US Health Insurance - US Federal Employee Retired

SteveK

Member
Jan 23, 2011
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Do Medical Facilities in the DR Accept US Health Insurance If you're a US Federal Govt retiree?

Would medical facilities accept FEPBLUE? (Blue Cross/Blue Shield)

Appreciate your response
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Cavok is correct. I have not come across any that will bill the US insurance directly. There are some (few) plans that cover "out of country" but normally you have to pay up front then submit the bills for reimbursement. I know of no medical facility that accepts BCBS Fed plan that I am aware of. You may want to contact the insurance and see if they will reimburse you for medical bills.
 
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SteveK

Member
Jan 23, 2011
86
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Cavok is correct. I have not come across any that will bill the US insurance directly. There are some (few) plans that cover "out of country" but normally you have to pay up front then submit the bills for reimbursement. I know of no medical facility that accepts BCBS Fed plan that I am aware of. You may want to contact the insurance and see if they will reimburse you for medical bills.
Thanks Keepcoming, Appreciate the info..glad I asked about this.
 

La Profe_1

Moderator: Daily Headline News, Travel & Tourism
Oct 15, 2003
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I am a retiree with Blue Cross and Blue Shield US coverage, but not a Federal plan.

I have been hospitalized several times while in the DR and the clinic billed BC/BS directly.

Blue Cross actually has a department that handles such claims. I would check with your Blue plan. Some Blue Shield plans do allow for direct billing for hospitalizations. The Blue Cross portion won't cover a visit to a doctor, however.
 
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cavok

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Jun 16, 2014
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I am a retiree with Blue Cross and Blue Shield US coverage, but not a Federal plan.

I have been hospitalized several times while in the DR and the clinic billed BC/BS directly.

Blue Cross actually has a department that handles such claims. I would check with your Blue plan. Some Blue Shield plans do allow for direct billing for hospitalizations. The Blue Cross portion won't cover a visit to a doctor, however.
Are you sure that isn't limited to certain specific, approved clinics and, even then, just during travel out of the country?
 

La Profe_1

Moderator: Daily Headline News, Travel & Tourism
Oct 15, 2003
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Are you sure that isn't limited to certain specific, approved clinics and, even then, just during travel out of the country?
It is limited to clinics that have signed contracts with Blue plans. My Blue plan website has a list, arranged by country and city, of clinics that have signed participation contracts. In Puerto Plata, Bournigal and Clinica Brugal were listed when I checked.

Plan must include out of area rider and, unlike Medicare, makes no distinction between traveling to or living in the location.
 

keepcoming

Moderator - Living & General Stuff
May 25, 2011
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Profe, I never knew. I have BCBS but have never found any clinic/hospital that would bill my insurance. I have the list of clinics/hospitals but each time they say I need to pay and then request reimbursement from my insurance.
 

La Profe_1

Moderator: Daily Headline News, Travel & Tourism
Oct 15, 2003
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KC, I don't know why they refused you, but they paid Bournigal an extortionate amount when I fractured my wrist and required fracture reduction under general anesthesia.

They paid again 10 days later when the wrist needed to be reset, too!

The thing is, that if they bill the Blue plan directly, they can bill in dollars, so as someone mentioned earlier in the thread the bill can get very high.
 

cavok

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KC, I don't know why they refused you, but they paid Bournigal an extortionate amount when I fractured my wrist and required fracture reduction under general anesthesia.

They paid again 10 days later when the wrist needed to be reset, too!

The thing is, that if they bill the Blue plan directly, they can bill in dollars, so as someone mentioned earlier in the thread the bill can get very high.
This is exactly why most other American companies don't do it. If that keeps up for long, BCBS will either drop that plan or you will be paying a lot to have it added on to your basic plan.
 
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La Profe_1

Moderator: Daily Headline News, Travel & Tourism
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This is exactly why most other American companies don't do it. If that keeps up for long, BCBS will either drop that plan or you will be paying a lot to have it added on to your basic plan.
In general, that is very true. I, however, am very fortunate to have a premium BCBS plan paid in full by my former employer. If the premiums go up, I won't be affected.

My BCBS is considered to be equal to or better than Medicare Part B, so the SSA does not require me to enroll in or pay for Part B. My annual limitation for out of pocket healthcare costs is about the equivalent of 3 months premiums for Part B. I am assuming that Part B is billed at around 200 a month.
 
