BlueCross/Shield Insurance

[cnkbud 0]

Hi Guys,

I am retired US gov and have subj insurance(Federal Program) as supplemental to medicare. In so much as medicare is not good overseas subj insurance becomes primary in the LOS and subj to the standard deductibles. I understand that several of the major hospitals there are accredited by BlueCross/Shield and will fill out the paperwork necessary for reimbursement. Just wonder what experiences anyone in the same situation as me, while either visiting or living there permanently, have with use of this insurance. Thanks and a great day. Old Bud

[Florida Guy 0]

I plan on retiring in LOS in about 10 years and insurance (or lack of) is my biggest fear. I have VA benefits but they will not cover me overseas because I wasn't a career veteran although I did my time in the military and was promised VA care for life. I have also been paying into Medicare all my working life (44 years so far with another 10 1/2 to go) and understand they also will not cover me overseas. That's a crock, if I put in my time (military/VA) and paid for it (Medicare), why can't I receive coverage?

 

I know I can purchase private insurance but it gripes my ass since I'm entitled to two different plans but can't benefit from either. I will also retire with VERY limited resources and I could sure use that money elsewhere.

 

I've heard rumors of the Medicare situation changing somewhere down the line, but as far as I know, it's just that ... a rumor.

[short 215]

I suspect the problem with medicade is that they don't have legal authority on overseas hospitals to stop billing abuse. Just look at how many providers have tried to rip of the government in the US already.

[Florida Guy 0]

You're probably right Short, that may have something to do with it. But the major hospitals in LOS are modern affairs with computers ... it sure seems that some arrangements could be made. Abuse the system and the relationship disolves. That would be a big hit as far as cash flow goes. Heck, it would be a bartgain in some respects considering how much cheaper quality health care is in LOS compared to the States.

 

I believe retired vets get coverage overseas (tricare) and get reimbursed for medical treatment they receive in private medical facilities. Surely someone could come up with a similar system for Medicare.

[Owen` 2]

A few tidbits I've learned chasing data

 

1) Medicare is not the same as Medicaid. Do not confuse the two. Medicaid is the US govt health plan for welfare (the UK calls it The Dole, I think) recipients. Medicare is the govt health plan for retirees over age 65.

 

2) You continue to pay Medicare premiums past age 65. It is health insurance.

 

3) Florida Guy above was ticked Medicare won't pay him living outside the country. Wanna get really mad? I am not sure, but I think for you to EVER be eligible, perhaps back in the US, you have to keep paying the premiums while in LOS -- even though you can't collect.

 

4) Note that all of this is for age 65 and up.

 

5) The VA will pay for your medical needs if you are 1) disabled from a military event/related condition 2) have income at a very low level. If you make too much money, VA will not cover you (unless you had a military disability) regardless of where you live. I confess I stopped investigating the VA options when I learned I would not be covered, so maybe there are loopholes others can fit through. I'm a former US Air Force officer and I could not qualify.

 

6) There is a community of US expats in Mexico who have built their own hospital and staffed it with US docs. They are lobbying hard for Medicare to cover out of country billings. This may or may not work. We'll see.

 

7) For the time period prior to abe 65, one needs insurance. It is during this time period that the issue of pre existing conditions kicks in. Insurance companies want to cherry pick the best risks to optimize profit. That means if you have hypertension in your background, they will insure you, but exclude all things associated with hypertension for X months (often 3 yrs, varies). For guys into their 50's this would include kidney problems, all heart problems and really just about anything else the insurance company want's to claim is related. This issue is quieter but MORE IMPORTANT than the deductible and monthly premium. Nothing worse than paying a few years of insurance, needing some heart drugs and have them say they will not cover it, never have been covering it and are never likely to, given you've now another pre-existing condition that developed before the time limit was up.

 

Anyone who goes to the pain to look into this, please pass along what you learn can be done in Thailand.

[RWB 0]

Interesting and very relevant topic. The VA will usually screw you every chance they get even here in the states. I was getting free care, agent orange related, when all of a sudden the VA decided I had too much money and wanted back pay. My divorce bankruptcy screwed them. I never went back for the disability I am entitled to. The story of my best friend, passed from agent orange, is a bit too long to tell, but it is a horror story about the VA. They reflect the present regime. As far as medicare, well, who knows what will happen there. Don't count on your gov't keeping any promises they made, ain't gonna' happen. They lied to us 35 years ago and they are telling even bigger lies now.

 

I will need to check with my company(still work for a gov't agency-local) insurance when I retire in a few years. It carries over into retirement and is pretty good. They may not want to cover when I move to LOS. That would hurt a bit in the pocket book. I enjoy good health, but at my age and with my "over use" of my body through the years, good health can't last. Insurance is a major factor to consider when moving. Regardless, I'm moving.

