Most people would be overjoyed to receive an 75% reduction in their family’s healthcare expenses.
I certainly was.
And, I’ll tell you how I did it.
Here’s my baseline. The last time I paid for health insurance in the U.S., it cost me $436 per month (scheduled to increase to over $1,000 per month by now) for my wife and me, who were both very healthy and in our late 50s. The policy had a $10,000 deductible per person. We did, however, receive two visits per year for which we had the privilege of just paying a co-pay, which I remember to be about $45. After that, all expenses were out of pocket until each of us reached our deductibles.
My wife and I were extremely reluctant to go to the doctor, lest we use up one of our two yearly co-pay visits, and we were very concerned about the financial impact of getting seriously ill, because our $10,000 deductible would be used up in a flash, and even after that, the insurance company would only pay a percentage of everything afterwards.
While certainly not the only reason, this rapid and significant rise in our healthcare costs was one of the things that made it easy to decide to move to try a move abroad, in this case, to Mexico.
In order to make this article less about my wife and my personal situation and more about the average American, I tried to do research in order to report how much the average American spends on healthcare. What I found is that the numbers are so varied and the dependencies so numerous and significant, that it is not possible to report a meaningful number.
Here are just a few of the considerations:
- Political. One side wants to make healthcare costs seem to be increasing, while the other side wants them to appear to be shrinking, so they report different things. Adding to this complexity is that the sides will most likely soon change.
- The amount of healthcare costs paid by those other than the patient, such as the government, insurer, employer, etc., varies widely, and it is not at all clear how much of that cost should be apportioned to the individual. For example, if your employer provides you with insurance, you may think that you’re paying much less than you actually are, because if your employer didn’t pay for your insurance (or part of it), you could receive part or all of what your employer paid for your insurance in the form of increased wages for you.
- How much you pay will depend on your income. For example, if you are low income, perhaps Medicaid pays for your healthcare, while if you earn more money, you must pay for some or all your healthcare yourself.
- Age. For many people, the day you qualify for Medicare, your healthcare costs decrease (in most cases; another complexity.)
- Employment status. If you’re self-employed, you tend to pay the most, while if you’re part of a large group, you tend to pay less. Large employers tend to get better deals.
- Where you live. The same insurance plan will cost you differently depending on where you live. Unfortunately, I lived in Arizona, which on average had an increase in premiums this year of over 100%.
I strongly suspect that this complexity is a symptom of the problem.
Here’s my situation in Mexico.
For roughly the same insurance coverage in Mexico but adding coverage in the US should my wife or I need it while visiting, we pay the equivalent of about $250 per month, about a 75% discount to what I would be paying in Arizona. This alone puts over $9,000 per year into my pocket.
Unless there’s a catastrophic healthcare event, though, I don’t plan to ever use my Mexican insurance. The reason is that the out of pocket healthcare costs in Mexico are so low, it’s not worth our time to even file a claim. Here are some examples, using US dollar equivalents, for private healthcare in Mexico:
- Before we first arrived at Ajijic (a popular expat destination on Lake Chapala, about an hour south of Guadalajara), I needed to see a podiatrist for an issue that had bothered me on and off in the US for about a year, but I didn’t see a doctor in the US because I didn’t want to use one of my two insurance-provided visits. In Mexico, I did see a doctor. My initial consultation in Mexico was $15, for which they apologized, because subsequent visits would be $12.50. Each visit was a full hour. Now I go just for regular maintenance. Why not? It’s $12.50 per visit.
- A pain I had experienced years ago flared up again in my shoulder, so I went to a physical therapist office and asked to make an appointment. They told me to come back in one hour. The therapist spent more than an hour and twenty minutes with me and charged $25. I was very impressed with the therapist’s knowledge and caring about my problem. His ultimate recommendation was that I should really be seen by a doctor. Given what I now expected the price would be for a doctor visit in Mexico, I was quite willing to go.
- When I walked into the doctor’s office, they couldn’t see me immediately unless I was experiencing an emergency, so I had to make an appointment for a few hours later that day. The doctor did an extremely thorough examination that lasted about an hour and a half. She discovered an unrelated problem, prescribed some medication for me to pick up at the pharmacy and three injections, one that would be done immediately, and the next two over the next two days. The cost for the doctor visit was $15, and the injections would be $5 each. The doctor told me that If I felt that the injections cost too much, she would let me know where to pick up the medication and have someone else do the injections. I figured that for $5 each, I would have them done in a doctor’s office.
- My wife and I get our teeth cleaned for $25 each in an office more modern than the one we visited in Arizona, by extremely competent dentists. We recently paid $75 to have one of the dentists repair a chipped tooth my wife received by tripping over one of our dogs.
As you are reading this, you may be thinking that it is very nice to have low cost, be seen pretty much immediately, and have healthcare professionals spending multiples more time with my wife and I than they would in the US, but what if the care I was receiving was low quality? Certainly, that wouldn’t be worth it.
From a personal perspective, the resolution to the problem at the podiatrist’s office was better than I would have predicted, and we can’t even tell where the chip in my wife’s tooth used to be. However, what about getting opinions from a wider set of people than just my wife and me?
Fortunately, in addition to being very pleased with the care I described and subsequent care, I have the advantage of having interviewed more than 500 people about their experience abroad for Best Places in the World to Retire. We have more than 9,000 answers on our site, a very large percentage of which are about what US and Canadian expats think of the healthcare they received in places like Mexico, Panama, Nicaragua, etc.
What struck me most before experiencing the healthcare quality and cost here myself is the close to uniform satisfaction these expats expressed about the care they received, some of which was for problems much more extreme than what I experienced; even life threatening. Now, after having experienced just a bit of the healthcare abroad (in this case, in Mexico, but other places report similar findings), I can say that I agree with them—the outcomes are on par with what you would get in the US, the personal attention is much, much better.
Another advantage is that the cost is so low, my wife and I will go to the doctor much more often, which has got to be good not only for our psychological well-being and long term health, but also for the health of our budget.
Chuck Bolotin is the founder of Best Places in the World to Retire(click on: https://bestplacesintheworldtoretire.com/), a website that provides credible information to those researching moving, visiting, or doing business abroad. Prior to that, Chuck founded, funded, ran and sold two companies. He is a frequent guest lecturer at the Eller College of Management MBA Program, mentored at the Arizona Center for Innovation, and frequently sat on the Desert Angels Screening Panel in Tucson, Arizona. After selling his home in Arizona and completing a one year road trip through Mexico, Chuck now lives in Ajijic, Mexico, with his wife, Jet, and their two dogs.
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