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Medicare Part A used in Mexico?

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Anyone heard of Medicare Part A being used in Mexico?  Someone told me this was being done.

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Well, it depends on what the 'rest of the story' is.  One can never tell what these "someone told me" stories actually are.   

Some Medicare/Medigap policies DO allow for Urgent and Emergency care to be REFUNDED if a problem happens when traveling worldwide. 

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Seriously, we have been over and over this subject.  Medicare A and B don’t cover anything outside of the U.S.  Medicare, in certain cases, will cover emergency medical services if something occurs during the first sixty days of travel.  It’s actually very easy to confirm this, rather than listen to what someone said....  go to the Medicare site, or call Medicare as many of us have done. Or talk to the company you have your supplemental policy with.  In my case it is United Health Care AARP plan F.  

The various Medicare Advantage plans may cover some things outside the U.S.....but that you would have to discuss with the insurance agent or carrier.

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2 minutes ago, Bettinka said:

Seriously, we have been over and over this subject.  Medicare A and B don’t cover anything outside of the U.S.  Medicare, in certain cases, will cover emergency medical services if something occurs during the first sixty days of travel.  It’s actually very easy to confirm this, rather than listen to what someone said....  go to the Medicare site, or call Medicare as many of us have done. Or talk to the company you have your supplemental policy with.  In my case it is United Health Care AARP plan F.  

The various Medicare Advantage plans may cover some things outside the U.S.....but that you would have to discuss with the insurance agent or carrier.

Medicare does NOT cover travel emergencies outside the US....(most) Medicare supplements have this limited travel coverage.  If you don't have a Medicare supplemental plan, you are out of luck on this 60 day travel outside-US coverage.  

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Yes, sorry, Bisbee is correct.  It is your supplemental policy that would cover an emergency.  As I said above, people should contact their providers for correct, current info..... and call Medicare itself with questions or concerns.  Below is a response I received to an email I sent regarding the “150” different Advantage policies etc. that are theoretically accepted by Hospital San Antonio and Lakeside Medical Group.  Phillip Moeller is something of a Medicare guru

The letter I sent to Moeller:       

"I live in Ajijic, Mexico. I have Medicare A, B, and AARP UHC Plan F.  I also have high deductible major medical private insurance here in Mexico.  Expensive, but worth it.  I go up to see my PCP and other specialists.  And i have Drs. here.  Lakeside Medical Group here says they accept about 150 different insurances.  In particular they say they accept many Advantage plans including United Health Care.  After due diligence I cannot figure out how this group does it?  Is it worth giving up my WEA insurance for Mexico and changing my Plan F to an Advantage plan?  Below is in its entirety from their website:

“What is an Advantage Plan?”

“Some Medicare Benefits have supplement plans which might include the Foreign Travel Benefits. These benefits are extremely limited. A better way to go is with a Medicare Advantage Plan like an HMO or PPO or any well known Medicare Advantage Plan. These plans are sometimes called “Part C” or “MA Plans,” and are offered by private companies approved by Medicare.”

“Medicare 800x800

Medicare pays these companies to cover your Medicare benefits. In general to qualify for a Medicare Advantage Plan you must have Medicare Parts A and B”

How can this work in Mexico? Lakeside Medical Group participates as a provider with many of the big name Medicare Advantage Plans like United Health Care, Blue Cross, Aetna, AARP Medicare Complete, Humana and many more. Since these companies are private insurance companies, but approved by Medicare, we are are able to accept them for coverage in Mexico.

Do I still have to pay for Deductibles and Co-Insurance? NO. Patients join medical groups for many reasons including being able to enjoy highly subsidized deductibles and co-insurance. By joining our medical group you will not have to pay any deductibles or co-insurances. Patients are not responsible for a percentage of billed charges or deductibles.

How To Obtain Medicare Coverage in Mexico as a benefit under a Medicare Advantage Policy

(Lake Chappala - Ajijic and Puerto Vallarta now, other areas coming soon)

Medicare Advantage Plans are different than Supplement Plans. Please see below.

In order to get a Medicare Advantage Plan, also known as a Medicare Replacement Plan: 

Step 1. You must have Medicare Part A and B

Step 2. You now must obtain a Medicare Advantage Plan (MA) from a private insurance company such as United Health Care, Humana, Aetna, BlueCross, and many other big name insurers. Sometimes Medicare Advantage Plans are called Part C Plans

Step 3. Go to this link at https://www.medicare.gov/find-a-plan/questions/home.aspx

Step 4. Enter you zip code of your US address that Medicare has on file for you

Step 5. Select the options on the Medicare form that are included in your Medicare Coverage.

