Receiving Medicare (B) services in USA while having a Mexican address

[gringal]

It does mention it.  I think it's quite clear when they said that you should stop paying premiums for MEDIGAP or Part D."If you have a Medicare Advantage or Medicare Part D plan before you move abroad, you should stop paying these premiums when you move"    

The basic question is:  How could a supplemental plan continue to offer coverage when the main plan, Medicare A and B, ceases to offer coverage when the person is not in the U.S.? It wouldn't make sense.

Next step would be to go directly to the OP's own policy and read the fine print about coverage outside of the U.S.

I've been suggesting that people go to the official gov't. source for information since I've met too many expats who think there is somehow a way around the problem.

Several years ago, a physicians' group in CA came up with a scheme whereby treatment was given in Mexico but then they billed it through their U.S. address. This was found to be fraudulent.  There are a few places that are still trying to go this route and its variations.  Beware.  Severe fines can be levied.  Best  to just find a policy in Mexico for those who reside here or go the IMSS/SP route.

 

 

 

[NLU]

I'm still not certain gringal is correct, because ...

I’m not exactly sure what a Medicare Advantage Plan is since Blue Cross and Blue Shield seem to differentiate between it and a Medicare Supplement Insurance Plan, but ……

http://www.bcbsil.com/medicare/medicare_supplement_planF.html

 “There are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused: If you no longer reside, live or work in an area where we are authorized to do business.”

I still own a Chicago condo, but have recently rented it to another party, so I cannot claim it to be my legal residence. I have family in the area, so I guess I’ll have to move in with one of my brothers.

[RickS]

A Medicare Advantage policy is definitely different from a Medicare Supplement (Medigap) policy although any one insurance company may offer both.

 

A Gap policy is used in conjunction with Original Medicare to cover things that Original Medicare did/does not cover.... it fills in the "gap" between what is billed by the provider and what is paid for by Original Medicare.  Gap policies are 'regulated' by Medicare and there are a number of 'alternative' coverages/costs available, each of which have explicitly defined services so that the customer can compare apples to apples when choosing between insurance carriers. Current costs for these gap policies generally run between $150-$250/mo. Using this model, a consumer can pretty much determine what their monthly medical cost will be 'regardless' of what condition comes around.  These policies do NOT generally cover prescription drugs. They have been around for decades.

A Medicare Advantage policy, which Medicare set up maybe 10 years ago, REPLACE Original Medicare (and any need for a Gap policy) with a more-or-less HMO type of coverage. Coverages are NOT standardized although one can pretty much compare different carriers. These policies generally require additional "fees" to be paid for things such as doctor office visits, co-pays and/or co-insurance for services, but their monthly premiums are MUCH less ($0-$40/mo) than a Gap policy. These fees are specifically spelled out within the Policy and different Insurers can charge different fees. The services provided by these policies must conform to Medicare guidelines and the cost for and authorization of all services are regulated by the gov (Medicare). Generally speaking, an Advantage policy is better (cheaper in almost any scenario) if/when a person is in fairly good health. Many/most Advantage policies also cover prescription drugs, with a co-pay, commonly called Plan D. Gap policies do NOT generally cover drugs and the customer must buy a Plan D policy if they want drug coverage.

To my knowledge both Medigap and Advantage policies require the customer to live in the US, and Advantage policies can differ from community to community in price and coverage, even if they might be only a few miles apart.