In 1991 Billy and Akaisha Kaderli retired at the age
of 38. Now, into their 3rd decade of this
financially independent lifestyle, they invite you
to take advantage of their wisdom and experience.
Tourism Follow Up
Readers' Questions and Our
I would like to thank everyone that sent well
wishes and concerns regarding my
recent hospital adventure. First let me
state that I am fine and good to go. I called the hospital long distance from
Panajachel to Guatemala City to speak with my lead doctor on follow up care as he
requested, and left my cell number there at the desk. He phoned me back within
30 minutes of my call.
So the great service continued even after I
was discharged from the hospital.
As you might imagine this medical experience
sparked a load of inquiries and comments from our Readers. We thought that some
of you may share the same questions or concerns, so we have posted a few of
these inquiries with our responses below.
Thanks again for taking the time to write and
to express your concerns regarding my health.
your article I still had some questions about your experience at the
Hospital in Guatemala.
As for your
$1,609.00 bill, how much was out of pocket?
To me, I don't
care what the total is, I care about how much is out of my own pocket
and your article makes it look like you got off cheaper with $1,609.00
overseas than $4,700.00 in the States but that's not the whole picture.
If you end up
paying the whole $1,609.00 then that article you wrote was very
misleading and that is what concerns a lot of folks who are considering
moving overseas. What happens when you end up with a $1,609.00 bill when
Blue Cross would have covered all but $100.00 of that in the States.
Please let me
know. Thank you for listening.
Thanks for taking the time to write. We appreciate your question and your
concern for the accuracy of our article.
As you know there are all sorts of
different health insurance policies available in the States. Some policies
provided by employers have a very low deductible and a small co-pay.
Those who are self-employed, unemployed or those who are watching their
monthly expenditures might not have this same low deductible, small
What do you pay monthly to receive a cap of $100 on your out-of-pocket?
Ours is a high deductible plan ($10,000) and if we are in a foreign
country when a health issue arises, the deductible doubles because these
doctors and hospitals are out of network.
To directly answer your question,
the total amount of $1,609 was out of pocket.
However, the cost for
these same services in the States would easily have been close to
$10,000 or more (emergency room care, emergency doctors, nurses,
administration of meds, a 2 night hospital stay, CT scan, x-rays,
medicines administered and the doctors and nurses who attended us in the
hospital) -- and the majority of that would have been out of pocket for
us even with our insurance.
Not only that, but we would not have
received our bill for several weeks at least, with the submission of billings
dragging on to our insurance company who would compute the deductible, the
amount allotted to the hospital, and how much we were responsible for in
accordance to our deductible and out-of-pocket limits. I would have spent hours
on the phone with the health insurance company and the billing department at the
hospital coordinating the figures.
Adventurer's Guide to Guatemala
Donít go to
Guatemala without this book! Take advantage of what we know. Click
Asking for an itemized billing would have
taken another couple of weeks, with the paperwork crossing over in the mail. We
would have been "stuck" in our home town in the States for many weeks, not being
able to resume our traveling lifestyle, until the paperwork was sorted through.
Lead Doctors in
hospitals in the States charge per visit, even if it is only for 2 or 3
minutes. That price - according to our previous experience in the States
- is hundreds of dollars per visit. Their Physician's Aids charge over
$100 per visit as well, and often the questions we have are not
answered. If anyone returns with the answer to your first question, you
are charged again.
In Guatemala City the total cost
for our lead doctor and his 6 visits was $150. The room charge in Centro
Medico Hospital was $150 for two nights plus the emergency room. In the
States that figure would have been several times that amount. You get
If you have an insurance plan
through your employer that provides all that you need with a cap of $100
then you have a very fine plan indeed.
That being said, it has been our position
that the American consumer needs to know what they are being charged for medical
services regardless of who is paying for them. The fact that most Americans do
not know or do not concern themselves with these costs contributes to these
costs spiraling out of control. If you had to pay out of your pocket for the
services you received, you would more than likely shop around for better
Again we thank you for taking the time to
write and for asking a very good question. Hope the information I provided above
gives you more insight into medical care options.Readers' previous
experience in the same hospital
Dear A and B,
You won't believe this: I was treated in the same hospital in 1992, I
think it was. Road wreck, they sewed my face back on, put me in a body
cast, and so on... you remember the story.
