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RVGRINGO

Blue Cross/Blue Shield and Mexico

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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.

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Thanks to all for the kind wishes. All in all, it was a good experience and I am slowly gaining strength. To respond to a few previous comments or questions:

I never signed anything; my wife did, as I was in the emergency room.

When we wanted to leave, the first option was to pay the total bill, which we refused to do as we had insurance.

The second option was to pay $70,000 against co-pay/deductables and sign a note for the total. I refused that as well.

Then, they said they would accept just the $70,000 pesos and release me. That seemed high.

Eventually, with BCBS approval completed, the actual co-pay/deductable was only $33,162.50 pesos, which we paid and were out.

I have never seen the total bill for any of my surgeries in Guadalajara hospitals; Stents in Jardines de Guadelupe, stents in Puerto de Hierro, abdominal colectomy in San Bernadette and, now, more stents in MexicoAmericano.

For folks our age, getting insured in Mexico is not an option and/or just impossibly expensive. If our home should sell, we would consider moving to some place like Ensenada, to be close to the VA for me and Medicare for both of us. Yet, the very thought of a move is exhausting and possibly impossible to accomplish. We are not even in a position to get our J-car out & may have to turn it into a planter. I can no longer drive (vision) and barely have the strength to go out to eat, on occasion and which we plan to do shortly; then, back on the oxygen tube!

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Thanks Alan, for the reply. I do accept some of your points but....

A few lessons to be learned from this. Read carefully what you sign when you are admitted to the hospital (surely they can not hold you at any price they choose to charge you afterwards). So,you can sign off your freedom ??? Scary thought, that not only you put your life but also your freedom of movement (if you survive) into their hands.

I also wonder if they can make you sign anything that is not completely backed by the law. I would say that, whatever you sign, the law is the deciding factor (but I am not a law specialist.....). Furthermore, if I get into the hospital, will I mentally be in the right (legal) state of mind to sign anything (I might be in shock...... especially after seeing the bill).

What is the value of a signature if you are temporarily (or long term for some of us) mentally challenged (like me sometimes).

Lesson number 2, I have experienced that with friends,...... always discuss the price (even though we are not used to do this NOB), especially if you are paying out of your pocket.

The comparison with causing a fatal car accident is not right, as being in a hospital you are not harming anybody else. If you cause somebody's death, that is a very different story.

Rony

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Speaking from the comfort of your arm chair how you would handle a situation is Ok BUT, I would suggest ,it is totaly differeent when you are actualy having a life threating situation....it's fine to be Monday morning quarter backs,

These instances being share are actual time events for which I apprecaite to hear about.. so plan, plan , including wills,post life plans, living wills and funeral plans etc

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Thanks Alan, for the reply. I do accept some of your points but....

A few lessons to be learned from this. Read carefully what you sign when you are admitted to the hospital (surely they can not hold you at any price they choose to charge you afterwards). So,you can sign off your freedom ??? Scary thought, that not only you put your life but also your freedom of movement (if you survive) into their hands.

I also wonder if they can make you sign anything that is not completely backed by the law. I would say that, whatever you sign, the law is the deciding factor (but I am not a law specialist.....). Furthermore, if I get into the hospital, will I mentally be in the right (legal) state of mind to sign anything (I might be in shock...... especially after seeing the bill).

What is the value of a signature if you are temporarily (or long term for some of us) mentally challenged (like me sometimes).

Lesson number 2, I have experienced that with friends,...... always discuss the price (even though we are not used to do this NOB), especially if you are paying out of your pocket.

The comparison with causing a fatal car accident is not right, as being in a hospital you are not harming anybody else. If you cause somebody's death, that is a very different story.

Rony

Yes always get a "quote" first as different hospitals have different fees. The lower the fees usually the lower the reputation and ambience is. The private surgeons usually will give you a good idea what you will be paying also. In many other cases my wife, friends and her large family have had with private medical care the costs were very affordable and they do shop around. So far no real out of this world cost for emergency admittance that she has heard of at the ones they use and the Dr.s they know. I presume the hospitals and Dr.s are worried about their reputation. It might be quite different for an Expat in a sticky situation and unscruplious Dr.s and hospitals.

$50.00 pesos for an aspirin was not acceptable to my wife but that was what they tried to get and this hospital has a very good reputation with many we know. I have been there many times visiting people. The last time I was there there was one guard at the entrance that was packing a gun or a tazer gun in a nylon gun pouch, not previously.

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RVGringo...I am so glad you are okay. I also am happy you have shared this information.

In response to many posts here...I am a cancer survivor, between my insurance which is private Mexican insurance and our funds, we could have bought quite the expensive mansion in these parts. ( Yes much cheaper than the states, but still , not cheap if you end up with something ongoing or many complications as I had.)

