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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.

Billy's Medical Tourism Follow Up

Readers' Questions and Our Answers

Billy and Akaisha Kaderli


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.


How much was out-of-pocket?

After reading 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.


Hi Cynthia,

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 co-pay plan.

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.

The Adventurer's Guide to Guatemala

Donít go to Guatemala without this book! Take advantage of what we know. Click here

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 the idea.

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 pricing.

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.


To watch an insightful and instructive video on Guatemala Medical Travel with interviews of both Doctors and Patients, Click here

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 think so!

Payment for services: credit card? check?

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.


Hi Marilyn,

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 some traveling.

All the best, and feel free to write any time!


U.S. Doctors think we are idiots?

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.

Stay safe,


Foreign medical insurance

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? 


Hi Anne,

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.


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About the Authors

Billy and Akaisha Kaderli are recognized retirement experts and internationally published authors on topics of finance, medical tourism and world travel. With the wealth of information they share on their award winning website, they have been helping people achieve their own retirement dreams since 1991. They wrote the popular books, The Adventurerís Guide to Early Retirement and Your Retirement Dream IS Possible available on their website bookstore or on

Retire 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.

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