Services for Medicare recipients now allowed in non-US countries

Medicare beneficiaries in the CNMI who need inpatient medical care and cannot receive such care at either the Commonwealth Health Center or in Guam can now seek treatment in foreign hospitals like those in the Philippines.

Resident Representative Pedro A. Tenorio made the announcement yesterday, saying that Medicare recipients present in the CNMI are now eligible to receive medical treatment in hospitals in non-U.S. countries following changes to the Centers for Medicare and Medicaid Services Manual System.

“This is good news for the CNMI,” said Tenorio. “Although this may not translate into a considerable windfall for the CNMI’s medical referral program, it should indeed help and, especially in these times of economic hardship, anything that may save some money and in turn improve health care should be vigorously sought after.”

The amendments now make it possible for Medicare to make payments to health care facilities outside the United States. Previously, usual exceptions to Medicare’s “foreign exclusion” policy involved medical services rendered only in Canada or Mexico.

With changes in the rules on “Services Not Provided Within United States,” Medicare beneficiaries receiving health care services can make payment claims on “emergency or nonemergency inpatient hospital services furnished by a hospital located outside the United States, if the hospital was closer to, or substantially more accessible from, the beneficiary’s U.S. residence than the nearest participating U.S. hospital which was adequately equipped to deal with and available to provide treatment of the illness or injury.”

It is highly important, however, that all Medicare beneficiaries check with Medicare to make sure that their circumstances match the requirements of the rules prior to receiving any medical care in the Philippines or other foreign country.

“I would especially like to thank Guam Congresswoman Madeleine Bordallo for all the hard work she put in on having the CMS rule amended to include Guam and the CNMI,” added Tenorio. “If not for her assistance, the CNMI would have a difficult time having its issues heard on Capitol Hill. It’s fortunate that we share many common concerns with Guam so that the CNMI can be included on various legislation, but until we get a delegate of our own, we must continually rely on the solid friendships we’ve built with Bordallo and the other territorial delegates,” said Tenorio. (PR)