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kimanjome

Cautionary note--large increase in medical costs here

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5 hours 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.

 

19 minutes ago, cedros said:

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

Some US policies (mine is with United Healthcare) will reimburse for medical expenses incurred abroad as a resident or tourist, although at a lower rate that would be the case with an in-network provider in the US. 

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My father has Blue Cross Blue Sheild, a couple of years ago he needed a hernia surgery and after they noticed he required a pace maker.  It was preaproved by BC/BS.  The surgery was done at the Mexico-Americano hospital in Guadalajara.  When it was time to pay, it was kind of an ordeal.  BC/BS didn't want to pay, they pretended like they weren't notified prior, which was a lie,  but after a few phone calls they eventually paid for all of it.  Insurance companies are such crooks!

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11 hours ago, CHILLIN said:

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.

 

Chillin there has been no influx of money into the health sector. Here is last weeks news.

https://www.google.com.mx/amp/s/www.infobae.com/america/mexico/2019/07/18/de-la-salud-al-deporte-la-larga-lista-de-los-sectores-que-la-austeridad-de-la-4t-de-amlo-ha-llevado-casi-al-colapso/%3foutputType=amp-type

Google Translation:
MEXICO
From health to sports, the long list of sectors that the austerity of AMLO 4T has almost led to "collapse." From
culture, farming, research, sports and health; All of these sectors have been affected by López Obrador's austerity policy
July 18, 2019
Andrés Manuel López Obrador took the oath as Constitutional President of the United Mexican States on December 2, 2018
Republican austerity is one of the central commitments of the presidential project of Andrés Manuel López Obrador. According to the president, his imposed budgetary measures eliminate the privileges that the public administration has had during six years to the detriment of the poorest population.

In pursuit of such austerity the Tabasqueño [AMLO] has cut the budget to the cultural, research, sports and health sector. In seven and a half months of government, Obrador has radically reduced government costs. Thousands of federal workers have been laid off and those who were lucky enough to keep their jobs suffered drastic cuts to their wages and benefits.

In one of its latest publications, the Washington Post noted that public hospitals in the country have canceled surgeries and forest fires have spread without anyone being able to stop them, because the cost reduction has resulted in neither material nor personal enough. Thus, this is one of the most characteristic features of the Fourth Transformation of López Obrador.

The health sector, the most hit

Mexican Social Security Institute [IMSS]

Seguro Popular


The government of the Tabasqueño [AMLO] began by eliminating pensions for former presidents, bonds and private medical insurance. Then, his attack on privileges reached children's stays [daycare] and the health sector.

The Ministry of Finance froze more than 794 million pesos of the budget allocated to 26 institutes, hospitals and centers of high specialty. In addition, it ordered a 30% reduction in operating expenses with respect to approved amounts and 50% related to personal [employees] services.

Marco Antonio García Ayala, leader of the National Union of Workers of the Ministry of Health [Secretaria de Salud], warned in May that the health system is collapsing due to the dismissal of numerous workers.

The institution has recognized that it suffers from a shortage of medicines 

At that time, the shortage of medicines had reached the basic sector, so that in nine states of the Republic there was an urgent shortage of antiretrovirals and oncology.

For months, hospitals have announced that they are not able to provide care for patients who come in day by day or have the necessary stretchers for everyone.

The cuts to the health sector budget made Germán Martínez Cázares, who was the general director of the Mexican Social Security Institute (IMSS), resign from office. "I am not going to fire the doctors. People are going to die in the streets ...", the former official wrote when he presented his resignation to López Obrador."

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OP here with update:  more info to help you all, so you don't end up in the same situation.

1. I have since learned that several hospitals are now charging US prices and insurance companies either won't cover at all, or only a percentage. No discount for cash. Unless your policy allows you to utilize them and you have it in writing, avoid Country2000, Puerto de Hierro, and Galeana. I glanced over my hospital bill and saw that I had been charged US $22- for a bottle of Microdycin antiseptic spray (saline water) that I bought for myself at the farmacia for $3-. That upcharge/gouging is a US trick.

