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What are you paying for health insurance Lakeside?


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Gosh, I thought they changed the name to Hongcouver. Only kidding, say I.

I used to live north of Seattle and so close to the border that we could watch TV from Vancouver and Victoria via a large outdoor TV antenna pointing north. Now, TV from most everywhere can be picked up via cable, Satellite TV, or by streaming. 

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There is no free medical care or free public education or free public transportation or free lunch.  Folks pay for those things their entire working, and post working, lives in taxes.  Everybody knows that and everybody knows that the tax structures are designed to benefit most the very wealthy and greedy corps who sometimes outsource needed jobs in order to get a little more profit.  Insurance companies and pharma companies have lots of lobbyists and rules are obviously tilted in their favor.  Rich people invest in those kinds of companies because they, miraculously, never lose money.  Those of us who make up the majority of the population pay the most and get the least...and that is by design.  It ain't changin' in my lifetime.

Alan

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6 hours ago, CHILLIN said:

I am sorry Pedro. I had a look at those cost of living websites on the internet last year. I was very surprised to find that the cost of living in Guadalajara was the same as Abbotsford, a community about one hour south of Vancouver. On the other hand, the cost of living in Vancouver was 117% higher than Guadalajara.

I don't need no stinkin' website.  My PERSONAL experience is that my expenses living here are 40% of what it would be if we had stayed in Alberta  . You rent,I don't.  And your Vancouver, Abbotsford, Guadalajara comparison is pure bullfarb and making that ridiculous post is what you should be sorry for.

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On 2/7/2022 at 1:20 PM, cstone said:

I would say that to feel at all comfortable paying for catastrophic care, $250,000USD is a minimum. Day to day and minor surgical/treatments/interventions are reasonable and easy to pay out of pocket, but cancer, brain surgeries, open heart surgeries, kidney failure, trauma from a car accident, etc., can pile up the bills quickly. Then, if you spend $100K the first incident, you need to have enough to cover another one , whether for you or your spouse. At my age, it is highly unlikely that I would be able to easily earn more $$$ to put in the fund.

I agree. If you want to survive a serious condition, $250,000 is a reasonable slush fund. Also, do not give up Medicare A and B. I have an Ajijic friend who flies back to the US every two weeks to receive cancer treatment she cannot afford in Mexico.

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Neverless it IS a reasonable figure for 2 people to have if they are self-funding all medical conditions here that could present themselves to one as they grow old. That's specifically why Canada has its medical program and the US has Medicare. One pays all of their life and then, in the end, really bad health conditions are more-or-less covered. And yes many won't have anywhere near that amount at all much less for a slush fund,  but....

 

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1 hour ago, RickS said:

Neverless it IS a reasonable figure for 2 people to have if they are self-funding all medical conditions here that could present themselves to one as they grow old. That's specifically why Canada has its medical program and the US has Medicare. One pays all of their life and then, in the end, really bad health conditions are more-or-less covered. And yes many won't have anywhere near that amount at all much less for a slush fund,  but....

Excellent post Rick. Meaningful and helpful. Having paid in 100's of thousands $$$ for healthcare benefits for myself and employees, then to walk away from all that to practically brag about how much you have spent on private Mexican Healthcare, just to keep alive? Makes no sense at all, unless your money is from lucrative drug deals or real estate flips, and you somehow avoided paying tax or prison on all of that. In the situation I am thinking of the bulk of the money was raised on the backs of taxpayers by way of a teacher's salary and retirement plan.

Now the beast, who we should not awake, will be awoken and spread his foul poisons, and his extraordinarily bad breath. Apparently Martyrs do not feel justified spending money on dental hygene.

