American Health Insurance Woes

[jaideeguy]

My father, recovering at age 87 from fractures brought on by osteoporosis, has been visiting from Hawaii and is thinking of moving permanently to the Land of Smiles -- provided he doesn’t have to give up too many perks he feels he earned in a long workday.

So, could anybody out there tell us who/how to contact about: Medicare, and the new drug benefit; the cheapest source of Fosamax (or similar) for soft bones. He’s currently paying $195 a month (soon to go up to $211) for a union-sponsored medical insurance policy -- with doubtful chance of reimbursement for out-of-US expenses. Has anyone out there had any experience in getting repayment from American health insurance providers while out of country?

If my father chooses to stay, he will probably be facing more med expenses in the future and we are considering dropping his health insurance and just pay out of pocket...which may [or may not]be much cheaper than the $200+/mo he is paying for insurance.

We’ve heard the Consulate isn’t very helpful to ex-pats

True?

thanks in advance for any info or personal experience

[lopburi3]

Medicare does not pay overseas.

You should check with the insurance he has as to if they pay overseas and/or can be converted to a policy that does. I suspect obtaining from a new insurance provider would not be possible at his age.

[cathyy]

Yep, no Medicare outside the US.

Try looking for alendronate instead of Fosamax. It's the generic name for it, and is more likely to be available. Many, many of the pharmacy workers here don't know the generic names for the brand names, and vice versa, so you have to be ask for both before you decide it's not available. You also need to check several pharmacies, including a hospital pharmacy.

[jaideeguy]

Thanks for info on medicare. I didn't think that it was available, but wanted to confirm.

So, do any Americans out there with health insurance have any experience with claims for medical expenses abroad? My father has not yet canceled his insurance, but is considering it if his Kaiser Permenante health insurance balks at the small claim that he is trying to process.

Anyone with experience in this matter??

[lopburi3]

I have experience, generally good, but my insurance is designed for coverage everywhere and specific group so would not be helpful in your fathers situation. He needs to find out what/how long/when they cover and if policy can be converted to one that does it better.

[PeaceBlondie]

You and your father need to read the fine print in the medical insurance policy, which may be available online if it's as big as Kaiser Permanente's plan. I'm in the envious position of having a plan that costs me and my pension a total of US$420 per month, and it pays 90% of overseas claims, after deductibles. Thank God I worked for a company that had that as a retirement option.

But even with my plan, I have to pay the money first, and hope and pray I'll get a refund after I file the claim.

[richard10365]

I have Tricare (retired US Military). It only pays 75% and I have to pay 25% of the bill first.

I had an accident in CM this year and stayed in the hospital. The tricare rep in BKK helped me with the paperwork and called me yesterday to tell me the hospital will get paid and they also sent me a check. Too bad the check they sent me was for U.S. Dollars. Not sure where to cash that.

Edited December 9, 2006 by richard10365

[Thaigreg]

I have Tricare (retired US Military). It only pays 75% and I have to pay 25% of the bill first.

I had an accident in CM this year and stayed in the hospital. The tricare rep in BKK helped me with the paperwork and called me yesterday to tell me the hospital will get paid and they also sent me a check. Too bad the check they sent me was for U.S. Dollars. Not sure where to cash that.

Hi Richard,

I have been using TRICARE Standard for the past 4 years for my wife and I and have the same problem with them sending the check to me here. I just send the checks to my bank in the US for deposit. It beats not having any reimbursement at all.

Greg

[dclaryjr]

I have Tricare (retired US Military). It only pays 75% and I have to pay 25% of the bill first.

I had an accident in CM this year and stayed in the hospital. The tricare rep in BKK helped me with the paperwork and called me yesterday to tell me the hospital will get paid and they also sent me a check. Too bad the check they sent me was for U.S. Dollars. Not sure where to cash that.

Hi Richard,

I have been using TRICARE Standard for the past 4 years for my wife and I and have the same problem with them sending the check to me here. I just send the checks to my bank in the US for deposit. It beats not having any reimbursement at all.

Greg

Can you use Tricare Prime in LOS? What about Tricare for Life after hitting 65 (shaky since that includes using Medicare)?

[PeaceBlondie]

Okay, on this subject: I'm eligible for Tricare but have almost never used it, because my primary insurance is FEHBP for civilian federal employees. But I'll be 65 in August, and eligible for Medicare then, too. So, everything gets confusing. If I keep FEHBP and it remains primary, do I just opt for the cheapest Medicare and the free Tricare? Even though my primary health plan costs me $105/month, it pays well and it pays for overseas care, after the fact. Does Tricare reimburse the provider directly, in Thailand? If so, are there only a handful of expensive private hospitals like Bumrungrad that accept Tricare?

As for reimbursement, I have my health plan send the checks to an address in the States, and my friend deposits it in my stateside bank account. But if I get a check here, I deposit it in my Thai bank, pay a big fee, and wait a month for it to clear.

[JimGant]

The tricare rep in BKK helped me with the paperwork and called me yesterday to tell me the hospital will get paid and they also sent me a check.

Richard,

"Hospital will get paid" implies that you didn't have to pay up-front (i.e., hospital "accepts" Tricare). But then you say Tricare also sent you a check, implying you did pay up-front. Could you please explain? Thanx. Oh, who's the Tricare rep in Bangkok?

[JimGant]

Can you use Tricare Prime in LOS? What about Tricare for Life after hitting 65 (shaky since that includes using Medicare)?

Tricare Prime appears to be available in Thailand only to active duty types and their dependents.

After age 65, Tricare Standard switches to Tricare for Life (TFL), but requires that you be enrolled in Medicare B (about $88/mo this year). But since Medicare doesn't pay overseas -- and TFL is a supplement to Medicare -- TFL then acts identically to Tricare Standard when applied overseas, to include $150 deductible and 25% co-pay. (But our civilian "friends" at the Pentagon tried to add fees, plus quadruple the deductible to Tricare Standard. Congress put them on hold; no doubt, tho', some increases will come about.)

[mouse]

I remember hearing about a retired Colonel that was trying to educate the hospitals about TriCare and had convinced a nuumber of them to perform services without immediate payment based on TriCare. I think there was even a list of Hospitals floating around. Last time I was in Hospital for surgery, I paid up front and then filed a claim and was paid within three weeks. Incidentally the deductable does not apply when hospitalized.

Edited December 10, 2006 by mouse