I'm pretty happy with Medicare.
It is simple for me as a patient.
Doctors seem to accept it although I hear they take such a huge discount on what they are paid that it barely covers the overhead of their practices. I give them my Medicare card, supplemental card, and pharmacy card. They copy them and they seem to know what to do to collect money for the service.
It isn't free healthcare. I paid into Medicare for the entirety of my working life-- 50 years. Now, retired, Medicare subtracts $670.50 a month from my Social Security and I pay another $125/month in supplemental insurance. Paperwork goes back and forth between the provider and Medicare and the insurance and then I pay some token amount about three months after the service.
College classmate Erich Almasy has retired in Mexico. He describes his own experience accessing health care in Mexico.
Guest Post by Erich Almasy
Health Care in México
One of the first things that people moving to México ask about is health care. Can I find a decent doctor? Will I be able to afford checkups, medicines, and even surgery? What if I get cancer? My personal experience is that the health care we receive here is as good or better than any we received in the United States or Canada. And certainly a lot cheaper.
A little backstory. My wife and I lived in Canada for twenty years, where we got used to handing over our health card and getting no bill: higher taxes but peace of mind. When we left six years ago, waiting times were getting longer but still tolerable. On our way south to our new home in México, we stopped in Pennsylvania and signed up for Medicare Part B. We had been in Canada when we turned 65 and had not signed up for the monthly Part B premium because we could not have used Medicare in Canada and had no doctors in the United States. In its infinite wisdom, Medicare said we would have to pay a penalty for each year we had not signed up, after saving it roughly $40,000. We disputed this, and three years later, Medicare agreed and refunded our penalty, but by that time, we had canceled it because of cost and accessibility. And so, we arrived in San Miguel de Allende without health insurance.
A quick note about our home here: San Miguel is one of the most popular tourist sites for Mexicans, who visit on vacations, for weddings, and to buy second homes. It has become as expensive or more costly than Mexico City, with over 600 restaurants in a city of 180,000. Expats make up between eight and ten percent of the local population. Rated globally as one of the most desirable small-city destinations by Conde Nast and other publications, we are a 500-year-old Spanish Colonial, UNESCO World Heritage site. Based in the desert highlands of central México, we are about four hours by bus from the capital.
After arrival, we bought international health insurance from one of the world’s most reputable companies at the time. I say “at the time” because when COVID hit, they refused to cover it and promptly went bankrupt. I still receive regular messages (but no refund) from the creditors’ committee. Faced with reliance upon local health care options, we were pleasantly surprised. Exhaustive, six-page blood, stool, urine, bone density, and for my wife, mammogram tests cost less than $125. Our physician, an American/Mexican nicknamed the “Gringo Doctor,” charges $75 for a 90-minute review of every line item in the tests. No previous doctor had ever done that. For a hand injury, a next-day MRI was $250.
Our physician is even more valuable because she is associated with major hospitals both in San Miguel and an hour away in the large city of Santiago de Querétaro. She can provide referrals for any specialist, and then she books an immediate appointment. When I dislocated my collarbone in a fall, she set up a next-day appointment with an orthopedic surgeon who specialized in shoulders. Most medicines that require a prescription up north are over-the-counter here. For antibiotics, sleeping pills, and opioid painkillers, we receive prescriptions from her via email or ZOOM. In a few cases, local doctors charge “Gringo Pricing,” but after being quoted $500 for a colonoscopy, I found a better doctor in Querétaro who bundled in an endoscopy for $175. Like all health care, it pays to shop.
Many Canadian residents maintain their Canadian healthcare by returning “home” every six months or pretending to. A large number of Americans are more comfortable with the doctors they have in the States and fly back to use Medicare or health insurance. However, an increasing number of expats I know stay here for major procedures, including prostate, back surgery, and even cancer. A good friend who is in a position to afford a U.S.-based option chose to have his lung cancer treated here after comparative research.
Outside of medical treatments, I am most impressed with dental and veterinary health care here. In Canada, both were outside of any national scheme, and prices were as high as in the United States. A dental checkup with X-rays was typically over $350, and any procedure for one of our dogs could cost from $500 to $1,000. In San Miguel, a dental cleaning, checkup, and online X-ray are $60, with a new crown about $125. Our vet is the most expensive in town, but when one of our dogs was poisoned, he came in on a Sunday afternoon to diagnose and treat for $100. Medical (especially plastic surgery) and dental tourism in México has become so popular that a national resort just opened a medical clinic/hotel/resort in San Miguel. The Mexican town of Los Algodones (across the border from Yuma, Arizona) is known as “Molar City” because it has only 5,400 people but 600 dental clinics. Now you know where to get your implants!
According to the U.S. Department of State, 1.6 million Americans live in México. When Trump was elected, the Biden administration was attempting to make it possible for expats to utilize Mexican health care through Medicare. It was estimated that this would save the Medicare system upwards of $50 billion annually.
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