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Discontinuing Medicare while in Philippines on Phil-Health


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ex231

I believe you and Easy44 but you both have very conflicting experiences with Phil-Health coverage. Can anyone explain why these two guys had such widely different experiences?

 

I don't understand it either. Have a friend here that had kidney stones and I think they paid somewhere around 20% for him too. Maybe it depends on your ailment/problem?

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Absolutely keep your Medicare active and paid up. Medical emergencies often happen when you least expect them.

Sorry, pesos, for both my wife and me...actually here we pay for all the relatives phil health...trust me its cheaper in the long run lol

For $55 PER YEAR anything you get is a benefit.  This is probably the biggest bargain you can find in the Philippines and is available to almost anyone.  I have mentioned this before, but I only paid

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cebubird

Just wondering if this can be done and if it should be done. On the pro side MediCare will cost me about $105 a month and can't use it while in The Philippines. That money can then be put into a bank account and saved for emergencies. On the other hand if I have a serious medical problem I'm going to want to jump on a plane and head to a US ran hospital on Guam, Hawaii or California where I'll need Medicare. Ideally I'd like to be able to turn Medicare off and on as needed but my guess is this is easier said than done. Just wondering what other members would recommend, especially those that go back and forth frequently. I'd appreciate your advice on this.

 

Your 105 is for doctors/prescriptions. Medicare-a is not turned off and you can still go to a hospital on Guam.

I discontinued my 105 part bwhen I came here 5 years ago. Just signed up again as we are returning later this year, and yeay-no I will pay 150 a month, but the 105 was very much needed when we first came.

If you're planning on being here a few years, by all means, discontinue part b.

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Edwin

Your 105 is for doctors/prescriptions. Medicare-a is not turned off and you can still go to a hospital on Guam.

I discontinued my 105 part bwhen I came here 5 years ago. Just signed up again as we are returning later this year, and yeay-no I will pay 150 a month, but the 105 was very much needed when we first came.

If you're planning on being here a few years, by all means, discontinue part b.

Were you eligible right away or have to wait for an open enrollment period for it to go into effect?

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throttleplate

i was taught as a young man to never go without car insurance and never go without health insurance.Look what happened to paul when he went back to the states and lets just say for an example he was eligible for medicare but he dropped it? For $100.00 a month why unless you are that broke and shouldnt be here in the first place would you pass up such cheap costing insurance?

 

I went home to the usa last year to visit dad and guess what? yeah i ended up getting a shoulder operation and i am now cured and cost me about $1700.00 of my own out of pocket money while the bill was $35000.00

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Salty Dog

Phil-Health paid around P26,000 of my wife's surgery and hospital bill for an appendectomy. The total bill was around P100,000 for 7 days in the hospital, drugs and surgery.

 

Of course the doctors made her pay in cash before she could check out of the hospital. They didn't deduct the amount they would be getting from Phil-Health even though it was part of the P26,000. I guess they just consider it a bonus. In other words, I paid the same as I would have had to pay with no Phil-Health, as far as doctors fees were concerned. So the portion of the Phil-Health listed as going for doctors fees, didn't reduce my bill at all. 

 

The next time she had some light day surgery done. It cost about P9,000 and Phil health paid about P6,000 of it.

 

When I was in the hospital for 32 days with no Phil-Health, all the doctor's fees were included in the hospital billing and I didn't pay anyone separately. The total bill was around P1,500,000. While I had to pay it all upfront, my TRICARE Insurance paid me back around P1,350,000 million.

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tomaw

Your 105 is for doctors/prescriptions. Medicare-a is not turned off and you can still go to a hospital on Guam.

I discontinued my 105 part bwhen I came here 5 years ago. Just signed up again as we are returning later this year, and yeay-no I will pay 150 a month, but the 105 was very much needed when we first came.

If you're planning on being here a few years, by all means, discontinue part b.

Thanks. That makes sense.
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You don't have to be in the hospital over night to be cover always ask Phil Health in the hospital office , not the nurse , my daughter fell split her lip Dr Stitch it the nurse said sir your not covered  she  stay 4 hrs not over night, I go to Phil Heath at the hosp  . There they say she cover as considered a minor surgery they pay over 20% NOW!!!!! ( AS to my Part B  the can try to bill me later if they want  all they have to do is sue me, as  i don't have any assets  ,and don't think they will want to come here to find me or sue me here in the PH when i get back here .,And most big hospitals come under the Hill Burton act .... they where give federal money long time a go , maybe still help you  get around a big bill if you have no assets

 

The Hospital Survey and Construction Act (or the Hill–Burton Act) is a U.S. federal law passed in 1946, during the 79th United States Congress. It was sponsored by Senator Harold Burton of Ohio and Senator Lister Hill of Alabama.[1]

The Act responded to the first of President Truman's proposals and was designed to provide federal grants and guaranteed loans to improve the physical plant of the nation’s hospital system. Money was designated to the states to achieve 4.5 beds per 1,000 people. The states allocated the available money to their various municipalities, but the law provided for a rotation mechanism, so that an area that received funding moved to the bottom of the list for further funding.

