Choosing Mexico? Part 1

We’d been talking about, planning, and dreaming about becoming expats for a very long time. Choosing Mexico as our first foray was not even on our radar scope until quite recently. So, friends and family ask, why Mexico? Of all the possibilities, how did Mexico become the focal point?

When we first started discussion a move outside the U.S., we focused primarily on Ecuador. I did all the usual vetting: International Living magazine, websites, blogs, books and the like. We focused primarily on Cuenca or Loja. Neither of us are beach people and we both like cooler weather, so the coast was out.

Good friends of ours made a similar decision and they executed pretty quickly. They took an exploratory (which we had yet to do) and decided on Manta. They adjusted pretty well and then came the earthquake in 2016. Manta was close to the epicenter and was badly damaged. Our friends had to quickly escape.

In addition to the earthquake (as if that wasn’t enough), they had issues with internet connectivity, which for us is mission critical. So with their direct experience and the relatively long travel distance to Ecuador, we moved it down on the list and began to explore anew.

Our friends told us that several of their friends in Manta were exploring Lake Chapala as an option. We had not really considered choosing Mexico as an option (oh, my, those drug wars and murders and don’t drink the water!).

Still, we started looking there. We discovered plenty of online resources. Plus, Bonita had already visited Mexico a couple of times in her life, so she was encouraging.

We started evaluating our must-haves. Availability of reliable internet connections? Check. Great weather? Check. Easy transit? Check. We were starting to become comfortable with choosing Mexico.

Were we concerned about the blizzard of negative publicity rampant in the U.S. about Mexico? About how “dangerous” it is? Of course. Yet, we also knew enough to undertake our own evaluation.

First, Bonita had been to Mexico as a tourist. She had had very pleasant experiences.

Second, I had travel experience in so-called dangerous zones. Back in 1999 I had visited Ireland. You may have to dredge your memory on that one, but at the time, the U.S. news was brimming with reports of street wars, murders, drive-bys and violence between Catholics and Protestants all stirred up in a stew of political drama with England and Ireland.

When friends heard I was going, I got severe warnings about how dangerous it was.

Of course, I flew to Dublin, stayed in Dublin, and loved Dublin. Turns out, all the “danger” was happening in Belfast, hundreds of miles away and then, only in a few neighborhoods. Now, should I be afraid to visit New York City because there are areas in NYC that I should avoid? I posit no. Just don’t go there and I’ll be fine.

Same in Ireland in 1999 and same in Mexico, 2017 and 2018.

So, having done our research, it was time for both of us to venture on an exploratory trip, which I will discuss in a subsequent post.


The Healthcare Experience in Chapala Mexico–Bonita’s Story Part 3

In Part 1 of Bonita’s story here and Part 2 here, Bonita is diagnosed with ovarian cancer and begins treatment in the U.S. After a well-earned vacation in Mexico, we contemplated, debated and then planned a provisional move there. Here is the conclusion of her initial experience with healthcare in Mexico.

We decided that the stars were aligned for a six-month over the winter trial in Chapala. I hand-carried copies of my recent scan results and other pertinent medical records with me. We got to Chapala early in December (2017) and one week later with arrangements made via email, I met with Dr. Diego in his clinic in Guadalajara and received my first infusion in Mexico my first deep experience of healthcare in Mexico.

THe staff greet me by name at the reception desk and personally escorted me up to the consultation room. Dr. Diego spent a half-hour with me reviewing the records and discussing the treatment plan to ensure that ti was the same that I had been receiving stateside. He then escorted me to the modern treatment room and introduced me to the nurses and the pharmacist who would be administering the chemotherapy.

The pharmacist interviewed me for medication allergies and surgical history. The nurse checked my vita signs and noted that my blood pressure was slightly elevated. She notified the doctor and he came back into the treatment room to discuss this and rechecked my blood pressure. He gave the go-ahead to proceed with the treatment but advised me that he would be watching the blood pressure and that there might be a need for additional medications to control it. The drug was administered with flushes befor and after over an hour.

