Jump to content
Chapala.com Webboard

lakeside medical insurance


Recommended Posts

I just arrived from portland where I had United health as a medicare advantage provider which I dropped when I moved here since I thought I read on this chat that most medical providers would not accpect any uSA insurance except perhaps for an ER visit.  I continue to have plain old medicare and also am able to pay out of pocket rather than spending the 72 a month I was paying united in portland.  However, I tried to get an appt to get established with a cardiologist at lakeside medical since I have a pace maker and got an email telling me I HAD to have Medicare Advantage insurance before I could schedule any appt  and they then referred me to an agent who can sell me some.  I am loathe to do this for obviousl reasons - I can't figure out why MED ADVANTAGE is required by Lakeside since I very much dout United Health would cover any major surgical procedure done in Mexico

I would appreciate any experiences/help/other cardiolgist recommendations that any of you more experienced folks can offer - I did get an appt with Sam Thelen as my GP - chose him because he got good reviews here and I can pay the 800 pesos for the intro visit myself.  -

 

 

Link to comment
Share on other sites

20 minutes ago, dottiejane said:

I just arrived from portland where I had United health as a medicare advantage provider which I dropped when I moved here since I thought I read on dis chat that most medical providers would not accpect any uSA insurance except perhaps for an ER visit.  I continue to has plain old medicare and also am able to pay out of pocket rather TEMPthan spending the 72 a month I was paying united in portland.  However, I tried to get an appt to get established wif a cardiologist at lakeside medical since I has a pace maker and got an email telling me I HAD to has Medicare Advantage insurance before I could schedule any appt  and they tan referred me to an agent who can sell me some.  I am loathe to do dis for obviousl reasons - I can't figure out why MED ADVANTAGE is required by Lakeside since I very much dout United Health would cover any major surgical procedure done in Mexico

me would appreciate any experiences/halp/other cardiolgist recommendations dat any of you more experienced folks can offer - me did get an appt wif Sam Thelen as my GP - chose him because he got good reviews here and me can pay the 800 pesos for the intro visit myself.  -

 

 

I am "confused"..if you are able and willing to go the "pay as I need treatment" then there is no reason to have the type of discussion with the Cardiologist or any other specialist. Just have that CC ready or cash to cover the treatment.

Bye the why I think you should have thought twice about canceling  the Advantage insurance plan as it may have had the rider to cover you whilst out of the country for a few months. Many people at Lakeside use their Advantage Plans (illegally) here which is a personal decision and requires no comment's from would be purists or experts on this forum. We are all adults who some time suffer from senior moments!!!

Link to comment
Share on other sites

I too am confused ergo my question - it seems that Lakeside Medical REQUIRES an advantage plan in order to register for a doctgor  or at least that is what my email said -this wasn't a discussion with the cardiologist - it seems to be the way Lakeside works - you can't get to see a doctor without a plan   there is a JEFF who sells one month to one year plans that Lakeside does accept - I have a call into him but he has not returned it - I cancelled mY united health - at a cost of 72 a month - because I thought I read - perhaps mistakenly - that any of those plans ONLY cover ER and URGENT care - and not regular checkups etc - also I am not out of the country for a few months - I am here permanently - I kept medicare in case I did have some horrible thing happen - I then would fly direct to portland and use the medicare - seemed silly to pay for United if I couldn't use it here - anyway consufing is right - I will look for an american -canadians have a whole different system - who might have answers

  

Link to comment
Share on other sites

16 minutes ago, lakeside7 said:

I am "confused"..if you are able and willing to go the "pay as I need treatment" then there is no reason to have the type of discussion with the Cardiologist or any other specialist. Just have that CC ready or cash to cover the treatment.

Bye the why I think you should have thought twice about canceling  the Advantage insurance plan as it may have had the rider to cover you whilst out of the country for a few months. Many people at Lakeside use their Advantage Plans (illegally) here which is a personal decision and requires no comment's from would be purists or experts on this forum. We are all adults who some time suffer from senior moments!!!

Sorry l7 but it's fraud like that that causes all of our Medicare premiums to keep rising. I for one will call that out and you can put your "senior moments" where the sun don't shine!

  • Like 1
  • Thanks 2
Link to comment
Share on other sites

10 minutes ago, dottiejane said:

I too am confused ergo my question - it seems that Lakeside Medical REQUIRES an advantage plan in order to register for a doctgor  or at least that is what my email said -this wasn't a discussion with the cardiologist - it seems to be the way Lakeside works - you can't get to see a doctor without a plan   there is a JEFF who sells one month to one year plans that Lakeside does accept - I have a call into him but he has not returned it - I cancelled mY united health - at a cost of 72 a month - because I thought I read - perhaps mistakenly - that any of those plans ONLY cover ER and URGENT care - and not regular checkups etc - also I am not out of the country for a few months - I am here permanently - I kept medicare in case I did have some horrible thing happen - I then would fly direct to portland and use the medicare - seemed silly to pay for United if I couldn't use it here - anyway consufing is right - I will look for an american -canadians have a whole different system - who might have answers

  

If any Mexican doctor insists you must have a Medicare Advantage Plan in order to be treated...run, don't walk away from that situation. The last thing you need is to be involved with Medicare fraud.

