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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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I am not very well informed about the Canadian rules but was a specialist in Health Insurance before retirement. Most US policies have a provision
for foreign travel and will reimburse you for whatever payments you make in a situation that is called threat to life or limb. Most insurance
companies do not have a direct connection to hospitals in Mexico so it is reasonable to expect the customer will pay the bill, submit the bills on
return, and will usually get reimbursed for "Normal and customary" which is usually based on a percentage of allowable Medicare reimbursement rates.
Some will pay a percentage of amount billed but they know the rates are much lower in Mexico than they are for the United States or Canada.
Hopefully these kinds of discussions will get people to check with their agent about how they are covered when traveling to a foreign country.
And it certainly makes sense to have evacuation insurance of one kind or the other if you think it is important to return to your country of origin
for treatment.
Too many people come down for vacation and think it is like an extended trip to Disneyland and when an accident or illness strikes then they are
totally unprepared. When I had clients who were travelling abroad, I always filled them in beforehand about what they could expect. But, if most
people are like a lot of my clients they only read the policy after they have a problem.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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or have a credit card that has a sufficient balance to pay Dianamed or other ambulance. | Quote: | Originally posted by bajaguy
Anyone who travels to (or lives in) Baja/Mexico should have travel and or evacuation insurance. If you don't, you are gambling with your life.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Yes Bob, but hopefully she had medicare or other insurance to cover most of her expenses in the US. | Quote: | Originally posted by durrelllrobert
A friend here in Punta Banda was extremely ill last week so Cruce Rosas was called and their ambulance transported her to the new International
Hospital (downtown Ensenada on Lazaro Card##as behind the DHL office) at no charge. At that hospital she was treated and stabilized in ICU for about 4
hours ($500 US) and then transported by THEIR private ambulance to secondary at San Ysidro with one of their doctors on board, as well as her
husband.($800 US) and they accepted a US credit card for the whole bill.
At secondary she was transferred to a US ambulance and driven to Scripps hospital in Chula Vista (about 8 miles) for $2,200 and the ICU there runs
$3,800 / day. |
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durrelllrobert
Elite Nomad
Posts: 7393
Registered: 11-22-2007
Location: Punta Banda BC
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Mood: thriving in Baja
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| Quote: | Originally posted by EnsenadaDr
Yes Bob, but hopefully she had medicare or other insurance to cover most of her expenses in the US. | Quote: | Originally posted by durrelllrobert
A friend here in Punta Banda was extremely ill last week so Cruce Rosas was called and their ambulance transported her to the new International
Hospital (downtown Ensenada on Lazaro Card##as behind the DHL office) at no charge. At that hospital she was treated and stabilized in ICU for about 4
hours ($500 US) and then transported by THEIR private ambulance to secondary at San Ysidro with one of their doctors on board, as well as her
husband.($800 US) and they accepted a US credit card for the whole bill.
At secondary she was transferred to a US ambulance and driven to Scripps hospital in Chula Vista (about 8 miles) for $2,200 and the ICU there runs
$3,800 / day. |
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She's on Tricare from the VA
Bob Durrell
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Feathers
Nomad
Posts: 447
Registered: 9-14-2009
Location: La Bocana
Member Is Offline
Mood: Happy
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| Quote: | Originally posted by durrelllrobert
A friend here in Punta Banda was extremely ill last week so Cruce Rosas was called and their ambulance transported her to the new International
Hospital (downtown Ensenada on Lazaro Card##as behind the DHL office) at no charge. At that hospital she was treated and stabilized in ICU for about 4
hours ($500 US) and then transported by THEIR private ambulance to secondary at San Ysidro with one of their doctors on board, as well as her
husband.($800 US) and they accepted a US credit card for the whole bill.
At secondary she was transferred to a US ambulance and driven to Scripps hospital in Chula Vista (about 8 miles) for $2,200 and the ICU there runs
$3,800 / day. |
wow.  just WOW.
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CaboMagic
Super Nomad
Posts: 1109
Registered: 4-30-2005
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Have to say Pescador - I find your input/posts so valuable. Thank you for them.
We provide the following note to every client. Welcome input from any Nomads on additional info we ought provide:
In Cast of Emergency
No one wants a vacation trip interrupted by an emergency – in Cabo or back home.
It is important to be prepared.
You can provide your home/office with our contact information. Vonage Tel 619.819.8634 or US Tollfree 888.475.5337
We can generally get a message to you provided we know the name your resort/villa/timeshare reservation is in. This is important.
We respectfully suggest you don’t use any product for the first time in Cabo – especially over the counter sea-sickness meds!
Why not do a test run before you travel to be certain you don’t suffer from an adverse reaction.
If you find yourself in an emergency medical or dental situation contact the General Manager of your resort – ask if they have an on-site physician.
Some provide contact information for a general doctor or dentist.
