About 15 years ago, my husband and I made the decision to “ditch the 9 to 5” in the US and move to Costa Rica. Since we were only 34 and 42 at the time, we were both healthy and quite honestly, the last thing I was worried about was health insurance. Of course, that all changed…
We were on a weekend trip in a port town. As I was crossing the street, a taxi cab driver decided to speed up, not look, and hit me. I bounced off the hood of the car and lay in the street. Thankfully, I was “ok” and had not broken anything; but, I did hit my head pretty hard.
A nurse happened to be off duty and saw the accident. She ran out of her boyfriend’s car to care for me. They put me in their car and said they were going to bring me to a clinic. A CLINIC! Oh no! If this is like anything in the US I don’t want this…I want a REAL Hospital. So we insisted. What we did not know was the difference between a PUBLIC hospital and a PRIVATE hospital or clinic. Trust me, a PUBLIC hospital is not where you want to end up!
I was in the public hospital waiting room along with probably 25 other people who had varying degrees of emergencies. It was a first come, first serve basis. One man was wheeled in clearly very, very ill, moaning and screaming. Another person started vomiting all over the floor with no one to assist. Right then, it almost put me over the edge. But, I was trying to be calm and wait it out to see a doctor. In the meantime, I had to use the restroom. I was told to go into this room which had about 50 men in either recovery from an operation or some sort of illness. They were all squeezed together in this horrible, dirty, smelly, room. There was one tiny, FILTHY, bathroom for all of these men to use and that was the one I was directed to! No soap, no toilet paper, and I am a woman – DISGUSTING! Apparently, if you are in a public run hospital in Latin America, in general, you need to bring these items with you. I am not making a joke, this is the reality. At this point, I did not care how beat up I was or if I had a concussion, I just wanted to get out of there!
This experience was quite different from the experience I have had in the private hospitals in Costa Rica, Mexico, and Argentina – which is where we have homes. Was my experience with the public hospital unique? I was told by locals in all of these countries that we call “home” that unfortunately, the answer was “no”. This was when I decided I better look into some “real” health insurance and avoid the public hospitals at all costs.
The private hospitals tend to take everyone directly through the emergency room or walk in. Service is usually almost immediate. I had a routine cosmetic procedure performed (which in the US I would have been in and out of the doctor’s office in a couple of hours) but I was given the option of spending the night in a private hospital room, so that it would be easier for both my husband and myself (as I am a big baby when it comes to anything medical). I had another surgery in a private hospital in Mexico and again I was given my own room. The care was impeccable. In order for a doctor to work in a private hospital in Mexico, they are required to have an additional level of certification. Most speak English as well. Although I have not spent the night in the hospital in Argentina, my husband has landed in the emergency room with a benign tumor. His care was outstanding.
Now, if you are from the US, Canada, Europe, Australia, etc, the first scene I described would be shocking to you. Most natives, who have the ways and means, opt for private insurance. As an expat, sometimes our options get a little complicated because we travel a lot or we don’t speak the language well enough to understand what a “local” insurance policy may or may not cover or what shock lies before us. In most cases, the “local” insurance options are very much “you get what you pay for”. Many Mexican based policies for private coverage are also quite expensive and do not cover you anywhere else. They also all tend to have per incident deductibles and co-pays. This means, you break your leg today, you pay your deductible. You break your arm tomorrow, you have to pay your deductible all over again…plus your co-pay!
Well, I found a great option with expats in mind. The insurance I opted for allows me the freedom to choose from ANY private hospital or clinic, any doctor, in almost ANY country in the world except the US. In the US, I do have to stay “in network”(some options allow you to choose any hospital or doc). To keep costs down, I can have the option to exclude the US care. For the two of us – now 49 and 58 – without US coverage, runs around $2300 including the US coverage, is about $4700. I had the option of something cheaper but I like a bit more coverage for the “what if’s”. I hope that if anything major were to happen to me, I can make it back to the US for my treatment as the policy includes medevac.
I felt it was worth the US coverage for that piece of mind. I only have my ANNUAL deductible to meet (NOT PER INCIDENT), and the hospital direct bills the insurance company. My policy also does not require facturas – just receipts – scanned or faxed (not originals) – so it is very easy to file a claim. Also, in case I need help, there is someone who is a native Spanish speaker to clarify any issues.
I have found that health insurance is a critical necessity as an expat. We all want to travel freely while discovering our new environments. If you think it is not necessary to have quality health insurance, you really have no idea how risky it is if you do not have it!