2. If you have the time, find someone--hopefully your doctor, if you don't have insurance--who can act as a health care advocate to negotiate on your behalf in advance. Not having insurance, I blindly followed my doctor's guidance, assuming he/she would know a rough estimate of what this procedure should and would cost and would act in my best interests (and I still don't know if the doctor was aware it would cost so darn much). Unfortunately, I was in a lot of pain, and I wasn't confident I would be able to fly back to the US and have the surgery right away, so I took the local route, thinking there was no possible way this surgery would cost more here in Mexico than in the US, paying cash!

3. Believe it or not, had I gone to the US I discovered that as a self-pay, cash, this particular surgery would have cost me appx $6,600 in Tulsa, $8500 in Dallas, Houston, and Chicago, and $11,500 in NYC. You are reading this correctly. Of course had I used my BC/BS in Florida, I would have had to pay a deductible of $2500, then the next 20% of all costs up to $5000---and this is decent insurance coverage. Doctors and hospitals will gouge an insurance payor, so I'm certain that had I used my US insurance my bill would have easily been $40 or $50k, and I would have ended up paying a minimum of $7,500 out of pocket, plus all the other little "gotchas".

4. Do your research. Although I am not gullible, and I did have previous surgery here at a moderate price, this second (unrelated) incident was a different situation inasmuch as that I assumed this particular surgery would also be priced fairly. After all, I knew the US prices, right? I did the best I could with the information I had, but you win some, you lose some, and in this case, I lost.

5. Be prepared for an emergency. Know the names of the hospitals that have the equipment and services you might need at reasonable prices. I've already heard from friends that Hospital San Francisco is reasonable and has a CAT scan machine and can handle strokes (although the new hospital in San Antonio may be able to do so, also--or at least be able to stabilize). San Javier is also full-service and reasonably priced.

Plan ahead! About expat insurance: I'm only 58, and I can afford a decent expat policy at a kind-of affordable price. But when I turn 60, my policy will automatically increase by 25%, not including the annual rate hikes. Then there will be annual rate hikes after that, of course, and another 25% increase at age 65. By the time I am 72, an expat policy with a $5,000 deductible will cost me about $5,000 a year. That is far too rich for my blood. I would be better off living in the USA with a MediGAP plan (additional $250 a month)  that covers almost everything, A to Z. I'm starting to think that PappysMarket has the right idea, moving to a border town. Or, if you can get an EU passport (much easier than you would think, if you have a mother, father, or grandparent from the EU) to relocate abroad, your partner can automatically go with you. The bottom line is, plan, plan, plan. 

Be up-to-date with what is happening in Mexican health care. The recessional economy and the shortage of public healthcare is creating a demand which will only drive up prices further. Of course the prices can go only so high before they implode, but in the meantime, be alert. Due to the shifting economy, some procedures which are being done in Mexico are being done in Costa Rica's best hospitals for considerably less cost. 

Call me, Poorer But Wiser (and healthier, too).

 

 

 

 

 

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The surgeon[one of the Quality Care group] that did my gall bladder also did my double hernia at San Javier. My tiny room[who needs big] was right at the nursing station. He gave me a choice of 3 hospitals up front and I chose SH because it was least costly. He told me the entire cost up front for every thing each time. $5300usd +/- gall bladder, $6800+/- double hernia You the OP seems to have handled your situation entirely differently. I obviously had no surprises and as I said before I think insurance is a waste of $'s and from what you say puts a big M on your forehead. I pay my doctors with a cheque from my Interac bank account  and the hospital with Interac debit card or Scotia credit card because the hospitals want part payment up front. Hmm! Thomas Tusser.

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7 minutes ago, Ferret said:

MONEY.

Oh...Gracias

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I had a very severe attack of pancreatitis in March. Was admitted to Tera Nova hospital in Guadalajara. I had emergency gall bladder surgery that day, not laproscopic, due to infection. I was in the hospital five days and the bill was $8,700, including Doctor. I consider that very fair. Sounds like you were paying too much.

