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kimanjome

Cautionary note--large increase in medical costs here

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I want to caution other readers about something that has happened to me recently, and it was just confirmed when I spoke to an insurance agent here who is receiving the same news--prices here are increasing dramatically for hospital services. 

Last week I discovered I needed gallbladder surgery. I had been in a lot of pain for the prior few weeks, and this was a surprise attack--I didn't even know I had gallstones!  Anyway, I made the decision to stay in Mexico and have the surgery, as opposed to flying back to the USA and using my BC/BS insurance there, which has a $2500 deductible. I thought, okay, maybe it will be $4,000-$5,000 in Mexico, considering in the US an average self-pay (I researched it) for laproscopic surgery is around $6K-$9K. Certainly Mexico would be less. 

No. The bill from the hospital, alone, with a 2-night stay, was over $7,000 USD!!!!!!!!!!!! I was not on a ventilator, or attached to a dialysis machine, nor in the ICU. I was in the surgical/prep/recovery area for about 5 hours, total. I won't even get into the other charges, separate, for the physicians, which I don't begrudge.The team did their jobs and I have recovered nicely.

What is happening--I have been told, and some of you are aware of these changes--is that the national healthcare system, including places like the Joco Hospital--is running/has run? out of funding, or is receiving insufficient funding, and therefore unable to provide services in a timely manner. This is forcing patients into other options, ie, private hospitals, which is driving up the costs of care to a ridiculous level. 

Both my housekeeper (Seguro Popular) and my gardener (IMSS) have recently been discussing this with me, but I didn't pay attention until I witnessed it first-hand. We know Seguro Popular has lines that run around the the corner and down the block, but the IMSS system, which my gardener has, now appears to be be no better. He requires prostate cancer surgery and, after numerous trips and hours of waiting, has been sent home because the computer system is down, or the equipment is broken, and he is no better than when he started.  This is confirmed by numerous articles we are reading in the press about how AMLO realizes there is a problem with the health care systems here and wants to overhaul them. But in the meantime... 

One of the reasons I had moved to Mexico was the reasonable retirement costs, which included quality medical care at affordable prices.  I am re-thinking this. I can get a comprehensive medical insurance policy in Portugal or Spain for both myself AND my 72 year-old spouse for the same monthly fee ($350) that I have just been quoted for myself age 58, here in Mexico. Caveat emptor.

 

 

 

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We were forced to sell in PV last year when our excellent retiree coverage announced that for Medicare eligible retirees the premium would increase on last Jan. 1 from $324 to $1183 if you were not in the US and using Medicare as primary. I always thought it was primarily due to widespread fraudulent claims from Mexico but your post makes clear that wasn't the only reason. It was a no brainer decision for us no matter how much we loved Mexico. That $1183 has since gone up to almost $1500 while the $324 has remained the same.

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OP...sorry for the surgery need.  But won't your BC BS coverage partially reimburse you (and not just hospital but for doctor fees, too)?  

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Don't forget there are general public hospitals in Guadalajara, just as in the U.S.A. The ones here work as a sort of hybrid, accepting Seguro Popular and offering non-profit type pricing.

If you are country shopping, Greece has vastly expanded its "golden visa" programme this year, with many alternative investments.

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Gaul  bladder removed at the end of last year. Stayed 2 nights at San Javier. My recollection is the payment for both all hospital expenses and doctors was $7000CDN +/- total. The surgeon was from Quality Care and he selected the anesthesiologist. We always pay all medical out of pocket and use whatever private hospital our doctors have privilege in. We have SP only as backup in case of accident somewhere. The only time I have ever had a hospital charge close to the OP's is when I was at Del Carmen for 5 days,3 of which were in intensive care.

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17 minutes ago, CHILLIN said:

Don't forget there are general public hospitals in Guadalajara, just as in the U.S.A. The ones here work as a sort of hybrid, accepting Seguro Popular and offering non-profit type pricing.

If you are country shopping, Greece has vastly expanded its "golden visa" programme this year, with many alternative investments.

 

Chillin those types of arrangements with outside medical alternatives have all been canceled by AMLO including childrens cancer treatment. The previous administration had budgeted socialized medicine to function properly but now is very under funded and being slowly left to rot. See the last few posts I posted in the link to understand the new reality being forced on Mexicans.

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Wow. Even the $7,000 CDN--which seems somewhat reasonable--will probably have skyrocketed by now. I was driven to 3 different private hospitals, until we could find one with a bed available. I have discovered that this is due to the health care crunch here, which, as I mentioned earlier, is forcing patients who would otherwise be using SP and IMSS, into the private system--which has us "by the scrotum", so to speak. If it were just my experience I would chalk it up to bad luck, but the fact that my maid, gardener, and the non-Mexican insurance agent are all reaffirming this tells me that something is very amiss.  

And what AlanMexicalli says is true, I have been reading it in the news (unfortunately I did not foresee how this would affect me directly!)--the public healthcare system has basically run out of money and is falling apart. So we--all of us, Mexicans and expats alike--are at the mercy of whatever is available.

