Medical insurance for US 'resident' long-term cruisers

[belizesailor]

Originally Posted by CaptsWife

BelizeSailor, that is really good to know. We are planning on spending the 2018 hurricane season there. We are not spring chickens any longer, but we also have no major health issues. But you never know when something could happen. We do have international health insurance through IMG, but it will be hard for us to even reach our deductible, as it stands right now. I've heard other good things about healthcare in Guatemala. This is very encouraging. Thanks.

Dont wait for a problem, find it early. With easy affordable care in Guate there is no reason not to get a full battery of annual exams.

I really like MultiMedicas in Vista Hermosa in Guate City. Big medical building with almost every specialty you can think of plus labs, radiology, and a small hospital all under one roof. One stop shopping.

http://www.hospitalmultimedica.com/en/main.php

We go to Guate City about once a year and spend a few days getting thuroughly checked out...and visiting some nice resturants etc.

We are hoping to find a similar arrangment in Panama, but have not as yet. However, we still need to investigste healthcare in Panama City more.

Oh well...another excuse to visit Guate. This past year we timed our visit so we could get our exams done in Guate City, then catch the kite festival in Sumpango (amazing event), then to Lake Atitlan for a few days, then to the Rio Dulce for month...Guate is an amazing country.

[Augi]

""Dont wait for a problem, find it early. With easy affordable care in Guate there is no reason not to get a full battery of annual exams.

I really like MultiMedicas in Vista Hermosa in Guate City. Big medical building with almost every specialty you can think of plus labs, radiology, and a small hospital all under one roof. One stop shopping.

.::Multimedica::.

We go to Guate City about once a year and spend a few days getting thuroughly checked out...and visiting some nice resturants etc.

We are hoping to find a similar arrangment in Panama, but have not as yet. However, we still need to investigste healthcare in Panama City more.

Oh well...another excuse to visit Guate. This past year we timed our visit so we could get our exams done in Guate City, then catch the kite festival in Sumpango (amazing event), then to Lake Atitlan for a few days, then to the Rio Dulce for month...Guate is an amazing country.""





Belize Sailor,

We also utilize Multi Medica on Vista Hermosa in Zona 15. We spend 6 months a year in Guatemala. We live at 6800 ft elevation in San Lucas Sacatepequez, 10 minutes from Antigua and 45 minutes to 1 hour hour from the airport and Multi Medica(6 hour drive from Rio Dulce and 1.5 hour drive from Puerto San Jose). Because of the altitude San Lucas has a perfect climate. It never goes below 40 F or above 75 F. Most of the time we have 50's F and 60's F. We have no heat or air conditioning. Occasionally my wife will use a space heater on a chilly morning or we will will light a fire in the fire place.

Everybody is different(depends how each individual values the trade offs), but the quality life is much higher for us in Guate for 1/2 the cost of the USA. The major negative is security especially in Guatemala City. However we find the security issues in Guatemala are manageable much more so than Rio de Janerio or Cape, S. A., two other places we have lived. Like almost anything else a litlle common sense goes a long way.


Regards,

Augi

[Sawbonz]

Originally Posted by sagablu

You are most correct. The US system is in a downward spiral. Too much utilization and the prices are insane. A client showed me a bill from a 4 hour procedure, $246,000, no joke. The dr ended up getting $68,000. No where else does this occur. Highly skilled practitioners with a high level of responsibility should be well paid, but I happen to know those Dr owns a $10 million condo. Thus runs through the system. Cost of insurance is the symptom of this and gets worse every year. Our politicians have not a a clue how to fix it.

That doctor may have CHARGED $68k (which is stupid) but I can guarantee you he didn’t get it.

[belizesailor]

Originally Posted by Augi

""Dont wait for a problem, find it early. With easy affordable care in Guate there is no reason not to get a full battery of annual exams.

I really like MultiMedicas in Vista Hermosa in Guate City. Big medical building with almost every specialty you can think of plus labs, radiology, and a small hospital all under one roof. One stop shopping.