The nurses and the doctor checked with me every ten to fifteen minutes. I ad no conerns. My bloos pressure did not go higher so no additional medication was prescribed. There was a very clean and comfortable bathroom just around the corner from the infusion room. The recliner in the influsion room was powered by an electronic controller. There was no television (which I did not miss). They offered me a beverage.

After the infusion, I was escorted to the reception area to make payment. The bill was exactly as quoted ahead of time and they were fine with taking my U.S. Visa card. The doctor did explain to me that his portion of the bill–$100 (U.S.); $2,000 (Mexican Pesos)–he would prefer payment in cash in pesos on subsequent visits.

I requested him to prepare a bill in U.S. dollars and his notes translated for submission to my insurance company in the U.S. He took my insurance information and said that they would take care of it.

I left the clinic very pleased and comfortable. He said he would email me the appointment time for my next treatment in two weeks.

We’re off to a very good start with healthcare in Mexico.

The Healthcare Experience in Chapala Mexico–Bonita’s Story Part 2

In Part 1 of this post, Bonita shared her journey with cancer and embarking on a vacation to Mexico for rest and investigation and the possibility of cancer treatment in Mexico.

Family voiced some trepidation about traveling and particularly traveling to Mexico. (Is it safe????)  Even so, we visited for two weeks as tourists on an informational quest, partly about cancer treatment in Mexico. We were wonderfully assisted along the way. One of our Air BnB hosts directed us to an insurance service that many expats in the Chapala-Ajijic area use. We also met with several agents at the Lake Chapala Society (an active group providing lots of local information to help expats learn the ropes).

We were dismayed to find that I am not insurable for cancer treatment in Mexico with my pre-existing condition. I would have to pay out-of-pocket for all cancer treatment. However, along with that “bad news” I was assisted by the insurance agent with Blue Angels to get an appointment with a local oncologist, in two days time nonetheless.

Dr. Diego Herrera works mostly in Guadalajara, yet visits a satellite clinic in Ajijic weekly. We had a very pleasant and informative visit. He assured me that I could receive the same treatment (chemo) that I was receiving stateside and was willing to get me a cost quotation to pay directly for the care.

This forty-five minute consultation cost me $40 (U.S.). I was greatly encouraged and began to correspond with Dr. Herrera via email periodically after we returned to Wisconsin to make additional preparations and further our “feasibility study.”

I was again very fortunate to learn that my employee “retired” insurance would reimburse me for cancer treatment in Mexico as long as it was consistent with my ongoing medical care (no “alternative clinics”). I would have to pay upfront, get the bills and medical records translated into English and U.S. dollars and be reimbursed rather than the doctor and clinic being paid directly by the insurer.

My U.S. doctor was very supportive of my decision to pursue treatment in Mexico. Once I got the dosages of the drugs from my WI provider–which was not as easy to do as I assumed it would be–I emailed that information to Dr. Herrera and within a week had my quote.

The treatment being provided in the U.S. at a cost of about $57,000 per month would cost about $15,000 (U.S.) in Mexico. A lot to pay out-of-pocket, but $40,000 less per month is substantial. The cost of the periodic scans I need to document response to therapy is $14,000 (U.S) in Wisconsin and $4,000 (U.S.) in Mexico.

I was very impressed with how much more transparent the pricing and billing is outside the U.S. In Mexico, all citizens have access to basic healthcare and treatment at state-owned facilities, for free. Those with better financial means can purchase affordable insurance with allows access to well-run private hospitals and clinics.

For expats, private insurance in Mexico is more affordable than the “affordable care act” coverage in the U.S. In the Chapala area, we can also purchase a clinic membership that allows full access to physician services in that clinic for about $300 (U.S.) a year. Lab tests, x-rays and pharmacy service are independently paid by the patient. For under $2,000 (U.S.) per year, an expat can buy more comprehensive coverage or catastrophic coverage.

To be continued.