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Why do you think Medicare is not legally available in Mexico except for emergencies by travelers only?  And then only if you have part B&C.  They could save billions by allowing other countries to provide goods and services to US citizens who live abroad or even who travel for dental and medical tourism.  It isn't just because there could be fraudulent overcharging because that problem is huge in the US system already.  It isn't because it is assumed that medical training or care here is inferior. Medical school here followed by the required training in the US is approved by the AMA.  Lots of US doctors go to schools overseas where it is cheaper.  Why is it so hard to purchase and import prescription drugs from countries where they are much cheaper?  Why is it so hard to find a doctor who will accept new Medicare patients?  Why does a stay in a hospital room cost more than the presidential suite at a fancy hotel?  I'm not talking about food, meds, exams, treatments, or anything else except the bed and the room it's in.  Why do insurance companies have so many exclusions for medical issues like vein surgery, foot problems, TMJ, congenital disorders, pregnancy treatment, eyeglasses, hearing aids, dental surgeries or treatments, etc.?  Are those not medical issues?  If I can't chew my food, walk normally, hear people talk, see to drive, or was born with a defect or condition that required continuous care, am I not needing some help? 

The whole thing stinks of corruption and mismanagement on a level that shows me that the "well entrenched" who profit from the crappy system do not ever want it to change for the betterment of society at large.  Angry and frustrated?  Yes and for that and many other reasons I'm not going back.

Alan

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Another thing to consider in costs is which hospital you go to. We self-fund our medical care and took a huge hit at Hospital San Javier a few weeks back. My wife had a single stent installed on an emergency basis. Our doctor estimated the cost to be $200,000MX. The surgeon estimated the cost to be $300,000MX. Hospital San Javier charged us $555,202MX. Our doctor and surgeon both expressed shock and worked with the hospital but that only reduced our bill to $480,000MX. My wife was in the hospital one night (she was admitted at 6pm and was discharged at 2pm the next afternoon).

Be prepared. Know in advance which hospitals you want to use. Hospital San Javier will never be on our list!

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That is why we keep our "Med-Jet" policies and U.S. insurance up to date. $24,000 US is higher that most USA hospitals for a stent..No way to justify that bill, pure greed. Stay away from San Javier as they are known for their vast overcharging.

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23 minutes ago, ManxMan said:

Another thing to consider in costs is which hospital you go to. We self-fund our medical care and took a huge hit at Hospital San Javier a few weeks back. My wife had a single stent installed on an emergency basis. Our doctor estimated the cost to be $200,000MX. The surgeon estimated the cost to be $300,000MX. Hospital San Javier charged us $555,202MX. Our doctor and surgeon both expressed shock and worked with the hospital but that only reduced our bill to $480,000MX. My wife was in the hospital one night (she was admitted at 6pm and was discharged at 2pm the next afternoon).

Be prepared. Know in advance which hospitals you want to use. Hospital San Javier will never be on our list!

I guess there are Horry story's here as well as NOB. I would certainly contest that hospital charge. Usual for surgeons to charge separately, so your only hospital fee would be the room charge plus meds and sundries.

everyone can share different experience, good bad and ugly. Regardless what others have , my favorite go-to primary care doctor is Dr Rodriguez Snr. at Ajijiccityguide Clinic. And when I have need serious work done on Guadalajara I emphasize to him I have limited funds and need Mexican hospital with Mexican fees. So far for me it's worked. There are dozens of "smaller" hospitals in Guadalajara which can provide excellent car and attention

for their advantages .The advent of private insurance in Mexico is killing inexpensive cost for health care, slowly but surely MX is going down the path of the USA

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If you want to talk about what hospitals to stay away from due to overcharging, please place Puerto Hierro de Sur on your list. 

Two years ago I had laproscopic hernia surgery.  The surgeon charged me 50,000p.  for him and his medical team.  Then, Puerto Hierro de Sur  Hospital charged me 149,900 p for the equipment during the surgery and my one day stay  in a room.   This was not even an overnight stay, since I left at 7 pm the evening of the surgery !!

My surgeon, who is well known here, expressed dismay and said that had happened to three of his patients at that hospital in one week.   He said he would have consulted with the business manager, but the guy he knew had left for another job that week.  He said he would hesitate doing further surgeries there.  Shortly thereafter, he started doing the same surgery at San Antonio Hospital. 

The sad  fact is that major hospitals here are getting greedy and changing pricing practices similar to those north of the border.  The other sad fact is that we don't have Medicare down here to cover those inflated expenses.   Medicare usually stipulates how much they will pay a doctor and hospital for given procedures !    The worst part in the US is that hospitals and doctors will cost shift, meaning they will bill (inflate) private insurance patients more to cover the underpayment they will get from Medicare or Medicaid.   