[Florida Guy 0]

When I first got out of the service I had no insurance coverage and had some minor medical problems that the VA took care of (including minor surgery). Follow-up was a bitch and no matter how minor, was an all day affair.

 

I later received medical insurance through my employer and the last time I used any VA benefits was 1977. In 1989 I decided to start my own business and purchased private medical insurance but after a few years it was breaking me. The expense was astronomical, so I decided to drop it. My personal friend happens to be a doctor, so I went to him for regular care and decided I'd keep the VA in my "back pocket" in case of a catastrophic illness or major injury etc. My doc was getting a bit concerned with my blood pressure and when I priced the meds he wanted me to take, I decided to again consider VA.

 

A few years ago I decided to get a COMPLETE physical since I was in my 50's and had never really had one. I contacted VA and they ran me through the whole gamut of tests at no charge to me. I was put on blood pressure meds again at no charge. Believe it or not, they even supply my Viagra! (said the ED was caused by the high B/P)

 

I fell under the income radar because being self-employed, I can cover most of my living expenses through my business and show very little actual income. Last year I had to give myself a raise and it threw me into a higher income bracket. Now my VA medical care is still free but the prescriptions run me $8.00/month (per prescription). The care has been excellent and I'm usually seen at my appointment times or within an hour if they're exceptionally busy and running behind. The system has improved dramatically since the 70's! A couple weeks ago I had my first colonoscopy and was given a clean bill of health. This week I have an appointment for tests as they're a bit concerned with my cholestoral levels.

 

Needless to say, not having this care will be a major setback for me "when" I move to LOS. I was hoping to have Medicare to fall back on but that's out also. It's something I'm really going to have to figure out when the time comes to relocate. Hopefully something will change in the next 10 years.

[Owen` 2]

FloridiaGuy, sounds like you got in under the VA's radar. I do recall

there being some mention of the income threshold being relaxed if

you were already a VA medical services recipient. No way around

this; you have to study and find out what works.

 

As for Medicare, with you in your 50's you probably have paid enough

into the system that if you suspend payment for a time, and then resume

it in order to collect, all is well. There are websites to study for this, too.

 

Nobody has a crystal ball on this stuff. My read is no society can

endure medical expenses occupying 10 or 20 or 30% of GDP, which is

what healthcare in the US is on track to do. My read is this will never

occur because it simply cannot. Certain realities are going to kick in --

and one of them is that there are several EU countries that spend

far far less in healthcare costs than the US and have roughly equivalent

death rates. From the perspective of morbidity, the US is not getting

any return on its healthcare investment.

 

Yes, there is nowhere in the world with better high tech procedures and

if you need them, that's the place to be -- but when a gastroenterologist

sticks that fiber optic tube down your throat to look for an ulcer, he

will take a swab or snippet of tissue from several places that look just

fine because he gets paid $400 per swab/snippet to do so. The big price

tags are from diagnositics, not treatment. Someone wanders in complaining

of diarrhea and they may wind up with a colonoscopy, even if they say

they ate raw oysters the night before. The docs get to bill for this and

because the procedures are totally safe, there's no reason for them

not to run up the bill.

 

It will reach a point where people just don't go to the doctor. Simply that.

They won't go. The data suggests that not going, on average, doesn't

make you die any faster because those countries spending less have the

same life expectancy. From that perspective, the high deductible catastrophic

plans will probably evolve to be the norm. If you need an eye infection

dealt with, you'll pay that out of pocket. If you have a heart attack,

insurance will kick in.

 

Your total average yearly cost? A few thousand dollars.

[cnkbud 0]

Hi Guys, no flaming intended here but although the feedback so far is interesting and somewhat informative, can someone answer my original question. What experience has anyone had there using their Federal Program Blue Cross/Shield insurance. Thanks guys, have a good one and enjoy. Old Bud

[Owen` 2]

Hi Guys, no flaming intended here but although the feedback so far is interesting and somewhat informative, can someone answer my original question. What experience has anyone had there using their Federal Program Blue Cross/Shield insurance. Thanks guys, have a good one and enjoy. Old Bud

 

I have no solid data, but I did do a cursory look at BC/BS (I have it

within my company) within the last year and determined that it

would not provide coverage outside the US. Almost no insurance

will. This is why travel policies like TravelGuard exist.

 

I would be surprised if they do something special for retired civil service,

but yes, it is possible. A recheck might be wise. Or perhaps email

the hospitals themselves. It is a two way street. BC/BS saying they

pay or reimuburse is only half the issue. The other half is the hospital

has to accept them.