It’s a good idea to check with your insurance provider in the USA about their policy concerning benefits/coverage
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Kgryfon
Senior Nomad
Posts: 624
Registered: 1-27-2009
Location: East Bay, CA
Member Is Offline
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| Quote: | Originally posted by Kgryfon
What if you have no one to stay with you? They just leave you there to rot in your own feces until you die? What if you have two broken legs, or a
heart attack and can't walk to the pharmacy? No meds for you so you writhe in pain or die? |
I'm bumping this because I didn't get an answer, and I really would like to know since I am single. I most likely wouldn't have someone that could
sit with me 24 hrs a day...so...what would happen?
Edited to say I WOULDN'T ,not would, have someone to stay with me.
[Edited on 6-20-2014 by Kgryfon]
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Travelinleah
Junior Nomad
Posts: 35
Registered: 10-6-2013
Location: North Idaho
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Mood: Waiting.....
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Can a tourist who only spends winter in Baja get IMSS or seguro popular? Am I right in thinking that it is better to go to public hospital rather than
private? I've been gathering my credit cards in case of such an emergency, hearing the horror stories of injured tourists in Cabo. What about Good Sam
Travel Assist, anyone have any idea if this good enough for evac etc? http://www.goodsamtravelassist.com/
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Katiejay99
Nomad
Posts: 429
Registered: 9-3-2008
Location: Todos Santos
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Mood: it is what it is
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The Public hospital is cheaper whether you have insurance or not.
I think you have to be a resident or at least own property in order to get Seguro Popular, but I am not certain. I know that you must have a CURP
number.
One of the prerequisites to be admitted is that you have someone with you. Another is that if you need surgery, depending on the surgery, you need 1
or 2 people to donate blood in your name. It must be done before you will be admitted for surgery.
I hope this helps.
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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You need a CURP card and if you are a renter you are eligible for Seguros Popular. You can show an electric bill or Telephone bill. The fee varies
by office from free in some places in Ensenada to 1200 pesos a year for an individual. The individual has some ability to charge what they think is
right. But if you take out a year and don't use it, where else could you get basic coverage for $100 US dollars a year.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Katie, I worked for several years in the IMSS hospital in Ensenada, and they don't require you to have someone sit with you 24 hours a day. You first
brought this up about getting a prescription filled and that you must have someone sit with you. This also is not true. If a patient has Alzheimer's
then they must be supervised by a family member but a normal functioning person who has all of his or her faculties doesn't need to have supervision.
If you have an outpatient procedure, then yes you would need someone to drive you home. In an emergency surgery situation it is pretty obvious you
would not be required to donate blood before hand, however, with an elective surgery they might require it due to the scarcity of blood
available. | Quote: | Originally posted by Katiejay99
The Public hospital is cheaper whether you have insurance or not.
I think you have to be a resident or at least own property in order to get Seguro Popular, but I am not certain. I know that you must have a CURP
number.
One of the prerequisites to be admitted is that you have someone with you. Another is that if you need surgery, depending on the surgery, you need 1
or 2 people to donate blood in your name. It must be done before you will be admitted for surgery.
I hope this helps. |
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Mulegena
Super Nomad
Posts: 2412
Registered: 11-7-2006
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| Quote: | Originally posted by EnsenadaDr
Katie, I worked for several years in the IMSS hospital in Ensenada, and they don't require you to have someone sit with you 24 hours a day. You first
brought this up about getting a prescription filled and that you must have someone sit with you. This also is not true. If a patient has Alzheimer's
then they must be supervised by a family member but a normal functioning person who has all of his or her faculties doesn't need to have supervision.
If you have an outpatient procedure, then yes you would need someone to drive you home. In an emergency surgery situation it is pretty obvious you
would not be required to donate blood before hand, however, with an elective surgery they might require it due to the scarcity of blood
available. | Quote: | Originally posted by Katiejay99
The Public hospital is cheaper whether you have insurance or not.
I think you have to be a resident or at least own property in order to get Seguro Popular, but I am not certain. I know that you must have a CURP
number.
One of the prerequisites to be admitted is that you have someone with you. Another is that if you need surgery, depending on the surgery, you need 1
or 2 people to donate blood in your name. It must be done before you will be admitted for surgery.
I hope this helps. |
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First, let me state that I'm not taking
issue with the veracity of anyone's statements.
My observations, admittedly limited, support the theory that every patient in either a Seguro Popular or Seguro Social (IMSS) hospital-- at least here
in the Mexican State of Baja Sur-- in practice has someone with them 24/7 during their in-patient stay. If they are receiving blood as a part of their
treatment the patient is required to replace it or pay for it. This is what I've seen in practice, not necessarily written down in the rulebook, but
experienced personally or heard from others in corroboration.
Edited to add this link to a pertinent article: http://www.bajainsider.com/baja-life/health/emergencymedical...