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On 2/12/2022 at 8:49 AM, ManxMan said:

Another thing to consider in costs is which hospital you go to. We self-fund our medical care and took a huge hit at Hospital San Javier a few weeks back. My wife had a single stent installed on an emergency basis. Our doctor estimated the cost to be $200,000MX. The surgeon estimated the cost to be $300,000MX. Hospital San Javier charged us $555,202MX. Our doctor and surgeon both expressed shock and worked with the hospital but that only reduced our bill to $480,000MX. My wife was in the hospital one night (she was admitted at 6pm and was discharged at 2pm the next afternoon).

Be prepared. Know in advance which hospitals you want to use. Hospital San Javier will never be on our list!

Wow, just 18 months ago, I had three stents implanted for just over 225,000 pesos.

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I pay the hospital with my Intercam debit card and the doctor[s] seperately by cheque from my Intercam account. My doctors usually give me a choice of 2-3 hospitals that they have privileges at. I have been quite pleased and surprised by how low the hospital charges are and that includes the infamous[on this board] Puerto Hierro and San Javier.

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But, how recent was your last visit to Puerto Hierro de Sur?

I should have checked their price prior to the  procedure, but never expected that amount. I had only paid 43,000 p the year prior to Hospital Country 2000 for major back surgery and spent the night in the hospital there.  That also included the sophisticated equipment the neurosurgeon used during surgery.  Huge difference !!!  

 

 

 

 

 

 

 

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3 hours ago, mexijims1 said:

The surgeon charged me 50,000p.  for him and his medical team.  Then, Puerto Hierro de Sur  Hospital charged me 149,900 p for the equipment during the surgery and my one day stay  in a room.   This was not even an overnight stay, since I left at 7 pm the evening of the surgery !!

A naïve question (even though I've been spending winters here these past 20 years, and own a property now, but have only travel insurance):

Are you, and others who commented previously, surprised the hospital charged you at all on top of surgeon fees, or because they charged this much / more than expected? And, would they charge as much if you had private insurance, or are these wild rates only for self-financing individuals?

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Well, I had private insurance which did not cover my back surgery because they deemed it a pre-existing condition ( prior back operation 29 yrs ago).

Second one, where I was way overbilled, I did not get prior authorization because I thought it would come in much under the amount I paid at Hospital Country 2000, and therefore would below my insurance deductible.

Basically, they were billing me as a private individual, not knowing or caring if I had insurance!  I could have seen Puerto Hierro Sur jacking up that price so outrageously if it had been direct billing with an insurer, but that was not the case.

As a result, an agent told me that insurers are starting to see some of those outrageous billing practices and are removing them from their direct billing listings. 

Also, you are seeing fewer non-Mexican private insurers in the market place.  These billing practices might well lead to the only options of: individual paying out of pocket, having private Mexican insurance (with totally different co-pay and deductible options and issues); or, IMSS.   

 

 

 

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I will be upfront about this and say the missus has good catastrophic insurance because I don't think she would be able to tolerate the bawdy freak show that exists at many of the public and general hospital wards. Especially with her 40 plus years in healthcare.  I, on the other hand, have thick skin and can see the humor in practically anything, however surreal.

The last time I was in a public mixed ward here, men and women, about 18 beds, there were not even any privacy curtains and there were two families actually living in the ward! Let it all hangout, living the love of the common people.

The comings and goings were far more interesting than anything I have seen on television - except maybe Scrubs.

