In 2010, the average cost to
the US government of a
Medicare beneficiary was
US$11,743 a year. With
portable Medicare
coverage, Fil-Am retirees
can save the federal coffers
up to US$1 billion a year,
according to a Filipino lobby.

I don't have much
time left, I think.
There's nothing
better than spending
the rest of my days in
the land of my birth

By Bert B. Eljera in Las Vegas

    fter 30 years, Ely Barros thinks it's time to end the chase of the American
    Dream and return to the Philippines.

There is little sense staying in the United States any longer. The kids are grown,
a failed marriage is only a distant memory and a new love makes the prospect of
going home even more tempting.

The town of his birth beckons, and finally, a comfortable, peaceful retirement is

Home is Borongan, Eastern Samar, a coastal town on the Pacific with swaying  
palm trees, white beaches, blue-green waters and golden sunsets.

There is just one catch: In January, his transplanted kidney gave way after 11
years. He has to go on dialysis again.

Without private insurance and relying on Medicare, Barros faces huge expense if
he returns to the Philippines and seeks treatment there.

Barros is one of thousands of Filipino-Americans -- estimates say as many as
200,000 -- who are planning to retire to the Philippines but are prevented from
doing so by lack of medical coverage.

A proposal is under way in the United States Congress  to allow returnees to
enjoy  Medicare coverage in the Philippines. Several topnotch hospitals and
doctors associations there are willing to provide medical services to returning

"This would be a tremendous help," Barros says. "It would finally fulfill my dream
of going home for good."

Long road

But after more than three years, the quest for portable Medicare, which started
with the formation of US Medicare Philippines (, has a
long road ahead.

    Medicare is a federal program that provides medical coverage to
    US citizens 65 and older. It also extends coverage to younger
    people with Lou Gehrig's disease, permanent disabilities and end-
    stage renal health complications.

    A drug prescription benefit was added to hospital and doctors
    coverage during the George W. Bush presidency.

    In addition, Part C or Medicare Advantage that provides basic and
    extra healthcare services are offered by private health
    maintenance organizations. .

    Also, there are Medigap plans to supplement what original
    Medicare does not cover. Private insurance companies offer them.

However, coverage outside the United States is not allowed unless in an
emergency situation and an American hospital is not available.


The lobbying effort for portable Medicare is centered on the premise that it's a win-
win situation; that allowing retirees to bring their Medicare benefit to their home
country will save the US tons of money.

"The average cost per beneficiary was US$11,743 per year in 2010," says Eric
Lachica, a co-founder of US Medicare Philippines. "A savings of at least
US$5,000 per beneficiary is achievable if the money is spent in the Philippines."

If 200,000 (a conservative estimate because at least 100 of the four million
Filipino-Americans in the US retire every day) chose to return to the Philippines,
they would save Medicare $1 billion a year.

This relieves pressure on Medicare, which is expected to go bankrupt in 12 years,
according to some studies, Lachica says.

A couple of precedents give Lachica and his group hope that the US Congress  
will pass a law that allows Medicare portability eventually.


In 2010, Saipan and Guam were allowed critical medical treatment in Philippine
hospitals that meet Joint Commission International standards.

Patient expenses were reimbursed by Medicare or by private insurance plans.
Tricare, the Department of Veterans Affairs' health plan, reimburses US military
retirees who live in the Philippines for their medical expenses in certain
designated hospitals.

President Benigno S. Aquino III has vowed to bring up Medicare portability with
President Barack Obama Obama during his visit to the country in April after
canceling the trip last year.

Lachica's lobby has partnered with several hospitals, doctors groups, nurses
associations, and community groups to help advance the Medicare portability

On Jan. 16, it launched its 2014 campaign at the Nurses Global summit at the
Manila Hotel.

Attended by more than 300 nurses and supporters, the gathering was graced by
Nurses Association of America president Victoria Navarro, Secretary Imelda
Nicolas of the Commission on Filipinos Overseas , Sec. Enrique Ona of the
Department Health and  Vernie Atienza, general manager of the Philippine
Retirement Authority.

"We appealed to the nurse leaders and our partners to renew their commitment
to the cause of Medicare portability for thousands of returning elderly Filipino-
Americans by ensuring high quality healthcare and low medical costs," Lachica

"We urged them to persuade US Medicare Advantage insurance companies to
provide full emergency coverage for our retirees here and to build confidence in
doing business with the top hospitals and their doctors."


The advocacy group later consulted and talked strategy with the Retirement and
Healthcare Coalition (, formed by the four influential foreign
chambers of commerce (American, European, Japanese and Korean).

The group, which included Daisy Tucay of Virginia, Lily Chan of Maryland, Susan
Jimenez of Texas, Rusty Francisco of Florida, Lourdes Ceballos of Nevada and
Lachica also met with US ambassador Philip Goldberg and his economic affairs
counselor at the US embassy.

They discussed the challenges and prospect of extending long-term Medicare
coverage to US citizens who visit or retire in the Philippines.

They told Goldberg their 2014 goal to obtain a Philippine healthcare industry
study of the past year's cost savings experience. It would include the quality of
care provided US military retirees in TRICARE PH program and the 30,000 Guam
Medicare American beneficiaries who can be treated at top Philippine hospitals
at negotiated low charges.

Goldberg, in turn, expressed interest in the idea, considering that about 400,000
Americans live in the Philippines.

The group will also visit Cebu and Iloilo and meet partners there.

Support from hospitals

Philippine hospitals that have signed up as partners are  Medical City, Cebu's
Chong Hua Hospital and Cebu Doctors Hospital. There are ongoing negotiations
with Ayala Land, St. Luke's Hospital, Makati Medical Center and Cardinal Santos

If Medicare portability is a long road full of humps, it does not faze Lachica.

A political science graduate of the University of Southern California and a son of a
Fil-Am World War II veteran, Lachica worked 17 years for the passage of the Fil-
Am Veterans Equity Bill that resulted in the 2010 release of US$300 million for Fil-
Am vets and their families.

In addition, thousands of veterans acquired US citizenship, many of whom,
ironically, want to return to the Philippines, hopefully with Medicare coverage.

"There are enough reasons to remain in the United States," Barros says. "My kids
are here and my grandchildren are growing up. It would be nice to spend time
with them."

But with old age and long-term care looming, it makes more sense to spend
retirement in the Philippines, he says.

"I hope this effort to make Medicare portable succeeds and soon," Barros says.

"I don't have much time left, I think. There's nothing better than spending the rest
of my days in the land of my birth."
End of the chase
Why this Pinoy wants to live out his
American Dream in the Philippines
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