Between 2007 and 2008, rumors and reports emerged that US Medicare coverage is possible in the Philippines. In general, US Medicare coverage is limited to all 50 states. Has Medicare Finally Gone Portable? This article explores the truth behind the conversations.
A look back
Sources estimate that of the 4 million legally resident Filipinos in the US in 2008, about 80 percent hold US citizenship and some are covered by Medicare.
Medicare is the US federal health insurance program. It was first established in 1965 for the benefit of citizens aged 65 and over. In 1972, the program was revised to allow younger people with Lou Gehrig’s disease, permanent disabilities, and terminal kidney problems to enroll.
Understand the structure
Medicare is an umbrella term that can include a number of plans:
- original Medicare that provides hospital insurance and medical insurance
- Medicare Advantage which provides both basic and additional care services as offered by private health maintenance organizations (HMOs) and
- prescription drugs that may or may not be associated with a Medicare Advantage plan
Plus, there are Medigap plans to supplement what original Medicare doesn’t cover. They are offered by private insurance companies.
The current policy is lettered C to J. However, in a fact sheet released by the U.S. Department of Health and Human Services, new Medigap plans M and N will replace plans H, I, E, and J starting June 1 this year .
Off-shore Medicare coverage in theory
Under the original plan, the circumstances that allow Medicare transferability are limited. Coverage outside America is permitted when a foreign hospital is closer than any other hospital on US soil. In rare emergencies, those traveling through Canada “without undue delay” can also take advantage of off-shore coverage – provided the Canadian hospital is much closer than a US hospital.
In March 2010, the State Department of the Philippines confirmed that under the original Medicare plan:
“…Residents of Guam and Saipan…are allowed to seek medical treatment…in emergencies, using their Medicare benefits in Philippine medical facilities, due to the Philippines’ proximity to Hawaii, the closest U.S. state.”
This development has been attributed to the efforts of Madeleine Bordallo, Guam congressman, and Roberto Romulo, former Secretary of the State Department, who lobbied for Philippine hospitals to be allowed to provide Medicare reimbursements.
Off-shore Medicare coverage in practice
My Philippine Retirement made a number of calls to verify whether hospitals in the Philippines have already refunded Medicare benefits under the original plan. There were no recorded cases yet, staff said. In fact, most hospitals seemed unaware of “US Medicare.”
They have provided the following list of respected international health insurance plans, some of which are related to Medicare Advantage plans:
LIST A.International health insurance coverage in selected Philippine hospitals in Luzon as of March 2010
- (Allianz) Global Care – Asian Hospital
- AETNA – Asian Hospital
- AETNA Global Benefit – Makati Medical Center
- Alliance – Asian Hospital
- Blue Cross International – Asian Hospital
- Blue Shield – Asian Hospital
- Calvo’s – St. Luke’s Hospital
- CIGNA – Asian Hospital
- GMC Services – Makati Medical Center
- HTH Worldwide – Makati Medical Center
- IMA – Makati Medical Center
- IMG – Asian Hospital
- International Health Insurance of Denmark – Makati Medical Center
- International SOS – Makati Medical Center
- Net Care – Asian Hospital, Makati Medical Center
- Pacific International – Asian Hospital
- Prestige International – Makati Medical Center
- StayWell – St. Luke’s Hospital
- TakeCare – Asian hospital
- TieCare – Asian Hospital, Makati Medical Center
- Vanbreda International – Asian Hospital, Makati Medical Center
- William Russel – Asian Hospital
The use of insurance benefits varies by health maintenance organization (HMO), insurance plan, and maintenance hospital. The insured must inquire about their Medicare Advantage benefits by HMO or plan name. Specific concerns can be sent to the hospital’s respective customer service and credit/billing departments.
LIST B. Contact details of select Philippines-based hospitals that honor international health insurance with potential Medicare Advantage Tie-Ups
- Asian Hospital and Medical Center: info@asianhospital.com * +63 (2) 771-9000/ +63 (2) 876-5838
- Makati Medical Center: sales@makatimed.net.ph * +63 (2) 870-3000/ +63 (2) 870-3008
- St Luke’s Hospital: info@stluke.com.ph * +63 (2) 723-0101/ +63 (2) 723-0301
Impact on Philippine retirement decisions
The affordability of health care in the Philippines has been somewhat let down by the “pay-as-you-go” system, but a recent turn of events is changing the way potential retirees view the minor inconvenience of “cash first.”
One such development is the direction Medicare portability is heading. Statistical trends indicate that by 2011, Medicare spending will soon exceed trust fund revenues. This can be avoided when cheaper offshore facilities are used to deliver the same quality of healthcare as in the US, experts explain.
Another development is the Health Reform Bill on Patient Protection and Affordable Care signed by US President Barack Obama in March 2010. The current reform allows offshore coverage and insurance for people with pre-existing health conditions. There will also be a $695 minimum annual tax penalty for those unable to purchase health insurance – now no longer just an option but a requirement.
Many American taxpayers fear that the latest health reform will come with a higher price tag. “I expect my insurance premium (monthly payments) to go from $100…to over $500,” fears Terry, who works for the federal government and hopes to retire in 2020.
Lower take-home pay (and savings) coupled with the fact that U.S. Medicare coverage is available in the Philippines (usually through Medicare Advantage plans) is prompting former Filipinos like Terry to rethink the Philippines as a good place to get cheap but decent health care – still the “best hit” to dollar earnings.*
Is US Medicare coverage in the Philippines
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