Friday, January 6, 2012

Medical Care and Insurance Coverage in Mexico

Clem and I on the beach after his last cancer treatment

This post is for all the people who would love to come to Mexico but their concerns about receiving quality health care here is holding them back.  Clem and I have quite a history with the health care system in and around the Pescadero area and I wanted to share my experiences.

My husband and I have been visiting and now living in Pescadero for the past five years.  During this time my husband was diagnosed with advanced stage 4 cancer.  After his diagnosis I was suddenly thrust into a position of being his patient advocate and acting on his behalf with both with the American and Mexican health care systems.  

Interestingly my husband’s disease was diagnosed here in Mexico after a year of unsuccessful diagnostic medical visits in the United States in which all his tests were dictated by our insurance company and my husband's age.  In 2008 after a fifteen minute Doctor’s exam in Cabo my 46 year old husband was accurately diagnosed with stage 4 colon cancer.  The exam which included an ultrasound, blood/stool tests, and a colonoscopy was completed in 48 hours and cost us approximately $1000.00.

In the three and a half years that have followed his diagnosis I have compiled a wealth of knowledge about the medical systems of the two countries.  Many people refuse to move or travel to this amazing country because of their inaccurate fear of poor health care.  We are not those people.   Despite my husband’s condition we sold our home in the United States this year and now live in Pescadero full time.  Recently I experienced the nightmare that all patient advocates fear and I am writing this article to describe my experience for those who may have their own questions or concerns about receiving emergency medical treatment in our area.

My husband is currently recovering from a pretty nasty brain tumor.  The radiation treatments he received in the US have left him with intermittent brain swelling episodes and one of these episodes recently thrust him into a day of  gran mal seizues.   He convulsed for approximately six hours that day.  After an hour of near hysteria on my part I found myself in the company of  Mario Trejo the operations manager at St. Luke’s Hospital in Todos Santos.  Mario is a professional, bi-lingual, kind hearted, man who calmed my worries and took on our case as if I was one of his own family members.  He first assured me that the hospital had a plan for my husband’s care and then lead me through the process of understanding my financial options.  Within a few minutes conversation Mario was on the phone with my US insurance company discussing our situation and getting their approval for payment on our emergency.

That night I found myself camped outside the Intensive care unit in Cabo where the closest neurologist could be located.  Mario, Adrian Gonzale. and the Doctor  rode in the ambulance with us there and handled all the details including providing me with coffee.  For the next three days the St. Luke staff was in and out of the hospital and always just a phone call away. Several times a day Mario talked with the neurologist or the Internist on duty to keep me updated on my husband’s progress.  

I have spent many hours in medical facilities worrying.  First and foremost I have worried over my husband’s health and recovery but as every caretaker has experienced there is also the worry that we will not have the funds to pay for the treatment.  Even though I did not openly speak of this worry Mario knew that this plagued me and everyday he would encourage me and give me the details of his conversation with my insurance company.  After all was said and done I did not pay one single peso for the excellent medical care that my husband received.  I was never pressured to sign anything or asked for my credit card. I simply received excellent health care accompanied with a compassionate and professional business experience.

I know that there are those of you reading this that can’t believe this story and are wondering how this could be.  I wondered this same thing.  We were in an emergency situation and many U. S. insurance companies cover the costs of such events.  The problems that arise usually come from the different types of “insurance/medical coding” between the two countries and Mario at St. Luke’s seems to be an expert in that field.  How lucky we are to have a group of young professionals such as this in our community.

In October of this year my husband received treatment in Tijuana at the Rubio Cancer Center.  He received custom cancer vaccines along with stem cell therapy which has been slowly eradicating his brain tumor.  The treatment was expensive but we got in line with and behind a huge group of people who have been cured of their diseases by Dr. Rubio over the past 30 years.   When Mario found out that I had paid this out of my pocket he VOLUNTEERED to code the services for my insurance company for me.  VOLUNTEERED.

So like I said this post is about spreading the word.  I hope to host an informational meeting with Mario to help others interested in learning more about insurance options available for medical care in Mexico.  Drop me a line here or email me if you are interested in attending.  I am also available to discuss any of the types of cancer therapies that my husband has received here in Mexico.

1 comment:

  1. Quite a lot of information about the healthcare in Mexico. It's good to know you have firsthand experience about it. Thank you for sharing.

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