Understanding Medicare & How it Benefits You While Living in Mexico
Having the right medical coverage while in a foreign country is necessary if you want to get great treatment at excellent facilities. Without it, you could end up in a place with mediocre care and staff members – not to mention, you’ll likely have to pay for the bill. Below you will find information about Medicare and how it can be used while you’re living in a foreign country like Mexico.
What is Medicare?
In the United States, Medicare is a national social insurance program, administered by the US Federal Government since 1966, that guarantees access to health insurance for Americans aged 65 and older who have worked and paid into the system, and younger persons who have End-Stage Renal Disease (ESRD) or individuals who have a disability and receive social security benefits. Medicare offers four different health plans, known as Part A, Part B, Part C and Part D. Each of the plans offers different coverage options for medical services. Here is a closer look;
- Part A – Gives you coverage for inpatient hospital stays. You can also receive care in a skilled nursing facility, home health care or hospice care. This is known as hospital insurance.
- Part B – This is considered to be medical insurance. It covers doctor bills, outpatient care, preventative services and medical supplies.
- Part C – Offers Medicare Advantage Plans that are offered from a private company that has a contract with Medicare. You receive Part A and Part B benefits with this option. Coverage also includes HMO, PPO, private fee-for-service plans, special needs plans and Medicare medical savings account plans. Once enrolled in this option, your medical bills will be covered by the plan, not by Original Medicare. Prescription drugs are covered by most plans as well.
- Part D – This covers prescription drugs and is added to Original Medicare, Medicare medical savings account plans and some fee-for-service plans and Medicare cost plans. You can sign up for Part D through a private company or insurance company who is approved by Medicare. This option follows the same rules as Medicare Prescription Drug Plans.
Can I use My Medicare as an Expatriate Living in Mexico?
A lot of the senior citizens who are heading South of the Border to Mexico are worried that their Medicare benefits will render useless – and for good reason. Simply put, Medicare only offers benefits to individuals who reside in the 50 Contingent United States or its territories, such as the U.S. Virgin Islands, Puerto Rico, Guam, American Samoa, Northern Mariana Islands and the District of Columbia.
Does Medicare Offer Medical Coverage in Mexico?
While in Mexico, you will not be able to receive Medicare benefits, not even for prescriptions drugs or emergencies. So you could end up paying the entire medical bill for illnesses and injuries that you have treated in Mexico. If you want to receive help with paying for your medical bills, it will be necessary to obtain an international insurance policy that will cover such costs and unexpected occurrences.
There are three scenarios that will allow you to receive Medicare coverage when outside of the United States:
- You’re traveling through Canada as a way to get from or to Alaska to or from the U.S. and a medical emergency arises.
- You are within the U.S. and a medical emergency takes place, but the closest hospital that offers services for your illness or injury is in Mexico or Canada.
- You live in the U.S. and the nearest hospital that can treat you is in Mexico or Canada – it doesn’t matter whether it’s an emergency or not.
As you can see, these situations wouldn’t be relevant to U.S. citizens who are looking to retire in Mexico.
Do Hospitals in Mexico Accept Medicare for Medical Expenses?
Medicare doesn’t offer coverage in Mexico unless it meets one of the above scenarios. Expatriates in Mexico who are American citizens have to fly back to the U.S. to receive their Medicare benefits. Hospitals in Mexico will require payment to them before you are released after treatment has been received. Medicare only offers coverage outside of the U.S. when there is an emergency that occurs within 60 days of leaving the U.S. If you have a plan other than the Original Medicare, such as an HMO or PPO with a private company, then you will need to check your policy to see what services are offered across the border.
Does Medicare provide Air Evacuation Coverage if Living as an Expatriate in Mexico?
If you are a Mexican expatriate and require an emergency air evacuation, then you may be surprised to find out that you will have to pay for the bill. Medicare rarely pays for air evacuations, unless it’s for an emergency transport that a ground vehicle is unable to provide. You will also have to be getting transported to a hospital within the United States, since Mexican medical services may not be covered by your Medicare policy.
If I have a Medical Emergency in Mexico will Medicare cover the expenses?
Medicare is known to pay for emergency services that take place outside of the U.S., but some plans will only pay for a portion of the bill. Although U.S. Hospitals must submit claims to Medicare for you, foreign Hospitals are not required to file Medicare claims. You will have to check your policy to see if medical providers outside of the U.S. are covered. The aforementioned scenarios will be covered by Medicare, or if the accident or illness took place within 60 days of you moving to Mexico.
Expatriate Medical Insurance Plans offered by West Coast Global Insurance Services
In order to ensure that your health is protected while an expatriate in Mexico, you will need to obtain an international medical insurance policy or accident & illness health protection. An International major medical insurance policy will offer a variety of benefits, including;
- Hospitalization and outpatient care
- Prescription coverage
- Deductibles between $0 and $20,000
- Up to an unlimited medical benefit amount depending on carrier and plan type
- Maternity and newborn care
- Air Evacuation – Life Flight
You can also find plans that offer emergency air evacuation coverage. You owe it to yourself to obtain medical coverage that will pay for the medical services that you need. Go to West Coast Global Insurance Services today to learn more.