  • Like 2
Link to comment
Share on other sites

P - i hope you weren't referring to me - i have no desire to defraud anyone - and the sun seems to be shining EVERYWHRE these days - I trust that a question on this chat space does not always get responses like yours - a simple question - a simple answer with no insuts would suffice

 

Link to comment
Share on other sites

2 minutes ago, dottiejane said:

i just got a call from the insurance person and he said just what I thought - that I would just call the doctor's office and get an appt and pay out of pocket - the email was confusing but I am old and Hot so there you are - 

Make sure you get a proper receipt showing you paid in cash, just in case that outfit gets embroiled in a fraud investigation.   BTW, how is the situation in Portland?

  • Thanks 1
Link to comment
Share on other sites

1 minute ago, dottiejane said:

P - i hope you weren't referring to me - i have no desire to defraud anyone - and the sun seems to be shining EVERYWHRE these days - I trust that a question on this chat space does not always get responses like yours - a simple question - a simple answer with no insuts would suffice

 

No insult to you was intended or made. lakeside7 perhaps yes. Don't just take my word for it but take it as part of your "education" into life in Mexico. My best wishes to you.

 

Link to comment
Share on other sites

Pay as you go and any doc here will see you. You don't need insurance which is a big waste of money. We Canadians and yer fellow USA-ers THAT live here function under the same system in Mexico, can answer and have in many threads on here about this topic.ad infinitum.

  • Like 1
Link to comment
Share on other sites

thanks - I see that dr briseno is also with quality care so will try his number there - just need to have my beside "device" which evidently reads my heart all  night hooked up to the medtronic office in mexico - one fellow I met here also has a pace maker but goes to a doc in GDL - without a car that would not be a s convenient as finding a doc here - anyway - all will be well - forget your troulbles and just be happy as Judy Garland used to sing - unhappily I don't think she followed her own advice but that is for another day.  

  • Thanks 1
Link to comment
Share on other sites

You posted just as I was about to do so... Dr. Hector Briseno at Quality Care is THE best imho. Quality Care is located in the San Antonio Hospital Complex... behind Farmacia de Guadalajara or to the east side of the hospital entrance. I pay cash when I see him. No insurance required.

Link to comment
Share on other sites

1 hour ago, lakeside7 said:

Bye the why I think you should have thought twice about canceling  the Advantage insurance plan as it may have had the rider to cover you whilst out of the country for a few months.

The OP isn't "out of the country for a few months". 

2 hours ago, dottiejane said:

had United health as a medicare advantage provider which I dropped when I moved here

 

Link to comment
Share on other sites

1 hour ago, dottiejane said:

thanks - I see that dr briseno is also with quality care so will try his number there - just need to have my beside "device" which evidently reads my heart all  night hooked up to the medtronic office in mexico - one fellow I met here also has a pace maker but goes to a doc in GDL - without a car that would not be a s convenient as finding a doc here - anyway - all will be well - forget your troulbles and just be happy as Judy Garland used to sing - unhappily I don't think she followed her own advice but that is for another day.  

Hector Briseno is my and my wife's cardio. She just had her pacemaker checked by Hector and the manu. tech that comes to the Quality care office for that purpose.

 

Link to comment
Share on other sites

Basic line of thought is that "all banks and insurance companies SUCK -- they just vary by degrees ! " 

That said, the use of Medicare here, unless truly treated within the specific time frame of your visit here ( not living here) is fraud !  IT is just a matter of time before the US catches up with these practices.  I am surprised they have not been already caught.  Unfortunately, these current practices artificially drive up the medical costs here.

Your best bet is to pay for medical out of pocket ( savings).  Unfortunately, everything here is catching up to the US in terms of cost of living, including cost of medical care.   

  • Like 1
Link to comment
Share on other sites

11 minutes ago, mexijims1 said:

 

  Unfortunately, everything here is catching up to the US in terms of cost of living, including cost of medical care.   

I've been here over 16 years and I call BS nonsense on what you just wrote. I doubt that you will get a doc in the US to do a house call and if they did would they charge you $800mp[$40usd]. It was $10-15usd around 2017 so it's still a bargain and waaaaaaaaay less than in the US. I'm Canadian and my buck is below 16 right now and I can tell you even with that it's waaaay less costly in every respect in Mexico. I suggest that you stop making things up.

