A very common question we get asked is, “What do you guys do for health insurance?” The short answer is… Nothing.
Once you leave the USA, healthcare becomes much cheaper. It’s actually affordable. Most doctors and dentists, that we’ve come across, have all trained in the USA or Western Europe prior to moving to wherever they are now. For example, in Austria, I had contracted a really bad ear infection while on vacation. I popped into an apothecary to see if I could buy some antibiotics and they told me that I had to see the doctor first. They advised that the office was located just across the street. I entered the office and was seen immediately after filling out a simple form telling them who I was and where I lived. No red tape, only one single half page of information. The doctor spoke English, gave me a three-day antibiotic treatment and sent me on my way. On my way out of the office, the receptionist vehemently apologized to me about me having to pay for services because I wasn’t an EU resident. It cost me $25.00 for the doctor visit and antibiotics. They printed out my receipt so I could file it with my insurance company when I returned home. That was less than my copay in the USA, I wouldn’t even waste the stamp to send it in.
In Japan, Bronson’s crown separated from his tooth. We called around to find an English-speaking dentist who was able to see us in between patients. We were asked if we had any of the three national or private insurance options they offered in Japan. As we did not, we had to pay out of pocket for a temporary crown until we arrived home in the USA. The cost for an emergency treatment and temporary crown without insurance coverage was $70.00. If we had the time to stay and wait for the crown to be cast and adhered, the total cost would have been $200, including the $70 we paid for the initial visit. When we arrived in the US and spoke to our dentist about it, she was floored. She said that the minimum cost out of pocket she would usually charge would be $500. Not to mention the moulding and crown later.
In Thailand, I ended up jamming my ring finger and it swelled so badly that I couldn’t remove my titanium ring. We had experience with ring removal in our previous jobs and attempted every trick in the book. Because it was made of titanium, you could only cut it with a Dremel or bolt cutters. Unfortunately, we were forced to find a hospital to get my ring cut off. At the hospital it was obvious they had never dealt with titanium rings before. They tried wire cutters, they tried a “ring cutter.” I was in the ER for an hour before this local hospital told me I had to go to the nearest big city and they would be taking me to the O.R. to remove my ring. UM… NO. I explained that we needed bolt cutters or a bone saw and water. Two hours later, and nearly losing my finger due to lack of circulation (literally within half an hour and I would have had to amputate), I was given a nerve block and a maintenance man brought in a pair of bolt cutters. Nobody in the hospital had ever done anything like this before, so Bronson and I took it upon ourselves to get shit done. Bronson grabbed the bolt cutters and prepared to cut the ring off as I watched and videoed the experience. He was able to cut part of the ring off by quickly and forcefully pressing down and cutting at the same time, but then I had to spin the ring around so he could cut the other side to get the ring to fall off. There were metal shards stuck under the ring and having to spin the ring around on my finger literally ripped my skin open. He was able to cut the other side of the ring off and I regained feeling and circulation back in my finger. The entire emergency department watched in awe and when the ring was finally cut off, everyone clapped and cheered. This was my only disappointing medical visit, but I’m glad they let us do what needed to be done without the worry of liability. The entire visit was free.
In Mexico, I ended up having a serious bout of Pneumonia. I suffered with it for over a month and a half before caving in and going to a doctor. I spent weeks prior, taking numerous different antibiotics before having to go to the hospital and get 5-days’ worth of antibiotic injections, a new nebulizer and 2-weeks’ worth of breathing treatments. The nebulizer, 5 different breathing treatment medicines and antibiotics for two weeks, blood cultures, throat swab cultures and 5 days of injections with three follow up visits cost me $140.00 total. I also take levothyroxine daily, and I can get my Rx filled in Mexico literally 100 pills for $15.
In Guatemala, Kaden was cooking dinner and just happened to not pay attention while cutting vegetables. He sliced his finger open with an 8” chef knife. He ran out of the kitchen holding his finger and said “Damnnit!” As I walked up to him to see what was wrong, he said that he cut his finger. When I examined his finger, it was a full thickness cut that we knew was going to require stitches. Kaden looked at his hand, saw the blood and fainted. We lowered him gently to the floor until he regained consciousness. Due to the toque de queda (curfew) in place due to the #Rona, we were required to take an ambulance to the hospital around the corner. Our friend Alfredo had to call the Fire Department for us because there isn’t a designated phone number like 9-1-1 and each municipality has a different phone number.
The Bomberos arrived promptly assessed Kaden in the house and disinfected us as we stepped into the ambulance. Once we arrived at the hospital, we were greeted at the door, the staff was called to their positions. The doctor examined Kaden, numbed him up, gave him 6 stitches, an antibiotic treatment and a tetanus shot. All this cost $160, including the ambulance ride. The ambulance even gave us a ride back home after he was all stitched up. 10 days later, Bronson was cutting our grass with his machete, and ended up slicing his finger open as well, only his was waaaayyyy deeper. Like, you could see the bone and tendons, deeper. It was during daylight and we were able to walk to the hospital around the corner this time. The doctor did the same procedure, but left a side of his finger open to drain. 5 stitches and 40 minutes later and all the same medicines, we were out of the hospital with another $160.00 bill.
While in Antigua, we also went to see the dentist for a deep cleaning and x-rays. For all three of us, the cost was less than $100.00. I also had to have my bite-guard replaced. In the USA these cost me $900.00 and have to be done every 5 years and take a week or more to receive. I got a brand new one similar quality for $68.00. Health care costs vary in each department, and the department we were in is one of the most expensive because it’s filled with tourists, but still, much cheaper than in the USA.
The two visits in Guatemala and the one in Mexico (amounting to over two years of medical care) with my daily medications and dental visits cost us less for all of these visits than one month of medical insurance premiums that I may or may not use and can never get reimbursed for. No thank you, I’ll keep my money and pay out of pocket. I will say though, we have considered a catastrophic health plan that for a year would only cost $2600 for all three of us or $4500 if we want a comprehensive plan that will cover us for two months out of the year in the USA. There aren’t many countries that require you to have medical insurance, but Costa Rica does. We also have vehicle insurance that covers accidents and medical care up to $5000.00 and credit cards that have a $50,000.00 medical benefit limit. So, no matter what we do, we’re covered.
The next question people ask is, “are you happy with the healthcare you receive?” Absolutely. They have been top notch. I’ve not had any bad experiences with any of these medical professionals with the exception of Thailand, but at least in Thailand they knew they were out of their depth and weren’t afraid to take on new ideas and less orthodox treatments.
People also ask if the care is comparable to the US. I would say yes. Not always top of the line, but at a minimum we’ve not really struggled to find quality health care. The equipment might not be what you expect in the USA. Not as new or state of the art, but it does the job and as a result, costs much less.
Even Veterinarian care is much cheaper down here. Roxy got hit by a car last Christmas and we took her to an emergency vet in Guatemala city where she got antibiotics, x-rays, blood work, and IV and shots they kept her overnight for monitoring and the entire visit was less than $200.00. In the states that easily would have been $400.00 just for the emergency visit. Not including anything else. To get her health certificate, health check-up and all shots and boosters for international travel here cost $175 and was way more complete and thorough, where in the USA we spent over $400 only included a bordatella shot.
Overall, healthcare for animals and humans is much less expensive once you leave the USA. There are lots of medications you can purchase at the pharmacy without having a prescription. If you have a chronic condition that you know you’ll need ongoing medication for, you can likely skip the doctor visit and just show up at a pharmacy and ask them for the medicine you take.