- Thread starter SteveK
- Start date
US Health Insurance - US Federal Employee Retired
She spends about 4 to 6 months here annually. Not a legal resident at all. Just overstays on a tourist card.
CMC billed an exorbitant amount to BlueCross BlueShield directly
This is like a "Reverse Gringo Price". CMC is using the Gringo to ripoff his Medical Insurance. Easier and more profitable then the normal procedure..........But it works for both CMC and the client I guess..............
Is it possible they sent the bill in pesos and were paid the peso amount in dollars?
I remember when pesos and dollars were equal. You could pay in restaurants, for example, in either. As the rate changed, many tourists mentioned how expensive eating out was in DR. They were still paying peso bills in dollars.
My experience with Bournigal Direct billing BCBS was in 2004. They billed over $11,000 for 2 overnights, 2 trips to the ER and 2 reductions of a wrist fracture under general anesthesia. Everything was done twice because the first orthopedist who treated me was "conservative" and the broken bone ends did not stay aligned.
I am still surprised they billed BCBS directly. My family has a medical billing company (quite large) and I have never seen anything come through for the DR. I have seen travel insurance claims from the DR, but never a direct bill for a commercial medical insurance. Facility charges (hospital, surgery, etc..) are always high due to the contracted discount that the insurance receives. I am not sure how that would work in the DR. Of the total bill how much did the insurance actually pay.
They paid every penny! The out of area rider that enabled direct billing specifies that they pay the actual billed amount, not the contracted, discounted amount.
Remember, this was 19 years ago. I cannot imagine what that would be billed at now.
So you have 2 policies... a medicare advantage AND local dominican insuranceFirst answer is I have Dominican Insurance and that is what I use.
Second one is I have a Medicare Advantage plan that covers the 20% so I pay NOTHING extra EVER. Do some research yourself and you will find out something that has been around for many years.
Medicare Advantage Plans cover all Medicare services
Medicare Advantage Plans cover all Original Medicare services, and some offer drug, vision, hearing, dental, or wellness coverage.www.medicare.gov
I'm glad I brought up this topic because I'm sure there are those who may be vulnerable with a BIG BILL thinking that they were fully covered by their health insurance. You certainly wouldn't want another heart attack after opening up the envelope with a surprise Medical $$$BILL....That'll take you to your grave.
You should be fine with local local insurance but I'm not too sure if Medicare and the VA Care covers the DR. You may need to go to a VA Facility nearby PR or the VI's for medical treatment. As for Medicare, I'm not sure but maybe one of the other DR1 board members might have an answer.
To clarify, I use my DR insurance for run-of-the-mill stuff, and go to the Miami VA for more serious stuff. Miami VA is pretty much known for being the best of the best. Treatment there is beyond impressive.