Please everyone get your insurance before something happens...I had no insurance in states, as was here, big mistake as now, in order to get insurance in US in state I am from will ONLY be 30,000 USD, yes that is right and they will not cover anything to do with cancer..so I am a health insurance prisoner here so to speak...

Having been a health care professional before Mexico I might add, it does cost money for a nurse to administer a medication, she is not working for free. $5. for an ASA is not ridiculous in a hospital...latest I heard in Mass. hospital over $20. USD for a Tylenol in hospital...

When you go to a private hospital such as those mentioned except IMMS and Seguro Popular and Civil, you sign many many papers re: payment...you will pay and possibly a responsible party will pay...my son signs for me, he has no money LOL...but I am signing that if my insurance does not pay I will. You need a pass to leave the property...I have heard of some leaving due to the long delays in getting out, and guess what the police did indeed show up at their homes..just saying.

You have insurance in US of some sort, great...so if you have a heart attack, you will make it to USA for treatment, I think not, a major car accident, highly unlikely, you cannot fly unless stable..

Trust me emergencies happen, you have no control and many times you are not going to be able to return to US..example..I fell unexpectedly in house due to a vaso vagal syndrome caused from Chemo..haha, light fall, thought no big deal WRONG..I broke my hip...ambulance, hours on floor awaiting someone to return home and woudl the flight to US have been a possibility,,,NO way..

Be prepared..life happens and not always how we wish..I speak from experience and I am one of the younger gringas here and hey bad health hit me..Please do not let money be the force that decides whether you live or die..make arrangements..

I can tell you between cancer care and all the subsequent complications, numerous surgeries etc. I have had..WITH insurance...we are highly in debt..health/illness costs even here..be prepared.

Once again RV Gringo I am so happy you are okay..You are in my thoughts!

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Very well said, Beerk, and thanks for the good wishes. They are returned in kind.

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RVGringo...I am so glad you are okay. I also am happy you have shared this information.

In response to many posts here...I am a cancer survivor, between my insurance which is private Mexican insurance and our funds, we could have bought quite the expensive mansion in these parts. ( Yes much cheaper than the states, but still , not cheap if you end up with something ongoing or many complications as I had.)

Please everyone get your insurance before something happens...I had no insurance in states, as was here, big mistake as now, in order to get insurance in US in state I am from will ONLY be 30,000 USD, yes that is right and they will not cover anything to do with cancer..so I am a health insurance prisoner here so to speak...

Heatlh care is changing drastically in US. Under the new Affordable Care Act, preexisting conditions must be covered. As far as what you'd pay, run your numbers on this calculator.

http://kff.org/interactive/subsidy-calculator/

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When you check into a private hospital you do sign many papers as mentioned in some posts, the most important one is called PAGARE! This document is the legal base for the hospital to take any means it takes to get paid for their services. Many hospitals have premises rented out to insurance companies, if your insurance has such an office a visit before checking in might be the best thing you could do. Somebody mentioned lawyers on the post, yes hospitals have lawyers available who will try to work out arrangements with you if you cannot pay up after receiving services, I have observed that in more than one hospital. To get back to check-in procedures, you have to make somebody responsible for you who will co-sign all the paper work and become legally responsible for payment. Some surgeons take on the task to do that for you if they know you well enough, of course they do take a cut on the bill, as does your GP who refered you to the surgeon. Nothing illegal about this, thats just how things work around here.

Speaking in particular to those without insurance, be aware that you will in most cases deal with three (3) bills. One for the hospital which covers your room and everything supplied during the stay in that room. This of course includes the famous 50 Pesos for administrating a pill and many more items. The second bill is billed by the Operation Room facility which usually is a separate company for billing purposes. This bill is the more expensive one where they charge you for the use of the facility, the personnel attending you, the instruments and meds used as well as such items as stents, baloons etc. The third bill is your surgeons fee which can run up to 4000USD per hour and of course surgery often stretches on over one hour which will double the amount very conveniently.

To sum it up: Bill #1 the less expensive, Bill#2 the most expensive and Bill #3 very expensive.

I have had several experiences with my partner for various cardio procedures, some unnecessary as it turned out later in the opinion of another cardiologist. We even found out later that some hardware that was billed previously did not show up at a later procedure, a very disturbing experience.

Going back to the complain about the 50 Pesos charge for administrating a pill, in my opinion its outrageous since private hospitals pay lower salaries with less benefits to their staff than IMSS.

Hope my contribution helps some of you to understand better how private hospitals work in Mexico and that you must ask questions on how much it costs before signing that PAGARE!

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Heatlh care is changing drastically in US. Under the new Affordable Care Act, preexisting conditions must be covered. As far as what you'd pay, run your numbers on this calculator.

http://kff.org/interactive/subsidy-calculator/

Since most of us are covered by Medicare in the U.S., the ACA doesn't apply to us does it? I doubt that the insurance carriers in the ACA cover patients outside the U.S. anyway.

