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vandenberg
Elite Nomad
Posts: 5118
Registered: 6-21-2005
Location: Nopolo
Member Is Offline
Mood: mellow
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U.S. medical insurance
How do you Nomads, that live in Baja ( especially BCS ), deal with your medical needs.when treatment in California is wanted?? I live in Loreto
permanently, have medicare plus blueshield supplemental, and need carpal tunnel treatment badly. No more residency in Sacramento, only some friends
and family. As everyone knows, getting appointments and treatment takes time. Lots of it. And staying with people you know gets old quick. Remember
company and fish after 3 days...? So, the alternative is getting treatment ( operation ) in Baja, meaning La Paz.. Don't doubt the competency of their
physicians, but doesn't this imply that your , very costly, insurance is only good for life or death situations ?
I know that I can't be the only one with this dilemma, so please let's hear from Nomads that have experienced this kind of situation and how they
dealt with it.
Your input will surely be appreciated. 
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fishbuck
Banned
Posts: 5318
Registered: 8-31-2006
Member Is Offline
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This is a great question. I don't know the answer but as someone who plans to retire in Baja I am also interested.
Wouldn't San Diego be the logical choice for medical treatment. Why would that be so difficult. You could schedule the surgery and either drive or
fly. It may require a stay in a motel but shouldn't be more than a week. I would imagine that SD has the very finest medical treatment. If the surgery
goes okay then any follow up visits could be handled locally.
Is that too simple?
[Edited on 12-6-2006 by fishbuck]
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jerry
Super Nomad
Posts: 1354
Registered: 10-10-2003
Location: loreto
Member Is Offline
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i too am intresten in medical info in bcs as im too younge to get medicar ill be footing my own bill witch i havent choosen yet my problem is the us
insurance isnt any good in mexico the mexican insurence isnt any good in the us?? or so i hear any heads up??
jerry and judi
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vandenberg
Elite Nomad
Posts: 5118
Registered: 6-21-2005
Location: Nopolo
Member Is Offline
Mood: mellow
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Schedule surgery ? How, without being present. Doctors won't do anything without seeing you first. Loreto, being over 700 miles below the border, is
no picnic to drive. Stay in a motel for a week or so, plus staying for follow up visits ? No idea where you're from fishbuck, but most motels in that
area run in the 70 to 100 dollar a night range, a little beyond my budget for any extended stay, which is unavoidable for any kind of medical
treatment, surgery or not. Had some medical work done in Sacramento last summer. Took almost 2 months to get everything done and that was with the
doctors giving me priority for living in Mexico. For some procedures it takes months to get an appointment. Luckely have friends there that let me use
their cabin in Tahoe. And nowadays, flying back and forth at close to $ 500.00r/t is out of the question for most folks.
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bajabound2005
Ultra Nomad
Posts: 2760
Registered: 10-15-2005
Location: Punta Banda, BCN
Member Is Offline
Mood: words cannot describe...
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Medicare will cover no expenses outside the country. Your supplement MAY cover emergency treament. I'm not sure if all supplement plans do so, but
Plan J seems to cover emergency treatment. You'll still have to pay the hospital here and then get reimbursement for covered charges from the
insurance company. Our neighbor fell on Thanksgiving Day and broke her hip. After surgery and several days in the hospital the bill was about $8000
total. They had to pay it but the Supplement plan will reimburse 80% of the bill.
Read your policies carefully. Some may say they only cover emergency treatment if you've been out of the country less than 90 days...in which case,
you just arrived a couple weeks ago!
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modhatter
Newbie
Posts: 22
Registered: 6-30-2005
Member Is Offline
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Medicare suppliment
I am unclear as to why you would continue to carry and pay for a supplimental policy if you didn't have some ideas how to use it if you became ill. I
would suggest that staying with friends and or relatives would be your only avenue.
However, this is not a life threatning condition. I am not clear on the theray needed, but you might want to consider the cost of having the
proceedure done in Mexico, and then compare the costs (travel and convenience) There are competent doctors in Mexico.
Personally, my own plan as with many other gringo's is to use Mexican doctors for all non-life threatning conditions, and keep US insurance in case
anything really major occurs and you do not have faith in treatment in Mexico or they do not have treatment or equipment avail. that you might need.
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fishbuck
Banned
Posts: 5318
Registered: 8-31-2006
Member Is Offline
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| Quote: | Originally posted by vandenberg
Schedule surgery ? How, without being present. Doctors won't do anything without seeing you first. Loreto, being over 700 miles below the border, is
no picnic to drive. Stay in a motel for a week or so, plus staying for follow up visits ? No idea where you're from fishbuck, but most motels in that
area run in the 70 to 100 dollar a night range, a little beyond my budget for any extended stay, which is unavoidable for any kind of medical
treatment, surgery or not. Had some medical work done in Sacramento last summer. Took almost 2 months to get everything done and that was with the
doctors giving me priority for living in Mexico. For some procedures it takes months to get an appointment. Luckely have friends there that let me use
their cabin in Tahoe. And nowadays, flying back and forth at close to $ 500.00r/t is out of the question for most folks. |
Okay I booked you a room at the Motel 6 in Chula Vista for $40 a night. Jump in your car and drive to GN. Use your good hand. Stay one night for about
$30 . Get up early and drive to San Quintin. Stay one night for about $30. Show up the next day at the doctor in San Diego after lunch. I assume you
have a telephone so you should be able to schedule an intial visit. While you're there schedule the surgery. Stay in SD for a day and rest and then
drive yourself home. Repeat the trip in a month or so as required to return for surgery.
