspicions.. Fortunately this forum doesn´t reach a whole lot of people.

I don´t like to jump in unless I know what I´m talking about and sometimes that even fails,:)

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Never used SkyMed myself, but I have had several friends here use it, and all swear by it. RVGRINGO is correct, you must be stabilized first, so you'll get some care in a Mexican hospital. That's not unique, or just a SkyMed rule: medical best practice is to stabilize the patient before transfer. SkyMed provides a bilingual advocate to you at the local hospital until transfer. My friends reported SkyMed worked as advertised: one requested immediate evacuation back to the States, while another waited a month and tried some local hospitals before deciding to go back: SkyMed evacuated both cases. I also know of a case where SkyMed evacuated some one who hadn't yet officially applied, but just got sick after attending the info seminar and was thinking of applying.

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5 hours ago, lakeside7 said:

Pete, I was under the impression  that SkyMed did not accept the "over 80's" or are you grandfathered in ??

I am grandfathered in. I just renewed for another 5 years.

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Recent blurb from Medicare:

What to know about Medicare when you travel abroad

Planning to travel abroad this summer? Before you go, remember that Medicare usually does not cover health care services or supplies while you’re traveling outside the United States (except in these rare cases).

Learn More

That doesn’t mean you have to travel abroad without health coverage. Here are 3 ways you can get health coverage outside the U.S.:

  1. If you have a Medicare Supplement Insurance (Medigap) policy, check your policy to see if it includes coverage when traveling outside the U.S.
  2. If you have Medicare Advantage or another Medicare health plan (instead of Original Medicare), check with your plan to see if they offer coverage outside the U.S.
  3. Consider buying a travel insurance policy that includes health coverage.

Safe travels!

Sincerely,

The Medicare Team

 

 
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Sky Med stayed in Mexico when Medical Air Service left Mexico because of financial and lack of membership.

Both have similar benefits however Sky Med seems to have seems to have improved their benefits where they will actually fly you back to your hoe address in the US

 

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  • 2 years later...

I have spoken with Jeff Goble a few times and met with his partner, Greg Hovey today (after listening to his presentation yesterday). I am not buying insurance thru he, or his partner. You can make your own decision.  We met at 12:05 pm at Black Coffee. At 12:14, he got up, said he needed to check out of his Air BnB. This was just after I told him I was not buying today as I was not a lawyer and wanted my attorney to review the policy. facing facts, I am in Mexico with little legal recourse of a business deal between Americans - Mexico doesn't care. And immediate departure is putting it mildly.  Here's what else I know:

1. He brought no presentation to the meeting at the American Legion, nor did he have business cards.

2. He claimed to be from Sonora, San Carlos - his agency is on LinkedIn - says Tuscon Az.

3. The website he touted "SafeTravelInmexico.org - well, I was on it last night - today, after the meeting, google did not recognize the website - I am very good at digital media, having been a global digital marketing consultant to Kellogg's for 5 years, amongst others for over 20 years. I know how to research via the web.

4. The policy he was trying to sell me today - I mean he started the meeting asking my birthdate and he was generating the policy on his phone without me even asking - well I was on his website yesterday - The policy on the site was from a company called "Worldwide" - I googled them today - no website appeared. (note: I use a US based VPN network - I can get anywhere on the web)

5. Yesterday, he mentioned to the crowd how you need to return to the US at least every six months for the coverage via Medicare Advantage to be valid here.  I was able to confirm there is such a medicare rule for Medicare Advantage providers, HOWEVER, that rule is for domestic travel in the US, not foreign travel.  The only information I have been able to gather says 60 days of emergency coverage, and this is travel from the US. 

6. Also, you MUST reside in the state the advantage plan is from.  Residing in Mexico, you run the risk of the company denying coverage.

7. I also wondered - how could Lakeside also have no deductable and no copay? Is it due to them charging US rates?  In Mexico, we have to pay the hospitals then turn in a claim - LMG pays for you then bills the insurance companies - Mmmmmmm - could they be paying Mexican medical rates and charging US rates?

8. I don't know, but for my money, I think all this is too good to be true, folks are hearing what they really hope to be true, and need to be true - but for me, it is buyer beware.

9. As others have mentioned - call your provider and seek the truth. I can afford getting health insurance, I can not afford having a major medical claim denied coverage.

 

 

 

 

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Just made me wonder - dozens of expat communities in multiple countries - is there another example of the services under medicare offered by LMG in any other country? Or any agent other than Goble?  Contacting Boomer Benefits, a very large broker in the US. Speaking with them on Monday.

Also went on Blue Cross Blue Shields site - under being eligible - #3, you must live in the plans area. Doubt virtual mailboxes count.  

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The revival of this topic.... can Medicare be used in Mexico..... is indicative of two things: people who just want the answer to be yes, and 'crooks' who want to make them believe that they can.

NO form of Medicare is available in Mexico... or any other non-US location.... EXCEPT in an emergency situation while traveling during a 60 day visit. Period. And that generally is on a reimbursement basis... you pay here and your Medicare provider pays you back when you file a claim later. 

With Original Medicare and a Supplement (gap insurance... so named because it pays the 20% that Medicare doesn't pay) one can live anywhere and see any doctor, for any problem, in any other location in the US, assuming that doc is willing to treat Medicare patients. With Medicare Advantage.. aka Part C Medicare... 'tho, one is confined to having a doctor and a medical facility(s) WITHIN a very specific and sometimes very small geographical area close to their home. If/when outside of this area, treatment can only be had in an emergency situation, often on a reimbursement later only model. 

Additionally, IMO those who suggest that "Medicare should cover services in foreign countries because Medicare could reap the benefit of lower costs there"  just don't understand what a nightmare that would be. If we think fraud within the system in the US is a problem... and it surely is.... trying to contain that fraud worldwide would be wholly impossible and Medicare would go bankrupt in a New York minute!

My apologies for the long winded response....

 

 

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