Boomers in Paradise

[jrm30655]

Anyone have any experience with Boomers in Paradise and their group health insurance program?

Positive or negative comments welcome.

[El Saltos]

My experience is limited to their not answering questions I sent them concerning their insurance offering.

[traderspoc]

they answered very question for me in depth,

about six months ago,

joined program in October, was surprised that, your pre-existing conditions are forgiven after a year, without a medical exam.

which is rare for a insurance company to do that.

by being group they have negotiated better benefits foe all members

they have over 300 members

[Nicole Dugas]

Took their insurance in June, Ava answered all our questions, it is true that all pre=existing conditions are erased after 1 year.

We also have many discounts around town and will have some more as time goes along.

Ava is very nice to deal with.

[SunshineyDay]

Is this the same program that Focus on Mexico offers? Who is the local representative for Boomers?

[twelveoaks]

Is this the same program that Focus on Mexico offers? Who is the local representative for Boomers?

Valerie Friesen reps both Focus and Boomers. She is in the Integrity offices at the Interlago plaza

[JRPJR]

Has anyone filed a claim for any significant amount and received payment from the underwriters?

[jrm30655]

Has anyone filed a claim for any significant amount and received payment from the underwriters?

bump

[hensley]

Yup our neighbor has and Boomers made all kinds of promises to cover all the surgeries and in the end did not come through, now my friend is in financial ruin with a lot of stress added to it all, since the hospital is threatening to take everything she has.

[Joyfull]

That is VERY upsetting to hear Hensley. I also have Boomers. I asked Valerie when I got it last Spring if anyone had made a claim here Lakeside, and she said no. I am sure many of us asked and were told there had been no claims because it was so new...then we all trusted. This is insurance for something catastrophic like heart attack, stroke, cancer, trauma (car accident), neurological not hip or knee replacements, etc. What kind of surgery did your neighbor have?

[kookielendmeyourcomb]

That is VERY upsetting to hear Hensley. I also have Boomers. I asked Valerie when I got it last Spring if anyone had made a claim here Lakeside, and she said no. I am sure many of us asked and were told there had been no claims because it was so new...then we all trusted. This is insurance for something catastrophic like heart attack, stroke, cancer, trauma (car accident), neurological not hip or knee replacements, etc. What kind of surgery did your neighbor have?

Yes, of tremendous concern to all of us who signed up with Boomers in Paradise group policy, underwritten by Best Doctors. A friend was told several weeks ago that there had been one claim to date, a very major claim, covering not one, but two traumatic events, and that the unsurance company had covered it almost immediately. What are we paying $1000 approx, a little less, per year for? I am thinking that this really was too good to be true.

[solajijic]

It is important to remember with catastrophic policies like the one Boomer is offering that even tho it says you have $1 million coverage per year it is limited to the specific dollar amounts in each category. The separate categories add up to more than a million $. The categories can be combined however it is very easy to use up the approximately $150,000 dollars allocated to each medical category.

When I looked at this policy its primary value to over age 65 was payment for stabilization and flight to somewhere else to use other benefits, like Medicare.

So really your $1000 premium per year is essentially purchasing $150,000 or so per specific medical event, not $1 million.

Below is a like to a specific category policy. I don't now if this is the Boomer policy or not, but it is an example of how benefits in these types of policies are allocated.

http://www.bestdoctors-ins.com/downloads/en/Ultimate%20Care.pdf

[jkgourmet]

Actually, I think (but am not positive) that the Boomer Policy had an annual limit of $500K for total claims. Not $1million.

[lcscats]

The boomers policy may not be the same as the Best Doctors policy sold directly. Also lets be real. My 80/20 Mexican policy from my former employer costs $7800 dollars/yr. My wifes Best Doctor policy is $1100 dollars a year. It is catastrophic coverage with large deductible. My policy covers everything after 1500 dollars. You get what you pay for. We just set aside a savings account for my wife to use if she gets sick. The best Doctors policy my wife has needs cash backup. So think of the Best Doctors policy as partial self insurance.

[Gilligan]

Back to the original question, Does anyone have any personal experience getting a claim paid by the Boomer's policy.

That seems to be a relevant question for which there is, as yet, no answer.

[solajijic]

That has been answered. There is one significant claim. It has not been handled as would have been hoped.

[Mad_Max]

That has been answered. There is one significant claim. It has not been handled as would have been hoped.

one significant claim acknowledged on this webboard - I know a zillion people down here who do not read/participate in this webboard. So one report means about zero to me.

And when I saw their premiums - a red flag went up - couldn't figure out how they could be profitable

[lcscats]

Well if you want to understand it you can read the policy. Yes it is cheap. It will not rebuild your tennis elbow or such like your NOB policy. It will cover certain things and we think there is value in that. As I said before think of these policies as partial self insurance. You have to set money aside to go with these kinds of policies. Comparing my full coverage conventional policy with my spouses policy is not a valid comparision. I am sorry I don't have any data on payouts for you but I think it was important that folks understand what this policy is about. Stand alone insurance this is not. As you said look at the cost of the premium.

[behnwau]

Pay your own medical is our policy and make sure you have enough to do so.

[traderspoc]

best doctors through boomers has many limitations what they pay, see boomer web site,

but for $1000 each to be covered worldwide with a $5000 deductible its worth the $1000,

it a limited policy at a limited price.

yes it only covered $100,000 US for infections, if you go over that, you pay out of your pocket. if you do not have the cash you

are in trouble.

when we renew in January now that they have many members they will be negotiating better benefits.

will be interesting to see what the improvements will be.

also I will save over $200 a year using local companies that that have offered boomers members discounts see web site

[SunshineyDay]

Any experience with the Best Doctors policy thru Focus on Mexico? I was told the policy was not available thru Boomers in Paradise.