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Two members of this board had their gall bladder removed at Jocotepec hospital. Cost, 4,000 pesos to rent the special equipment. The public hospitals are cautious on who gets general anesthesia. You have to produce a lot of letters from various specialists. Also, all these hospitals are pretty slack as to telling what you eat while healing, it would be so easy for them to produce a handout in English or Spanish.

It is so not much contracting out to outside private doctor s or clinics, the big general and public hospitals can nearly handle anything now as far as expertise, but they are waiting for equipment to fill all these new hospitals.

The first step is to attend either the IMSS or Seguro clinics in Chapala (unless it is an emergency) and they will write the "work order". If the turmoil is as bad they say (AMLO did release a large chunk of funding recently) the doctor will know, or phone around to the social workers to find where to get you treatment. There is no doubt they are running an austerity government, but as we all know the best way to drain a swamp, is to cut off the water, the cash.

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Yes,

18 minutes ago, CHILLIN said:

Two members of this board had their gall bladder removed at Jocotepec hospital. Cost, 4,000 pesos to rent the special equipment. The public hospitals are cautious on who gets general anesthesia. You have to produce a lot of letters from various specialists. Also, all these hospitals are pretty slack as to telling what you eat while healing, it would be so easy for them to produce a handout in English or Spanish.

Yes, Chillin, but the recent news is that the Joco hospital isn't functioning/open at all times or some of the new equipment is no longer available. And I have been reading of patients being turned away from Joco and sent to Guad. I think these are new developments and that the health care crunch is just hitting this area now.

I remember when I moved here just under 3 years ago, the SAT clinic was open on scheduled days for services. Then it was only open sporadically, usually for flu shots. Now it is closed. Things are deteriorating, and quickly. Thus: if money is no object, or you have decent health insurance coverage, then you are okay. But if you plan to pay out of pocket as in the past, beware.

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1 hour ago, Bisbee Gal said:

OP...sorry for the surgery need.  But won't your BC BS coverage partially reimburse you (and not just hospital but for doctor fees, too)?  

No, US insurance won't cover outside of US (unless within the 25 mile border zone, and you have to just be passing through, not living there), period. Nor will Medicare. So, be prepared, as the saying goes.

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It is a shame but it seems medical costs are going up a lot everywhere. What can you do except be prepared?

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24 minutes ago, kimanjome said:

 

I remember when I moved here just under 3 years ago, the SAT clinic was open on scheduled days for services. Then it was only open sporadically, usually for flu shots. Now it is closed. Things are deteriorating, and quickly. Thus: if money is no object, or you have decent health insurance coverage, then you are okay. But if you plan to pay out of pocket as in the past, beware.

SAT clinic is back open. new roof, new paint, lots of work being done on the building.

They have a doctor on site mon-fri 8am - 2pm.

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29 minutes ago, kimanjome said:

Yes,

Yes, Chillin, but the recent news is that the Joco hospital isn't functioning/open at all times or some of the new equipment is no longer available. And I have been reading of patients being turned away from Joco and sent to Guad. I think these are new developments and that the health care crunch is just hitting this area now.

I remember when I moved here just under 3 years ago, the SAT clinic was open on scheduled days for services. Then it was only open sporadically, usually for flu shots. Now it is closed. Things are deteriorating, and quickly. I want to say, if money is no object, or you have decent health insurance coverage, then you are okay. But if you plan to pay out of pocket as in the past, beware.

The SAT clinic is NOT closed...it is under renovation. there is still a nurse there and the doctor has not a regular schedule since the space is cluttered with debris and workers. Since I always "butter up" the nurse/receptionist there with chocolate bars, when I went last week with a urinary track infection, she got the Dr. Jose on the phone for me and he scheduled an appointment this Monday morning and in all the clutter and confusion he wrote the prescription (I had the urinary test from the Dilabim lab here with me). I am assuming that once this total rehab is over the clinic will be up and running again. Maybe the Doctor will be there on a limited basis but still better than nothing.    

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Keep a sharp eye on Mexican healthcare premiums upon renewal. If the price goes up mucho or the deductibles increase mucho you will know which way the wind is blowing. Private companies don't like to lose money.

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So Pappy, are living in Rosarito now? You would have lots of fellow travellers, still get lots of sunsets, and you are already used to a busy Mexican resort town. I'm pretty sure it is less than 25 miles from the border. Find a Medicare doctor south of San Diego.

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16 minutes ago, pappysmarket said:

Keep a sharp eye on Mexican healthcare premiums upon renewal. If the price goes up mucho or the deductibles increase mucho you will know which way the wind is blowing. Private companies don't like to lose money.

But the Mexican health insurers are part of swamp too. Rate increases are locked into the amount of medical inflation. Guess who gets to make those decisions? Plutocrats in CDMX. When asked when our private premium went up 16% in one year, when US medical inflation at that time was less than 3% the agent shrugged as if to say that's the way in this country. Get used to it. Well, I hate swamp water, yuck!

