The first question people ask of me when they hear (to their horror) that I actually live full time in Mexico is,
"What do you do about medical problems?" You may be surprised to hear my answer, "It is wonderful. but the problem is you have to pay for it yourself". Luckily it is cheap compared to the United States (all medicine is cheap compared to the United States!). Without divulging much about my personal life (you may have noted that I do not!), I will say that I have had the occasion to visit a hospital here a couple of times.
Let me begin by talking about the Mexicans or Nationals as they are called here. For the most part, they do not trust doctors or hospitals and if possible, will self mediate. There may even be witch doctors or shamans here. You can't go two blocks in Puerto Vallarta without passing some sort of pharmacy. There are three kinds. We have the ones that dispense prescriptions drugs (with no prescriptions necessary), and the Farmacias Similares that sell sort of unauthorized generic drugs or maybe just similar in chemical compounds but produced in kitchens. They are much cheaper. You can buy a Viagra like pill for about $2.00 (or so I have been told, I really would not know!) Most popular with the Nationals are the homeopathic pharmacies. They sell herbs, lotions and concoctions that have been used here for centuries (maybe even thousands of years). Although most of my Mexican friends swear by them, I have so far stuck to the drugs I know (and I know a lot of them!).
The doctors are wonderful and all I have met speak perfect English. There is a woman here in Puerto Vallarta by the name of Pamela who disperses medical advice by email. She will answer medical questions or can refer you to a doctor or hospital. She knows every English speaking doctor here and will even make the appointment for you and email you a map to their office. This is of no cost to you. Now she may get a kick back or referral fee from the doctor or hospital, but it is free to us. She has recommended a dermatologist, podiatrist and a heart doctor to me. All were excellent and quite reasonable. I had three skin cancers removed and one had to be cut out and sent to a lab for analysis. I had to go back for the results and to have stitches removed and I think the total bill was about $100.00. I think Pamela may have first sent me to Dr. Lupita at the hospital a few blocks away, but then everyone I know goes to her, so maybe someone else did. She is so good she is authorized or approved by several medical insurance companies in the U.S. (just not by mine = more on that later) She is my regular doctor for "whatever":.
The hospitals are as clean, orderly and neat as any you will find anywhere. In fact my hospital room (yes I did spend a few days there) was as nice as any I have been in. It was a large private room with a large window with a nice view, a T.V., dresser, a few chairs and a large tile bathroom. Nurses were on call in less than a minute and most spoke some English. They were all very kind and extremely accommodating. Of course once I was up and wandering the halls I found that there was only one other patient on my floor.
After my first visit to emergency, I discovered the "Clinicas" They are always next to a small pharmacy. You just walk in to the pharmacy, make an appointment and go next door and sit in a chair until someone comes out and calls you. Sometimes I am the first one there and sometimes there will be six to ten people waiting (I walk on and come back later). My first visit there was when someone told me about the vitamin B shots they got there. Vitamin B is supposed to give you energy and strength and when I was worn out by one of my moves, I stopped by. The shot cost 20 pesos (maybe $1.50). You have to buy the medication and I think a weeks worth of shots might have been $30 or $40.00. Many such medications come already in disposable syringes. At first I thought I needed my FM3 card (or residency card) but since then no one has ever asked for it. I thought that they must be government sponsored, but I was told that they are privately funded. Whatever, it is nice for us "poor people".
Mexican Nationals who is gainfully employed are also covered by a sort of Medicare program (except they have no co-pay). They do have very powerful unions here that promote most of these programs. If the National is not employed (farmers, poor people, etc) they can still get medical help by other government financed clinicls. The medical service is pretty bad there I am told. They have to wait for hours and usually there are no specialist and sometimes they don't have the necessary medication.
You may recall my bad fall a couple of years ago went I was first taken to Emergency ("Fear of Falling"), well I wound back up in emergency last November. I was hospitalized for five days. No surgery and other than pain killers, no costly drugs (that I know of) but I was on an IV. When I was finally told I could go back home, I wondered about the bill. I gave them the information on my insurance in the U.S. Yes, I am definitely old enough for Medicare, but I elected to go with an HMO (with smaller co-pays) They did ask me for a down payment of 20,000 pesos. I never saw the final bill from the hospital, nor did I see one from the two doctors that attended me.
The nice lady who handles payments, was very helpful and rather attractive. His name is Esmarelda (a pretty name too). She contacted my insurance company and at first was told that everything could be handled by email. she said she would take care of it. This turned out not to be true. She called me back into her office for my insurance company was now telling her that they would only deal directly with me. They would not only accept a claim by email, but had forms that they would only mail to my address in the U.S. This took about two weeks. I had Donna pick them up and she had to UPS them to me. This took another week. Esmarelda filled out the forms (with some help from me) and submitted the claim. We were told it would take four to six weeks. They admitted receiving the claim on January 11th and for months there was no action at all. Finally they did contact me to ask for copies of all the tests the hospital had performed (I do not know why the hospital did not send them before). Luckily I had already forwarded them to my primary care doctor in the States. Then they needed proof of the payment I had made so I scanned my bank statement and sent that off.
Nothing happened and no one would return my calls. Finally I got through and found that they had settled it and the checks had been sent to my address in the U.S. I sent Donna off again and she found two checks, but no explanation of how much they allowed nor any mention of the money I had already paid the hospital. I knew how much they sent in dollars, I just did not know what I owed in pesos, so I was off to see Esmarelad again. All this took five months. I was shocked at the bill they expected me to pay. It was far higher than I had expected and much less than what the insurance company sent me. Esmarelda set up a meeting with the hospital administrator. After going over all the charges, the major bill was from the specialist who did finally come to the emergency room and then saw me each day I was in the hospital. His bill was more than I would have expected in the U.S. We went round and round and then I said, " Look, I would like to settle this now, but if you prefer, you can work with my insurance company for another six months" That is when he said that he thought they could settle for the amount the insurance company sent. They does leave me stuck with the 20,000 pesos that I already paid (four months rent for me!)
The "specialist" had way over charged (maybe because I was an American, maybe because I had insurance). He finally agreed to lower the bill somewhat (I will not be gong back to him). Dr. Lupita who stopped by every day to see me never submitted a bill at all. We agreed to an amount in pesos, but it still left me stuck with the 20,000 pesos. Maybe I should have haggled longer, maybe I should have just stone walled them and refused to pay. What could they do to me? Well, maybe a lot since I am a guest in a foreign country. I have to look on the bright side. At least my insurance company did pay most of it.
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