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Since most of us are covered by Medicare in the U.S., the ACA doesn't apply to us does it? I doubt that the insurance carriers in the ACA cover patients outside the U.S. anyway.

maybe most... but some came down in their 40's and 50's and are not coverd in the states

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I am not eligible for Medicare, not old enough, and pre-existing conditions for adults will not go into effect until until 2014, despite what you read. Many have already been dropped by insurances or their co pays, deductibles etc. are so high you cannot afford anyway.

If my condition had been in states even with insurance we would be bankrupt at this time...or I might be dead..since insurances are not covering many things now a days, ask any one with a chronic condition. Affordable healthcare is a matter of opinion and what state you live in...I have family there and their insurance costs are prohibitive, so do you eat, have shelter or buy health insurance..get a tax credit or rebate that does a lot of good, in times of financial need.

At this point in time I have many pre-existing conditions, I am an insurance companies nightmare...my Mexican insurance has guaranteed lifetime renewal..

Ask around to those who have actually had medical emergencies here...stories will be told and you might be thinking twice about being prepared.

Either way my story is not the issue...it is to be insured before something happens...Medicare does you little good here in mexico where it is not accepted in an emergency...and frankly there are many many health emergencies in life...some bigger than others..

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BC/BS is that a medicare kind of insurance?

My wife is covered by Medicare with a Plan B with Humana in Florida, is that covered here in any way?

I have had IMSS for 11 years and was told by the Dr at local IMSS he was recommending that I be cancelled (84). Mago say's they cannot do that. Will see tomorrow when I am scheduled to see IMSS.

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BC/BS is that a medicare kind of insurance?

My wife is covered by Medicare with a Plan B with Humana in Florida, is that covered here in any way?

I have had IMSS for 11 years and was told by the Dr at local IMSS he was recommending that I be cancelled (84). Mago say's they cannot do that. Will see tomorrow when I am scheduled to see IMSS.

Can you clarify when you met with with "Dr" and do you mean the administrator ( who could be a Dr) indicated the cancelation?

Also have you been a "regular" visitor to the clinic or once in your 11years? And which clinic.Thanks

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Regarding the folks who indicate that they have BC/BS covererage and that it has paid for proceedures in Mexico

Question does the company know that you "resided" in Mexico or do you give a NOB address and that you just happen to be visiting Mexico and have a medical problem.

Having the BC/BS coverage provided by your company is a good perk...

For myself, 5 years ago my company elected to cease offering the benefit and "helped" source for a different suplement insurance.

It was a can of worms and insurance companys asking for pre exisiting conditions etc and need to have NOB residence

So question is, are your fudgeing your place of residence for any suplementry insurance?

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Can you clarify when you met with with "Dr" and do you mean the administrator ( who could be a Dr) indicated the cancelation?

Also have you been a "regular" visitor to the clinic or once in your 11years? And which clinic.Thanks

Can you clarify when you met with with "Dr" and do you mean the administrator ( who could be a Dr) indicated the cancelation?

Also have you been a "regular" visitor to the clinic or once in your 11years? And which clinic.Thanks

He was not the administrator but a Dr assigned to me here in Chapala, I have not been a regular user, 3 times in 11 years. I was buying this trictly for emergency care. I have 100% free with the VA .

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Yes always get a "quote" first as different hospitals have different fees. The lower the fees usually the lower the reputation and ambience is. The private surgeons usually will give you a good idea what you will be paying also. In many other cases my wife, friends and her large family have had with private medical care the costs were very affordable and they do shop around. So far no real out of this world cost for emergency admittance that she has heard of at the ones they use and the Dr.s they know. I presume the hospitals and Dr.s are worried about their reputation. It might be quite different for an Expat in a sticky situation and unscruplious Dr.s and hospitals.

$50.00 pesos for an aspirin was not acceptable to my wife but that was what they tried to get and this hospital has a very good reputation with many we know. I have been there many times visiting people. The last time I was there there was one guard at the entrance that was packing a gun or a tazer gun in a nylon gun pouch, not previously.

Curious- do you think security guards on floors or entrances of hospital would forcefully detain a patient or taser them to force therm to stay until their bill total bill had been paid or arrangements made-In RV's situation , sounds ludicrous to force patients to stay extra days- at that point, If able one could demand a lower daily rate....as some things do seem negotiable at hospitals.

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Medicare- supposedly covers Emergency Care outside the US- it is intended for travelers- However, has anyone had any experience with an emergency such as RV's - Life or Death where they have tried using that option of Medicare- paying and then asking for reimbursement??

