Seeking medical treatment abroad: What are the rules?

I need to hear about your experiences with getting referrals for medical treatment abroad—how long does the process actually take, is the paperwork manageable, and is there any way to speed things up?

Here’s the situation: doctors here are capable of performing the procedure, but Medicare (no longer) covers certain essential components needed for the treatment. Now, I'm being advised to look at options outside the US...

I'm looking for real-world accounts from people who have been through this. Thanks, Grace Rodriguez16

I'm not entirely certain about the specifics, but I suspect you'll end up footing the whole bill yourself if you decide to seek treatment abroad. I guess you could file a claim afterward, and maybe—just maybe—Medicare would reimburse you, but honestly, that seems pretty unlikely. The only exceptions I've heard of involve really severe or rare conditions that simply can't be treated here in the States.

Grace Rodriguez16 said:Could anyone share their experiences regarding referrals for medical treatment abroad? I'm wondering how long the whole process takes, whether the paperwork is manageable, and if there is any way to speed things up.

The reality of the situation is that here in the United States, there are doctors capable of performing certain procedures, but Medicare (no longer) covers specific components required for the treatment. Consequently, I’ve been advised to seek care overseas...

I am looking for your actual, firsthand accounts. Best regards, Grace Rodriguez16

Referrals for Medical Treatment Abroad

- This is an option if the necessary treatment cannot be performed within contracted health facilities in the United States, but can be successfully completed abroad;
- Before heading overseas for treatment, you must submit a request to the Centers for Medicare & Medicaid Services along with the following documentation:
a) medical records
b) a recommendation from a specialist physician for overseas treatment, including proposed foreign healthcare institutions where the procedure can be performed;
- The Centers for Medicare & Medicaid Services will issue a decision regarding the right to receive treatment abroad via a formal ruling.

You should study the regulations on the right, conditions and manner of using health care abroad (found in the Federal Register 80/07 and 85/07- amendment)

Thanks, I’ve already done my homework on all of this. Now I’d just like to hear (read, actually :-)) from someone who has actually lived through it.

Reach out... please.

Best, Grace Rodriguez16

Bump. I'm looking into this too.

I didn't even realize there was already a thread for this... I ended up posting my question under a completely different topic.

Anyway, I’m looking for some guidance here—does anyone know where I should even start when dealing with something like this?

I’m looking at getting surgery that’s only performed by two hospitals and three specific doctors in my area. One of those hospitals hasn't even been able to schedule anything because some essential equipment has been broken for four months now, and they have absolutely no clue when it'll be fixed. At this rate, I'm looking at a wait time of maybe a year. As for the other hospital, I've already been there, and they completely misdiagnosed me—and that was the very surgeon who would actually be performing the procedure. So, now I'm stuck needing a whole new consultation just to get back on a waiting list for an operation that could happen whenever they feel like it..

I've been living in constant pain for a year and a half now, and honestly, it’s just miserable. It’s reached the point where I can’t even hold down a job. Because of that, I’m planning to submit a claim to Medicare to see if they’ll cover the costs of having the surgery done abroad, at least up to the amount it would cost here in the States. Has anyone actually had any luck getting them to cover even a portion of the expenses?

And what does "medically necessary timeframe" even mean to these people when I practically should have had this surgery a year ago? If things had gone right the first time, I might have been looking at a six or seven-month wait at the other facility. Not to mention, everyone keeps giving me verbal advice suggesting it’s better to just go overseas since this kind of surgery isn't exactly rare globally, but nobody will put that in writing. It feels like they’re still basically learning on the job here.

Can anyone point me in the right direction regarding how to find and actually get in touch with a top-tier urologist within the European Union?

I am trying to locate a clinic in the EU that might actually offer a real cure for someone's condition.

Would you consider a University hospital in New York City or Chicago to be solid choices?

There isn't much point in staying here—the doctors just seem to ignore the problem entirely.

velvetbear372 said:Can someone point me toward a top-tier urologist within the European Union?

How do I find a clinic in the European Union capable of actually treating this?

Are the University Hospitals in New York City and Chicago reliable choices?

Staying here is pointless; the doctors just ignore the issue entirely.

Are you looking at private practices or just public healthcare?
You could try searching Google Maps using German terms for specialists or clinics to see what pops up, then reach out directly.

PS: With urological issues, sometimes the real culprit is actually bowel permeability.