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Since we are dealing in cautionary notes, when Ms. Chillin went for gall bladder removal at a boutique hospital (tier 2) in Guadalajara, performed by a popular surgeon from Integrity clinic, we were quoted $5,500 U.S. cash. This was carefully counted out, at least three times and placed in an envelope. After surgery the Dr. came, we asked him to count it. He said he was scheduled for another surgery, he didn't have the time. Twenty minutes later, he phoned to say that he had sent someone to the bank and the teller said it was 6,000 pesos short. He then came to the room and said he was the one who opened the envelope and discovered the shortfall. We buckled, just wanted to get out there, we could not accuse a popular doctor on his own turf and luckily we had the cash, that is why he asked for pesos, which we were more likely to be carrying. The lesson is well known in Mexico, if you pay in cash, watch very closely as it is counted, there are masters of sleight of hand. Do not allow yourself to be distracted. I knew one amateur magician and one croupier. They could both make bills, chips and coins disappear in a blink. Oh yes, the only reason he wanted the gall bladder out was he detected two very small cysts which could be cancerous. On the followup, he had completely forgot that he had ordered a biopsy, he searched his computer and found the report. Completely benign.

You can't protect yourself against corruption, but you have a better chance with fraud.

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13 hours ago, happyjillin said:

The surgeon[one of the Quality Care group] that did my gall bladder also did my double hernia at San Javier. My tiny room[who needs big] was right at the nursing station. He gave me a choice of 3 hospitals up front and I chose SH because it was least costly. He told me the entire cost up front for every thing each time. $5300usd +/- gall bladder, $6800+/- double hernia You the OP seems to have handled your situation entirely differently. I obviously had no surprises and as I said before I think insurance is a waste of $'s and from what you say puts a big M on your forehead. I pay my doctors with a cheque from my Interac bank account  and the hospital with Interac debit card or Scotia credit card because the hospitals want part payment up front. Hmm! Thomas Tusser.

Happy, when you start adding the $5300 and $6800 together, that is more than the annual cost of an insurance premium with decent coverage. Granted, you may not have costs in excess of $11,000 USD every year, but one year you might have $20K, the next year, $3K and then an insurance premium starts to make sense.

I'm all set now because I am still relatively young, but over 70+ then you start gambling with this kind of thing. You don't know when a stroke or heart attack is going to happen, and even with evac insurance you can't be flown until you are stabilized, which could take a few days. I guess one can rely on SP to stabilize, but you would still need to evac insurance to get you back to where you have Medicare coverage or whatever. With my partner (72) I figured if something big and bad happened I would hire a driver to take him to the border, then we would head into Texas. But that is assuming he would be well enough to be driven. 

I don't know how those of you over 70 are doing it.  If prices continue to increase so rapidly here, how can it be  managed?

 

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On 7/27/2019 at 10:53 PM, kimanjome said:

Happy, when you start adding the $5300 and $6800 together, that is more than the annual cost of an insurance premium with decent coverage. Granted, you may not have costs in excess of $11,000 USD every year, but one year you might have $20K, the next year, $3K and then an insurance premium starts to make sense.

I'm all set now because I am still relatively young, but over 70+ then you start gambling with this kind of thing. You don't know when a stroke or heart attack is going to happen, and even with evac insurance you can't be flown until you are stabilized, which could take a few days. I guess one can rely on SP to stabilize, but you would still need to evac insurance to get you back to where you have Medicare coverage or whatever. With my partner (72) I figured if something big and bad happened I would hire a driver to take him to the border, then we would head into Texas. But that is assuming he would be well enough to be driven. 

I don't know how those of you over 70 are doing it.  If prices continue to increase so rapidly here, how can it be  managed?

 

I'm well over 70 had 2 strokes and 5 stents all here and originally from Canada  and I'm just fine with the medical treatment and paying out of pocket. I don't need insurance nor ivac. We did due diligence and are not house rich and cash poor,like some people that move here and forget they are even going to get older than when they came . We have car insurance for liability only.

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I know nada about the social services or other insurance schemes serving the broad Mexican population.  Do the costs mentioned here for common medical procedures apply to the ultimate out-of-pocket prices the average Mexican would have to pay (whose per capita GDP is around US$10k per year, while US  per capita GDP is US$65k...)?   Thanks.

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9 hours ago, happyjillin said:

I,m well over 70 had 2 strokes and 5 stents all here and originally from Canada  and I,m just fine with the medical treatment and paying out of pocket. I don't need insurance nor ivac. We did due diligence and are not house rich and cash poor,like some people that move here and forget they are even going to get older them when they came . We have car insurance for liability only.

Yes, but in your "due diligence" you decided to establish non-residency in Canada and are therefore unable to deduct medical and drug costs from your tax returns. That is a lot of money left on the table.