Step 6. Select the best Advantage coverage Company/Policy that fits your personal needs.

If you already have Medicare Advantage (MA) call Lakeside Medical Group to be sure they accept that Company/Policy for full group health coverage while in Mexico. Lakeside Medical Group accepts most Advantage Plans.

TOLL FREE WHILE IN MEXICO: 01 (800) 681-9396

TOLL FREE WHILE IN US: 1 (888) 449-7799

Once confirmed with Lakeside Medical Group, register With Lakeside Medical either over the phone or using their website at www.lakemedicalgroup.com

Lakeside Medical Group

In addition to the above Medicare Advantage Plans the following Medicare Supplement Plans D, E, F, G, M or N are accepted by Lakeside Medical Group

Lakeside Medical Group accepts the Medicare Foreign Travel Benefit.  

Supplement Plan is either D, E, F, G, M or N. These plans include the Medicare Foreign Travel Benefit

Foreign Travel  Emergency Coverage Benefit has a lifetime maximum of $50000.00 USD. 

The care rendered must be of an urgent care or emergency nature

The emergency must be within 60 days or your trip”"   No

Response from Mr. Mueller in part:

Medicare Advantage (MA) plans do not cover care in Mexico. Some Medigap supplement plans, as you note, do cover emergency care outside the U.S., but it is limited and usually has a $50,000 cap.

I have never heard of a Medicare Replacement Plan. 

Thanks for taking the time to write, and best of luck.

Phil Moeller

Philip Moeller
Author, Get What's Yours for Medicare
Co-author, Get What's Yours: The Secrets to Maxing Out Your Social Security
“Ask Phil” on PBS NewsHour

Twitter; Linked In

Disclaimer:

Notice: I do my best to provide accurate information about Medicare, Social Security, and other aging and retirement issues. I do not claim infallibility. Before acting on what I write, you should contact the pertinent agency and, if you’ve got one, your own adviser.

 

Welllllll, I don’t know... maybe I’m just beating a dead horse and eventually I’ll be proved wrong, right, whatever.

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I am not good at reading fine print but it all come down to the quote from above "The emergency must be within 60 days or your trip”. Now, unless you want to jockey back and forth NOB every 60 days this would be worthless to most of us expats here. I have VA Healthcare and the same thing basically true with that. Unless you are paying VERY high premiums for private healthcare here, for old geezers like me, Seguro Popular is pretty much the best for emergencies until you can get to a Medicare facility or a VA hospital in the US.

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15 minutes ago, Bettinka said:

Yes, sorry, Bisbee is correct.  It is your supplemental policy that would cover an emergency.  As I said above, people should contact their providers for correct, current info..... and call Medicare itself with questions or concerns.  Below is a response I received to an email I sent regarding the “150” different Advantage policies etc. that are theoretically accepted by Hospital San Antonio and Lakeside Medical Group.  Phillip Moeller is something of a Medicare guru

The letter I sent to Moeller:       

"I live in Ajijic, Mexico. I have Medicare A, B, and AARP UHC Plan F.  I also have high deductible major medical private insurance here in Mexico.  Expensive, but worth it.  I go up to see my PCP and other specialists.  And i have Drs. here.  Lakeside Medical Group here says they accept about 150 different insurances.  In particular they say they accept many Advantage plans including United Health Care.  After due diligence I cannot figure out how this group does it?  Is it worth giving up my WEA insurance for Mexico and changing my Plan F to an Advantage plan?  Below is in its entirety from their website:

“What is an Advantage Plan?”

“Some Medicare Benefits have supplement plans which might include the Foreign Travel Benefits. These benefits are extremely limited. A better way to go is with a Medicare Advantage Plan like an HMO or PPO or any well known Medicare Advantage Plan. These plans are sometimes called “Part C” or “MA Plans,” and are offered by private companies approved by Medicare.”

“Medicare 800x800

Medicare pays these companies to cover your Medicare benefits. In general to qualify for a Medicare Advantage Plan you must have Medicare Parts A and B”

How can this work in Mexico? Lakeside Medical Group participates as a provider with many of the big name Medicare Advantage Plans like United Health Care, Blue Cross, Aetna, AARP Medicare Complete, Humana and many more. Since these companies are private insurance companies, but approved by Medicare, we are are able to accept them for coverage in Mexico.

Do I still have to pay for Deductibles and Co-Insurance? NO. Patients join medical groups for many reasons including being able to enjoy highly subsidized deductibles and co-insurance. By joining our medical group you will not have to pay any deductibles or co-insurances. Patients are not responsible for a percentage of billed charges or deductibles.

