RickS Posted December 2, 2017 Report Share Posted December 2, 2017 23 minutes ago, AngusMactavish said: Emergency service are covered here when one is a Medicare Advantage subscriber. Yes, but in order to have a Medicare Advantage policy in the first place one MUST LIVE FULLTIME in the service area NOB wherein it was obtained. Could one game the system and fraudulently obtain a policy by saying they actually lived in the service area when they truly did not and actually lived in Mexico full time? Maybe, but the operative words here are ‘game’ and ‘fraudulently’. As Bisbee Gal has suggested, the subject here is “Medicare” in Mexico for persons living in Mexico.... not visiting nor gaming the system to make it appear that one lives in the US. It just does not exist. Period. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 Again, you can maintain a DOMICILE in the US and get an Advantage plan. One can have many residences in various countries and living full time in one would be impossible. Your domicile is where you say it is. I really don't care what you do or think. Link to comment Share on other sites More sharing options...
Bisbee Gal Posted December 2, 2017 Report Share Posted December 2, 2017 Medicare Advantage plans are based on where you actually live. From Medicare.gov Who can join a Medicare Advantage Plan? You can generally join a Medicare Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), or Medical Savings Account (MSA) Plan if all of these apply: You live in the service area of the plan you want to join. The plan can give you more information about its service area. If you live in another state for part of the year, check to see if the plan will cover you there. You have Medicare Part A and Part B. You don't have End-Stage Renal Disease (ESRD). Find someone to talk to Find someone to talk to in your state Select your state... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Minor Outlying Islands Utah Vermont Virgin Islands of the U.S. Virginia Washington West Virginia Wisconsin Wyoming Is your test, item, or service covered? Search Medicare.gov for covered items Footer Link to comment Share on other sites More sharing options...
RickS Posted December 2, 2017 Report Share Posted December 2, 2017 Bisbee Gall, you and I are NOT going to change this person’s mind with the facts. Hopefully those who might be considering living in Mexico won’t depend on that information when they make their medical decisions. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 Distinctions Between Domicile And Residence Link to comment Share on other sites More sharing options...
RickS Posted December 2, 2017 Report Share Posted December 2, 2017 I'm done.... Link to comment Share on other sites More sharing options...
Bisbee Gal Posted December 2, 2017 Report Share Posted December 2, 2017 Hopefully people will call their Medicare Advantage plans and ask them if they can continue to be a member if they move to MX and find the answer for themselves. Some things like health insurance are too important to screw around with. If others want to lie to their insurance carrier about where they live, good luck with that. I agree, Rick....adios to this topic! Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 1 hour ago, Bisbee Gal said: ..adios to this topic! Gracias. Link to comment Share on other sites More sharing options...
Bisbee Gal Posted December 2, 2017 Report Share Posted December 2, 2017 One last thing... This is a post from Oct. 27, 2017. Link here: http://www.chapala.com/webboard/index.php?/topic/74151-keep-medicare/&tab=comments#comment-555279 Quote AngusMactavish Posted October 27 Dump Part B, Advantage or not. You always have Part A and that is the big buck coverage. Actually you can not qualify for an Advantage plan if you live here unless you tell some stories. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 Too bad some have poor English skills. The story is the difference between one's residence and their domicile. If I had a house here and one in France, I could still claim a US domicile and get an Advantage plan. I quit my US domicile and the named plan because I have no intention of returning to the US, but prior to that I would go back every six months for my tests and drugs. You can too. Link to comment Share on other sites More sharing options...
pappysmarket Posted December 2, 2017 Report Share Posted December 2, 2017 ....And that gives you Medicare coverage SOB? I don't think so. As long as you pay Part B you can always return NOB and use your Medicare. As has been said before, gaming the system is not out of the realm of possibility but anyone COUNTING on doing so might be in for a big (monetary) surprise and possibly more if you are actually engaged in Medicare fraud. Perhaps you might get to meet Michael Flynn. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 Medicare Part B is not the same as a Medicare Advantage plan. The latter in my experience covers out of country emergency medical costs. Link to comment Share on other sites More sharing options...