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39 minutes ago, CHILLIN said:

Yes, but in your "due diligence" you decided to establish non-residency in Canada and are therefore unable to deduct medical and drug costs from your tax returns. That is a lot of money left on the table.

For tax purposes I was a non resident Canadian the last few years and I have been able to deduct medical expenses incurred in Mexico. I don't understand what you are saying. 

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53 minutes ago, CHILLIN said:

Yes, but in your "due diligence" you decided to establish non-residency in Canada and are therefore unable to deduct medical and drug costs from your tax returns. That is a lot of money left on the table.

Canadian non-residents CAN deduct medical expenses. I do it all the time. (Tax Preparer 30 years)

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1 hour ago, CHILLIN said:

Yes, but in your "due diligence" you decided to establish non-residency in Canada and are therefore unable to deduct medical and drug costs from your tax returns. That is a lot of money left on the table.

Perhaps you have failed to do due diligence because I can deduct a portion of  ALL medical costs including drugs ,doctors, hospitals,dentists, PT'S and even appliances like the very expensive chair lift we are about to purchase for our stairs.

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15 hours ago, utilitus said:

I know nada about the social services or other insurance schemes serving the broad Mexican population.  Do the costs mentioned here for common medical procedures apply to the ultimate out-of-pocket prices the average Mexican would have to pay (whose per capita GDP is around US$10k per year, while US  per capita GDP is US$65k...)?   Thanks.

No it wouldn't. 59,000,000 Mexicans are enrolled in the Seguro Popular, 54,000,000 are enrolled in the IMSS, Federal government employees and their families are enrolled in the ISSSTE and Pemex empolyees and their families are enrolled in the Pemex medical plan. All are free to these Mexicans. The current government of AMLO has drastically cut funding to the Seguro Popular and IMSS and they are in turmoil now. The previous administrations funded them correctly and expanded them considerably and they served Mexicans. Now it appears they are not functioning properly and not serving Mexicans as before.

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On 7/26/2019 at 5:46 PM, lakeside7 said:

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

 

Yes, I know that was "tongue in cheek"  but I've seen it happen often enough in reality....so

Why not ask for GOSUPPORT ME while you're at it? When we moved to Mexico for the long haul, we put most of the money from our house sale in the U.S. into a "contingency" fund rather that buying a house in a more upscale neighborhood, canceled Part B Medicare and paid for own medical and hospital care....like responsible adults.  Anyone have a good excuse for doing otherwise?

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I too self-fund for most things. I recently (last week) had surgery to fix two hernias. Total cost about $2700US. Work done at the Ajijic clinic, surgical team from Guadalajara, with my GP in attendance throughout.

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I have a friend who has since passed away. He had no medical insurance and needed 3 surgeries in one year, paying out of pocket. His doctors knew that and found him reasonably priced hospitals and negotiated the price for him. One doctor, the third surgery, took intallment payments for his work since my friend had money coming in but did not have enough to pay the doctor his whole fee immediately.  So try to get help from your doctor.

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2 hours ago, gringal said:

 

Yes, I know that was "tongue in cheek"  but I've seen it happen often enough in reality....so

Why not ask for GOSUPPORT ME while you're at it? When we moved to Mexico for the long haul, we put most of the money from our house sale in the U.S. into a "contingency" fund rather that buying a house in a more upscale neighborhood, canceled Part B Medicare and paid for own medical and hospital care....like responsible adults.  Anyone have a good excuse for doing otherwise?

Not all are as fortunate as you to have the funds from a house sale NOB to put into a "contingency" fund. Many live in near poverty here which is a step up from the streets of anytown USA where they would be living had they not come here. This is a reality for many elders these days, especially single women whose SS savings were made smaller than their male counterparts because of vast income disparity between the sexes. This does NOT make them irresponsible adults, it signals a problem within the society in which they have spent most of their lives, working hard and doing the best their personal circumstances have allowed.

We have very little money, a house many wouldn't even consider due to its size and lack of amenities, but we're happy and express our gratitude daily for our blessings. What we will never do is belittle anyone in need of help or suggest they should have lived their life differently to arrive at a place that is more acceptable to those who like to toot their own horns for somehow thinking they're better human beings. Compassion takes one further on the path home than judgements. 

 

 

 

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