So I worked for a big health insurance company for 11 years. Of which 4 of those I worked in international claims.
We would get these claims from Mexico sometimes for people with terminal cancer.
The companies were U.S companies, some canadian. But clinics were in Mexico.
Ever see those commercials for “cancer treatment centers of America” where they promise new innovative and experimental treatments?
They used to run commercials all the time. Well all the facilities are all located in Mexico.
(Now it’s been about 6 years since I last worked there and maybe these companies don’t exist anymore. I hope not).
Anywho. We would get these medical claims in for literally a few million dollars.
For vitamin B shots.
Water exercises.
Massages.
Nothing innovative. No actual cancer treatments.
Just pain killers and vitamin B shots.
People would stay there for a month or two then die.
But that’s only part of the horror.
The cancer centers would not release the bodies of the person until the debt was paid.
Yeah they would hold them for ransom.
That’s why desperate people would try to get the u.s health insurance company to pay some of it. But we wouldn’t. Because 1. It’s considered medical tourism. And 2. It’s not considered legitimate health care.
We felt bad for the families whenever one of these claims came through. They would often submit it multiple times trying to get it paid. With letters begging us. Which is how we learned that these companies won’t release the body of the deceased until they were paid.
They have been sued many times but still going strong.
There are lots of them not just the one I mentioned.
Switzerland also has expensive medical. Almost same as U.S.
Most other countries cheaper but it’s hard to know if there is fraud. People go get cosmetic surgery and send in a bill for a deviated septum but it was a cosmetic nose job.
Generally only accidental or emergency care is covered for foreign countries where it’s not easy to get to the u.s.
For example you get injured or have a heart attack in Mexico near U.S border, you better go to the U.S hospital if it’s closer or it won’t be covered.
There was exceptions made for expats living abroad.
There was one company that had like 8 families that it insured. All lived in different foreign countries.
I think they were maybe doctors.
The company was a charity that’s well known but I don’t want to say who. They were very good to their employees though. They paid some crazy gold platinum plan for these people. We covered everything for them and their family and even reimbursed them in their currency.
Had like a $200 deductible and no copays or something crazy like that.
So I worked for a big health insurance company for 11 years. Of which 4 of those I worked in international claims.
We would get these claims from Mexico sometimes for people with terminal cancer.
The companies were U.S companies, some canadian. But clinics were in Mexico.
Ever see those commercials for “cancer treatment centers of America” where they promise new innovative and experimental treatments?
They used to run commercials all the time. Well all the facilities are all located in Mexico.
(Now it’s been about 6 years since I last worked there and maybe these companies don’t exist anymore. I hope not).
Anywho. We would get these medical claims in for literally a few million dollars.
For vitamin B shots. Water exercises. Massages.
Nothing innovative. No actual cancer treatments.
Just pain killers and vitamin B shots.
People would stay there for a month or two then die. But that’s only part of the horror.
The cancer centers would not release the bodies of the person until the debt was paid.
Yeah they would hold them for ransom.
That’s why desperate people would try to get the u.s health insurance company to pay some of it. But we wouldn’t. Because 1. It’s considered medical tourism. And 2. It’s not considered legitimate health care.
We felt bad for the families whenever one of these claims came through. They would often submit it multiple times trying to get it paid. With letters begging us. Which is how we learned that these companies won’t release the body of the deceased until they were paid.
They have been sued many times but still going strong.
There are lots of them not just the one I mentioned.
https://oig.hhs.gov/fraud/enforcement/ctca-agreed-to-pay-82-million-for-allegedly-violating-the-civil-monetary-penalties-law-by-paying-remuneration-to-physicians-for-referrals/
https://www.nbcnews.com/business/consumer/consumer-group-says-most-u-s-cancer-centers-use-misleading-n934041
https://pubmed.ncbi.nlm.nih.gov/1878788/ Questionable cancer practices in Tijuana and other Mexican border clinics
sounds like those places are pseudoscience just preying on the desperate.
Why is medical tourism not covered? Seems like they should be on board with cost saving
Maybe, maybe not.
Some places are as expensive or more.
These Mexico cancer centers charge way more.
Switzerland also has expensive medical. Almost same as U.S.
Most other countries cheaper but it’s hard to know if there is fraud. People go get cosmetic surgery and send in a bill for a deviated septum but it was a cosmetic nose job.
Generally only accidental or emergency care is covered for foreign countries where it’s not easy to get to the u.s.
For example you get injured or have a heart attack in Mexico near U.S border, you better go to the U.S hospital if it’s closer or it won’t be covered.
There was exceptions made for expats living abroad.
There was one company that had like 8 families that it insured. All lived in different foreign countries.
I think they were maybe doctors.
The company was a charity that’s well known but I don’t want to say who. They were very good to their employees though. They paid some crazy gold platinum plan for these people. We covered everything for them and their family and even reimbursed them in their currency. Had like a $200 deductible and no copays or something crazy like that.
Best plans I’ve ever seen.