pappysmarket Posted December 2, 2017 Report Share Posted December 2, 2017 .....As long as they don't dig too deep into your actual living arrangements. Kind of like using Canadian satellite outside of Canada. Be careful what you say and sign your name to. And NEVER submit your claim through the USPS. That becomes mail fraud if they want to make an example of you. When I worked as a medical claims manager for a major insurance company a walk-in claimant who "just wanted to make sure we received his paperwork" set off all fraud alarms. The good ones know how to avoid Federal crimes. Without pulling up actual contract language I would be willing to bet what is required is "residence" and domicile is probably nowhere to be seen. These people know all about gaming the system. But, I have been wrong before. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 2, 2017 Report Share Posted December 2, 2017 Your living arrangements have no bearing upon your domicile. Some people are actually world citizens with no literary, but their domicile is where they say it is. Link to comment Share on other sites More sharing options...
pappysmarket Posted December 2, 2017 Report Share Posted December 2, 2017 6 minutes ago, AngusMactavish said: Your living arrangements have no bearing upon your domicile. Some people are actually world citizens with no literary, but their domicile is where they say it is. OK, you win! Link to comment Share on other sites More sharing options...
REC Posted December 3, 2017 Report Share Posted December 3, 2017 https://www.medicareresources.org/blog/2015/07/21/a-medicare-enrollees-guide-to-travel-coverage/ https://www.medicareinteractive.org/get-answers/medicare-and-other-types-of-insurance/medicare-and-living-abroad/medicare-coverage-when-living-abroad https://www.medicareinteractive.org/get-answers/medicare-covered-services/medicare-coverage-overview/does-medicare-cover-my-care-when-i-travel It seems like it would be pretty easy to determine how long you are out of the U.S. through customs/immigration, stamps in your passport, your foreign immigration status, etc. The "intent" is not to cover us outside the U.S. and while you "might" be able to get away with lying about your status you are pretty much committing fraud. The facts are the facts. Trying to trick the system is not something I would take a chance with regarding my health - especially in a life threatening situations. But to each their own. If you just do things right you don't have to worry. Seems pretty black and white to me. This whole discussion seems pretty silly. Just do it right! Link to comment Share on other sites More sharing options...
tomgates Posted December 3, 2017 Report Share Posted December 3, 2017 Mod--time to close. OP said they could put aside $150,000 towards emergencies here in Mex and use Medicare in the US. Done deal. Link to comment Share on other sites More sharing options...
AngusMactavish Posted December 3, 2017 Report Share Posted December 3, 2017 REC, you quote Medicare, but I keep talking about the Advantage plan. Apples and kumquats. Medicare Part C May Cover Your Trip Abroad One of the biggest benefits for anyone with Medicare Advantage is that they can travel and still be seen by a doctor or receive emergency care if something were to happen on their trip. Since retirees often travel, it’s difficult to do so if you only have Original Medicare, which is just Part A and Part B. Some Medicare Advantage plans provide coverage benefits for all health care needs when enrollees go outside of the United States, but it’s best to check with your health insurance company first. https://medicarepartc.com/medicare-advantage-traveling/ Link to comment Share on other sites More sharing options...
zerbit Posted December 3, 2017 Report Share Posted December 3, 2017 And everything discussed about Medicare and all it's associated components now could be radically different in the very near future. Things are potentially changing. So all of this is speculation. And the status of Seguro Popular is as well. It's all a crap shoot at any given time. Nothing is certain, I guess you just have to use your best guessing skills. Link to comment Share on other sites More sharing options...
gringal Posted December 3, 2017 Report Share Posted December 3, 2017 Just now, zerbit said: And everything discussed about Medicare and all it's associated components now could be radically different in the very near future. Things are potentially changing. So all of this is speculation. And the status of Seguro Popular is as well. It's all a crap shoot at any given time. Nothing is certain, I guess you just have to use your best guessing skills. The "impression" I am getting from the various news sources is that for those currently on SS, things won't change and the possible changes with affect new beneficiaries. SP seems to be getting more funding and is expanding its services. I wish us all luck, but I doubt that expats will ever be able to use Medicare in Mexico as our regular health care payment option. Link to comment Share on other sites More sharing options...
zerbit Posted December 3, 2017 Report Share Posted December 3, 2017 16 minutes ago, gringal said: The "impression" I am getting from the various news sources is that for those currently on SS, things won't change and the possible changes with affect new beneficiaries. SP seems to be getting more funding and is expanding its services. I wish us all luck, but I doubt that expats will ever be able to use Medicare in Mexico as our regular health care payment option. And yet, allowing out of country care at a lower cost would save money and allow more care for those in the system if funds were not cut as a result of savings. The claim of rampant fraud is used to prevent this, but it actually just keeps US dollars in the pockets of US care providers. And both parties have had chances to allow Medicare to be used abroad and have resisted. I guess they just want the current fraud to benefit US crooks. Link to comment Share on other sites More sharing options...
