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I’ve already done some research and read a lot of articles on this website, but i still seem to be getting conflicting answers/points of view (mostly from elsewhere). So, i was hoping other members could help me settle this issue once and for all (for now, lol): American Medicare, does it transfer to Costa Rica? i’m 99% sure the answer is no, but i read/heard somewhere differently… Also, for V.A., do they get any extended benefits overseas in CR?
Medicare absolutely, unequivocally DOES NOT pay for medical care received outside the United States. There is a clinic in San Jose that’s supposed to be taking care of U.S. military veterans who are covered by Tri-Care, but somebody else will have to fill in the details.
Medicare does not, however, the private insurers as of the last 2 years are changing their rules to cover medical expenses outside the US. More insurers will definitely come around when they realize how much money they can save, which of course helpds their bottom line. My insurer, which is Blue Cross/Blue Shield will cover 70% of all medcial expenses incurred outside my network in the US. The only catch is that the invoices have to be in US dollars.
After having researched the VA websites, VA does pay for service-connected disabilities in Costa Rica. I am a disabled vet and a military retiree, my understanding is Tricare and VA reimbursed service-connected medical care are available in Costa Rica. For more info on VA, go to http://www.va.gov.
Just got off the phone with a Tricare rep for the south region(Latin America and Canada)and there is no medical facility listed as a Tricare provider. Finally told me that all treatment facilities were deleted due to an outbreak of fraud. So, you need to be under Tricare Standard. Have to pay annual premiums up front and there is a $150 deductible for member; $300 for families and a 25% cost share. Here’s the biggie–You must pay all costs up-front and file a claim to be reimbursed, minus your 25% cost share and deductible.
In understanding Medicare coverage, one has to first understand that there is regular Medicare, and there are what are called “Advantaged” Medicare plans that came out during the Bush years. Regular Medicare does not cover people outside of the country. Regular Medicare, as many people know, generally covers 80% less deductions. Consequently, many people buy “Supplementary Medicare” and some of the supplementary plans do give partial coverage to people out of the country for emergency situations. With the Medicare Advantaged plans, they are run by different insurance companies. Their coverage is different than regular Medicare and each plan is different in coverage. These Medicare Advantage plans are run like HMO’s. For basically emergency situations, some of them do provide some coverage outside of the country. When it comes to Medicare Advantaged plans, one cannot make a blanket statement as to whether there is coverage or not outside of the U.S. since each plan and each company offers different things. It is highly unlikely that any of these plans offer a high level of coverage outside of the U.S. for routine things. Whether one is in regular Medicare or in an Advantaged plan is left up to the individual. As always, the insurance companies want the healthiest people and try to deny coverage to those that are the sickest. When one turns 65, one can pretty much choose what plan to go with but once in a plan switching to something else can be difficult and expensive for anyone that has significant medical problems. One of the proposals of healthcare reform is to cut back the payments to the insurance companies that run these Medicare Advantage plans because they cost the government more money than regular Medicare and do not provide outcomes that are any better.
I also have services from the VA here in Portland. I would not in a thousand years think for one minute that I could move to Costa Rica, run up huge medical bills and think the VA would shell out the cash. You must find someone in the VA system who is both knowledgeable and can lead to the very person who will pay your bills or reimburse you. Off the top of my head, I would think that is probably someone in VA headquarters in Washington DC. Personally, I would call my congress person and see who they have as their office contact with the VA. I would explain what I am trying to do and see what they recommend. My Congressman’s person has been handling VA issues for him since his first election 12 years ago and she is a gem!
Also, if I understand the preliminary report I just received on the Immigration Law, every foreigner living in Costa Rica may have to join the CAJA period. I am waiting to hear from attorney since he is currently going through the text of the law. You may want to wait and see what shakes out about this provision. In the mean time however, I would start to talk to someone at the VA or your congress person’s office about your issues.
Tom on a budget in Portland, Oregon
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