Recent Medical experience

Yes I was told with insurance they charge more. However for this new diagnosis I have 21,000 Mx deductible and 10% co pay so could be 21 + 50 = 70,000 mx. Not fun but I guess better than 500,000 mx out of pocket.

Country 2000 excellent care and I have been in several Guad hospitals. I recommend Dr. Jose Manual Gonzalez to Sun Fan for spinal fusion. He is a neurospinal specialist and excellent. He comes to Quality Care every 2 weeks. Explains everything with plastic models of the vertebraes on his desk and answers all questions.

Heads up for Americans with Medigap Supplemental G in the event you require emergency surgery out of the US. In my case deductible 250/USD, no prescription reimbursement, and no IVA reimbursement. 80% payoff on surgeon and hospital only. So in my two experiences, I paid out of pocket about 30%. YMMV

If @sm1mex surgery was covered as emergency surgery, he would have been out of pocket about 100,000 (my guess) with a Medigap claim.

Tough decision to make with Medigap vs Mexican healthcare insurance when you look at the accelerated Mexican insurance premiums for 70+ group. Either way, there is no free lunch.

Medical insurance here for people over 65 is quite expensive even with a $5000 USD deductible. This of course means that most of your regular medical costs all year won't meet the deductible, so you won't be reimbursed. We used to have insurance with a $1500 USD deductible and rarely were we able to use the insurance, so we gave it up. It was about $6500 USD per year, 6 years ago. I imagine it is probably 30% or 40% higher now. If we had of been paying the $6500 per year for the past 6 years it would have been $39,000 USD). Our recent experience cost us approx. $17,500 USD.......so we are still ahead.

Yes it’s a crap shoot. I have insurance and expensive. I am in remission 12 years stage 4 colon cancer so pretty well married to insurance necessity. My colon surgery and 6 months double chemo and 10 years follow up about 250 million US dollars treated here in Mx. so maybe I’m still ahead. But ya never know about cancer. It is never cured. Also had multiple surgeries for adhesion complications resulting in intestinal blockages. In my case it as comfort to have Mx insurance but it goes up about 20% a year. There goes my social security.

My hip replacement hospital/doctor costs would have been almost zero in the US with my Medicare and Supplemental policy.

But....at the time I needed the surgery (considered elective surgery) we only had the house in Ajijic.  

I did a cost/benefit analysis before deciding where to have the surgery.  Since we flew to the US fairly often and rented houses and cars I was able to estimate very accurately using actual houses and cars we had rented, as well as cost of airline tickets.  

Needed 4 round trip tickets to US (I no longer sit in the back of the plane at my age ) for myself and spouse, one visit for the mandatory consultation, then another one likely weeks or months later for the actual surgery.  Yes my spouse could have chosen not to accompany me on the consultation trip, but at our ages we prefer tag-team medical visits .  Flights would have totalled about 4K USD.  

Needed a 1-level, Airbnb or VRBO house rental, with 2BA, a w/d, internet/wifi, and a king bed for 4 to 6 weeks.  fyi, vacation rentals soared in cost during and since pandemic.  Lodging would have been around 4K USD.

Car rentals were in short supply in mid-2022.  Needed a good sized car with easy passenger entry and exit, for 4 to 6 weeks as we'd have to stay in US for follow-up medical visits post-surgery.  Car rental would have been about 2.5K.  

Total estimate to have it done in US was 10.5K and there was also the possibility of having to stay longer if there were any complications or problems.  My estimated cost of surgery at HSA was 200K pesos, mas or menos.  My total cost was actually 205K pesos, or 10.1K USD as reflected on my credit card statements (August 2022).

It was a no-brainer to stay in our 1-story Ajijic home, sleep in my own bed, use our own Honda CRV and be only 15 minutes from the hospital and doctor's office.  I saw the surgeon for follow-up for 6 weeks (those visits included in his surgical fee).  

We recently bought a 2nd home and car in the US and future elective surgeries will likely be on Medicare's dime

This has been a very informative discussion. Thanks to all who contributed.

I hope Sharon is all healed up by now.

A little more info, I asked my friend (who fell down a couple steps and fractured her right ankle and sprained the left) how it turned out financially and this is what she said:
30,000 pesos for surgeon, anesthesiologist, hospital room and nurse pre-op and recovery, operating room. First rate. Included in-home doctor follow-up visists for 2 months. She said he had to rebuild ankle.

Clinica Ibarra in Chapala coordinated it all, their ortho was her surgeon, and the surgery was done at the Ajijic Clinic/Hospital. She is now up and walking again with assistance.

You can draw your own conclusions.

While I agree that the Ajijic Clinic would be very affordable I would personally not get any surgery there. I don't think they are well enough equipped for an "operating room" emergency. Just my opinion......YMMV

CanuckBob wrote:While I agree that the Ajijic Clinic would be very affordable I would personally not get any surgery there. I don't think they are well enough equipped for an "operating room" emergency. Just my opinion......YMMV

Jreboll wrote:
I agree that as we get older some of us are in delicate health but for most minor procedures a local clinic serves a purpose and they’re worth considering.

I used to use Ajijic Clinic (calling it a Hospital is misleading IMO).