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cavok

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In general, that is very true. I, however, am very fortunate to have a premium BCBS plan paid in full by my former employer. If the premiums go up, I won't be affected.

My BCBS is considered to be equal to or better than Medicare Part B, so the SSA does not require me to enroll in or pay for Part B. My annual limitation for out of pocket healthcare costs is about the equivalent of 3 months premiums for Part B. I am assuming that Part B is billed at around 200 a month.
That is one phenomenal insurance plan! I never heard of that before. I think I pay about $140/mo for PartB(?).
 

AlterEgo

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In general, that is very true. I, however, am very fortunate to have a premium BCBS plan paid in full by my former employer. If the premiums go up, I won't be affected.

My BCBS is considered to be equal to or better than Medicare Part B, so the SSA does not require me to enroll in or pay for Part B. My annual limitation for out of pocket healthcare costs is about the equivalent of 3 months premiums for Part B. I am assuming that Part B is billed at around 200 a month.

We pay over $500 a month (for both of us) for our supplement, on top of cost of Plan B Medicare, so you’re very fortunate. Our supplement covers us worldwide for emergencies, with a $250 deductible. We have to pay then get reimbursed.
 

SKY

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Apr 11, 2004
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We pay over $500 a month (for both of us) for our supplement, on top of cost of Plan B Medicare, so you’re very fortunate. Our supplement covers us worldwide for emergencies, with a $250 deductible. We have to pay then get reimbursed.
Did you ever use it here?
 

windeguy

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Jul 10, 2004
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In general, that is very true. I, however, am very fortunate to have a premium BCBS plan paid in full by my former employer. If the premiums go up, I won't be affected.

My BCBS is considered to be equal to or better than Medicare Part B, so the SSA does not require me to enroll in or pay for Part B. My annual limitation for out of pocket healthcare costs is about the equivalent of 3 months premiums for Part B. I am assuming that Part B is billed at around 200 a month.
That is one phenomenal insurance plan! I never heard of that before. I think I pay about $140/mo for PartB(?).
Part B:
Premium$164.90 each month (or higher depending on your income). The amount can change each year. You’ll pay the premium each month, even if you don’t get any Part B-covered services.
Who pays a higher Part B premium because of income?
You might pay a monthly penalty if you don’t sign up for Part B when you’re first eligible for Medicare (usually when you turn 65). You’ll pay the penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. Find out how the Part B penalty works and how to avoid it.
 
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La Profe_1

Moderator: Daily Headline News, Travel & Tourism
Oct 15, 2003
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We pay over $500 a month (for both of us) for our supplement, on top of cost of Plan B Medicare, so you’re very fortunate. Our supplement covers us worldwide for emergencies, with a $250 deductible. We have to pay then get reimbursed.
My costs are limited (single coverage) to a yearly deductible of $100, a yearly cap of $500 on out of pocket expenses for the 20% on doctor visits and prescription co-pays of $1 or $5 (generic vs name brand) on prescriptions of up to 90 days.
 

kenshireen

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May 21, 2022
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Part B:
Premium$164.90 each month (or higher depending on your income). The amount can change each year. You’ll pay the premium each month, even if you don’t get any Part B-covered services.
Who pays a higher Part B premium because of income?
You might pay a monthly penalty if you don’t sign up for Part B when you’re first eligible for Medicare (usually when you turn 65). You’ll pay the penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up. Find out how the Part B penalty works and how to avoid it.
IRMA. I pay more than double for part B. If your income is above a certain limit there is IRMA. It is a penalty for having income above a certain limit and the penalty can double or triple the normal part B
 

SKY

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We pay over $500 a month (for both of us) for our supplement, on top of cost of Plan B Medicare, so you’re very fortunate. Our supplement covers us worldwide for emergencies, with a $250 deductible. We have to pay then get reimbursed.
I have the same with a plan from United Health Care and pay nothing in additional to my regular Part B Premium. And I had a major operation with a two week stay in a hospital and payed nothing. Also no Referrals necessary and no co pays. They have a similar Emergency plan but I never used it as I have coverage in the DR that works. Your plan seems the same, but maybe you are paying extra for this Worldwide Emergency that might be better.