How To Obtain Medicare Coverage in Mexico as a benefit under a Medicare Advantage Policy

(Lake Chappala - Ajijic and Puerto Vallarta now, other areas coming soon)

Medicare Advantage Plans are different than Supplement Plans. Please see below.

In order to get a Medicare Advantage Plan, also known as a Medicare Replacement Plan: 

Step 1. You must have Medicare Part A and B

Step 2. You now must obtain a Medicare Advantage Plan (MA) from a private insurance company such as United Health Care, Humana, Aetna, BlueCross, and many other big name insurers. Sometimes Medicare Advantage Plans are called Part C Plans

Step 3. Go to this link at https://www.medicare.gov/find-a-plan/questions/home.aspx

Step 4. Enter you zip code of your US address that Medicare has on file for you

Step 5. Select the options on the Medicare form that are included in your Medicare Coverage.

Step 6. Select the best Advantage coverage Company/Policy that fits your personal needs.

If you already have Medicare Advantage (MA) call Lakeside Medical Group to be sure they accept that Company/Policy for full group health coverage while in Mexico. Lakeside Medical Group accepts most Advantage Plans.

TOLL FREE WHILE IN MEXICO: 01 (800) 681-9396

TOLL FREE WHILE IN US: 1 (888) 449-7799

Once confirmed with Lakeside Medical Group, register With Lakeside Medical either over the phone or using their website at www.lakemedicalgroup.com

Lakeside Medical Group

In addition to the above Medicare Advantage Plans the following Medicare Supplement Plans D, E, F, G, M or N are accepted by Lakeside Medical Group

Lakeside Medical Group accepts the Medicare Foreign Travel Benefit.  

Supplement Plan is either D, E, F, G, M or N. These plans include the Medicare Foreign Travel Benefit

Foreign Travel  Emergency Coverage Benefit has a lifetime maximum of $50000.00 USD. 

The care rendered must be of an urgent care or emergency nature

The emergency must be within 60 days or your trip”"   No

Response from Mr. Mueller in part:

Medicare Advantage (MA) plans do not cover care in Mexico. Some Medigap supplement plans, as you note, do cover emergency care outside the U.S., but it is limited and usually has a $50,000 cap.

I have never heard of a Medicare Replacement Plan. 

Thanks for taking the time to write, and best of luck.

Phil Moeller

Philip Moeller
Author, Get What's Yours for Medicare
Co-author, Get What's Yours: The Secrets to Maxing Out Your Social Security
“Ask Phil” on PBS NewsHour

Twitter; Linked In

Disclaimer:

Notice: I do my best to provide accurate information about Medicare, Social Security, and other aging and retirement issues. I do not claim infallibility. Before acting on what I write, you should contact the pertinent agency and, if you’ve got one, your own adviser.

 

Welllllll, I don’t know... maybe I’m just beating a dead horse and eventually I’ll be proved wrong, right, whatever.

My other subject/posting and general interest  contains the reply I received from the SAT Hospital when I presented my policy . The kicker is in the small print of any policy that you may have..and note the possible follow up by the ins company to establish when you last departed the USA

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Just now, gringohombre said:

I am not good at reading fine print but it all come down to the quote from above "The emergency must be within 60 days or your trip”. Now, unless you want to jockey back and forth NOB every 60 days this would be worthless to most of us expats here. I have VA Healthcare and the same thing basically true with that. Unless you are paying VERY high premiums for private healthcare here, for old geezers like me, Seguro Popular is pretty much the best for emergencies until you can get to a Medicare facility or a VA hospital in the US.

Gringohombre I agree with your general statement...However respectful I would suggest that any care and attention that you may receive from a "private" hospital is going to much better than what to expect from Seguro Popular

As aside most Mexican nationals (not my maid and gardener) I talk with when I mention the "love" that Gringos have for SP or IMSS just roll their eyes in disbelief

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36 minutes ago, lakeside7 said:

Gringohombre I agree with your general statement...However respectful I would suggest that any care and attention that you may receive from a "private" hospital is going to much better than what to expect from Seguro Popular

As aside most Mexican nationals (not my maid and gardener) I talk with when I mention the "love" that Gringos have for SP or IMSS just roll their eyes in disbelief

Respectfully, I am not understanding. If I do not have private insurgence, how am I going to get into a "private" hospital. All is relevant...I paid for a hip replacement at a "private" hospital here years ago and it fell apart after 2 days, requiring an emergency trip to the VA hospital in Phoenix, complete restructuring, infection and months recuperation there. On the other hand I had a complicated hernia operation by Seguro Popular that was perfect and everything was free!

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... which proves (to me!) that anecdotal stories are worth nothing when talking about a 'specific' event.  YMMV,  one person's experience with a product may be different from another's, is very often appropriate.

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