Blue Cross/Blue Shield and Mexico

[RVGRINGO]

Last Friday, I suffered a heart attack and survived the first hour by eating aspirin, taking oxygen and resting quietly. Called my cardiologist for instructions and to arrange to meet at Hospital Bernadette in Guadalajara. He quickly called back to tell me they would not accept me, nor any other BCBS insureds, because BCBS had not yet paid my bill for major abdominal surgery and 11 day hospitalization in February.

We quickly followed instructions to go to Hospital MexicoAmericano, which works with BCBS, and got lost for a bit before finding it and getting into the Emergency Room. Soon, I was in Cardiac Catheterization, getting more stents and surviving another attack, caused by a blood clot, while on the table. Two of three blockages were resolved; the third being inaccessible, and I spent the night recovering. Saturday moring I was OK to be released, but BCBS does not work on weekends, nor does their international contractor in Chicago. Calls go to voice mail. So, the hospital held me. Then BCBS, on Monday, wanted 24-48 yours to get the details to the hospital and allow my release. It took until Wednesday morning!

If you have an emergency, try not to have it over a weekend.

Weak and wobbly, but still alive.

[eagles100]

Glad you're now ok but what an ordeal.

That's terrible that they have not paid the bill from February.

As we are looking for medical insurance, we might not consider Blue Cross/Blue Shield with your experience.

I hope you recuperate well and quickly.

[Gilligan]

Glad to know you are still alive, even if it is weak & wobbly.

Thanks for the heads up on BCBS. Good things to know.

[bdlngton]

Last Friday, I suffered a heart attack and survived the first hour by eating aspirin, taking oxygen and resting quietly. Called my cardiologist for instructions and to arrange to meet at Hospital Bernadette in Guadalajara. He quickly called back to tell me they would not accept me, nor any other BCBS insureds, because BCBS had not yet paid my bill for major abdominal surgery and 11 day hospitalization in February.

We quickly followed instructions to go to Hospital MexicoAmericano, which works with BCBS, and got lost for a bit before finding it and getting into the Emergency Room. Soon, I was in Cardiac Catheterization, getting more stents and surviving another attack, caused by a blood clot, while on the table. Two of three blockages were resolved; the third being inaccessible, and I spent the night recovering. Saturday moring I was OK to be released, but BCBS does not work on weekends, nor does their international contractor in Chicago. Calls go to voice mail. So, the hospital held me. Then BCBS, on Monday, wanted 24-48 yours to get the details to the hospital and allow my release. It took until Wednesday morning!

If you have an emergency, try not to have it over a weekend.

Weak and wobbly, but still alive.

Glad to hear you survived. Sounds like a real ordeal you went through, exacerbated by the Hospital Bernadette not accepting you.

I also have Blue Cross/Blue Shield Worldwide Blue Card. I have only ever had to call them once about what to do in a possible emergency, which did not happen. That was not on a weekend. Did you call their Worldwide Blue Card number on the back of your card during this situation for advice as to where to go? I know that their preferred provider hospitals do change as they negotiate contracts. I definitely think that your situation with Bernadette not accepting you because BC/BS had not paid your previous bill needs to be addressed with BC/BS. I wonder if one of their preferred providers can refuse to treat you. Definitely something to follow up on with them.

Is your cardiologist a BC/BS preferred provider through the Worldwide Blue Card? I have not used any doctor here through this insurance but am curious as to how it works. I am also assuming that you have the Worldwide Blue Card coverage.

[HarryB]

BC?BS is satan incarnate! However, San Javier hospital deals with them and protects the patient.

[Xcalaker]

Would you please clarify exactly what kind of BCBS coverage you have?

Thanks.

[RVGRINGO]

Hospital MexicanoAmericano is the preferred hospital in the system. They make all the calls. I was indisposed.

I am not aware of more than that, but my cardiologist was instrumental in getting some costs reduced and/or stopped.

[RVGRINGO]

Would you please clarify exactly what kind of BCBS coverage you have?

Thanks.

It came with my retirement; that is all I know.

