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investigative report ( HOSPIEAL SAN ANTONIC) Part I

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Post by Problem Child on Sat May 04, 2019 3:13 pm

Went in to review the place. Didn't have my  body cam on.

Definitely a WIP (Work in Progress).

Asked about details of Insurances that would cover service, specifically Medicare and VA. Insurance lady out until Monday.

They are not "Fully staffed" yet. No dentist(s) on staff yet.

Took a self guided tour. What there is seems very nice; of course it's new. Equipment is SOTA. Even a small Chapel (Works if you're Catholic).

I have my ideas on how the insurance part works, but will hold expressions until I talk with the insurance person.

BTW: This is noted as a  Tier 2 hospital (Google it  - - interesting)

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Post by Jreboll on Sat May 04, 2019 3:40 pm

Medicare does regular inspections to hospitals in the system. How would they accomplish this in Mexico?

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Post by Problem Child on Sat May 04, 2019 4:18 pm

Jreboll wrote:Medicare does regular inspections to hospitals in the system. How would they accomplish this in Mexico?

The signage says Medicare Advantage, which is something different. Some Medicare Advantage plans may provide coverage benefits health care needs, though it is "iffy" if travel outside the United States. the Devil is always in the details. People who are moving to or living in a a foreign country cannot, with some very limited exceptions, use Medicare to pay for health care when they are living overseas.

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Post by RickS on Sun May 05, 2019 11:02 am

Waiting with bated breath for what you learn about the "Medicare Advantage" insurance coverage noted on the sign outside.....
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Post by Problem Child on Sun May 05, 2019 11:34 am

RickS wrote:Waiting with bated breath for what you learn about the "Medicare Advantage" insurance coverage noted on the sign outside.....

I will be getting all the ins. info I can Tuesday. If you have Medicare Advantage, your coverage AND LIMITATIONS will be in your information handbook.

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Post by Trailrunner on Sun May 05, 2019 12:25 pm

Jreboll wrote:Medicare does regular inspections to hospitals in the system. How would they accomplish this in Mexico?
I believe JAHCO comes to Guad to inspect the hospitals that accept US health insurance. I read a blog once by a gringa RN who worked in one of the teaching hospitals in Guad. She described the same preparatory pandemonium that I remember when I worked at Kaiser. 

Perhaps with a JAHCO accreditation our little hospital can also accept US insurance? Pure speculation on my part.
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Post by Problem Child on Sun May 05, 2019 12:41 pm

Trailrunner wrote:
Jreboll wrote:Medicare does regular inspections to hospitals in the system. How would they accomplish this in Mexico?
I believe JAHCO comes to Guad to inspect the hospitals that accept US health insurance. I read a blog once by a gringa RN who worked in one of the teaching hospitals in Guad. She described the same preparatory pandemonium that I remember when I worked at Kaiser. 

Perhaps with a JAHCO accreditation our little hospital can also accept US insurance? Pure speculation on my part.

I wouldn't put that much weight to accreditation i Mexico due to the massive corruption. Sort of like "Approved by J.D. Power."Did you know the companies evaluated by J.D. Power in fact pay the firm to use its name in their ads, and a hefty amount of cash is said to be changing hands. ... "Some consumers might wonder if J.D. Power gives awards only to companies that can pay thousands of dollars in licensing fees.

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Post by mattoleriver on Sun May 05, 2019 1:11 pm

My understanding is that Medicare Advantage (Medicare part C) is private insurance that can be used in place of Medicare parts A and B. The Advantage plans are all very much defined by locality and none are offered outside of the U.S. Some localities may have several plans available while others, even within the same state, may have very few choices. Since it is private insurance some options, such as coverage while traveling abroad, can be offered on some plans. I believe that the same is true of Medigap plans for those who choose to go with Medicare parts A and B.
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Post by Problem Child on Sun May 05, 2019 1:43 pm


As I said: The Devil is in the details (sometimes in the 8pt mouse print)
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When it comes to Medicare coverage, everyone has different needs. Some people are more interested in wellness benefits, for example, while others look for the best coverage for prescription drugs. If you’re enrolling in Medicare and you’re hoping to do some international traveling, one question has extra importance: do Medicare Advantage plans cover overseas travel?

This article will give you the basics on Medicare and overseas travel, and how Medicare Advantage plans compare when it comes to choosing the right Medicare coverage for you.
How do Medicare Advantage plans work?

Medicare Advantage, also known as Medicare Part C, is simply an alternative way to get your Medicare Part A and Part B benefits. The main difference between the two is that Medicare Advantage plans are offered by private insurance companies, which means each company has some freedom to set its own premiums, cost sharing, and benefits.

All Medicare Advantage plans must cover, at a minimum, everything that Original Medicare covers, but they are free to include additional benefits, such as routine vision and dental care, and wellness benefits such as free gym membership through the Silver Sneakers program. In other words, you don’t lose any essential Medicare benefits if you choose Medicare Advantage, but you may gain a few perks.
Does Medicare cover overseas travel?

Original Medicare typically does not pay for emergency care when you’re traveling outside the U.S. There are a few exceptions:

   If you’re in the U.S. and have a medical emergency, but the nearest hospital capable of treating your condition is in a foreign country, Medicare may cover allowable charges.
   If you’re traveling through Canada on a direct route to Alaska and you need emergency care, Medicare may pay for your treatment if a Canadian hospital is closer than a U.S. hospital.
   If you’re on a cruise ship in U.S. territorial waters and you need health care services, Medicare may cover allowable charges if the ship is more than six hours from a U.S. port.

Keep in mind, if you do get covered health care services outside the U.S. under the circumstances mentioned above, your normal Part A and Part B deductibles apply, as well as any copayment or coinsurance amounts. In addition, although U.S. hospitals must submit a claim to Medicare on your behalf, this is not true of foreign hospitals. You’ll need to get itemized bills from the hospital, doctors, ambulance service, and any other health care providers you see, and submit them yourself to Medicare upon your return.
Do Medicare Advantage plans cover overseas travel?

Because Medicare Advantage plans must provide the same benefits, at a minimum, as Original Medicare, your Medicare Advantage plan usually covers foreign travel in the situations mentioned above.

However, some Medicare Advantage plans may offer additional benefits for emergency and/or routine health care if you are traveling outside the U.S. If you travel internationally, or plan to once you’re enrolled in Medicare, it’s a good idea to contact the different Medicare Advantage plans you’re interested in directly to find out exactly what benefits are available. In some cases, you may have to pay your expenses upfront and get reimbursed by your plan. Other plans may have a maximum limit on overseas travel benefits.
How can I get Medicare benefits for overseas travel?

If you definitely want coverage for health care outside the U.S., you may want to enroll in Original Medicare and a Medicare Supplement Plan. Medicare Supplement Plans C, D, E, F, G, H, I, J, M, and N may cover up to 80% of certain health care services you need when you’re traveling overseas, after you meet your plan deductible for foreign travel. The expenses must occur within the first 60 days of your trip, and not otherwise be covered by Original Medicare. These plans also have a $50,000 lifetime limit on overseas travel benefits. You can get more information about overseas travel benefits, restrictions, and exclusions in your plan brochure.

Medicare Supplement Plans can only be used with Original Medicare, however, so you unfortunately can’t purchase a plan if you choose Medicare Advantage.

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