Early Retirement Extreme Forums

Apparently it's cheaper to fly yourself + a US surgeon to get a knee replacement in Mexico rather than deal with the US health care system in the US. Indeed so much cheaper that patients get a $5000 bonus check from their employer['s insurance] for doing it this way. How soon until this process becomes standardized by US insurance providers to take the general uncertainty (FUD) out of DIY medical tourism?

I know it's not uncommon in the EU for procedures that aren't covered by national healthcare, like dentists and opticians: A dentist from county X sets up shop in country Y and patients from X then travel to Y see the dentist there to avoid the regulatory capture of their home country, X.

https://www.nytimes.com/2019/08/09/busi ... exico.html

Built into the business model of this hospital in the Cayman Islands: https://www.youtube.com/watch?v=BjQCCgyhmU8

It's profitable to do this within the US. Pay for transport to city 300 miles away and get surgery done there rather than closer and more expensive rural hospital.

Why can't we have an Amazon for heath care? Put "hip replacement" in the search box and up come hospitals in Greensboro, Guadalajara and Guangzhou. Has limited scope for a car accident or a stroke but that shouldn't get in the way of what is possible.

I'm amazed insurance companies are jumping on this bandwagon. What a cluster! Just to add to @unemployables point, most expensive medical issues are not emergent. IMO medical tourism is a very good option for an ERE'er with enough capital to hop on a flight.

Since working in healthcare, I'm certainly more worried about my medical condition than I used to be. It's easy to become a hypochondriac. Still, there is no way i'm paying an ACA premium without subsdies. It's just too expensive, and the deductibles are so high, it's not like I'm going to the ER unless I'm really, REALLY concerned anyway. My plan is an extremely high deductable "emergency" policy to cover me just in case I experience crushing chest pain or get run over when on my bike. Otherwise, it's medical tourism. In all fairness I have enought experience to know with a realtively high level of accuracy what is and is not an emergency, and can intreprete many of my own tests if I chose to get them done and pay out of pocket for lab work or the like. If I actually get sick with a chronic illness, then plans would have to be adjusted.

@c_l
Agreed, ACA without subsidies is a no-go. You mentioned an extremely high deductible emergency plan. Could you please share the details (where to find, cost, coverage, etc.)?

Frita wrote: ↑

Thu Aug 15, 2019 9:17 am

Agreed, ACA without subsidies is a no-go. You mentioned an extremely high deductible emergency plan. Could you please share the details (where to find, cost, coverage, etc.)?

We use the bronze plan at Christian Healthcare Ministries, which is $45 per person per month, plus their Brothers Keeper add-on which is an additional fee. I can highly recommend them to anyone who is OK with their membership guidelines.

@GandK - are those guidelines legally enforceable ? Seems ripe for fodder to arbitrarily deny payments

chenda wrote: ↑

Thu Aug 15, 2019 2:40 pm

@GandK - are those guidelines legally enforceable ? Seems ripe for fodder to arbitrarily deny payments

Honestly, I couldn't say. What I can tell you is that we, and many members of our church, use these folks, one of them for cancer (the main concern in our household). I've never heard of there being a problem other than payments being delayed because of insufficient documentation when filing, and the patient in question confessed that she'd made the mistake.

The only thing that gave us pause was our preexisting conditions. During the phase-in period for those, if those specific conditions cause major expenses, you'd foot the bill. However, once that time has passed, as far as we can tell they meet all their obligations.

@GandK - Glad to hear it's working well.

Has anyone gone abroad for cosmetic work ?

Frita wrote: ↑

Thu Aug 15, 2019 9:17 am

You mentioned an extremely high deductible emergency plan. Could you please share the details (where to find, cost, coverage, etc.)?

Some areas do offer non ACA compliant temp plans inside of a single network, they are good options and much cheaper as they do not cover preexisting conditions. I've used these before. Terms usually run 3-12 months. My current geographic area does not have any of these options, hence I elected to do a healthshare, just like @GandK.

Regarding health shares, they are NOT legally obligated to cover your medical costs. They generally do not cover pre-existing situations and payout per "incident". So do your homework to decide if it's right for you. Achedotally, I know many, many patients who were hospitalized with healthshares, and without exception, they followed through on the commitments promised. Still, I realize the risk exists. OTOH, ACA plans are subject to balance billing, which happens very frequently if you need out of network care. So, essentially the plans are worthless if you travel out of your home network regularly. Healthshares have no network. As a result, IMO, they are superior to ACA plans for emergency situations that occur out of network. Health shares are also superior in that the money you pay in goes directly to someone who needs the coverage each month, with minimal operational costs (some will even tell you where your money went and allow you to send letters of healing/encouragement). No massive wastes as with large insurance companies. Since I am basically insuring only for emergent situations, and travel/move frequently inside the US, it's obvious why I'm currently contributing to a healthshare. They are not for everyone. If I had a preexisting condition with a reasonable possibility of exacerbation/complications, or had expensive Rx medications, I would choose ACA and try to modify my income to max subsidies.