[mexbound]

Wife had surgery at San Javier Hospital about 4 weeks ago. BCBS picked up the whole bill except my $500 USD deductible. Oscar at San Javier handled everything with BCBS. I never had to talk to a BCBS agent. I did have to leave an "open" American Express voucher with the Hospital to leave the hospital. But they never had to use it when BCBS approved the surgery about 4 days after we left the hospital. This was an emergency surgery.

[Rony]

First of all..... so happy to hear B, that you are fine now.

I have heard this so many times, in different hospitals, where they threaten to keep you (or they actually keep you) if the bill has not been paid. How would they do this ? Tie me down to the bed with police escort next to me..... and for how long ?? Until I live to be a hundred and in meanwhile they would have to feed me ? Do they lock the doors (they would lose an extra bed for a while, no ??)..... lock me up in the basement ?? .... torture me and make me eat tortillas all day ?? .... waterboarding with Tequila ?? Force me to listen to banda music while hanging with my head in a toilet without toilet seat ??

Always wondering about this. Please, enlighten me.

Rony

[bdlngton]

BC?BS is satan incarnate! However, San Javier hospital deals with them and protects the patient.

According to the BC/BS Worldwide Blue Card web page San Javier is not a preferred provider hospital. It could quite well be but that would require checking with BC/BS. I have found that their lists of preferred providers so not always include every provider and that they change as contracts are renegotiated. It is quite possible that whether they are covered depends upon the policy you have with BC/BS. I am only familiar with the Worldwide Blue Card program as that is what I have.

[bdlngton]

First of all..... so happy to hear B, that you are fine now.

I have heard this so many times, in different hospitals, where they threaten to keep you (or they actually keep you) if the bill has not been paid. How would they do this ? Tie me down to the bed with police escort next to me..... and for how long ?? Until I live to be a hundred and in meanwhile they would have to feed me ? Do they lock the doors (they would lose an extra bed for a while, no ??)..... lock me up in the basement ?? .... torture me and make me eat tortillas all day ?? .... waterboarding with Tequila ?? Force me to listen to banda music while hanging with my head in a toilet without toilet seat ??

Always wondering about this. Please, enlighten me.

Rony

I can tell you from personal experience that del Carmen would not let me off the floor to even go down to pay the bill. There was a guard at the door of the unit I was in. The orderly pushing me in the wheelchair would not have been willing to wheel me on out if the guard said no. It was catch 22. Finally my friend, who had gone next door to pay the surgeon, came back and took my credit card down to the cashier, then the cashier came up with the receipt for me to sign. At that time I had insurance through a different provided that did not have an arrangement with the hospital so I had to pay everything (a very good reason to have a credit card with room on it) and then file for reimbursement.

I understand that if you cannot pay the bill that they will bring in a lawyer who will draw up a contract that obligates you to pay, at least by monthly payments. I do not know that for sure. But, of course, most hospitals will not even admit you if you can't prove some kind of coverage or ability to pay (like running your credit card) before you are even admitted. I think the only hospitals that have to receive you are the public hospitals like Hospital Civil. Again, I have no personal experience with this so I am only commenting on what I have heard.

I do think that making you listen to endless banda music would be a very effective way to get you to come up with the money however possible.

[Guest bigd]

Makes having emergency medical treatment in Mexico a real scary deal?

[catbird]

Last year I had major surgery that was covered by BCBS. I had already preregistered at San Javier so all I had to pay was $250d. If you preregister before you have a problem it will help the process.

[lakeside7]

Last year I had major surgery that was covered by BCBS. I had already preregistered at San Javier so all I had to pay was $250d. If you preregister before you have a problem it will help the process.

I think that you have hit the nail on the head..plan ahead and check which hospital will use your insurance company....

given the recent experiences by folks ref payment, it seems that local hospitals are getting bilked by NOB insurance company's, hence payment for service prior to leaving the facility is mandatory...system is getting more like NOB each year....the cost for providing these new hospitals and procedures does not come cheap, even in Mexico..

lucky you have insurance ...for the other poor indigents go line up on a gurney at IMSS or Hospital; Civil!!!