.::Multimedica::.

We go to Guate City about once a year and spend a few days getting thuroughly checked out...and visiting some nice resturants etc.

We are hoping to find a similar arrangment in Panama, but have not as yet. However, we still need to investigste healthcare in Panama City more.

Oh well...another excuse to visit Guate. This past year we timed our visit so we could get our exams done in Guate City, then catch the kite festival in Sumpango (amazing event), then to Lake Atitlan for a few days, then to the Rio Dulce for month...Guate is an amazing country.""





Belize Sailor,

We also utilize Multi Medica on Vista Hermosa in Zona 15. We spend 6 months a year in Guatemala. We live at 6800 ft elevation in San Lucas Sacatepequez, 10 minutes from Antigua and 45 minutes to 1 hour hour from the airport and Multi Medica(6 hour drive from Rio Dulce and 1.5 hour drive from Puerto San Jose). Because of the altitude San Lucas has a perfect climate. It never goes below 40 F or above 75 F. Most of the time we have 50's F and 60's F. We have no heat or air conditioning. Occasionally my wife will use a space heater on a chilly morning or we will will light a fire in the fire place.

Everybody is different(depends how each individual values the trade offs), but the quality life is much higher for us in Guate for 1/2 the cost of the USA. The major negative is security especially in Guatemala City. However we find the security issues in Guatemala are manageable much more so than Rio de Janerio or Cape, S. A., two other places we have lived. Like almost anything else a litlle common sense goes a long way.


Regards,

Augi

Yes, Guate can be a little Wild West, but I love it.

We are now living in Volcan, Panama at 4,500'...quite a nice climate. The provence, Chiriqui, is a major agriculture area for Panama...lots of fresh produce and dairy available straight off the farm. The Pacific coast is only about 1.5 hours away and we have a good fish shop in town so can get good fresh fish in the moutains...one of the best sushi chefs in Panama has a resturant here...pretty cool.

Healthcare in this end of Panama (West) is OK and affordable, but not like we've become accostomed to in Guate City. Likely better in Panama City, but yet to try. We do have a small new hospital very close by for emergencies...vs Rio Dulce where we were half an hour by launcha to the closest town and then another half hour on the road to the nearest midsized town w a hospital.

Cost of living is favorable, no heating/cooling necessary, insurance is cheap (health, car, home), local produce is inexpensive, etc...

One big difference in Panama vs Guate is we think nothing of going off for a hike in the mountains/jungle...not always a good idea in Guate.

Now in Puerto Lindo getting the boat ready to splash for another season of cruising the San Blas...life dont suck (well...except for the working on the boat part!) [emoji41]

[freshalaska]

My surgeon in Fairbanks, Alaska charged me over $17000 for his services which was about one hour of surgery and this was almost 12 years ago. Criminal in my opinion. No ones time is worth that much.

[Sawbonz]

Originally Posted by freshalaska

My surgeon in Fairbanks, Alaska charged me over $17000 for his services which was about one hour of surgery and this was almost 12 years ago. Criminal in my opinion. No ones time is worth that much.

Charged does NOT equal what they get. Medical billing is very difficult and those outrageous charges are the result of someone who is a doctor and not business oriented enough to bill “correctly”.

[freshalaska]

$17000 plus is what my insurance told me they paid the doctor for his services.
If the surgeon over charged why did the insurance pay that amount. If the doctor didn’t get that amount who did? Where did the money go?

[Sawbonz]

Originally Posted by freshalaska

$17000 plus is what my insurance told me they paid the doctor for his services.

If the surgeon over charged why did the insurance pay that amount. If the doctor didn’t get that amount who did? Where did the money go?

It isn’t that they over charged, but I will explain how it works so that you understand.

