Bringing Medicare home in a balikbayan box

Loida Nicolas Lewis (center) opens her Manhattan home to a post-Christmas fundraiser for the Medicare in the Philippines campaign. Imelda Nicolas is third from left, Eric Lachica is to Loida’s left.

By Cristina DC Pastor

“Medical portability” is a new term being bandied about in the community. What it means essentially is that FilAms who choose to retire in the Philippines will continue to have access to their U.S. Medicare insurance.

I listened to a careful explanation of the concept courtesy of registered lobbyist Eric Lachica, formerly of the veterans equity issue, now chief campaigner for U.S. Medicare in the Philippines. The nurses and doctors who were invited to community and business leader Loida Nicolas-Lewis’ Fifth Avenue apartment, took turns airing their concerns and support.

Here’s where the concept is at this point. An estimated 200,000 FilAm Baby Boomers – out of an estimated 4 million FilAms — look to retire in the Philippines where they believe the quality of care is better than in an American nursing home. But if a bill is passed in the U.S. Congress allowing Medicare to be accessed overseas, that number may yet rise, according to Lachica.

“Many Filipinos would like to retire in the Philippines with their Medicare. The costs are cheaper and we have caring nurses,” he told the health care crowd gathered for a fundraising. “The lack of Medicare coverage is the only thing stopping them.”

In short, the medical portability concept needs a law. Which means FilAms need to marshal the troops once again to engage in assiduous lobbying, the way they did for veterans compensation in 2009 and the SAVE Act textile bill, which is still working its way through the congressional food chain.

Moving forward with the idea, the way it works is for a FilAm retiree to first pay out-of-pocket for a medical procedure, say, a dialysis. After a short time, Medicare will reimburse the cost.

“Right now,” said May Mayor, executive director of the Philippine Nurses Association of America, “when they know you’re a balikbayan, they crank up the bill.” She should know. Her brother had to undergo a procedure for kidney failure in Manila and was billed an enormous amount, not including doctors’ and lab fees.

The current annual cost per Medicare beneficiary is $11,743, said Lachica.

“We estimate that U.S. taxpayers will save at least $5,000 per year for each Filipino American senior who chooses to retire in the Philippines and avail of quality health care there,” he said.

I learned that four Philippine hospitals are, at this point, seen to qualify as participants. The St. Luke’s Medical Center, Makati Medical, Medical City and Chong Hua Hospital in Cebu are said to offer excellent services that can match American hospitals in terms of wellness standards, electronic medical records and the pool of competent doctors.

There is a precedent in Guam, said Lachica, who refers to Guam’s health insurance portability law as the template. In fact. Guam Rep. Madeleine Bordallo is the principal sponsor of the ‘Medicare in the Philippines’ bill. Others like Mexico and Costa Rica are curiously watching the Philippine campaign to see if it will be a success.

“This is the starting bill,” said Lachica. “We are the foundation.”

For now, the Philippine government appears disinterested in this idea.

“The challenge is to get Aquino to get behind the bill,” said Lachica. “It’s not his priority.”

But some in his Cabinet, like Health Secretary Juan Ona and Secretary Imelda Nicolas of the Commission on Overseas Filipinos, support the idea and see it as benefiting FilAm retirees and providing jobs to Filipinos. Lachica said each retiree who comes home is seen to create four new jobs.

“Dr. Ona is in full support of this campaign,” said Nicolas, the sister of Lewis. She believes that, like most historic journeys, medical portability needs to “start with a single step.”

The law might even encourage some doctors and nurses to come home and provide care. There are about 75,000 Filipino nurses and 22,000 Filipino doctors in the U.S., according to those in attendance.

A lot hinges on the outcome of the presidential election and the Supreme Court’s final ruling on the Obama health care law, said Lachica. For now, he said FilAms need to keep the discussion alive, and whatever they think of it, they need to be heard.

Classical guitarist Michael Dadap performs to an audience of doctors and nurses.

Cristina DC Pastor is the founding editor of The FilAm.


  1. J.J. Reyes wrote:

    American retirees relocating to the Philippines can still save money even if Medicare coverage stops at the U.S. border. The lifetime cost estimate for a couple age 65 years is $224,000 in premiums, co-payments and deductibles. If you self-pay for medical services in the Philippines, I doubt you will spend anywhere close to that amount. Should you ever need highly complex surgery, there is always the option of flying back to the United States for treatment under Medicare A.


  2. D. Molina wrote:

    Very interesting subject, great post.

  3. Rob wrote:

    I am a retired disabled US veteran, living as a permanent resident in the Philippines. I can not use Medicare while living here. I can not use (even in an emergency) the Philippine Veterans Hospital in Manila, in spite of the millions of dollars provided to that hospital each year by the US government. I can only use the “US” Veterans Outpatient Clinic for specific service connected issues. This care is provided on a space available basis only after Philippino WW II veterans, their spouses, and children receive treatment. I can not get counseling, or education benefits here, unlike Philippino veterans. So why in hell would we extend unearned US Medicare benefits in the Philippines to those who resided in the US for as little as 5 years? Most of them are already drawing Supplemental Social Security (direct deposit) even though they have long ago returned to the Philippines. Unless the US intends to allow US Veterans living in the Philippines the same Medicare benefits as Obama will give the Philippinos, I say “NO”.

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