Will Medicare cover me if I live (even part time) in Mexico?
John Venator - Casa de los Venados
Medicare will not pay at all for any services in any foreign country. That has been engineered in the US by doctors, insurance companies, hospitals, and drug companies. They don’t want to pay for any services in a foreign country because those services will be substantially cheaper and they want to keep those billed high. We had our Medicare prescription drugs arranged to be shipped to a US address and then when we go to the US or when we know that...
Medicare will not pay at all for any services in any foreign country. That has been engineered in the US by doctors, insurance companies, hospitals, and drug companies. They don’t want to pay for any services in a foreign country because those services will be substantially cheaper and they want to keep those billed high. We had our Medicare prescription drugs arranged to be shipped to a US address and then when we go to the US or when we know that we have friends from the US who are coming down to Mexico, we ask them to bring our prescription drugs to us because we get our prescriptions from one of those pharmacies. We can only get a 90-day supply at a time and they will not ship to a foreign address, which is a shame. As an example, in Chicago, there is over a million people of Polish descent and a lot of them work and then move back to Poland, their local town or village and live like the big men in town. In Poland, Mexico, and in a lot of other places, medical services are substantially cheaper, but US law forbids that any services be paid for in a foreign country.
Private insurance like our Medicare supplement does pay in a foreign country. It pays for services here but the basic things such as hospitalization, doctors’ fees, etc. will not be paid even one penny by Medicare.
(Pharmacy in Rocky Point, Mexico, pictured.)
Posted September 9, 2015
Melanie Lansing - Mexico Insurance Advisors
No, Medicare (Part A or B) will not cover you in Mexico even if you are here temporarily. The only time Medicare would cover you in Mexico is if you are on the border and the hospital in Mexico is closer than the hospital on the US side.
The misunderstanding of Medicare coverage in Mexico is just one of the misconceptions Americans in Mexico have about health care. I have also witnessed a lot of ignorance around how health systems in Mexico work,... No, Medicare (Part A or B) will not cover you in Mexico even if you are here temporarily. The only time Medicare would cover you in Mexico is if you are on the border and the hospital in Mexico is closer than the hospital on the US side.
The misunderstanding of Medicare coverage in Mexico is just one of the misconceptions Americans in Mexico have about health care. I have also witnessed a lot of ignorance around how health systems in Mexico work, especially when it comes to emergency situations. For this reason, Mexico Insurance Advisors created “Peace of Mind in San Miguel”, our community service project dedicated to educating Americans, Canadians and other English-speaking expats on how to be prepared for medical emergencies in Mexico. In our seminars our staff and team of Mexican medical & legal experts offer the following medical emergency preparedness tips: - Establish a relationship with a primary care physician in Mexico who answers his /her cell phone 24/7, keeps medical records, and is credentialed at the local private hospital.
- Know what numbers to dial to reach the Mexican Red Cross in a medical emergency.
- Keep a medical emergency card on your body with your emergency medical information & emergency contacts.
- Acquire private health insurance or sign up for Seguro Popular or IMSS.
- Prepare an advanced directive with a bilingual attorney.
We are starting to see a movement of Americans between the ages of 35-55 who cancel their Obamacare or corporate health insurance plans and purchase Expat Health insurance before moving to Mexico. They arrive here trusting and relying on the Mexican doctors and hospitals to provide excellent medical care. We have also seen a trend among Baby Boomers who are eligible for Medicare. Many more are canceling their Part A and / or B before relocating to Mexico, and also opting for an Expat Health plan.
(Doctor hotline image from Best Places in the World to Retire Healthcare Study, pictured.)
Posted June 29, 2016
Andre Bellon - Bellon Insurance Agents
Americans who have Medicare are only covered if they are in the States, so if they come live in Mexico, they’re not covered anymore. If they come to Mexico, they are going to spend 80% less than what they would spend in the States, and for that reason, they prefer coming here. In the States, these people have good doctors and great hospitals, but they don’t have the coverage, and that’s the reason they come to Mexico and buy a health insurance policy here. With that,...Americans who have Medicare are only covered if they are in the States, so if they come live in Mexico, they’re not covered anymore. If they come to Mexico, they are going to spend 80% less than what they would spend in the States, and for that reason, they prefer coming here. In the States, these people have good doctors and great hospitals, but they don’t have the coverage, and that’s the reason they come to Mexico and buy a health insurance policy here. With that, they have a solution for whatever is not covered by what they have. The situation in Canada is similar. The government in Canada gives them a “coverage without paying” because the patients pay for their healthcare coverage their entire life through taxes, but they’re not used to having to pay for it at the time of service. When they come here to Mexico, they lose their Canadian coverage after 6 months of being here in Mexico. If they don’t go back, they’ll lose their coverage, and getting their coverage back is really complicated.
