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In understanding Medicare coverage, one has to first understand that there is regular Medicare, and there are what are called “Advantaged” Medicare plans that came out during the Bush years. Regular Medicare does not cover people outside of the country. Regular Medicare, as many people know, generally covers 80% less deductions. Consequently, many people buy “Supplementary Medicare” and some of the supplementary plans do give partial coverage to people out of the country for emergency situations. With the Medicare Advantaged plans, they are run by different insurance companies. Their coverage is different than regular Medicare and each plan is different in coverage. These Medicare Advantage plans are run like HMO’s. For basically emergency situations, some of them do provide some coverage outside of the country. When it comes to Medicare Advantaged plans, one cannot make a blanket statement as to whether there is coverage or not outside of the U.S. since each plan and each company offers different things. It is highly unlikely that any of these plans offer a high level of coverage outside of the U.S. for routine things. Whether one is in regular Medicare or in an Advantaged plan is left up to the individual. As always, the insurance companies want the healthiest people and try to deny coverage to those that are the sickest. When one turns 65, one can pretty much choose what plan to go with but once in a plan switching to something else can be difficult and expensive for anyone that has significant medical problems. One of the proposals of healthcare reform is to cut back the payments to the insurance companies that run these Medicare Advantage plans because they cost the government more money than regular Medicare and do not provide outcomes that are any better.
Before making my first trip to Costa Rica with my wife, I seriously considered Caravan. They are reasonably priced for a tour company and may be the way to go. However, my wife and I decided to pick hotels in different cities on our own and use Intrabus to get door to door delivery from a given hotel in one city to a given hotel in another city (or at least be close to our selected hotel). We also chose hotels that were moderately priced such as La Sabana in San Jose, but certainly not the cheapest around. We signed up for excursions that approximated what Caravan had to offer but gave us a little more time on the beach. I compared all expenses when we got done and found out that we had saved about one third off of the Caravan price. Note that Caravan also includes additional taxes (in small print) above and beyond advertised trip prices. I suspect that if we had rented a vehicle, we would not have saved nearly as much, but I doubt if we would have exceeded the Caravan price either. Having a guided tour takes the worry out of getting around the country and where to stay, but there is a potentially a price to pay in cost, flexibility and adventure. Either way, however, it should be a fun trip and either way things should work out reasonably well.
The bedfellows with the Zionists are the Evangelical Christians, who constitute a fairly large minority of the U.S. population. They believe that the Second Coming cannot happen unless the Israelis return to their biblical homelands now largely occupied by Palestinians. Hence, they are happy that the Israelis keep expanding their settlements and stealing Palestinian land in violation of international law. So because of the strong Zionist/Evangelical lobbies, most American politicians only give lip service to Palestinian rights and support a strong Israeli government even as it continues its apartheid activities designed to subjugate the Palestinians. This American bias in turn pisses off the Arabs and others, and gives extreme radicals support from the general populations.
Edited on Sep 05, 2008 13:55
When someone becomes eligible for Medicare, one has to make a basic choice between going into a Medicare Advantaged plan or sticking with traditional Medicare and also buying what is called a Medigap policy to potentially cover things that Medicare does not cover. If one takes the first choice and goes into an Advantaged plan, many of these plans do cover emergency treatment outside of the United States (typically 70 to 80% with a deductible). Advantaged plans are written and changed by the insurance companies and are all different. Consequently, coverage outside of the U.S. can vary widely. If one stays with traditional Medicare, there generally is no coverage outside of the U.S. (except for a few minor exceptions were Medicare will cover people in Canada and Mexico, or at least that is what I have from a State of Colorado handout on Medicare). When staying in traditional Medicare, one normally buys a Medigap policy as well. The federal government writes the various plans. The most commonly sold plan for coverage is Plan F. A Plan F with a company like USAA is exactly the same as a Plan F with Mutual of Omaha or any other company with the only real difference being cost. Under Plan F (and plans C, D, E, and G) emergency care is provided for the first 60 days of one’s trip at the 80% level up to $50,000 lifetime maximum with a $250 deductible. So, in a sense, if one has one of the more common Medigap policies or if one is in a Medicare Advantaged plan, there is a fair amount of medical coverage for emergency situations during the first 60 days of a trip, but probably not for long-term residents.
Edited on Jan 08, 2008 20:51
Edited on Jan 09, 2008 10:07
Edited on Jan 09, 2008 10:09
Even though Caravan likes to advertise their tour price of $995, in much smaller letters they note that there are taxes of $149 based on double occupancy. So, don’t forget about the taxes and fees.
When looking at the on-line map for the new highway, it looks the same as highway 27 from Colon to San Juan de Mata and from there on highway 23 to Caldera as found on the map sold from this site. Does this mean that the map I purchased is sometimes showing highways that are planned and do not exist? Are there any more highways like this?