A physician gets the lower of what he bills or what his contract says with the insurance company. He also has to treat everyone the same and bill the same. If Company A’s contract says they will pay him $50 and Company B’s contract says they will pay him $100 for the same service he would have to bill at least $100 to get the maximum from each company. If he bills $50 both Company A and Company B will only pay him $50, causing him to lose out on the extra $50 that Company B would have paid. Most doctors are not, however, business men so they bill $200, $500 or even $5000 so that they don’t miss out on income. The good business man would do like we did...bill $130 and give the patient with no insurance a $30 discount to pay at the time of service. That requires knowing what every insurance company contract says for every service and is a lot of work. The less inclined guys bill $500 and write off the difference from the allowed amount of their insurance contracts and just look like a schmuck with the no-insurance patient.

So, all of that to say that the insurance company didn’t pay that much and he wrote off the difference. A sad truth that many don’t know is that the insurance company negotiates your discount for you and pays a lot less than they appear to.

[freshalaska]

On the doctors billing statement it stated how much the insurance paid towards my bill and that I was responceable for the balance which was 20 percent of the doctors charges. If the insurance nogatiacted a lower fee then I as well should of paid 20 percent of the lower fee. Health care cost in Alaska are about as high as you will anywhere in the us. How do you know the doctor didn’t see that full amount. I don’t think you do.

[Sawbonz]

It’s possible that that doctor didn’t have a contract with your insurer. That’s pretty unusual but it does happen. Infrequently enough that I feel pretty confident saying it didn’t happen, but I can’t be 100%.

If it did happen you may not know that you can negotiate payments after the fact. Hospitals are notorious for billing so high that they will often take an 80% or greater discount.

[john61ct]

All of the above just reinforces that the medical industry in the States is completely FUBAR, just ridiculous.

A doctor should not need to know anything about business, there should not be any private profit making involved at all.

[Sawbonz]

Originally Posted by john61ct

All of the above just reinforces that the medical industry in the States is completely FUBAR, just ridiculous.

A doctor should not need to know anything about business, there should not be any private profit making involved at all.

Employed physicians don’t need to know anything about business, but those in private practice do. You will notice that that is a decreasing number in 2018.

No private profit making....sigh. I can’t argue with your opinion that those who spend over a decade in training, accruing hundreds of thousands of dollars in debt, missing out on the fun and important parts of life (birthdays, anniversaries, holidays, school events) in dedicating their time by working long hours to those who are often unable or unwilling to pay or unappreciative of those sacrifices shouldn’t make a profit. I can, however, say that I disagree.

[john61ct]

Generous salaries sure, just not a business, people becoming doctors for the money should not be a thing.

Of course their education should also be a right, not private.


Another new wrinkle
https://khn.org/news/bad-bedside-man...ulnerable/amp/

[Sawbonz]

Originally Posted by john61ct

Generous salaries sure, just not a business, people becoming doctors for the money should not be a thing.

Of course their education should also be a right, not private.


Another new wrinkle
https://khn.org/news/bad-bedside-man...ulnerable/amp/

Salaries come from the business. You have to not only charge/collect enough to pay the doctor but the employees, rent, utilities, malpractice insurance, business insurance, building insurance, maintenance, equipment, repairs, etc...

Food is too expensive, but it is also a business to produce what we eat. It’s no more of a right to eat than it is to get medical care.

[mikereed100]

Originally Posted by sagablu

You are most correct. The US system is in a downward spiral. Too much utilization and the prices are insane. A client showed me a bill from a 4 hour procedure, $246,000, no joke. The dr ended up getting $68,000. No where else does this occur. Highly skilled practitioners with a high level of responsibility should be well paid, but I happen to know those Dr owns a $10 million condo. Thus runs through the system. Cost of insurance is the symptom of this and gets worse every year. Our politicians have not a a clue how to fix it.

I would argue that they know exactly how to fix it, but lack the political will to do so. In all other industrialized countries medical costs are regulated and thus more in line with reality. It aint rocket surgery, but as long as policy is driven by campaign funding I doubt we will see change.

It is frustrating to see politicians arguing non-stop about who will pay for heath care, without addressing why we pay so much.