BajaNomad - What to do in the event of a health care emergency?

What to do in the event of a health care emergency?

pauldavidmena - 11-3-2013 at 03:30 PM

As a Nomad wannabee, I have health insurance provided by my U.S. employer, but I have no idea what that means South of the Border. Granted, I only visit for a week at a time a couple of times a year, but I'm hoping that the duration and the frequency will increase over time. Once that's the case, the laws of probability make it more likely that either my wife or I, both healthy and in our mid-fifties, will have some sort of health emergency in Baja. If that were to happen, what would be the typical recourse?

For background (and FWIW), most of our visits have been to the Todos Santos area (Pescadero, Las Tunas, San Pedrito, etc.). My current health insurance is through Blue Cross / Blue Shield of Massachusetts.

cabonotcho - 11-3-2013 at 03:39 PM

here in Cabo we have centromedico and amerimed or something like that but sadly they will charge you alot, however on a really nice note the mx redcross has always been excellent and do xrays they did well for my son when he fell on his head 25 yrs ago- im sry i know this isnt much help but i think most drs are kinda quacks anyway-plz just be safe and you can by medivac insurance is your so inclined.Oh and no sadly most U.S health insurance is not recognized south of the border.

[Edited on 11-3-2013 by cabonotcho]

Med Emergencies

bajaguy - 11-3-2013 at 04:11 PM

In a medical emergency/event in Baja, the majority of doctors, hospitals and ambulance services will require cash or a credit card deposit or payment.

In my research, I have found that "almost all" US health insurance coverage is not valid south of the border.....with some exceptions.

If you are "on vacation" and need emergency treatment/care, some US insurance MAY reimburse you. US Medicare is not valid south of the border, but I have a supplemental Plan F that will reimburse emergency treatment/care.

My suggestion is to find through referrals and first hand info a competent health care professional in Baja and also check out the hospitals where you will be located.

A second suggestion is to invest in a Medical Evacuation insurance plan that will take you to the nearest US hospital for initial treatment/stabilization, then transport you to US hospital of your choice, not just the closest US hospital.

Depending on where you are located, the method of transportation and the level of care while being transported, an evacuation can cost between $25,000 and $100,000

We did our research and selected GEOS Worldwide Evacuation Insurance:

http://www.geosalliance.com/geos-services/worldwide-medical-...

Another service that you can take advantage of is free, and offered by Sharp Medical Centers in San Diego. With one call, Sharp will arrange your evacuation/transport from almost anywhere in Baja.....but you need cash and insurance to cover local costs and transportation to the US border. Your US insurance takes over once you are on the US side.

http://www.sharp.com/international-services/index.cfm

Good luck

[Edited on 11-3-2013 by bajaguy]

Healthcare

captkw - 11-3-2013 at 04:36 PM

Vagabundos del mar has some fly programs that sound like a deal..I drank so much tokillya when I was younger.... I'll live for a long time with the pickle factor !!

DENNIS - 11-3-2013 at 04:47 PM

Quote:

Originally posted by bajaguy
In a medical emergency/event in Baja, the majority of doctors, hospitals and ambulance services will require cash or a credit card deposit or payment.

And it won't be cheap. "Sick or hurt while gringo" can be expensive.

I know.

Ateo - 11-3-2013 at 04:49 PM

What to do in the event of a health care emergency?

I cross my fingers, in Mexico and in the USA.

bajaguy - 11-3-2013 at 04:53 PM

Dennis.......not to get too personal, but did the VA reimburse you for any of your "emergency" expenses (doctor, hospital, ambulance, meds)???

Quote:

Originally posted by DENNIS

Quote:

Originally posted by bajaguy
In a medical emergency/event in Baja, the majority of doctors, hospitals and ambulance services will require cash or a credit card deposit or payment.

And it won't be cheap. "Sick or hurt while gringo" can be expensive.

I know.

DENNIS - 11-3-2013 at 05:31 PM

Quote:

Originally posted by bajaguy
Dennis.......not to get too personal, but did the VA reimburse you for any of your "emergency" expenses (doctor, hospital, ambulance, meds)???

No. I didn't ask. I was too far out of it to take care of business at the time.
Anyway, I went to Kaiser.
Since then. I've changed all my care to the VA.
Being down here, and all that stuff being up there, I'm not capable of chasing down all the loose ends. It's easier for me to just forget it.

dtbushpilot - 11-3-2013 at 05:37 PM

We have Blue Cross Blue Shield of New Mexico, they will reimburse me for medical expenses incurred in MX. I have to pay the bill and submit it for reimbursement. I haven't done it in several years but just recently had a physical exam in MX (blood work, tests etc.). I sent the receipt in a few days ago, I'll let you know if they pay.

