Bogleheads

[theac]

I'm wondering how fees get paid. Let's say the insurance will pay 80% of the bill. How would it work if you had something done overseas, for example in Thailand, where prices are much cheaper than in the US?

My insurance will pay for any medical treatment world-wide, so long as the treatment is legal in the US, the bill is written in English, and in US$. So if the service costs $1000 in the US, but only $250 in Thailand, does that mean you only get reimbursed on 80% of the Thailand price? (My guess is yes, and I will call my insurance to ask, but just wanted to get some Boglehead feedback from those with first-hand experience before I do).

Or, I wonder if they'll just pay the full $250 since you're saving them a lot by doing it at overseas prices.

Thanks

[CaptMidnight]

[gwin]

If your US plan is like most plans (for ex., all the BCBS's), then everything outside the US would be "out of network". A typical BCBS plan would have a specific in-network deductible, and a differerent out of network deductible, as well as different percentage "co-insurance" rates (for ex., you'd pay 20% of the bill if in-network, and 40% of the bill if out of network). Moreover, the "out of pocket maximum" also differs between in-network and out of network service.
So, typically, outside the US you'd first have to meet the larger deductible, then you'd pay 40% of the Thailand bill (which of course, is going to be comparatively CHEAP due to the low costs there).

[theac]

It's a union (retiree) medical plan and my monthly fee is $263 (only for myself).

If I go to a doctor while I'm in the US that is on a (long) list of contracted providers (all doctors, including acupuncture, lab, x-rays and MRIs, etc) I pay zero with no deductible.

If I go out-of-network (whether in the US or any foreign country) they will pay 80% and I pay 20% on any service that is legal in the US. I then have a $250 annual deductible.

For contracted hospitals, I pay 10% up to an annual max of $2000 (no deductible).

Out-of-network hospitals (in US or overseas), they pay 80% and I'm subject to the (total) annual deductible of $250 as noted above.

Vision plan has a $25 deductible and I can get a basic pair of bi-focals every 2yrs at Costco (I can pay for extra like tinting etc if I choose). For $25 more I can get a 2nd pair.

Dental, ($25 deductible) and I have a very good dentist (in the US) that accepts what the insurance pays.

It looks like my best bet is to get my medical services done while in the US, but I don't want to make special trips to the US just for that (unless it's something VERY serious).

And to use my insurance overseas, it seems hardly worth the trouble for the dental and vision because those are so cheap overseas. It seems the main thing my insurance will be good for overseas would be serious illness or accidents. That security alone will be worth the $263 I guess?? (but I'd like to get more out of it, to justify paying $263 per month).

[jebmke]

i was an expat in Europe for 3 years and my US plan covered everything as if I was in the US. I had to submit the invoices on my own. However, the invoiced amount was fairly small. I was treated as if I was a citizen in Europe and was charged only the copays that citizens pay under their universal health coverage (Belgium).

My current plan (a retiree plan) treats non-US services as "in-network". I am currently doing a consulting assignment in Belgium and I asked them to confirm in writing that this was their policy (which they did).
_________________
When you discover that you are riding a dead horse, the best strategy is to dismount.

[celia]

Calling your insurance company is the best way to get the info you need.

Mine said I would pay for the services and then get reimbursed by insurance when I sent in a claim.

[celia]

[sommerfeld]

It may also help to know something about the medical system in the country you're visiting.

While wandering around in Kamakura, Japan in the middle of the summer
(discovering why it is that the hand fan is such a staple of Japanese culture), some of my fellow tourists became convinced that I needed immediate medical attention.

I knew I was probably a little dehydrated. They said I was turning blue. They talked me into getting immediate medical attention.
I ended up in an ambulance on the way to the Kamakura hospital.

I was fine. I was a little dehydrated but the blue was from a printed cotton japanese handkerchief/hand towel that had been given out at the conference I was attending -- I had been using it to wipe sweat off my face all day, and the unfixed indigo dye had come off on my face.

Anyhow, when the Kamakura ER let me go, they wanted cash. They had no interest in either my credit card or my medical insurance card.

Fortunately they only wanted the equivalent of about $120.00 ...

[rwcox123]

When I was in Australia last year, I had to go to the ER because I nearly fainted -- as it turned out, from loss of blood via a stomach bleed. I was reimbursed 80% of the costs by my US health insurance. Fortunately, the bills were in English -- otherwise I would have had to have them translated. (Total cost was about $800 -- here, probably $5-10,000.)

When I was in Thailand in 2004, I was bitten by a dog and had to get rabies shots. But that wasn't worth submitting to my insurance here -- total cost was well under $100. (Here it would have been over $1000 -- for exactly the same vaccine.)

But your insurance coverage may vary. Medicare, for example, pays nothing for health care outside the US.
_________________
Beyond all hope, set free to light.

[theac]

Thank you all for the feedback.

I did call years ago and they told me I pay overseas out of pocket, send the receipt to them, and get reimbursed (80%). But I didn't ask 80% of what. I'm sure it will be of the (discounted) overseas price actually paid, but will call to be sure.

Yes, I will have to maintain constant coverage not because of "pre-existing" clauses (don't apply) but because open-enrollment is only once a year, in January, so if I let my insurance lapse, and get in an accident (or discover a brain tumor) in February, I can't renew medical insurance for 11 months. A little too long to wait!

"When I was in Thailand in 2004, I was bitten by a dog and had to get rabies shots...."

Wow that's pretty serious (especially in Thailand, I've seen some pretty mangy dogs!) What kind of shots did you get? As a kid I heard it's a long needle into the belly button, is it true or have they come up with better stuff?

P.S. Great pics rwcox

[SarahShaw]

[rwcox123]

[gwin]

Nothing is "always true" in every single case....except perhaps the speed of light. I don't think that changes depending on location and time.
Moreover, it's not surprising that the more "impressively modern" a place is, the more expensive it is.




One thing that I found out that from the experience that was interesting is that despite all the talk that we hear about medical facilities overseas being cheaper and better than what we have in the States, that's not always true - not even in a place as impressively modern as Singapore.[/quote]

[SarahShaw]

[grabiner]