[J.Miller]

I suppose it sounds trite but: Get Well Soon! You seem to be one of the best and most well informed sources of information and I would surely miss your advice if you were not feeling well enough to participate.

[Rony]

I suppose it sounds trite but: Get Well Soon! You seem to be one of the best and most well informed sources of information and I would surely miss your advice if you were not feeling well enough to participate.

very true !

[doberwoman]

Good that you are ok.

Our experience with San Javier and Blue Cross, years ago, was ok, I supported the service, with an American Express Card, and we have any problem....I was never charged in AE, and everything was ok this way....but times change...

[Lexy]

RVGringo--You take care now! Glad you're OK.

Lexy

[AlanMexicali]

I have had experience with a private hospital in regards to the vascular surgery my mother in law had, 90% clogged arterial artery in her neck, a stroke victim and an invalid. They will take a deposit which is about 40% of what the final bill was and when that runs out they asked for another deposit. She was there for just over a week and they brought up the accumulating bill for my wife and my Dra. sister in law to see every few days and left a copy.

When the private Dr.s released her they billed separately. The hospital brought up the final bill that day. My wife and her sister went over the entire bill and disputed the frivolous charges, like $50.00 pesos for an aspirin etc. This took 3 hours. The accounting department took off all the dozens of frivolous charges and in the beginning my mother in law had all her daily medicines with her and they charged her every time the nurses gave them to her [charge for administering medicine per pill] and billed her for the medicine itself per pill at an inflated cost, a large frivolous charge there alone. A charge every time a nurse took her vitals every 3 hours, It was very clear the hospital would not let her leave until the bill was settled and according to everyone that is simply the way it is in private hospitals here in San Luis Potosi.

I am glad you are OK RV. Alan

[valbogyo]

I think that you have hit the nail on the head..plan ahead and check which hospital will use your insurance company....

given the recent experiences by folks ref payment, it seems that local hospitals are getting bilked by NOB insurance company's, hence payment for service prior to leaving the facility is mandatory...system is getting more like NOB each year....the cost for providing these new hospitals and procedures does not come cheap, even in Mexico..

lucky you have insurance ...for the other poor indigents go line up on a gurney at IMSS or Hospital; Civil!!!

I really appreciate this post. I think many of us have policies we have not used and I never thought to check that the list of hospitals, with a relationship to my Insurance company.... remains the same, year after year.

I went for some diagnostic tests, at my hospital of choice (St Javier). I assume that means I registered there.

[Rony]

I have had experience with a private hospital in regards to the vascular surgery my mother in law had, 90% clogged arterial artery in her neck, a stroke victim and an invalid. They will take a deposit which is about 40% of what the final bill was and when that runs out they asked for another deposit. She was there for just over a week and they brought up the accumulating bill for my wife and my Dra. sister in law to see every few days and left a copy.

When the private Dr.s released her they billed separately. The hospital brought up the final bill that day. My wife and her sister went over the entire bill and disputed the frivolous charges, like $50.00 pesos for an aspirin etc. This took 3 hours. The accounting department took off all the dozens of frivolous charges and in the beginning my mother in law had all her daily medicines with her and they charged her every time the nurses gave them to her and billed her for the medicine itself per pill at an inflated cost, a large frivolous charge there alone. It was very clear the hospital would not let her leave until the bill was settled and according to everyone that is simply the way it is in private hospitals here in San Luis Potosi.

I am glad you are OK RV. Alan

Especially in a situation like that, if I would not need a wheelchair,.... I would just walk out, securtity guard or no security guard. For a fragile old lady, it might be a little more difficult but I can imagine in a Mexican family, where 5 strong brothers might lend her a hand, that it would not be that difficult. Even if police would get involved,.... what can they do in a consumer's dispute (Profeco or ministerio publico yes,.... but that would take time), because that is basically what it is.

It is not a small thing to take somebody's freedom of movement (even in Mexico). Also feels a bit like blackmailing (and isn't that against the law). Furthermore, where in the law does it say that a private hospital (or any other) can keep you as a prisoner ?

I would be very curious to find out about that.