For foreigners- Canadians and Americans- it’s complicated leaving their coverage, and when Americans reach a certain age, if they have not been with Medicare, they will not be able to get coverage for a specific time period if they didn’t request their coverage beforehand, on time.
Some people keep their Medicare in the United States because they say, “If I get into a long term situation, I will go back and have treatment done in the US, but if it’s something like getting a stroke, or a heart attack, and I need immediate attention while living in Mexico, I’m not going to be covered.” And that’s the reason they purchase health insurance policy here, without terminating the one that’s in the States or in Canada.
Most of the expats don’t keep their Medicare because most people who live in Ajijic have the intention of staying in Mexico for the rest of their lives. A lot of them say, “I’ll never go back to the United States. I prefer Mexico. It’s cheaper, and people are more likeable, plus you get better treatment from doctors.”
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A lot of people have said that the doctors in the States only receive you, tell you what condition you have, and then charge you. Here in Mexico, the doctor welcomes you all the way from the door, takes you to the lab if necessary, will accompany you to the hospital, and will receive you there. It’s a really personal treatment, and that’s what most foreigners like, plus healthcare services are cheaper in Mexico than in the United States or in Canada, if you have to go to the private system.
(Expat exploring Mayan ruins, Mexico, pictured.)
Posted November 17, 2016
Cathie Smith LoCicero - Cathie Smith Insurance
Medicare does not cover Americans in Mexico. Medicare only covers Americans in the United States. It is for people 65 years and older or some people can get Medicare if they're younger depending on certain medical conditions that they may have. You can still use your Medicare even if you've lived in Mexico either part-time or full time if you have a supplement to your Medicare. This depends on what kind of supplement you have. There's a special...
Medicare does not cover Americans in Mexico. Medicare only covers Americans in the United States. It is for people 65 years and older or some people can get Medicare if they're younger depending on certain medical conditions that they may have. You can still use your Medicare even if you've lived in Mexico either part-time or full time if you have a supplement to your Medicare. This depends on what kind of supplement you have. There's a special package that you can also get in certain types of supplements that would cover you for immediate emergencies only when you're outside of the United States. There are so many types of supplements and insurance in the United States, on a state-by-state basis.
If you have the Medicare supplement called Plan F, this plan would reimburse you for emergencies. For example, you went to an emergency room in a hospital Mexico because you broke a leg or you had a heart attack, you would generally pay that hospital and then file a claim when you get home to the United States. You would have a deductible and Plan F only reimburses 80 per cent of what they allow. It also only covers you to the point that you're stable. The moment you're stable, you're on your own. It helps you a little bit, but it's only good for an immediate emergency. It does not cover any doctor's visits and continuing hospital care.
Plan F also only covers you during the first 60 days of any trip. That's a big misconception that a lot of people have when they move to Mexico. They think, "I've got a supplement that I paid for and I've got Plan F, so if I have a heart attack or stroke, then I'm covered for the emergency part." You must prove to Medicare when you entered Mexico. I know so because I had a claim so I went through this myself. I had to prove what date I entered Mexico so that they knew that I had not been there for more than 60 days. Plan F would only cover the immediate care for that emergency and anything after that you would have to pay out of your own pocket.
(Cathie LoCiero giving a seminar on emergency healthcare options, Baja California Sur, Mexico, pictured.)
Posted June 17, 2017
Yvon Marier - Travel Info Mexico
No, Medicare will not cover you in Mexico and if you have Medigap Plans C, D, E, F, G, H, I, J, M, and N pay 80% of the billed charges for certain medical necessary emergency care outside the U.S. after you meet a $250 deductible for the year.
These Medigap policies cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.
No, Medicare will not cover you in Mexico and if you have Medigap Plans C, D, E, F, G, H, I, J, M, and N pay 80% of the billed charges for certain medical necessary emergency care outside the U.S. after you meet a $250 deductible for the year.
These Medigap policies cover foreign travel emergency care if it begins during the first 60 days of your trip, and if Medicare doesn’t otherwise cover the care.