[Edited on 6-17-2014 by Mulegena]
"Raise your words, not your voice. It's rain that grows flowers, not thunder." ~Rumi
"It's the mark of an educated mind to be able to entertain a thought without accepting it." ~ Aristotle
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Katiejay99
Nomad
Posts: 429
Registered: 9-3-2008
Location: Todos Santos
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Mood: it is what it is
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EnsenadaDr I respectfully acknowledge your knowledge of Baja North.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Here is an article in Spanish which states that IMSS asks the families to respect the hours of visitation and NOT be at the bedside between the hours
of 7 and 8 am and 4 pm and 6 pm. when the staff is giving medication and providing personal care to the patient.
It also states that the patient must have time to recuperate and in no cases are family allowed at the bedside at that time. So where this idea o
24/7 of being with the patient is confusing to me. They do suggest to have a spokesman for the family to discuss issues etc.
http://www.elsiglodetorreon.com.mx/noticia/894931.pide-imss-...
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SFandH
Elite Nomad
Posts: 7084
Registered: 8-5-2011
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Doc, maybe different hospitals do things differently...............
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Could be, I know that when I worked in the US the family of the patient, especially large Mexican families wanted to have everyone in the room when
the limit was 2 visitors at a time. It was very hard to enforce that rule without offending anyone especially when the patient was tired and just
wanted to rest.
I imagine that most hospitals in Mexico try and respect the family's wishes, but the rules set by IMSS are for all of their hospitals, as I remember
the nurses shooing out the families during these times and were strict about it. | Quote: | Originally posted by SFandH
Doc, maybe different hospitals do things differently............... |
[Edited on 6-18-2014 by EnsenadaDr]
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Katiejay99
Nomad
Posts: 429
Registered: 9-3-2008
Location: Todos Santos
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Mood: it is what it is
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EnsenadaDr: There are two types of public hospitals (as I am sure you know, but I mention it for our readers sake). The IMSS hospital is for people
with insurance under IMSS which is mostly government workers as I understand it.
The second one is for people with Seguro Popular. As that is what I have, that is the only one I can speak of. It is a fact that at the Salvatierra
hospital you absolutely MUST have someone there with you. Maybe I will scan the paperwork I got from the hospital and post it but I don't really feel
like doing it just to prove myself correct. I just got out of the hospital and I certainly do know their rules and regulations.
Also, only 1 person is allowed in the room at a time and visitors must hand over a form of ID to the guard before being allowed to enter. He has a
large tray in front of him with all of the room numbers on it with a place to put someones ID in that slot. The person with the patient is allowed to
leave to go get lunch, dinner or coffee (all to be eaten or drunk before entering the guard area). The guard will allow 2 ID's if someone has come to
relieve the other person. They get very testy if a slot is empty for more than an hour.
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vandenberg
Elite Nomad
Posts: 5118
Registered: 6-21-2005
Location: Nopolo
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Mood: mellow
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| Quote: | Originally posted by Kgryfon
I'm bumping this because I didn't get an answer, and I really would like to know since I am single. I most likely woudl have someone that could sit
with me 24 hrs a day...so...what would happen? |
My wife had surgery in the Salvatierra hospital in La Paz and I paid a nurse to be the person with her a nominal amount, since there was no place to
sleep in or near the room.
This was some time ago at the old location.
[Edited on 6-18-2014 by vandenberg]
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Here is the home page of the hospital for the family of patients where it says you can only visit patients from 11:00 a.m. to 12:30 p.m. and from 4:00
p.m. to 6 pm. ICU and pediatrics have different visiting hours. Look under guia para el familiar de paciente hospitalizado. (Guide for the family of
the hospitalized patient.) It's possible if you don't speak Spanish they would want a family member there all the time to translate for the staff.
http://www.hgejms.gob.mx/departamentos/trabajo.social/trabaj...
[Edited on 6-18-2014 by EnsenadaDr]
[Edited on 6-18-2014 by EnsenadaDr]
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Katiejay99
Nomad
Posts: 429
Registered: 9-3-2008
Location: Todos Santos
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Mood: it is what it is
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Boy, you are one stubborn woman!
Visitors have visiting hours and they are: 11am-12:30pm and 4pm-6pm. THOSE ARE VISITORS (which may or may not be family or a noted responsible party).
They are NOT the person who must stay with the patient 24/7. When you go into the hospital you must give them the name and phone number of the
person(s) who will be a "responsible party" ie there 24/7. As I had 2 different people helping me, they took turns. As one was with me the other was
actually living in my van (which I bought in October from a Nomad) and it was parked in the parking lot. The van has a refrigerator, stove and water
storage as well as the bed - its' a great camper/van.
Ok - look at #4 of your post. Es importante que la familia haga o tome turnos para el cuidado del paciente, no es necesario permanecer todos en el
Hospital. Which says: It is important that the family takes turns to care for the patient and it is not necessary for all of them to stay in the
hospital.
Also, my two friends are not family. One was Mexican who speaks no English and the other was American who speaks passable Spanish.
And if doesn't do it for you then I give up.
[Edited on 6-18-2014 by Katiejay99]
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