Retire in Dominican Republic: To Be or Not to Be?

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
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That may be misleading regarding Medicare in Santiago. Do you know of anyone who received Medicare coverage in Santiago? Probably not. Here is the official Medicare statement with regard to overseas coverage from medicare.gov:

"Travel outside the U.S.​


Medicare usually doesn’t cover health care while you’re traveling outside the U.S. There are some exceptions, including some cases where
Medicare Part B (Medical Insurance)
may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S. However, Medicare won't pay for health care services you get when a ship is more than 6 hours away from a U.S. port.

Medicare may pay for inpatient hospital, doctor, and ambulance services you get in a foreign country in these rare cases:
  • You're in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
  • You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another U.S state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
  • 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 an emergency exists."

How would you describe what the article is reporting?

And doesn't this seem to say you can get Medicare coverage:
  • 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 an emergency exists."
I'm guessing the folks at HOMS are willing to file claims with Medicare:

If you’re admitted to a foreign hospital under one of the situations described on page 1, and if that hospital doesn’t submit Medicare claims for you, then you pay the full cost to the health care provider.
 

SantiagoDR

On Vacation
Jan 12, 2006
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How would you describe what the article is reporting?

And doesn't this seem to say you can get Medicare coverage:
  • 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 an emergency exists."
I'm guessing the folks at HOMS are willing to file claims with Medicare:

If you’re admitted to a foreign hospital under one of the situations described on page 1, and if that hospital doesn’t submit Medicare claims for you, then you pay the full cost to the health care provider.

I'm guessing, wherever YOU LIVE IN THE U.S. - HOMS would not be the nearest to your home over a U.S. hospital.
 
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SKY

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Apr 11, 2004
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Good luck trying to get ANY clinic to let you walk from a bill with US Medicare. I would have to see it myself to believe it......
 
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windeguy

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Jul 10, 2004
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Doesn't the HOMS hospital in Santiago accept medicare?
Medicare cannot be billed in the DR. So HOMS is in the DR: Answer is NO.

I have never heard of anyone getting regular medical care in the DR and being reimbursed by Medicare.
That might work for an emergency room visit as described below.
Coverage for anything is very limited as in VERY limited out of the USA. Right from the source:


Travel outside the U.S.​


Medicare usually doesn’t cover health care while you’re traveling outside the U.S. There are some exceptions, including some cases where
Medicare Part B (Medical Insurance)
may pay for services that you get on board a ship within the territorial waters adjoining the land areas of the U.S. However, Medicare won't pay for health care services you get when a ship is more than 6 hours away from a U.S. port.

Medicare may pay for inpatient hospital, doctor, and ambulance services you get in a foreign country in these rare cases:
  • You're in the U.S. when a medical emergency occurs, and the foreign hospital is closer than the nearest U.S. hospital that can treat your medical condition.
  • You're traveling through Canada without unreasonable delay by the most direct route between Alaska and another U.S state when a medical emergency occurs, and the Canadian hospital is closer than the nearest U.S. hospital that can treat the emergency.
  • 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 an emergency exists.
Your costs in Original Medicare
You pay 100% of the costs, in most cases. In the situations described above, you pay the part of the charge you would normally pay for covered services. This includes any medically necessary doctor and ambulance services you get in a foreign country as a part of a covered inpatient hospital stay. You also pay the coinsurance, copayments, and deductibles you'd normally pay if got these same services or supplies inside the U.S.
In the situations above, Medicare pays only for services covered under
Original Medicare
:

  • Medicare Part A (Hospital Insurance)
    covers hospital care (care you get when you've been formally admitted with a doctor's order to the foreign hospital as an inpatient).
  • Part B covers emergency and non-emergency ambulance and doctor services you get immediately before and during your covered foreign inpatient hospital stay. Medicare generally won't pay for services (like return ambulance trips home) in either of these cases:
    • Medicare didn't cover your hospital stay.
    • You got ambulance and doctor services outside the hospital after your covered hospital stay ended.
Note
Foreign hospitals aren’t required to file Medicare claims for your travel medical costs. You need to submit an itemized bill to Medicare for your doctor, inpatient, and ambulance services if both of these apply:
  • You're admitted to a foreign hospital under one of the situations above
  • The foreign hospital doesn't submit Medicare claims for you