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On 2/11/2022 at 10:31 PM, barrbower said:

Why do you think Medicare is not legally available in Mexico except for emergencies by travelers only?  And then only if you have part B&C.  They could save billions by allowing other countries to provide goods and services to US citizens who live abroad or even who travel for dental and medical tourism.  It isn't just because there could be fraudulent overcharging because that problem is huge in the US system already.  It isn't because it is assumed that medical training or care here is inferior. Medical school here followed by the required training in the US is approved by the AMA.  Lots of US doctors go to schools overseas where it is cheaper.  Why is it so hard to purchase and import prescription drugs from countries where they are much cheaper?  Why is it so hard to find a doctor who will accept new Medicare patients?  Why does a stay in a hospital room cost more than the presidential suite at a fancy hotel?  I'm not talking about food, meds, exams, treatments, or anything else except the bed and the room it's in.  Why do insurance companies have so many exclusions for medical issues like vein surgery, foot problems, TMJ, congenital disorders, pregnancy treatment, eyeglasses, hearing aids, dental surgeries or treatments, etc.?  Are those not medical issues?  If I can't chew my food, walk normally, hear people talk, see to drive, or was born with a defect or condition that required continuous care, am I not needing some help? 

The whole thing stinks of corruption and mismanagement on a level that shows me that the "well entrenched" who profit from the crappy system do not ever want it to change for the betterment of society at large.  Angry and frustrated?  Yes and for that and many other reasons I'm not going back.

Alan

Here, here (hear, hear) 

I am denied any medical insurance based upon how I was born. I guess I may be checking out those 18 person wards some day which  Gary mentioned, although I'm halfway to outfitting my own home based hospital. <grin>

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20 hours ago, timjwilson said:

I am denied any medical insurance based upon how I was born. 

Yes, I guess being born with a Groucho Marx nose, eyeglasses and a cowboy hat makes for a tough road ahead!

Are you related to Kevin "Bloody" Wilson from Australia. He was an electrician until he decided to become a comedian. Funny bloke, but a bit too raunchy to make it outside of Oz.

Manuel the Bandito. Remember this is from the 1980's. He is 75 now.

https://m.youtube.com/watch?v=HiYVCNZ-Kzc

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3 hours ago, CHILLIN said:

Yes, I guess being born with a Groucho Marx nose, eyeglasses and a cowboy hat makes for a tough road ahead!

Are you related to Kevin "Bloody" Wilson from Australia. He was an electrician until he decided to become a comedian. Funny bloke, but a bit too raunchy to make it outside of Oz.

Manuel the Bandito. Remember this is from the 1980's. He is 75 now.

https://m.youtube.com/watch?v=HiYVCNZ-Kzc

So nose jobs aren't done in the civil hospital then?

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Reading these comments have made me rethink the move to Lake Chapala.  I had heard about the inexpensive and superior medical care in LC  but at 84 with a pacemaker and a history of breast cancer, I am totally confused as to what to expect. The idea of saving $250,000 for self-paying is not remotely possible for me.  One of the reasons I thought of moving was the cost of assisted living in Portland is about $5000 a month which I can't afford either and heard that the cost would be about $1600/month in LC - This is the kind of information that has to be deeply investigated before moving .  I have medicare A&B and United Health and this year i paid close to $3000 which included co-pays and 800 for the United Health coverage. I will have to really take a deep dive into this topic. 

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42 minutes ago, dottiejane said:

Reading these comments have made me rethink the move to Lake Chapala.  I had heard about the inexpensive and superior medical care in LC  but at 84 with a pacemaker and a history of breast cancer, I am totally confused as to what to expect. The idea of saving $250,000 for self-paying is not remotely possible for me.  One of the reasons I thought of moving was the cost of assisted living in Portland is about $5000 a month which I can't afford either and heard that the cost would be about $1600/month in LC - This is the kind of information that has to be deeply investigated before moving .  I have medicare A&B and United Health and this year i paid close to $3000 which included co-pays and 800 for the United Health coverage. I will have to really take a deep dive into this topic. 

It is a sticker shock for me too, even after 20 yrs of wintering in Mexico. I understand rates are different off the Gringo trail, vary greatly and may be worth investigating.

Slightly off-topic: neighbours in their 70s moved to Patzcuaro couple years ago where they have a lived-in nurse @ under $1000 / month, and a buddy left SMA for Lake Atitlan (Guatemala) and employs a full time young doctor for slightly more (but worries the doc will leave because it isn't such a great career move.) I have no idea whether these rates are high or low, but both expats are happy with the arrangement. Of course lived-in care, even if medical professionals, are no substitute for proper emergency insurance...

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