[Dr.Santiago]

I am not a big fan of insurance companies. In the end the companies have to answer to their shareholders(must make a profit)

With that being said, I have come to learn a good deal about the policy that Boomer's-in-Paradise offers and the way BEST DOCTORS operates as a whole.

Having attended the BEST DOCTORS seminar and having had a handful cases although there are some steps on part of the patient and the physicians (as with any insurance) it is overall a good policy.

If you have the BOOMERS-IN-PARADISE policy, I would suggest the following:

1. That you should have $5000.00 U.S. dollars stashed away in the bank per year per person on the policy. Be prepared to use it if the need arises.

2. BEST DOCTORS covers (according to them) when U.S. guidelines are followed as far as diagnosis and treatment are concerned. For example for CAROTID ARTERY STENOSIS, they will pay for diagnosis being made via MRA(magnetic resonance angiogram) and not having it done by an interventional procedure as can be done by a procedure done like a Cardiac Angioplasty. In short following UP-TO-DATE U.S. guidelines as far as diagnosis and treatment will get your claim paid sooner.

3. Be prepared to present documentation for your claim(illness) from the onset of symptoms or initial presentation. Thorough documentation is expected to be sent to BEST DOCTORS in the Miami office including testing results. If they are in ENGLISH then the claim is processed much sooner than the 3 week time span they tell you to give them.

I recently had a sit down talk with Valerie and she cleared up some misconceptions that I had. I do suggest that if there are any other doubts or need for clarification, she is the go-to person.

I can't say that either the BOOMERS or FOCUS can be considered "CADILLAC " policies that we have come to know in the U.S. but I think they do offer some good coverage for the MOST COMMON CATASTROPHIC conditions that tend to present themselves in the EXPAT population @ Lakeside.

[lcscats]

I am not a big fan of insurance companies. In the end the companies have to answer to their shareholders(must make a profit)

With that being said, I have come to learn a good deal about the policy that Boomer's-in-Paradise offers and the way BEST DOCTORS operates as a whole.

Having attended the BEST DOCTORS seminar and having had a handful cases although there are some steps on part of the patient and the physicians (as with any insurance) it is overall a good policy.

If you have the BOOMERS-IN-PARADISE policy, I would suggest the following:

1. That you should have $5000.00 U.S. dollars stashed away in the bank per year per person on the policy. Be prepared to use it if the need arises.

2. BEST DOCTORS covers (according to them) when U.S. guidelines are followed as far as diagnosis and treatment are concerned. For example for CAROTID ARTERY STENOSIS, they will pay for diagnosis being made via MRA(magnetic resonance angiogram) and not having it done by an interventional procedure as can be done by a procedure done like a Cardiac Angioplasty. In short following UP-TO-DATE U.S. guidelines as far as diagnosis and treatment will get your claim paid sooner.

3. Be prepared to present documentation for your claim(illness) from the onset of symptoms or initial presentation. Thorough documentation is expected to be sent to BEST DOCTORS in the Miami office including testing results. If they are in ENGLISH then the claim is processed much sooner than the 3 week time span they tell you to give them.

I recently had a sit down talk with Valerie and she cleared up some misconceptions that I had. I do suggest that if there are any other doubts or need for clarification, she is the go-to person.

I can't say that either the BOOMERS or FOCUS can be considered "CADILLAC " policies that we have come to know in the U.S. but I think they do offer some good coverage for the MOST COMMON CATASTROPHIC conditions that tend to present themselves in the EXPAT population @ Lakeside.

I would suggest more than 5000USD be set aside for emergencies.

[Curmudgeon]

OK here's some personal experience. While I have not had an actual claim, I did make use of their "Interconsultation" service, which is included in the policy at no extra charge. I sent them all the doctor's reports (in Spanish) and all the test results (xray, CAT scan, MRI, ultrasound). They immediately assigned a Spanish speaking doctor to co-ordinate my case, and sent off the documentation to two eminent specialists in the USA. Within a week I received a several-page assessment and diagnosis from each (along with the bio of the specialist).

This alone was worth the premium paid to Best Doctors.

[Dr.Santiago]

OK here's some personal experience. While I have not had an actual claim, I did make use of their "Interconsultation" service, which is included in the policy at no extra charge. I sent them all the doctor's reports (in Spanish) and all the test results (xray, CAT scan, MRI, ultrasound). They immediately assigned a Spanish speaking doctor to co-ordinate my case, and sent off the documentation to two eminent specialists in the USA. Within a week I received a several-page assessment and diagnosis from each (along with the bio of the specialist).

This alone was worth the premium paid to Best Doctors.

This is THE STANDARD PROCEDURE that BEST DOCTORS follows and was presented during the seminar which was held at the REAL DE CHAPALA HOTEL.

What I like about this aspect of the policy is that (when possible and not under emergency situations) it keeps some Doctors from doing unnecessary, risky and costly procedures (i.e. an INVASIVE carotid angiogram when and MRA is what is indicated)

For me, the peace of mind that is provided by Best Doctors recommendations, is worth paying for.

REMEMBER, no NEW HEALTH insurance policies are offered here in Mexico that do not have a limit. Those are a thing of the past. The private hospitals remind the doctors of this fact but often forget to inform the patients with such policies.