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1 hour ago, kimanjome said:

Wow. Even the $7,000 CDN--which seems somewhat reasonable--will probably have skyrocketed by now. I was driven to 3 different private hospitals, until we could find one with a bed available. I have discovered that this is due to the health care crunch here, which, as I mentioned earlier, is forcing patients who would otherwise be using SP and IMSS, into the private system--which has us "by the scrotum", so to speak. If it were just my experience I would chalk it up to bad luck, but the fact that my maid, gardener, and the non-Mexican insurance agent are all reaffirming this tells me that something is very amiss.  

And what AlanMexicalli says is true, I have been reading it in the news (unfortunately I did not foresee how this would affect me directly!)--the public healthcare system has basically run out of money and is falling apart. So we--all of us, Mexicans and expats alike--are at the mercy of whatever is available.

I said I pay out of pocket by cash,cheque or credit/debit card. My doctors give me a choice of hospitals. Never had to drive around like you. Wife was in the new hospital here in Chula Vista  a month ago and the charge wasn't huge. most of you are mentioning insurance, that are seemingly getting ripped off. We pay CASH have no private insurance which to me is like throwing money out the window.

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1 hour ago, kimanjome said:

No, US insurance won't cover outside of US (unless within the 25 mile border zone, and you have to just be passing through, not living there), period. Nor will Medicare. So, be prepared, as the saying goes.

In 2009, we were in a group health care plan (we were under 65, not on Medicare) and they reimbursed us for an emergency in Mexico.  This plan (with my ex-employer) paid for emergencies outside the US in any country regardless of how long we were absent from the US, so it may be worth your while to check if you haven't.  

We now have Medicare with a Medigap plan (also through my ex-employer) which covers us for emergencies outside the US but only during the first 60 days of each trip.  The Medigap plan has a deductible when used outside the US (the US component has none) and a lifetime limit for outside US emergencies.  

 

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1 hour ago, happyjillin said:

I said I pay out of pocket by cash,cheque or credit/debit card. My doctors give me a choice of hospitals. Never had to drive around like you. Wife was in the new hospital here in Chula Vista  a month ago and the charge wasn't huge. most of you are mentioning insurance, that are seemingly getting ripped off. We pay CASH have no private insurance which to me is like throwing money out the window.

I paid CASH. That is why I am so incredulous. And the overflowing hospitals: Country2000, San Javier, Puerto Hierro Sud---a totally new experience. These increases are going to be reflected in health insurance hikes, that's for sure. And now the news on Bloomberg and Moody's that Mexico is headed for, if not already in, a recession, will add to the further decline of SP and IMSS.

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1 hour ago, CHILLIN said:

So Pappy, are living in Rosarito now? You would have lots of fellow travellers, still get lots of sunsets, and you are already used to a busy Mexican resort town. I'm pretty sure it is less than 25 miles from the border. Find a Medicare doctor south of San Diego.

So CHILLIN, are you trying to imitate Eric Blair, uh, Clueless, uh Bon Belle or are you all one and the same?  Hmm.....

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4 hours ago, pappysmarket said:

We were forced to sell in PV last year when our excellent retiree coverage announced that for Medicare eligible retirees the premium would increase on last Jan. 1 from $324 to $1183 if you were not in the US and using Medicare as primary. I always thought it was primarily due to widespread fraudulent claims from Mexico but your post makes clear that wasn't the only reason. It was a no brainer decision for us no matter how much we loved Mexico. That $1183 has since gone up to almost $1500 while the $324 has remained the same.

If you don't mind my asking:  was this a US plan that was raising rates precipitously only on policyholders living outside the US?  What did the plan cover for those living outside the US...just emergencies or more than that?  Rates you quoted are per month per person?   

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I don't understand why BC/BS did not pay this.  I have BC/BS that covers the two of us.  One was recently in San Javier for a prostate biopsy.  San Javier filed the claim directly with BC/BS and they paid the entire bill.  Cost me absolutely nothing out of pocket.  Wonderful hospital and all the staff were very good.  What's the difference?

 

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50 minutes ago, Bisbee Gal said:

If you don't mind my asking:  was this a US plan that was raising rates precipitously only on policyholders living outside the US?  What did the plan cover for those living outside the US...just emergencies or more than that?  Rates you quoted are per month per person?   

No, coverage was worldwide. $300 ded., max out of pocket $2000/yr, no lifetime max see any doctor or stay in any hospital, pay and be reimbursed through Aetna but plan is self funded by BP, my wife's employer. Premium is total  for both of us. But rates were only raised for retirees not residing in the US and thus not using Medicare as primary coverage.

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4 hours ago, cedros said:

It is a shame but it seems medical costs are going up a lot everywhere. What can you do except be prepared?

Cedros the other insurance that is becoming more widely used at Lakeside is GOFUNDME , it helps to have a good script writer and of course no premium

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1 hour ago, JKL said:

I don't understand why BC/BS did not pay this.  I have BC/BS that covers the two of us.  One was recently in San Javier for a prostate biopsy.  San Javier filed the claim directly with BC/BS and they paid the entire bill.  Cost me absolutely nothing out of pocket.  Wonderful hospital and all the staff were very good.  What's the difference?

 

What is BC/BS? At first I thought it might be British Columbia extended coverage but more likely Blue Cross/Blue Shield.

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