Note:​

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:
  • Other insurance you may have
  • How much your doctor charges
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service
Things to know
The 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa are considered part of the U.S.
Medicare drug plans don't cover prescription drugs you buy outside the U.S.
Medicare supplement insurance (Medigap) policies may cover emergency care when you travel outside the U.S.
Note
Because Medicare has limited travel medical coverage outside the U.S., you may choose to buy a travel insurance policy to get more coverage. An insurance agent or travel agent can give you more information about the cost of travel medical insurance. Travel insurance doesn’t necessarily include health insurance, so it’s important to read the conditions or restrictions carefully.
--------

So forget about Medicare in the DR. If you want medical insurance in the DR get a local plan.
 
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Sailor51

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I have not found them to be cliquish at all. I guess different experiences. When I lived in the States years ago, I was the token white at an all black church. The members went out of their way to make me feel welcome, including a Thanksgiving home invitation.
Had the same experience at an AME church near a marina I stayed at. On the other hand a "fellowship" church totally ignored me when I waited to speak with the pastor. What ya gonna do?
 
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Sailor51

Happy to still be here
Oct 30, 2018
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Can a retired person from the United State use his/her insurance (Medicare/Veteran's Insurace/Private insurance in Dominican Republic?
If you're planning on returning to the US, keep the insurance. If not use the money for something else. Dominos and Presidente was suggested elsewhere. Maybe a guitar too ..
 

JD Jones

Moderator:North Coast,Santo Domingo,SW Coast,Covid
Jan 7, 2016
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OK, so what are they doing at HOMS with Medicare?

What does this mean?

Santiago.- Homs reached an agreement with Medicare so that Dominican patients who have foreign insurance can be treated at that care center.

Someone who knows, please. No opinions.
 

El Hijo de Manolo

It's outrageous, egregious, preposterous!
Dec 10, 2021
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Dominican Republic

windeguy

Platinum
Jul 10, 2004
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OK, so what are they doing at HOMS with Medicare?

What does this mean?

Santiago.- Homs reached an agreement with Medicare so that Dominican patients who have foreign insurance can be treated at that care center.

Someone who knows, please. No opinions.
All I can say is that Medicare regulations do not allow Medicare to treat patients outside of the US with the VERY limited exceptions of what I already posted above from the official US Government Medicare site. There is no way this can happen regarding HOMS or any other DR hospital or clinic.
 
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El Hijo de Manolo

It's outrageous, egregious, preposterous!
Dec 10, 2021
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Dominican Republic
All I can say is that Medicare regulations do not allow Medicare to treat patients outside of the US with the VERY limited exceptions of what I already posted above from the official US Government Medicare site. There is no way this can happen regarding HOMS or any other DR hospital or clinic.
I have no frame of reference on this, but my bet is on Winded's statement since he's the board's longest-time Medicare beneficiary
 
Jan 9, 2004
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OK, so what are they doing at HOMS with Medicare?

What does this mean?

Santiago.- Homs reached an agreement with Medicare so that Dominican patients who have foreign insurance can be treated at that care center.

Someone who knows, please. No opinions.
Adding to what has already been posted, Medicare does NOT provide coverage outside the US unless you meet one of the exceptions mentioned already.

However, if you have a Supplemental Plan to Medicare.................many of those plans cover for both emergency and urgently needed care for a period of time......... usually up to 6 months while abroad or out of the plans network.

Some years ago there was a move to change Medicare to cover the estimated 500,000 expats living in Mexico. It was not not successful.

Either HOMS miscommunicated or Listin misunderstood...........take your pick.


Respectfully,
Playacaribe2
 

windeguy

Platinum
Jul 10, 2004
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I have no frame of reference on this, but my bet is on Winded's statement since he's the board's longest-time Medicare beneficiary
I suspect not even close. Not even 2 years. I did research if I could drop my local insurance plan and use Medicare instead. The answer to that is a resounding no.