Medicare Accepted in Santiago/SD??

MEDICAID would make more sense to me. :ermm:

But you're correct. MEDICARE in DR would be good for US pensioners.

Rumors. The link will hopefully answer your question. There are only three situations for Medicare coverage in foreign hospitals.

When does Medicare cover health care services I get in a foreign hospital?

There are three situations when Medicare may pay for certain types of health care services you get in a foreign hospital (a hospital outside the U.S.):

1.You are in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat the illness or injury.

2.You are traveling through Canada without unreasonable delay by the most direct route between Alaska and another state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the illness or injury. The requirement of traveling through Canada “without unreasonable delay” is determined by Medicare on a case-by-case basis.

3.You live in the U.S. and the foreign hospital is closer to your home than the nearest U.S. hospital that can treat your medical condition, regardless ofwhether it is an emergency.Medicare coverage criteria still apply to the services you get in a foreign hospital

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http://www.medicare.gov/Publications/Pubs/pdf/11037.pdf

"3. You live in the U.S. and the foreign hospital is closer to your home than the
nearest U.S. hospital that can treat your medical condition, regardless of
whether it is an emergency.
Medicare coverage criteria still apply to the services you get in a foreign hospital."

That seems to indicate that you are covered by Medicare in the DR. However, that probably does not obligate a DR hospital to accept a Medicare patient.

I inquired at the new clinic in Sosua, and they are not taking medicare at present. One would think that in order for the North Coats to become a true haven for American retirees, Medicare coverage would be essential. - D

Danny W said:

"3. You live in the U.S. and the foreign hospital is closer to your home than the
nearest U.S. hospital that can treat your medical condition, regardless of
whether it is an emergency.
Medicare coverage criteria still apply to the services you get in a foreign hospital."

That seems to indicate that you are covered by Medicare in the DR. However, that probably does not obligate a DR hospital to accept a Medicare patient.

I inquired at the new clinic in Sosua, and they are not taking medicare at present. One would think that in order for the North Coats to become a true haven for American retirees, Medicare coverage would be essential. - D

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I could be wrong, but it seems more likely that #3 is referring to someone who lived in the US on the border with Canada or Mexico and the nearest facility which can provide the needed service is across the border. It would be no help to an American expat living in the DR, and would not seem to apply to a tourist either.

Having said that, I am fairly certain that there are a limited number of overseas medical facilities which are approved to be reimbursed by medicare, and rumors were rampant a while back that the new clinic in Santiago was in the process of gaining approval for this status.

AlterEgo,

An American nurse who lives in the north coast told me that when she visited the HOMS (Hospital Metropolitano de Santiago) they told her that they were seeking approval from Medicare. But in all honesty, I doubt that this will ever happen. You got to live in the US to get Medicare coverage. Here's the website of the hospital. You may want to shoot them a note Preguntas FrecuentesbyHOMS- Hospital Metropolitano de Santiago (email address at the very bottom).

AlterEgo said:

Today's Listin Diario - doesn't say when it goes into effect, does that mean immediately?

La Rep?blica - Llega a acuerdo con Medicare

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Translation, please!

check into

AlterEgo said:

You're right, of course, about having to live in USA. I was thinking about my husband and myself, who plan to keep our home in NJ and spend 5 months or so each winter in DR. Our legal address would remain NJ. I'd feel a lot better if I knew medicare + supplement was accepted there, and that I didn't have to buy a separate policy for DR.

Click to expand...

If you flip that formula and spend 4 months in NJ and 8 months here you can probably avoid your state tax (check of course with your accountant as I did with mine) and afford the best off shore medical policy (IHI DENMARK) which is transportable back the US and may in fact give you better coverage than Medicare which a lot of doctors are no longer accepting. worth looking into.

I will check with the boy of mine that has offices in HOMS....I know that from the start up, having the ability to offer service to Medicare and Medicade patients was one of the goals for the place.

That article seems to indicate that the agreements have been reached..we'll see about that. And I will check...

this would be an incredible boost for HOMS...