DavidE - 11-3-2013 at 07:15 PM

IMHO

Take 1st and 2nd degree first-aid courses. Learn CPR. A good class, not just as spectators. Learn what to do in case you suspect the victim has had a stroke or heart attack.

Get a comprehensive first aid kit. Something that will help to staunch bleeding, dress burns. A splint.

Work out a realistic program on how to get a victim to medical help ASAP. Tough to do alone, but find out for sure the response time of an ambulance. Work out something with the neighbors. No question in Mexico it may be a lot quicker to load the victim in a private motor vehicle and rush them to the hospital.

When you have time, actually drive to the hospital or clinic's emergency entrance. You would be amazed at the percentage of people who panic and drive around in circles especially at night.

In my opinion, what happens in the first half hour is crucial. The victim has got to be stabilized. Only an MD is qualified to do this. I have overheard too many people who believe "Medical Emergency! Call The Air Evac Service!" This is wrong as hell. First, FORGET the evac service until the victim receives proper stabilization from a Mexican MD. When the MD pronounces the victim fit to evac then call the air ambulance.

EnsenadaDr - 11-3-2013 at 11:22 PM

Seniors Beware: Medicare doesn’t cover you outside the U.S.
Original Medicare is a fee-for-service health insurance plan managed by the U.S. Federal government. On top of Original Medicare, there are Medicare advantage plans, which are health plans offered by private companies approved by Medicare, and Medigap policies, which are private health insurance policies sold to fill the gaps in Medicare.
Some Medicare Advantage plans provide worldwide coverage benefits for senior health care insurance needs, but you will have to verify with your plan prior to traveling outside the U.S. to be sure.
Some Medicap policies (C, D, E, F, G, H, I and J) provide Foreign Travel Emergency health care coverage for travel outside the U.S. Under these plans, Medigap policies pay 80% of the cost of emergency care during the first 60 days of each trip after a $250 deductible. A lifetime limit of $50,000 applies.
Medicare does not cover health care services when you are outside the U.S. Specifically, it does not provide international travel health insurance coverage except when you are within:
the U.S. Virgin Islands
Guam
American Samoa
the U.S. Northern Mariana Islands
inside the U.S. borders
Some exceptions for Travel in Canada and Mexico
There are a few exceptions in cases of travel to Canada and Mexico. In some cases, Medicare can pay for inpatient hospital services in these countries if:
You live in or are inside the U.S. and need medical care, but the closest hospital is in Canada or Mexico. When the foreign hospital is closer and easier to get to than one in your home country, Medicare may pay for those services. (Please note the ‘may.’)
You are crossing through Canada without delay between Alaska and another state and you need medical care. If a Canadian hospital is closer or easier to get to than the nearest U.S. hospital, Medicare may pay for those services. (Again, please note the ‘may.’)
Cover Medical and Evacuation for Just Dollars per Day
Travel medical coverage – even for seniors – is really a ‘no-brainer’ decision because it gives you loads of important medical coverage for just a few dollars a day.
Let’s take a look at an example to prove our point.
Say you’re 70 years old, traveling from your hometown in Florida and spending a month in Australia with an old military buddy who has retired there.
You don’t want trip cancellation coverage, but you do want good medical and evacuation coverage. Running these trip details through a comparison engine, we came up with some quotes.
Global Alert Preferred
Medical evacuation: $500,000
Secondary medical coverage: $100,000
Pre-existing conditions included
$47
Seven Corners Round Trip Choice
Medical evacuation: $1,000,000
Secondary medical coverage: $150,000
Pre-existing conditions included
$55
Travel Guard Platinum
Medical evacuation: $1,000,000
Primary medical coverage: $50,000
Pre-existing conditions Included
$56

http://www.travelinsurancereview.net/tips-and-advice/choosin...

EnsenadaDr - 11-3-2013 at 11:26 PM

What About International Coverage?