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Curious- do you think security guards on floors or entrances of hospital would forcefully detain a patient or taser them to force therm to stay until their bill total bill had been paid or arrangements made-In RV's situation , sounds ludicrous to force patients to stay extra days- at that point, If able one could demand a lower daily rate....as some things do seem negotiable at hospitals.

I think they would detain them at no charge once the Dr. releases them from medical care and I feel it would be up to you to pay extra if more care was needed that your family/friends could not provide for you there. Don´t forget on the wall there are signs that state it is their responsibility to be with a patient 24 hours a day to monitor them etc. not the responsibility of the hospital staff.

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Medicare- supposedly covers Emergency Care outside the US- it is intended for travelers- However, has anyone had any experience with an emergency such as RV's - Life or Death where they have tried using that option of Medicare- paying and then asking for reimbursement??

I think Medicare will, might, pay for emergency care that is to stabilize in conjunction with transporting the patient back to the U.S. It does not pay for long term medical treatment in a foreign country.

http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=339

Travel to a Foreign Country

If you will be traveling to a foreign country, Medicare will not usually cover your medical care.

However, Original Medicare and Medicare private health plans must cover your medical care you get outside of the U.S. in the following limited cases:

  • Medicare will pay for emergency services in Canada if you are traveling a direct route, without unreasonable delay, between Alaska and another state and the closest hospital that can treat you is in Canada.
  • Medicare will pay for medical care you get on a cruise ship if you get the care while the ship is in U.S. territorial waters. This means the ship is in a U.S. port or within six hours of arrival at or departure from a U.S. port.
  • Medicare may pay for non-emergency in-patient services in a foreign hospital (and connected physician and ambulance costs). It is covered if it is closer to your residence than the nearest U.S. hospital that is available and equipped to treat you medical condition. This may happen if, for example, you live near the border of Mexico or Canada.

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Medicare- supposedly covers Emergency Care outside the US- it is intended for travelers- However, has anyone had any experience with an emergency such as RV's - Life or Death where they have tried using that option of Medicare- paying and then asking for reimbursement??

Intended for travelers...ie: more than 30 days in country is not considered a traveler.

You will have to either way pay up front and get re-imbursed..good luck...

My husband goes back and forth to states, he has private stateside insurance and even then he is covered as long as he does not stay longer than 30 days...and they check his passport they say, never tried it. Even so, he would have to most likely pay up front and get re-imbursed though there are a few situations where insurance will pay direct, do not count on it though...

I am just saying, I have no expertise in health insurance I just know my situation and others I have heard of..

It is not the US here where you can go on a payment plan..and most of us here are not travelers here, we live here..sigh..so it is what it is..be prepared!

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Yes always get a "quote" first as different hospitals have different fees. The lower the fees usually the lower the reputation and ambience is. The private surgeons usually will give you a good idea what you will be paying also. In many other cases my wife, friends and her large family have had with private medical care the costs were very affordable and they do shop around. So far no real out of this world cost for emergency admittance that she has heard of at the ones they use and the Dr.s they know. I presume the hospitals and Dr.s are worried about their reputation. It might be quite different for an Expat in a sticky situation and unscruplious Dr.s and hospitals.

$50.00 pesos for an aspirin was not acceptable to my wife but that was what they tried to get and this hospital has a very good reputation with many we know. I have been there many times visiting people. The last time I was there there was one guard at the entrance that was packing a gun or a tazer gun in a nylon gun pouch, not previously.

For elective surgery you certainly can get quotes beforehand, but that is not practical in emergency situations. Elective surgeries, like plastic surgeries and joint replacements, can be done at smaller hospitals at lower rates than the big hospitals. You can even have some of those surgeries done here at Lakeside at Ajijic Clinic (or Hospital as it is now called) but my preference is to be in Guadalajara because if anything goes wrong it is much faster to get me to a major hospital with an emergency department.

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BC/BS is that a medicare kind of insurance?

My wife is covered by Medicare with a Plan B with Humana in Florida, is that covered here in any way?

I have had IMSS for 11 years and was told by the Dr at local IMSS he was recommending that I be cancelled (84). Mago say's they cannot do that. Will see tomorrow when I am scheduled to see IMSS.

There are different kinds of BC/BS policies. Mine is a Medicare supplement policy that includes the Worldwide Blue Card. This becomes my primary provider here as Medicare does not cover in Mexico. I believe someone asked if this would actually cover if they knew one was living, not just traveling, out of the US. This is what the page for BC/BS Worldwide Blue Card: " BlueCard Worldwide: Living or Traveling Outside the U.S." So, yes, you don't have to "pretend" to live in the US to have this coverage. Because mine is through the State of Washington as a retiree so I don't know if it's generally available to others as a Medicare supplement. Also I don't believe that all BC/BS policies include the Worldwide Blue Card coverage. But if you have this coverage and use a preferred provider here it is the same as using a preferred provider in the US and after meeting deductible you pay very little.

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