Total trip cost not including doctor about $300.
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
Member Is Offline
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I am a blue Cross blue shield Agent in Colorado (when I am home) and you should have world wide coverage, but some different deductible options.
check with the insurance company and ask if you are covered. Then check with medicare. I think that is where you run into the snag. Blues will
cover you probably but medicare is the first payee so they may not cover out of the US. Start with the benefit of descriptions on the Medicare
website and see. I have used my individual insurance and it covered things that I had done in Mexico but it was a seperate deductible. I paid the
bill and worked on reimbursement when I presented the bills.
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Capt. George
Super Nomad
Posts: 2129
Registered: 8-21-2003
Member Is Offline
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does anyone have knowledge of Mexican medical insurance??
gp
\"The penalty good men pay for indifference to public affairs is to be ruled by evil men\" Plato
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bajabound2005
Ultra Nomad
Posts: 2760
Registered: 10-15-2005
Location: Punta Banda, BCN
Member Is Offline
Mood: words cannot describe...
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we just met with an agent for mexican health insurance -- pre-existing conditions are not covered. Por ejemplo, my husband has a pacemaker -
anything regarding the heart was automatically eliminated. Age is also a consideration. Over a certain age (I think 75) they won't cover you. You
still have to undergo a physical exam to get the coverage. The rates are very inexpensive compared to the US, but know what you are getting.
I second Pescador's suggestion, talk to your supplement company (forget Medicare - they won't cover it out of the USA). Go to them with the US price
and the Mexico price - they may agree to pay for (part) if you have it done in Mexico since I'm sure the price differential would be to the insurance
company's favor! Remember though that in the US there is an agreed upon fee between Medicare/Insurance Supplement Co and the medical provider so you
have to compare apples to apples.
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fishbuck
Banned
Posts: 5318
Registered: 8-31-2006
Member Is Offline
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| Quote: | Originally posted by bajabound2005
we just met with an agent for mexican health insurance -- pre-existing conditions are not covered. Por ejemplo, my husband has a pacemaker -
anything regarding the heart was automatically eliminated. Age is also a consideration. Over a certain age (I think 75) they won't cover you. You
still have to undergo a physical exam to get the coverage. The rates are very inexpensive compared to the US, but know what you are getting.
I second Pescador's suggestion, talk to your supplement company (forget Medicare - they won't cover it out of the USA). Go to them with the US price
and the Mexico price - they may agree to pay for (part) if you have it done in Mexico since I'm sure the price differential would be to the insurance
company's favor! Remember though that in the US there is an agreed upon fee between Medicare/Insurance Supplement Co and the medical provider so you
have to compare apples to apples. |
Why the reluctance to just go to San Diego and take advantage of Medicare? Aren't you retired? What else do you have to do with your time?
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greybaby
Nomad
Posts: 182
Registered: 10-8-2004
Location: Idaho - formerly Cantu
Member Is Offline
Mood: Missing Baja
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I will probably ruffle some feathers here but have to jump in. Having worked in the medical field all of my adult life AND having lived in Mexico for
6 years and witnessed first-hand the availability (or lack thereof) of quality medical care, think seriously about the ramifications of retiring
outside of the U.S. when probably most of us, as we age, will need more medical care on a yearly basis. My husband and I lost both of our mothers
while living in Ensenada and decided then we could not subject our own sons to dealing with our care as we aged in a country where neither one of us
trusted the health care system (our friends who are nationals feel the same).
We have returned to Idaho and I now work in a large community health center and though our medical system is flawed it is still far superior to what
most of the world has to offer. It is important to be established with a physician or clinic that will continue to treat us as we reach Medicare age.
As much as I love Mexico and the people there, I think it is very important to think logically about health care needs as we approach retirement. My
theme when we lived there was if I looked like I was slipping, drive North fast!!
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Diver
Ultra Nomad
Posts: 4729
Registered: 11-15-2004
Member Is Offline
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Why not keep a US policy active with a US address ie your children or sibling ? If you have a serious immediate need for medical care, the binational
evacuation insurance would get you back to the US and bill your insurance company. Otherwise, you could take care of non-emergency needs when you
visit your relatives.
Who ever knows how long you have been in Baja at any given time anyway? You were just there on a short vacation, right ?