If you are a senior who spends more than 60 days outside the U.S. per year, Medicare Parts A, B or C do not cover you outside the 60 days and max out at $50,000.00 of coverage. When you have been outside the US for more than 60 days, you are uncovered.
There is a solution though: If you live outside the U.S. for 6 months per year or longer, you qualify for international major medical insurance. A global policy will follow you wherever you travel in the world.
Mexico on my Mind and their sister site, American Insurance for ExPats, has customer care representatives that can look at what you are currently paying for your Medigap policy, and potentially recommend a less expensive plan that will not only provide you with the coverage you need in the U.S., but also allow you to afford international major medical insurance outside the U.S.
The plans allows you to visit any doctor available to you outside the US, no matter where you are in the world. The IMG staff is multi-lingual and can work with any language and currency. While you remain in the US, Medicare will be your primary insurance, and when you are outside the U.S., you have coverage through an international major medical policy intended for catastrophic illness or accident while residing abroad.
You can customize your coverage plan, and then select from multiple deductibles and modes of payment in order to accommodate your financial means. With your medical history in mind, the program provides flexible underwriting methods to extend coverage to you that may be declined by other companies. In addition, you will also have direct access to their “Medical Concierge,” a unique service that provides you with personalized assistance in locating a local health care provider.
If you will be living outside the U.S. for more than 60 consecutive days, but are not planning to live there year after year, than a medical travel insurance policy is an excellent option. The application only takes about 10 minutes to complete, there is no age limit or health underwriting, and your coverage can begin as soon as the next day.

http://www.mexicoonmymind.com/medicare-coverage-outside-the-...

bajajudy - 11-4-2013 at 10:13 AM

Bajaguy
Did you notice that it doesn't cover preexisting conditions?

SkyMedBarbara - 11-4-2013 at 11:30 AM

SkyMed Air Evacuation is "Peace of Mind" when in Mexico. We take you Home (US or Canada). Critical accident or critical medical emergency. Up to 6 months in Mexico is only $495.00 a year and takes you HOME not just the closest hospital that can treat you. I have been a rep. in Loreto for over 6 years. Please u to u me if you have any questions.

El Jefe - 11-4-2013 at 11:46 AM

Fell off the ladder and busted my mellon last year. Went to Amerimed Hospital in San Jose del and got fixed. They took my credit card as payment hold and billed my insurance Anthem Blue Cross. Insurance paid 100% since it was an accident. Bill to credit card was cancelled.

Just check with your provider. Odds are that they will cover you on vacation in mex. But make sure you have a good credit line on your card or cards so you can "cover" the expense until the insurance company says yes they will pay.

Our plan for emergencies is to get stabilized in Mex and then travel commercial to USA ASAP for whatever procedures are needed.

sancho - 11-4-2013 at 11:58 AM

Quote:

Originally posted by DENNIS

And it won't be cheap. "Sick or hurt while gringo" can be expensive.

There was a notable person a few yrs. back, who was
essentially held against his will in a some med facility
in Ensenada, for a few days, before his release
because of a demand of $, don't know what you would
call that? San Felipe, to my knowledge, has had the
Hospital there closed and the Red Cross is not there, so I assume they are left up to their own scrambling

unbob - 11-4-2013 at 12:02 PM

Quote:

Originally posted by pauldavidmena
My current health insurance is through Blue Cross / Blue Shield of Massachusetts.

I have BCBS also. Are you aware of BlueCard Worldwide? There's a fairly long list of providers in Baja. Worth checking out!

pauldavidmena - 11-4-2013 at 04:09 PM

@unbob - thank you for the tip! It looks like there are 5 participating hospitals in Cabo San Lucas, about an hour from Todos Santos. Curiously, I didn't find any in La Paz, which is about the same distance away. It also didn't mention St. Luke's, a private hospital right in Todos Santos, nor the more modest Centro De Salud. :?:

unbob - 11-5-2013 at 12:03 PM

Quote:

Originally posted by pauldavidmena
It looks like there are 5 participating hospitals in Cabo San Lucas, about an hour from Todos Santos. Curiously, I didn't find any in La Paz, which is about the same distance away.

When I searched for 'Outpatient/Doctor' providers in La Paz, I got a list of 51 doctors. Also got a list of 7 dentists in LP. But also got zero 'Inpatient/Hospital' providers for LP.

pauldavidmena - 11-5-2013 at 04:47 PM

Quote:

Originally posted by unbob

Quote:

When I searched for 'Outpatient/Doctor' providers in La Paz, I got a list of 51 doctors. Also got a list of 7 dentists in LP. But also got zero 'Inpatient/Hospital' providers for LP.

@unbob - since I generally only visit Todos Santos for a week or so at a time, I was focusing more on hospitals than doctors, but I'm somewhat relieved that should I need follow-up care with a specialist, it's available in La Paz as well as Cabo.