[cnkbud 0]

Owen, thanks for your input. Yes! BC/BS Federal Program absolutely does cover one overseas, and that is only logical with the large number of US civil servants working overseas, the only thing is they become primary and one is subj to all their standard deductions in so far as Medicare is not good overseas, simple as that. When used in the US they are secondary to Medicare. Don't know about the non-government private plans but believe that is what you are referring to. You are exactly right about it being a 2 way street but and the ease and timeliness of the matter of reimbursement is subj to the medical provider. Thanks again and have a great day. Old Bud

[Rex7777 0]

While we're on the topic, do any of you guys have any experience with mail-order pharmacies of the type usually associated with health plans? For example, you might get three months of any medication for $35, and they mail it right to your place. But what happens if your place is in Thailand? Customs problems? Shipping expenses?

 

Rex

[Pilot 0]

While we're on the topic, do any of you guys have any experience with mail-order pharmacies of the type usually associated with health plans? For example, you might get three months of any medication for $35, and they mail it right to your place. But what happens if your place is in Thailand? Customs problems? Shipping expenses?

 

Rex

The biggest problem you'll have if you try to import drugs into Thailand via a mail-order pharmacy is with Thai Customs. I don't have any info on what would be necesary for the drugs to clear Customs but would imagine that it would be difficult.

 

I called VA and asked them about receiving my meds overseas and was told it is possible and the meds would be sent to the US Embassy where I would have to pick them up. Also there is a VA hospital in Manila that I could receive care at.

 

As far as coverage through Blue Cross/Blue Shield through the FEHB, you can call them at 1-800-699-4337. They should be able to answer any questions.

[BigDUSA 71]

I'm retired from the Post Office and according to my HMO, I'm covered overseas. They told me to pay the bill and send them in and I will be reimbursed. So far, I haven't had to use this.

[Owen` 2]

You former US civil servants and retired military who can get health care

overseas have a big plus, as long as it lasts.

 

When one turns 65, as of now, private insurers start saying no. And I

mean no at almost any price. The pre-existing conditions total have

accumulated to an unacceptable level by then.

 

So this becomes a major reason to keep an eye on Medicare. If

expats succeed in getting Medicare to send money for treatment

overseas, the age 65 problem disappears. If not, one has a very

difficult issue to address at age 65.

 

Keep an eye on this, guys. When govt pensions start to erode under

the pressure of demographics, one of the first things that will be

eroded will be healthcare advantages. Just like reducing your inflation

adjustment, this will be a quiet thing for the politicos to attack and

outrage will not result.

 

Stay alert.

Edited July 8, 2006 by Owen`

[cnkbud 0]

Owen, I hear where you're coming from guy but that ain't going to happen, remember, all those politicians probably also have the gov insurance plan and are going to protect their interests. It is one hell of a problem though and who knows how it will be sorted out for the future generations. I quess the US based health insurance providers just don't give a shit about US citizens traveling or living overseas, do so at your own risk and expense. BTW, sure hope someone here can answer my original question about use of their gov BC/BS ins while in the LOS but it looks like that ain't going to happen so might as well put an end to this topic. Have a good one and enjoy. Old Bud

[BigDUSA 71]

Civil servants take care of civil servants. I have a great health plan that cost $100USD per month and covers my family. Full medical, dental, vision and prescription drugs. Post Office takes care of most of the cost.

[Rex7777 0]

OK, I just did some research. If you're covered under the FEHB plan, Blue Cross/Blue Shield, for example, they'll have a list of so-called "preferred providers." I do believe that some of the big hospitals in Bangkok are on the list. In any event, the FEHB plans have members living all over the world, so they do have experience dealing with this issue. Ideally, you go to a preferred provider for treatment. You'd then either pay the full price or the co-pay. In either case, someone has to file a claim. If you pay the full price, I assume you'll be reimbursed for some or all of the cost of the treatment. Just as in the USA, some procedures might require pre-certification. In any event, you're covered.

 

As for medications: Thailand will allow for the importation of up to a 90 day supply of medication for personal use (the mail order pharmacies usually ship a 90 day supply), but it seems as though you have to get permission from the Thai FDA. You'll need a doctor's statement and certain other documents. I'm not sure who pays for the shipping or how much of a pain in the ass this would be. In the alternaive, you can obtain your medications in Thailand and file a claim with the FEHB plan for reimbursement.

 

The US State Department seems to have the best plan in terms of working all this out, but you have to be retired from the State Department (or certain other agencies) to enroll.

 

And as for future changes? Just remember, Congress is covered by the same plan. I simply don't see those guys voting to cut their own health plan.

 

Rex

Edited July 8, 2006 by Rex7777

[soibj 0]

You should call Blue Cross/Blue Shield and ask them, however I was concerned a little about coverage if the shit hit the fan up in LOS and they said I am fully covered and pay a deductible equivalent to that of the US. I just had to go to their website and print out all the participating facilities with the program. They told me I could go anywhere but it states on the website that the deductible is smaller from the facilites listed. Hopefully that helps some, if not, sorry.

 

http://www.bluecross.com/