Facilities that received Hill-Burton funding had to adhere to several requirements:

    They were not allowed to discriminate based on race, color, national origin, or creed, though separate but equal facilities in the same area were allowed. The U.S. Supreme Court struck down this segregation in 1963.
    Facilities that received funding were also required to provide a ‘reasonable volume’ of free care each year for those residents in the facility’s area who needed care but could not afford to pay. Hospitals were initially required to provide uncompensated care for 20 years after receiving funding. The federal money was also only provided in cases where the state and local municipality were willing and able to match the federal grant or loan, so that the federal portion only accounted for one third of the total construction or renovation cost.
    The states and localities were also required to prove the economic viability of the facility in question. This excluded the poorest municipalities from the Hill-Burton program; the majority of funding went to middle class areas. It also served to prop up hospitals that were economically nonviable, retarding the development wrought by market forces. Once Medicare and Medicaid were enacted, participation in those programs was added to the list of requirements for access to Hill-Burton funding.

The reality, however, did not nearly meet the written requirement of the law. For the first 20 years of the act’s existence, there was no regulation in place to define what constituted a "reasonable volume" or to ensure that hospitals were providing any free care at all. This did not improve until the early 1970s, when lawyers representing poor people began suing hospitals for not abiding by the law. Hill-Burton was set to expire in June 1973, but it was extended for one year in the last hour. In 1975, the Act was amended and became Title XVI of the Public Health Service Act. The most significant changes at this point were the addition of some regulatory mechanisms (defining what constitutes the inability to pay) and the move from a 20-year commitment to a requirement to provide free care in perpetuity. Still, it was not until 1979 that compliance levels were defined.
References

Sultz, Harry A., and Kristina M. Young. Health Care USA Understanding its Organization and Delivery

 

 

 

Also if you going to have a baby make sure you pay like 5.20 P a month on PH SSS ( Social Security) as when my wife had her C section they gave us P(9,000 maternity   leave payment and that was with out a job, they just call it that .as she was not working.  Also Phil health paid 19,000 Pesos

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cebubird

i was taught as a young man to never go without car insurance and never go without health insurance.Look what happened to paul when he went back to the states and lets just say for an example he was eligible for medicare but he dropped it? For $100.00 a month why unless you are that broke and shouldnt be here in the first place would you pass up such cheap costing insurance?

 

I went home to the usa last year to visit dad and guess what? yeah i ended up getting a shoulder operation and i am now cured and cost me about $1700.00 of my own out of pocket money while the bill was $35000.00

 

DUH!!!! You CANNOT "drop" Medicare!!!!! It's the part Bwe're talking about that you pay extra for.

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throttleplate

DUH!!!! You CANNOT "drop" Medicare!!!!! It's the part Bwe're talking about that you pay extra for.

R=E-L-A=X birdman,why do you want to drop B for 105 a month? Maybe your wing gets tore off by a hawk and you need to spend weeks back in the states for rehab and probably have another operation so the american docs can put the wing back on right side up as opposed to the ph doctor puting it on ya know upside down.

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cebubird

I give up-have it your way.

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tomaw

Thanks. That makes sense.

But what's it cost to just have part A?
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USMC-Retired

TRICARE becomes TRICARE for Life at Age 65.  You have to have Medicare Part B to maintain your TRICARE for Life eligibility.   If you don't sign up for Part B when you're first eligible or if you drop Part B and then get it later, you may have to pay a late enrollment penalty for as long as you have Medicare. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it.

http://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html

Not 100% true except in his case which then it is.  If you are in the states (key word does not apply to him)  If you have tricare prime and use US Family Health as your provider there are some additional rules to keep US Family Health.  http://www.tricare.mil/usfhp

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USMC-Retired

Phil Health is like an HMO in the US that regulates costs and then pays a portion of those costs.  You are responsible for the other part.   In the PH there is a dirty underbelly where they will attempt to over bill your for services thus trying to keep a portion because Phil Health going fees for doctors and nurses is so low.  

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Aerosick

But what's it cost to just have part A?

 

http://www.medicare.gov/your-medicare-costs/part-a-costs/part-a-costs.html

 

How much does Part A cost?

You usually don't pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes while working. This is sometimes called "premium-free Part A."

If you buy Part A, you'll pay up to $407 each month.

But, most people get premium-free Part A. You can get premium-free Part A at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
  • You or your spouse had Medicare-covered government employment.

If you're under 65, you can get premium-free Part A if:

  • You got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

In most cases, if you choose to buy Part A, you must also have Medicare Part B (Medical Insurance) and pay monthly premiums for both.

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Aerosick

Part B costs

You pay a premium each month for Medicare Part B (Medical Insurance). Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

How much does Part B cost?

Most people pay the Part B premium of $104.90 each month.

You pay $147 per year for your Part B deductible.

Some people automatically get Part B. Learn how and when you can sign up for Part B.

If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty.

If your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you may pay more.

Social Security will contact some people who have to pay more depending on their income. The amount you pay can change each year depending on your income. If you have to pay a higher amount for your Part B premium and you disagree (for example, if your income goes down), use this form to contact Social Security.

 

Part B.JPG

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