Is US Medicare Coverage in the Philippines Possible?

Between 2007 and 2008, rumors and reports came out that U.S. Medicare coverage in the Philippines is possible. asianbang Generally, U.S. Medicare coverage is limited to all 50 states. Has Medicare gone portable at last? This article explores the truth behind the talks.

A Look Back

Sources estimate that out of the 4 million legally staying Filipinos in America in 2008, approximately 80 percent hold U.S. citizenship and a number are covered by Medicare.

Medicare is America’s federal health insurance program. It was first created in 1965 to benefit citizens aged 65 and older. In 1972, the program was revised, allowing younger people with Lou Gehrig’s disease, permanent disabilities and end-stage renal health complications to enroll.

Understanding the Structure

Medicare is a collective term that may include a number of plans:

  • original Medicare that provides hospital insurance and medical insurance
  • Medicare Advantage that provides both basic and extra healthcare services, as offered by private health maintenance organizations (HMOs) and
  • prescription drug plans that may or may not be tied to a Medicare Advantage plan

Additionally, there are Medigap plans to supplement what original Medicare does not cover. They are offered by private insurance companies.

The current policies are lettered C to J. However, in a fact sheet released by the Department of Health and Human Services of the U.S., new Medigap plans M and N will replace plans H, I, E and J starting June 1 of this year.

Off-Shore Medicare Coverage in Theory

Under the original plan, the circumstances that allow Medicare portability are limited. Coverage outside America is permitted whenever a foreign hospital is nearer than any other hospital on American soil. In rare emergency cases, those traveling “without unreasonable delay” through Canada may also avail of off-shore coverage – provided again that the Canadian hospital is much closer than an American hospital.

In March 2010, the Department of Foreign Affairs of the Philippines confirmed that under the original Medicare plan:

“… Residents of Guam and Saipan… are allowed to seek medical treatment… on emergency cases, availing of their Medicare benefits in Philippine medical facilities, due to the proximity of the Philippines vis-a-vis Hawaii, the nearest US state.”

This development is credited to the efforts of Madeleine Bordallo, congresswoman of Guam, and of Roberto Romulo, former Department of Foreign Affairs secretary, who lobbied that Philippine hospitals be allowed to issue Medicare reimbursements.

Off-Shore Medicare Coverage in Practice

My Philippine Retirement made a round of phone calls to check whether hospitals in the Philippines have already reimbursed Medicare benefits under the original plan. There were no recorded cases yet, the staff said. In fact, majority of the hospitals appeared to be unaware of “U.S. Medicare.”

They did supply the following list of honored international health insurance plans, some of which have tie-ups with Medicare Advantage plans:

LIST A.International Health Insurances Honored in Selected Luzon-Based Philippine Hospitals as of March 2020

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