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comitan
Ultra Nomad
Posts: 4177
Registered: 3-27-2004
Location: La Paz
Member Is Offline
Mood: mellow
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Vandenburg
It seems nobody has really addressed this problem. A solution would be for 20 or more people to go in together and buy a condo in TJ they can be had
for around $100,000 and everyone who invested would have an investment and a place to stay. With the number of people that are now living in the BCS
don't think it would be difficult to find that many people.
Strive For The Ideal, But Deal With What\'s Real.
Every day is a new day, better than the day before.(from some song)
Lord, Keep your arm around my shoulder and your hand over my mouth.
“The sincere pursuit of truth requires you to entertain the possibility that everything you believe to be true may in fact be false”
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bajalou
Ultra Nomad
Posts: 4459
Registered: 3-11-2004
Location: South of the broder
Member Is Offline
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| Quote: | Originally posted by fishbuck
Why the reluctance to just go to San Diego and take advantage of Medicare? Aren't you retired? What else do you have to do with your time?
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Often for retired folks, it isn't the time that's a problem, it's the money for traveling and staying somewhere.
No Bad Days
\"Never argue with an idiot. People watching may not be able to tell the difference\"
\"The trouble with doing nothing is - how do I know when I\'m done?\"
Nomad Baja Interactive map
And in the San Felipe area - check out Valle Chico area |
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bajabound2005
Ultra Nomad
Posts: 2760
Registered: 10-15-2005
Location: Punta Banda, BCN
Member Is Offline
Mood: words cannot describe...
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| Quote: | Originally posted by fishbuck
Why the reluctance to just go to San Diego and take advantage of Medicare? Aren't you retired? What else do you have to do with your time?
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For routine medical care, driving 6 hours (round trip) and sitting at the border for 2 hours, and paying the tolls - it just isn't worth it. We are
trying to do routine things in Baja. For the major stuff (pace maker checks - it's an ICD so it can't be done over the phone) we do make the trip.
Lab work we do get done here (it's cheap) and fax the report or call in the results to the US doctors.
I do like that idea of a co-op condo though!
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MrBillM
Platinum Nomad
Posts: 21656
Registered: 8-20-2003
Location: Out and About
Member Is Offline
Mood: It's a Zip-a-Dee-Doo-Dah Day
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We're all Going to Die.
My attitude is to roll the dice and simply accept whatever happens. Most of the people who are so worried about the Medical situation are well into
Geezerhood like I am. Life has been mostly good and I've gotten my share. It won't be any big deal when I finally go Face Down and it'll make so
many other people happy.
The Clinics that are sprouting up in all of the Tourist areas seem to do a pretty good job with the mundane Medical tasks. One thing that would be a
good investment is the Air Evac Insurance since that mode of transport is obscenely expensive. I had a neighbor who paid over $25K to be flown to San
Diego when he had a Heart Attack. When I had some trouble in that regard, I closed up the house and drove for the border so that , if I croaked, I'd
be back in the U.S. and my wife wouldn't have to go through the Hellish process of getting the body out.
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greybaby
Nomad
Posts: 182
Registered: 10-8-2004
Location: Idaho - formerly Cantu
Member Is Offline
Mood: Missing Baja
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Mr. BillM, You've got the right attitude about it and that's why you can successfully live out your days in Baja. I applaud you.
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Don Alley
Super Nomad
Posts: 1997
Registered: 12-4-2003
Location: Loreto
Member Is Offline
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My wife and I have both had some minor diagnostic and consulting done at the Virginia Mason clinic in Seattle. They have a nice attached hotal at
reasonable rates, and a comprehensive hospital staff that can do pretty complete overhauls. You can consolidate a lot of medical work there, and
schedule several appointments with different specialists in a couple of days.
I believe there is a similar clinic in San Diego.
Not cheap, but insurance may cover expenses. Places like Virginia Mason commonly help patients from out-of-town, such as people from small towns with
limited health care options. I found them very good at scheduling to minimize time away from home.
Other than perhaps distance and air fares, is your problem different from the problems facing someone living in Turtle Falls, Wyoming?
We've kept a place in Kalispell. We just downsized to a smaller place this summer, but we did keep a place to hang out there. Medical work was one
reason.
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bajalou
Ultra Nomad
Posts: 4459
Registered: 3-11-2004
Location: South of the broder
Member Is Offline
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From areas line San Felipe, you can often be driven to the border, or use a local ambulance in much less time than getting a plane in for air-evac.
The local ambulance's make arrangements to be met by US ambulances at the border and avoid the long wait lines.
Like MrBill, dying ain't no big deal, it'll happen when it does and today I have nothing left undone with my life/relationships so I'm at peace to go
when it's my time. But I ain't volunteering.
No Bad Days
\"Never argue with an idiot. People watching may not be able to tell the difference\"
\"The trouble with doing nothing is - how do I know when I\'m done?\"
Nomad Baja Interactive map
And in the San Felipe area - check out Valle Chico area |
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