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.