Blue Cross Blue Shield In Davao/mindanao

[StayAtHomeDad]

hi guys,

 

My daughter and I both have Blue Cross Blue Shield insurance from America, and I was wondering if any of the members here have any experience using this type of insurance in Davao or any other part of Mindanao. After looking at the Blue Cross Blue Shield website, I discovered that the Davao Doctors Hospital is the only provider listed. However, I did also notice that they are not a preferred provider.Therefore,

 I am wondering if direct billing from Davao Doctors Hospital to Blue Cross Blue Shield is possible, or if you must first pay out-of-pocket and then submit a claim form to BCBS.

 

If any of you have experience with using the Davao Doctors Hospital, or another, and using direct billing for American or Canadian insurance, I would love to hear from you. Or, if you have any other experience related to using international insurance, I would love to hear your comments as well.

 

Thank you very much in advance for your posts and comments.

Edited March 5, 2013 by jessdaddu

[MikeB]

This is an important issue, best to address it directly with your provider. When I was moving here I bought Traveler's insurance for a few months, then bought a policy with a local company once I was settled.

[StayAtHomeDad]

Thanks for the reply. I agree completely. I am just wondering if anyone on the forum has any first-hand experience in dealing with this issue in Davao or Mindanao. I have found plenty of info about BCBS for Manila and Cebu, but no posts about experiences in the southern part of the country. I have my BCBS rep presently digging up as much info as he can. Nevertheless, I have a feeling that what he tells me may ultimately differ from the actual process I experience should ever need to use the policy here in the Philippines. I have lived here a long time and never had a need to use the policy - knock on wood. Still, if I do need to use it, I would like to go in at least knowing what to expect. Knowing if hospitals in Davao or Mindanao can bill directly or if must file for reimbursement will help me maintain an appropriate medical nest egg.

[i am bob]

What follows you should take with a grain of salt and then confirm with your company.  Why?  Because every company does things a little different.  

 

Though it may not be a preferred status hospital, you will still be covered.  It is recommended that you go to a preferred status hospital if possible.  The biggest difference you may see on your insurance is that, with the non-preferred hospital, many (most if not all) expenses will be queried by your insurance company in regards to if they were truly necessary and you will be the one who normally has to find the answers.  Usually this means getting the doctors to itemize what they did and have them explain why.  Now the good news...  Usually, if you are in an area where there is no preferred status hospital, that all goes out the window as long as you went to the hospital they listed instead.  There may be a few extra questions but easier to answer for you.  One thing you may find - if you policy has this of course - is that some insurance companies will pay direct to the hospital - all you need to do is sign the form.  This will be only for preferred status hospitals.

 

There are a few more things that may or may not happen with your insurance but that is something you will have to look at your policy or ask you agent for.  Why?  Too many do and too many don't do some things.  What I wrote above is a "Rule of Thumb" for both Canada and the US on their policies.  And it may not be fully true for yours - BC/BS have been known to have completely different policies in different offices under the same basic insurance standards (ie: same state).

[StayAtHomeDad]

Thanks Bob. I kind of assumed they would pay, but was not sure if would need to pay first and then submit a claim for reimbursement or what. I love Davao, and cant fathom living anywhere else in the Philippines. Still, there are times I wish Davao wasn't  just a big provincial town. Cebu and Manila are light years ahead of Davao in many areas, including heath care. I guess, I will just have to wait and see what the BC/BS rep comes back with. Scary thing is that I emailed Davao Doctors Hospital like half a dozen times over the last month or so, and they have yet to respond. Nevertheless, I am fortunate to have good coverage for my daughter and myself. I suppose even if I have to pay out-of-pocket and then submit a reimbursement claim, that it is much better than trying to self-insure completely or depend on Phil Health or a local Insurance company - there have been many scary stories in this area about local health insurance.

 

The Indian tribe of which my daughter and I are members has done very well with casinos in recent years, and one of the direct benefits has been full health care coverage for tribal members. The tribe actually bears the cost of the plan and BCBS simply administers the plan. They cover darn near everything and there is a max annual out-of-pocket deductible of only $100. No co-payments, meds are covered and many elective procedures that surprised me are also covered. So, I guess gambling has its positive side for some of us.

[Bruce]

I remember past posts on coverage that that no matter what the position of the company for 3rd party billing and hospital payments, the hospital always pushes for the individual to pay up front and then get reimbursment from their insurance company. A bird in hand thinking....

[MikeB]

I suppose even if I have to pay out-of-pocket and then submit a reimbursement claim, that it is much better than trying to self-insure completely or depend on Phil Health or a local Insurance company - there have been many scary stories in this area about local health insurance.

Don't believe everything you hear, my experience with local insurance has been the opposite - they covered everything, over 1 million pesos on a single claim; some was direct billed, some I paid out of pocket and was reimbursed. But that doesn't mean that will happen to you. Regardless of what they tell you don't plan on waving an insurance card and being admitted; they usually require a cash or credit card deposit here.

[MacBubba]

Don't believe everything you hear, my experience with local insurance has been the opposite - they covered everything, over 1 million pesos on a single claim; some was direct billed, some I paid out of pocket and was reimbursed. But that doesn't mean that will happen to you. Regardless of what they tell you don't plan on waving an insurance card and being admitted; they usually require a cash or credit card deposit here.

 

May I ask what local insurance company you've had commendable experience with?  And, are they significantly less expensive than North American medical coverage?  My wife and I are weighing our options.

 

Thanks.

[MikeB]

May I ask what local insurance company you've had commendable experience with?  And, are they significantly less expensive than North American medical coverage?

Blue Cross Philippines (not connected with BC - US). This pamphlet will give you an idea but it's not current so prices are probably a little more. There are also less expensive plans. Despite having (for me) a large claim there was no policy increase at renewal.

http://www.bluecross.com.ph/pdf/brochure_blueroyale.pdf

[StayAtHomeDad]

May I ask what local insurance company you've had commendable experience with?  And, are they significantly less expensive than North American medical coverage?

Blue Cross Philippines (not connected with BC - US). This pamphlet will give you an idea but it's not current so prices are probably a little more. There are also less expensive plans. Despite having (for me) a large claim there was no policy increase at renewal.

http://www.bluecross.com.ph/pdf/brochure_blueroyale.pdf

Great to know that there is a local company that provides good service. Fortunately, though, my health plan does not cost me anything so it would not be practical for me to purchase a local insurance policy. We do have PhiliHealth because it's so cheap and it just makes good sense to enroll in the program. Have not used it much, but it did save a few pesos on some tests and visits for my daughter a couple of years back.