HB

Hoping

Hoping that this turns out true, but have a problem with the Medicaid coverage. That is for low income family's or in certain states for uninsured children, and it is a combination of Federal/State, If they qualify for Medicaid and are taking Caribbean vacations, brings up the thread when every body was all over the gal from England, about her trips to see the boyfriend while she was on the dole.

Off Shore
Medicare yes, Medicaid no

Hillbilly said:

I will check with the boy of mine that has offices in HOMS....I know that from the start up, having the ability to offer service to Medicare and Medicade patients was one of the goals for the place.

That article seems to indicate that the agreements have been reached..we'll see about that. And I will check...

this would be an incredible boost for HOMS...

HB

Click to expand...

What is HOMS?

totally!

bienamor said:

Hoping that this turns out true, but have a problem with the Medicaid coverage. That is for low income family's or in certain states for uninsured children, and it is a combination of Federal/State, If they qualify for Medicaid and are taking Caribbean vacations, brings up the thread when every body was all over the gal from England, about her trips to see the boyfriend while she was on the dole.

Off Shore
Medicare yes, Medicaid no

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Absolutely agree!

Article translation using old translator:

Santiago.- The Homs an agreement arrived at with the Medicare so that
patient Dominicans that they have their sure foreigner they can be
attended in that center asistencial.

The doctor Rafael S?nchez Spanish said that they try to expand the cover
of the services that offer.

Also the Homs is observed like the ideal place to study the tropical
illnesses, for which this Monday will receive a delegation of the
International University of the Flowery one to coordinate joint actions.

They prepare a unit of investigation with the requerimientos of
international connections.

In the next five years intends to be an educational hospital asistencial
complete, where doctors will be formed in all the specialties.

The hospital has an educational agreement with the Pontificia Catholic
University Mother and Master (PUCMM).

Services Among the services that offers the HOMS figure:

Emergency and Traumatolog?a, Diagnostic Department of Images, Clinical
Laboratory and Bank of Blood, Department of Patolog?a, Unit of
Endoscop?a, Unit of Di?lisis, Cardiolog?a, Hemodinamia, Surgery
Cardiovascular.

Also, general surgery, surgery esthetics, surgery bari?trica, surgery
laparosc?pica, ginecobstetricia, unit of oncohematolog?a, trasplantes
multi-organs, service of odontolog?a advanced, hospitalizaci?n, intensive
care, intensive care pedi?trico and neonatal, pharmacy and medical plan
of evaluation executive.

new Sosua clinic

I was talking to the man who has opened the new clinic in Sosua. He told me that they were not taking Medicare, but had no problem with the other major US insurers. In fact, it was easier making arrangements with them than with the Dominican insurers.

AlterEgo said:

Today's Listin Diario - doesn't say when it goes into effect, does that mean immediately?

La Rep?blica - Llega a acuerdo con Medicare

Click to expand...

The article mentions "Dominican patients". Seems to me this may not apply to other nationalities.

Medicare is US

A.Hidalgo said:

The article mentions "Dominican patients". Seems to me this may not apply to other nationalities.

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Medicare is a US Federal government program. I am really at a loss to figure out how a foreign hospital is going to set up an arrangement with the US federal government to qualify as a Medicare facility. And if they did, then certainly any US citizen who is qualified for Medicare (has worked in the States on the books for 48 quarters ) would be eligible / Other elderly US citizens could buy into it.

But how on earth could they do it? I mean legally all the hospitals in Puerto Rico are qualified to take Medicaid which should have made Puerto Rico a premier retirement destination for Yanks, but it really hasn't ....... due I guess to the peculiar sort of love hate relationship that Puerto Rico has with the States and the colonialista attude......and perhaps because the gringos simply do not believe that Puerto Rican hospitals could possibly be as well equipped as any on the mainland.

Maybe they could do in parts of the Panama Canal zone in light of people having been there for so long but here?

But if there could be Medicare accepted in a foreign country, wouldn't Mexico or Costa Rica have figured this out a long time ago?

I can't imagine under what US statute it could possible be legal..

I think that they are just yanking everyone's chain.....

Even if they don't accept Medicaid/Medicare you can still get treatment in the DR and get reimbursed. I paid the clinic I was in like 100,000 pesos and got most of it back from my insurance in the US (Aetna).