But....3 times I went there outside of 8am and 9pm only to find the front door locked and shackled with no response after banging on it.  Last time was in October when I went at 7:30am and banged long enough that the "security" guard who I could see sleeping at the reception desk, woke up.  He came to the door and said, "come back at 8 when we open."

A month ago I took a urine sample there; after no results for over a week I contacted them.  They lost my sample, had no record of it.

I contacted my insurance Blue Cross Blue Shield of what hospitals to use in Guadalajara. They sent me a list of 4 hospitals. Joya Guadalajara, Mexico Americano, Country 2000 and San Javier. I will now do my research on them.

While I certainly agree with you all about the Ajijic Clinic, the amount of horror stories I have heard over the years has kept me from ever seeking medical care there. However, if the surgical team I have chosen to operate on me is comfortable doing the surgery there that is good enough for me. The added bonus of being hospitalized close to home and avoiding a 6-figure bill is very appealing.

I do know some people who have had very successful surgeries there - hips, ankle, abdominal hernia, vascular - all done by surgeons who aren't affiliated with the Ajijic Clinic/Hospital, I imagine they rent the space. A clinic or hospital is just a building as well as the equipment, what's important is the talent - or lack thereof - of the surgical team. An X-Ray is just a picture until it is read by a good radiologist or orthopedist.

As always, YMMV.

Stay away from hospital Americana. Our specialists won’t use that hospital. They lost there accreditation a few years ago. Don’t know about now. Have used San Javier and great but prefer Country 2000. Excellent. Easy check in and easy check out. Have your approval from Blue Cross when check in. Much easier to get out of there !!

Stay away from hospital Americana. Our specialists won’t use that hospital. They lost there accreditation a few years ago. Don’t know about now. Have used San Javier and great but prefer Country 2000. Excellent. Easy check in and easy check out. Have your approval from Blue Cross when check in. Much easier to get out of there !!

Trailrunner wrote:

I do know some people who have had very successful surgeries there - hips, ankle, abdominal hernia, vascular - all done by surgeons who aren't affiliated with the Ajijic Clinic/Hospital, I imagine they rent the space. A clinic or hospital is just a building as well as the equipment, what's important is the talent - or lack thereof - of the surgical team. An X-Ray is just a picture until it is read by a good radiologist or orthopedist.

As always, YMMV.

Equipment and facility are equally important. Surgeries can go sideways and require immediate or post-surgery intensive treatment (patient strokes out, goes into cardiac arrest, excessive unexpected bleeding, post-surgery infection, etc.).

I want my surgery in a hospital that is truly 24-7 with more sophisticated lab and radiology equipment as well as 24-7 lab and radiology staff.

Even if you were NOB there would only be skeleton staff between 7 pm and 7 am but there most definitely would be people on call. I believe that the best way to get the best care in an emergency situation is to have a really good family Doctor. They can smooth the way with both local hospitals and those in Guadalajara. They know which hospitals to use for elective surgeries as well.

After reviewing the hospitals, for me, I ranked them in this order, First- San Javier, Second- Country 2000 than Joyful Guadalajara and last Mexico Americano

What was your criteria for those picks?

Jreboll wrote:Drove to an urgent care to have my throat looked at, got to an exam room, and learned they were only doing telehealth visits when they wheeled this in

My Medicare supplement pays for TeleDoc visits, video or phone, even from here in MX. I found it helpful and a good tool for many issues, rather than drive to an Urgent Care. My phone visit from MX answered some q's I had on different meds available here than in US.

fyi, when I want to go to Urgent Care in US, I go to their app or website and book an appointment rather than just show up. I almost always get a same-day appt. that suits me, or next day if I want an early appt.

Jreboll wrote:When we got back from Mexico I went to urgent care because they had forgotten to take out a stitch in Mexico. The nurse in urgent care said they couldn’t do anything for us.(I ended up doing it myself)
They still charged my insurance 800 dls for the visit.

My Urgent Care visits (I had several past few years) bill my Insurance $245 and my copay is $40. When they do an xray or a test, they bill insurance various amounts, I pay nothing for x-rays or labs.

TeleDoc bills my Insurance $49 and I pay nothing.

[quote="CanuckBob"]What was your criteria for those picks?[/quot



I reviewed comments on Hospitals by people and looked at ratings of hospitals by professional groups and location of the hospitals. One rating service had San Javier the number 1 hospital in Western Mexico. It was close between San Javier and Country 2000 but San Javier listed Blue Cross and Blue Shield as an international insurance they accepted whereas Country 2000 didn't say.

Trailrunner wrote:I hope Sharon is all healed up by now.

A little more info, I asked my friend (who fell down a couple steps and fractured her right ankle and sprained the left) how it turned out financially and this is what she said:
30,000 pesos for surgeon, anesthesiologist, hospital room and nurse pre-op and recovery, operating room. First rate. Included in-home doctor follow-up visists for 2 months. She said he had to rebuild ankle.

Clinica Ibarra in Chapala coordinated it all, their ortho was her surgeon, and the surgery was done at the Ajijic Clinic/Hospital. She is now up and walking again with assistance.

You can draw your own conclusions.

MY FRIEND CORRECTED HER TOTAL COST:
My friend corrected her total cost of all this medical care from 30,000 pesos to 3000US or about 51,000 pesos.
Still a lot of good medical care for not a lot of pesos.