  • Confused 1
  • Sad 1
Link to comment
Share on other sites

from the few conversations I have had with longtime expats, everyone's experience seems different - one gentleman had a friend who needed three stints put in - one place quoted 50,00 american - he got it for 12,000 american I THINK - I always have to qualify what i say since sometimes people tell you the worse scenerio and then add a bit to liven it up - anyway either way that is way more than I would pay INSURED in the States -  I am hoping neither  stintsn or anything totally serious is in my future - according to my Vantage account, I have just about enough to pay for a box of aspirin 

  • Haha 2
Link to comment
Share on other sites

Rather than cross your fingers and hope for the best, what many expats do is self-insure. 

I paid for private medical insurance in Mexico for about 5 years, which I never ended up using, as paying out of pocket for the few times I have needed medical attention (I have no existing medical conditions, and do not need to take any medication, knock on wood) was far less than the deductible, even when I got an MRI for a back injury.

When I got over 70, the premiums got too expensive for me, and I was throwing money down the drain every year (yes, I realize that the concept of insurance is coverage for what ifs).

Now I try to sock away as much as I can afford to every year, i.e. as close to what I would have had to pay in private insurance premiums as possible, so that if something came up, barring some hugely expensive procedure, I could pay for it. So far, in my case, that has added up to $10,000 (and I also have a small investment I could dig into if necessary) that is in my bank account, and accruing interest, rather than disappearing into an insurance company's coffers.

And if I really needed to, I could use that money for something else, like another vehicle if my current one completely died.

But the reality is that if I were to develop some serious condition, very expensive to treat, I would likely have to move back to Canada, where my medical would be covered.

 

 

Link to comment
Share on other sites

25 minutes ago, dottiejane said:

from the few conversations I have had with longtime expats, everyone's experience seems different - one gentleman had a friend who needed three stints put in - one place quoted 50,00 american - he got it for 12,000 american I THINK - I always have to qualify what i say since sometimes people tell you the worse scenerio and then add a bit to liven it up - anyway either way that is way more than I would pay INSURED in the States -  I am hoping neither  stintsn or anything totally serious is in my future - according to my Vantage account, I have just about enough to pay for a box of aspirin 

As a recent arrival on a resident visa, you had to prove sufficient income or assets to be approved.  One reason for that is to ensure that you have the means to pay for your medical care here, or to fly back to US and use your Medicare, or buy Mexican private insurance or buy an evacuation insurance plan. 

Mexico has raised these income and asset requirements partly to weed out medical refugees who may become a burden to the state.  

 

  • Like 2
Link to comment
Share on other sites

I've been with the Mexican insurance company, GNP, for almost 20 years. Fortunately, I've only had to use it for a hip replacement and a foolish crash on a scooter (never again) that caused a break in my color bone and a couple of ribs.  The hip replacement required meeting deductible and small co-pay but the scooter incident was an accident so it had no deductible and was covered 100%. I have been happy with the Agent and the coverage. Currently, my monthly premiums are about $220 USD. I pay for the full year, in advance.

Salud!

Val Jones :)

Link to comment
Share on other sites

For the benefit of others here, if you drop GNP and then later want to acquire a new policy, GNP will not accept you after the age of 65.  Excellent insurance although a local agent here dropped the ball on my one claim.  His error cost me $5000 USD.  

Link to comment
Share on other sites

since i have precoonditions = pace maker and breast cancer and am OLD enough (85) to have ridden a dinosaur - - I doubt I could get GNP - what kind of error could it have been to cost 5000?  i keep off of everything with wheels - i just use the two feet I can still walk on - hoping I don't trip but there are no assurances even with them.  d

  • Haha 1
Link to comment
Share on other sites

19 minutes ago, dottiejane said:

 - what kind of error could it have been to cost 5000? d

He told me I had to pay out of pocket for meds and GNP would reimburse me.  It was a time critical situation.  GNP did not reimburse me because the protocol is that the agent is required to order the meds thru GNP.  Someone in his office was in training, like "Fake it until you make it."

Speaking about healthcare costs here, Puerta Hierro del Sur is 5000 USD per night for a room.  Best to have a Plan B.  

Link to comment
Share on other sites

LORDY - Plan B may be to get a ticket on volaris and go back to porland and medicare - i must admit, i missed something with all of the chats about the cheap medical care in mexico - actually since i am alone and as Chris Rock said, don't depend on your friends to take care of you - the main reason i moved here was to afford nursing home care if i need it - there was no place i could go in portland for less than 5000 a month unles you were willing to do section 8 and then there was a huge wait - i had signed up for Oregon's death with dignity law which if you get a 6 month terminal illness diagnosis allows for a quick and painless way out shall we say - the problem is if one has a stroke or some other miserable but non-terminal problem, there is little help - don't tell me I was wrong about that as well - will have to check  out with other americans here as to what they do - eat more kale is plan c

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...