gringal Posted December 3, 2017 Report Share Posted December 3, 2017 4 minutes ago, zerbit said: And yet, allowing out of country care at a lower cost would save money and allow more care for those in the system if funds were not cut as a result of savings. The claim of rampant fraud is used to prevent this, but it actually just keeps US dollars in the pockets of US care providers. And both parties have had chances to allow Medicare to be used abroad and have resisted. I guess they just want the current fraud to benefit US crooks. There's this: We expats have to fund our own health care needs, whereas if we had remained in the states, Medicare would have to spend money to take care of us under Part A. Medicare saves money by having the current prohibition. Some expats continue to pay for Part B "just in case", so Medicare gets to keep that money, too. But...that's something we had to factor in when we decided to move to Mexico, so I guess we have no good cause to complain. Link to comment Share on other sites More sharing options...
pappysmarket Posted December 3, 2017 Report Share Posted December 3, 2017 47 minutes ago, zerbit said: And yet, allowing out of country care at a lower cost would save money and allow more care for those in the system if funds were not cut as a result of savings. The claim of rampant fraud is used to prevent this, but it actually just keeps US dollars in the pockets of US care providers. And both parties have had chances to allow Medicare to be used abroad and have resisted. I guess they just want the current fraud to benefit US crooks. Never mind the actual fraud itself, can you imagine the cost of trying to authenticate a medical bill from say, Egypt, Venezuela, Kenya or even Mexico? We have insurance that is good worldwide and I can tell you that even a huge company like Aetna (who also processes vast numbers of Medicare claims as does Travelers Insurance for the government) has a hell of a time with my simple hernia and cataract surgeries. Foreign doctors and hospitals are not used to billing things the way American providers are. It results in multiple back and forth inquiries which has to be expensive for the company. Yes, they finally did calculate the benefit correctly and paid the right amount but it's 4 months later and they just got it right. After assuming Mexican Pesos were the same as USD and cancelling a couple of checks that were sent to providers instead of us. If they didn't make it clear that they were not just going to pay on a typical receipt you get in Mexico (Date of service, diagnosis and proper code for that service which is usually missing, in my experience) they would be flooded with fraudulent claims and the manpower to investigate them would far exceed any cost savings. Trusting people's honesty on a claim submitted to an insurance provider would be a sure fire way to go broke. Link to comment Share on other sites More sharing options...
zerbit Posted December 3, 2017 Report Share Posted December 3, 2017 2 minutes ago, pappysmarket said: Never mind the actual fraud itself, can you imagine the cost of trying to authenticate a medical bill from say, Egypt, Venezuela, Kenya or even Mexico? We have insurance that is good worldwide and I can tell you that even a huge company like Aetna (who also processes vast numbers of Medicare claims as does Travelers Insurance for the government) has a hell of a time with my simple hernia and cataract surgeries. Foreign doctors and hospitals are not used to billing things the way American providers are. It results in multiple back and forth inquiries which has to be expensive for the company. Yes, they finally did calculate the benefit correctly and paid the right amount but it's 4 months later and they just got it right. After assuming Mexican Pesos were the same as USD and cancelling a couple of checks that were sent to providers instead of us. If they didn't make it clear that they were not just going to pay on a typical receipt you get in Mexico (Date of service, diagnosis and proper code for that service which is usually missing, in my experience) they would be flooded with fraudulent claims and the manpower to investigate them would far exceed any cost savings. Trusting people's honesty on a claim submitted to an insurance provider would be a sure fire way to go broke. There are always solutions to technical issues if we seek them out. I won't go into fraud, as that is created by for profit issues. Link to comment Share on other sites More sharing options...
gringal Posted December 3, 2017 Report Share Posted December 3, 2017 As I see it, the major point is that Medicare saves ALL the cost of medical care for us by not providing for any care outside the U.S. except for travel. Why would they want to change that? If they are looking to save money these days, there is zero motivation to change their current policy. Link to comment Share on other sites More sharing options...
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