I actually know of at least 3 people who did just that, and paid a reasonable bill afterwards. Leaving does not mean that you should not pay your bills. That system works fine in Europe (or many other places), .... why should it not work here.

I just hate the fact that people in a fragile situation (and health care should be a universal human right whereever you live) are taken advantage of and even more so by holding them prisoner. Just imagine that all of a sudden, while you are on the surgery table for some reason your health insurance stops paying. YOU should not have to pay for the consequences.

I will try to find out what the Mexican law says about this because at the same time, we should respect the law.

Rony

[AlanMexicali]

Especially in a situation like that, if I would not need a wheelchair,.... I would just walk out, securtity guard or no security guard. For a fragile old lady, it might be a little more difficult but I can imagine in a Mexican family, where 5 strong brothers might lend her a hand, that it would not be that difficult. Even if police would get involved,.... what can they do in a consumer's dispute (Profeco or ministerio publico yes,.... but that would take time), because that is basically what it is.

It is not a small thing to take somebody's freedom of movement (even in Mexico). Also feels a bit like blackmailing (and isn't that against the law). Furthermore, where in the law does it say that a private hospital (or any other) can keep you as a prisoner ?

I would be very curious to find out about that.

I actually know of at least 3 people who did just that, and paid a reasonable bill afterwards. Leaving does not mean that you should not pay your bills. That system works fine in Europe (or many other places), .... why should it not work here.

I just hate the fact that people in a fragile situation (and health care should be a universal human right whereever you live) are taken advantage of and even more so by holding them prisoner. Just imagine that all of a sudden, while you are on the surgery table for some reason your health insurance stops paying. YOU should not have to pay for the consequences.

I will try to find out what the Mexican law says about this because at the same time, we should respect the law.

Rony

Rony.

When you sign into the private hospital and sign the consentual agreement/contract you have been notified of the conditions of your stay and you have confirmed that you have the funds at hand to be there or you "should" not sign on the dotted line. If you sign it and cannot pay you committed fraud and this is not taken lightly here where I live. If they hold you for "ransom" it is because you agreed to be held until the bill is paid in full. Don´t think these private hospital don´t have lawyers writing the contract you sign and know the consequences of you being held until payment has been made or arranged, even if you sign over your vehicle or house etc.

Once you leave and no arrangements are made in writing it probably would be near impossible for the hospital to collect if you decided not to pay and if they went to court everyone here knows how many years and what expenses are involved it would probably not be worth it in most cases. So they hold you to the contract you signed. Simply. If it is against human rights laws I would imagine an all cash deposit would be needed for you to be admitted, but it isn´t all the time and many times they do not know what will take place exactly. So I presume it is not against human rights laws to do it.

It might be similar when you cause a fatal accident and you sit in a jail someplace until you have the money to pay the deceased family member´s family the money you owe them. Only this time it is a hospital. Eventually you might end up sitting in jail if you cannot pay the bill.

[sm1mex]

If you are well and don't have insurance, please get some. sooner or later something may happen and you will need the financial help from the insurance company. I have Met Life with Bellon across from Superlake and it pays within 10 days and direct to the hospital and Drs. I have had many claims with no problem. It is a comfort to know I am insured when the next event happens. No one gets out of here healthy. Get coverage while you are still healthy and you can be approved for coverage.

After an illness, it is too late and no one will cover you.

[solajijic]

So grateful you are okay RVGringo.

Just curious what is the resting rate rack charge for the hospital room for the days they held you?

We have known several people who have signed their assets away or given the title to their cars as security until the hospital is paid. The interest is crushing and last time it was close to 12 % per month. One couple had to sell their home and several we know went back because of their hospitalized experiences. Regardless of the quality the pay now get yourself reimbursed was something they did not want to do again.

Our agreement between ourselves is for things like stents etc... pace makers that can be done tomorrow is we get on a plane Nob when we leave the doctors office. it take 6 hours to get to Cleveland. 2 to get to Texas. planes leave hourly. Our NoB insurance is good here but why buy the aggravation for something simple. We can afford to stay or go and we've decided the going would be best except for extreme emergencies. Thankfully we take no meds and have no issues, yet.