When I saw the picture I recognized the hospital immediately.
I had a similar experience at the
Centro Medico in 1995. An acute respiratory emergency. After a quick
trip from Antigua
I was immediately admitted to the emergency room and a specialist was
called -- no insurance or paper work beforehand. I eventually spent 4
days in the hospital with respiratory therapy each day.
Food was excellent;
staff also. My total bill was $850 -- and reimbursed 100% by my hmo upon receipt
to all my medical information provided by the hospital and physician. As a
former hospital staff evaluator I can say without reservation this was one of
the best hospital experiences one could possibly have had.
Comments on pricing
of U.S. care and Guatemalan care
Thanks SO much for
sharing - and showing that one of the biggest objections that we Americans have
to retiring - is unfounded.
And my other
comment is that what is *not* in your Guatemalan bill: the cost of all
of the malpractice insurance and frivolous lawsuits that they do NOT
have or the cost of the health Insurance behemoth. I've long said that
the lawyers and the health *insurance* *are* the problem in America:
doctors are afraid to actually *do* anything for fear of being sued -
and health insurance just adds a huge overhead and costs associated with
the hypochondriacs who suck up the majority of medical costs - because
they have insurance. Go back to letting doctors practice *medicine*
instead of law - and just PAYING FOR WHAT YOU GET - and people will only
get medical care that they *need* - and the costs will plummet.
But that won't happen here. Too many entrenched power structures.
an insightful and instructive video on Guatemala Medical Travel with interviews
of both Doctors and Patients,
Praise for medical
care in Mexico
First of all ... Good
Grief! So sorry that Billy had medical emergency, but relieved that all came
out for the best. And what a wonderful article praising the medical services in
Guatemala. Be advised! Stateside peeps may come down in droves for treatments
after reading this!
That aside .. I too am so very impressed
with the quality of medical attentions here in Mexico, the cost and the
aftercare that so often involves a home visit. Get that in the U.S.? I don't
Payment for services: credit card?
Thanks for that story about the
hospital in Guatemala City. I was just curious
about how you paid for that. Did they take credit cards or a check? Or do you
have an account in a bank that is readily accessible there, or what?
I love your blog. I just
retired last month from working as a Staff RN at a hospital and I agree that
medical care in the US is a mess. I'm trying to get myself organized now so I
can do some traveling. Thanks for your insights.
Thanks for taking the time to write and for your kind words about
enjoying our site. We appreciate that!
When Billy needed to be admitted into the hospital for the overnight
stay (it was 3 a.m.), I was taken to the admitting office and signed
some papers along with giving them my credit card. As a guarantee, they
wanted me to charge 20,000 Quetzales on my credit card. That translates
roughly to $2,500 USD.
When it was time to check out, one
of the hospitality aids took me to the daytime office, where they gave
me back my "guarantee payment" sheet for me to tear up and they charged
my card with the full amount that was spent.
When I got home, I
checked my credit card statement online for several days in a row to be sure
there was no double charging and everything turned out to be fine.
So you have first hand
experience of the medical system in the States... wow. Would I love to have a
conversation with you! ;-)
Congratulations on your retirement and how exciting that you are planning to do
All the best, and feel free to write any time!
U.S. Doctors think we
Hi, nice article on your
hospital experience. You are right in that in the US they do not explain a lot
to you. I guess they think we are all idiots and can't think for ourselves.
Plus, they are always in a hurry to get to the next one.
Hey you two,
I was wondering
why you didn't mention that one can purchase international health
insurance when traveling or living in foreign countries? Wouldn't that
help in covering hospital/doctor/surgery costs?
Thanks for taking the time to write. We appreciate it.
Yes, of course one can purchase travel insurance or foreign health insurance
while living overseas. We speak about this in
our books and we have a
Medical Insurance page as well as a
Medical Tourism page where one can get more information on these topics.
Thank you for bringing this up. I'll add these links to the bottom of this piece
to help anyone who wants to know more.
About the Authors
Early Lifestyle appeals to a different
kind of person Ė the person who prizes their
independence, values their time, and who doesnít
want to mindlessly follow the crowd.
Retire Early Lifestyle Blog
About Billy & Akaisha