USA - Medicare Part B

[Mike J]

Not legal.  That is why you need this California address.  At some point this doctor will be charged with bilking Medicare.  Assume you as a patient were to use medicare here under this plan.  Would you then be willing to testify under oath that you "lived" in California and just happened to be visiting the Philippines when you required medical treatment?

https://www.medicare.gov/Pubs/pdf/11037-medicare-coverage-outside-united-stat.pdf

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When does Medicare cover health care services in a
foreign hospital?
There are 3 situations when Medicare may pay for certain types of health care
services you get in a foreign hospital (a hospital outside the U.S.):
1. You’re in the U.S. when you have a medical emergency, and the foreign
hospital is closer than the nearest U.S. hospital that can treat your illness or
injury.
2. You’re traveling through Canada without unreasonable delay by the most
direct route between Alaska and another state when a medical emergency
occurs, and the Canadian hospital is closer than the nearest U.S. hospital
that can treat your illness or injury. Medicare determines what qualifies as
“without unreasonable delay” on a case-by-case basis.
3. You live in the U.S. and the foreign hospital is closer to your home than the
nearest U.S. hospital that can treat your medical condition, regardless of
whether it’s an emergency.
Remember, in these situations, Medicare will pay only for the
Medicare-covered services you get in a foreign hospital.

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Red highlight added by me.

[OnMyWay]

32 minutes ago, Mike J said:

Not legal.

You may be right.  I'm going to keep asking questions.

[AlwaysRt]

I have seen this topic, not sure if on this forum or somewhere else, of if it was the same company or not, but the legality was called into question then also. Treading way to close to Fraud in my opinion. If it were 100% approved then many companies would be offering their version.

[OnMyWay]

The hospital that prompted me to start this topic, Baypointe, is in hot water.  Sen. Gordon has accused them of overcharging and that got the ball rolling.  The last I heard, they have been downgraded to an infirmary so they can accept emergencies, but surgery is not allowed, so most patients will have to be transferred.  Many other services are curtailed too.

[JJReyes]

As already stated by others, this scheme is NOT Legal.  The medical services are offered in the Philippines, the billing is done in the United States pretending this was where the services were rendered, and the address on record is California.  When the authorities eventually catch on and declare it a scam, the corporations behind it folds and declare bankruptcy.  The government then goes after the participants (patients) for reimbursement.  

Tricare, the military insurance formally known as the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), was once hit with a fraudulent scheme by a hospital located in Subic Bay.  Over several years, the hospital billed more than $100 million for medical services, some of which were never performed.  One participant claimed a heart problem that required open heart surgery.  Tricare paid.  The same person had a heart attack while visiting the United States.  His medical records were forwarded to the hospital caring for him.  There were no scars on his chest to indicate a previous heart operation.

Tricare tightened up their system.  To avail to their reimbursement system for services, you need to use a hospital or clinic that's preapproved.  Now, if you qualify for Tricare, this is the superior program because it is global.  Medicare is limited to the United States with a few exemptions.  The example is an American traveling by car through Canada on his way to Alaska.  He requires emergency surgery.  A Canadian hospital is closer.  His expenses will be reimbursed by Medicare.

[Bobm]

Any further developments regarding this? 

[Mike J]

36 minutes ago, Bobm said:

Any further developments regarding this? 

Nothing has changed.  There is no medicare coverage if you live in the Philippines and get treatment here.

[Bobm]

Sounded too good to be true.