Posted June 18, 2017
Peter F Gordon, MD - Lake Medical Group
No, Standard Medicare Parts A and B only will not cover you in Mexico, BUT your supplemental or Medicare Advantage Plans, also called C Plan or Replacement Plan, will often cover you, and with the program we have available in Puerto Vallarta, there are no deductibles and no co-insurances. We have agreements with over 350 different insurance companies including most of the supplemental plans and Medicare Advantage Plans. This allows us to bill directly to...
No, Standard Medicare Parts A and B only will not cover you in Mexico, BUT your supplemental or Medicare Advantage Plans, also called C Plan or Replacement Plan, will often cover you, and with the program we have available in Puerto Vallarta, there are no deductibles and no co-insurances. We have agreements with over 350 different insurance companies including most of the supplemental plans and Medicare Advantage Plans. This allows us to bill directly to your insurance company for your medical expenses in Puerto Vallarta, Ajijic, Lake Chapala, and Guadalajara. And this includes hospitalizations, laboratory tests, x-rays, doctors’ visits, and in some cases, medications.
Posted June 21, 2017
Francisco Gutierrez - Isaac Insurance
I think is generally clear that Medicare won´t cover foreign medical expenses, except for the limited specific situations described by other contributors, but if you travel abroad or are considering to retire in a foreign country, it is imperative that you study well how Medicare works, when to enroll, and consider enrolling in the supplemental “Medigap” coverage that covers emergency medical situations while traveling abroad.
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I think is generally clear that Medicare won´t cover foreign medical expenses, except for the limited specific situations described by other contributors, but if you travel abroad or are considering to retire in a foreign country, it is imperative that you study well how Medicare works, when to enroll, and consider enrolling in the supplemental “Medigap” coverage that covers emergency medical situations while traveling abroad.
The supplemental coverage "Medigap" forms that include these benefits are C, D, F, G, M and N. Some are no longer sold, and some are not available in all States. The coverage lifetime limit is $50,000 with a $250 deductible and 20% coinsurance.
It is very important for you to get and keep written proof of everything done in your enrollment process, all your Medicare related documents, and later, all documents related to your traveling. Before definitely moving abroad, you will be doing several trips to your country of choice. Keep all records of your entries and exits of the US. If you have the Medigap coverage that includes Foreign Travel, each time you go out, you will trigger a continuous 60 days of emergency coverage. Your $50,000 coverage would be good enough in Mexico to cover most emergencies, including a bad accident, hearth attack or stroke. But remember that most likely you would need to pay for the service before you leave the hospital, and then request reimbursement to your Medigap Provider. Here is when gets a little complicated.
The following instructions are taken from the CMS Booklet (Centers for Medicare and Medicaid Services):
You will need to complete the proper form and submit an Itemized bill to request reimbursement.
“B. Each itemized bill MUST show all of the following information:
• Date of each service
• Place of each service Doctor’s Office Independent Laboratory Outpatient Hospital Nursing Home Patient’s Home Inpatient Hospital
• Description of each surgical or medical service or supply furnished. • Charge for EACH service.
• Doctor’s or supplier’s name and address. Many times a bill will show the names of several doctors or suppliers. IT IS VERY IMPORTANT THE ONE WHO TREATED YOU BE IDENTIFIED. Simply circle his/her name on the bill.
• It is helpful if the diagnosis is also shown on the physician’ s bill. If not, be sure you have completed Block 4 of this form.
• Mark out any services on the bill(s) you are attaching for which you have already filed a Medicare claim.
• If the patient is deceased, please contact your Social Security of fice for instructions on how to file a claim.
• Attach an Explanation of Medicare Benefits notice from the other insurer if you are also requesting Medicare payment.”
We often see that one of the hardest things when you get medical services abroad, is to get proper bills, description of the procedures and services received, and identifying your providers. It is a key point for filing claims to Insurance carriers, and very important for your medical records. Providers often avoid giving documentation for tax reasons, and patients become inpatients for leaving the place. Be patient. Get as many documents as possible: diagnostics, test results and interpretation, prescriptions, receipts clearly describing the service rendered, specify how much was charged, how much and how was paid. Everything must make sense and add up to what you will be claiming.
If you are still in the planning process, or you are already permanent in México and enrolled in Medicare, you may be eligible for a Mexican Policy that gives you a much broader coverage while here, that can pay directly to medical providers. Your policy can be tailored considering that for longer treatments and high specialty surgeries you would be going back home and get treated with Medicare. This combination can make quality medical services available while in Mexico at a very affordable cost. It will give you peace of mind and can save your life.
Posted January 17, 2018