What To Do As A Traveler To Mexico

by sherab

What To Do As A Traveler To Mexico

 

What To Do As A Traveler To MexicoIf you do not have out-of-country healthcare coverage, by all means go out and buy it before leaving for your trip. However, it’s advisable to first inquire of your credit card company, to ascertain if in fact you already have at least some coverage simply by virtue of, for example, having a gold or platinum card. You can then make a more informed decision concerned whether or not to purchase coverage, and if so at what level. On the other hand, a broken leg, gastrointestinal problem or other non-life threatening ailment can be attended by a private doctor or clinic without breaking the bank. Of course for an outlay of more than $100, it’s nice to be reimbursed.

If you intend to make a claim to your private carrier, credit card company or government funded health care plan, ensure that you not only keep all receipts, but request a written diagnosis and treatment plan, and that the prescriptions you are given indicate for what purpose each medicine is being prescribed (i.e. antibiotic, analgesic, etc.). Many doctors provide all required information simply as a matter of course. Accepted practice, at least except for when narcotic medications are being prescribed, is for the pharmacy to return prescription forms to you. Often medical plans require translations of each document that is presented to them as a prerequisite for processing and reimbursement. When in doubt, submit all documentation with your claim, making sure to determine if originals are required, and keep copies. Frequently, as is the case with Ontario, it’s a two step process. Treatment receipts and diagnosis is submitted to the provincial plan. Once you’re notified of the portion not covered, prescription receipts together with a request for reimbursement for the amount not covered by the province, is submitted to one’s private plan. In theory, between the two plans, 100% reimbursement is achieved.

You can ask the manager of your hotel or bed and breakfast to do you a favor by translating each of your supporting documents, to save you the trouble upon your return home. Make a note of the then prevailing rate of exchange, and submit a calculation to your plan with your documentation, to more easily facilitate payment. When a member of a clerical staff is processing your claim, he’ll be less inclined to put yours aside for another day or week if it already contains all the necessary and relevant data, organized in a readable format.

Concerning where to go in the event of illness or emergency, your accommodations host should be able to make recommendations for English speaking physicians with private practices, and for private clinics. Regarding competency of the former, while there is a medical school in Oaxaca, many doctors travel out-of-state for their post-graduate training such as to universities in Mexico City or the US, and regularly attend conferences and upgrading courses. Some travel abroad within the context of their specialization training. Indeed the Oaxacan populace appears to take notice of and prefer those physicians who are able to display foreign diplomas.

Our personal experience with emergency treatment over the past 10 years has been nothing but positive for ourselves, our family and our guests, at hospitals Carmen and Molina, both downtown … in terms of competence, speed with which one is attended, and the presence of English speaking ER doctors. On the other hand, we cannot recommend the emergency departments at the civic hospital or IMSS because of delays in receiving treatment, and at minimum in the case of IMSS unavailability of competent medical personnel 24 hours a day to attend to even a commonplace emergency (i.e. suturing). Having said this, many excellent surgeons with private practices perform surgery at the non-private hospitals where there tends to be the more state-of-the-art and sophisticated equipment.
The normal range in price for a consultation with a family doctor, specialist or dentist, in Oaxaca, is $20 – $50 (all figures are in US dollars and are approximate).

 

Purely Elective And Cosmetic Procedures

 

Over the past several years Oaxaca has become a popular destination for Americans and Canadians seeking both plastic surgery and extensive dental work. Word has spread of the competence and quality of work of both nip-and-tuck and dental surgeons, and of course of their extremely reasonable charges relative to those paid to hometown practitioners, and indeed to other Mexican cities. Many foreigners, as well as Mexicans from Mexico City and other regions of the country come to Oaxaca for face lifts, breast reductions and augmentations, liposuction and other appearance enhancing procedures. A friend who attended for plastic surgery in Oaxaca by a well-known plastic surgeon a couple of years ago, recently commented that she had read an article in a Canadian magazine indicating the cost for the same procedure which she had performed for $500, was $3,500 – $5,000 at home. In effect she had a free trip to Oaxaca, and returned home with extra money in her pocket, looking lovelier than even after the swelling dissipated.

Our personal experience with dental treatment has been extremely positive. Cost tends to be about a third to a half of American and Canadian prices, for example for crowns and bridges, implants, root canals, gum and bone work, etc. While the use of nitrous oxide (laughing gas) has not yet arrived in most Mexican cities, a dentist with a gentle touch can more than make up for that lack of temporary high while in the chair.

 

Resolving The Ex-Pat Conundrum

 

Get whatever coverage is made available to you both in your homeland and in Mexico, subject of course to affordability.

With IMSS coverage costing about $400 annually for a couple (if one spouse is 60 years old or over, the cost jumps to over $500), why not go for it regardless of what other coverage you already have. Then supplement IMSS with international coverage for catastrophic injuries unless you have other similar insurance from another source. Our Oaxacan friends tend to disagree, but theirs is a different mindset where insurance in general has historically not been stressed or valued, be it home, car or health.

Some American acquaintances swear by IMSS since it provides regular care including preventive procedures, all dispensed by government employed physicians including specialists, together with lab tests, medication and hospitalization. There are restrictions the first year of enrolment, and there are caveats. The level of cleanliness in the clinic environment tends to be below the standard to which most of us have become accustomed growing up in the US and Canada. Many physicians have not received the quality of medical education of their private counterparts. The medications provided through the clinic pharmacy are often not the best available in the marketplace for treatment of a particular ailment, because of cost. Often the wait to see your designated doctor or for your lab tests can be long, requiring a half day commitment for each step in the process: visiting a general physician, going for one set of tests, then for another, and finally seeing a specialist.

So why bother with IMSS at all, with all these downsides? It’s a failsafe, another form of assurance that you’ll be cared for in the event of a lengthy and serious illness. As suggested earlier, often it’s the largest hospitals such as IMSS which have the best equipment, and surgeons with private practices who perform some of the surgeries. And there is no additional cost for hospitalization once you have full IMSS coverage. While attending a private clinic is more akin to your experiences before moving to Mexico, if you must remain in hospital for a lengthy period of time, the cost of doing so in a clinic could be prohibitive…just like back home.

Visiting private physicians, and even biting the bullet and getting your tests done at privately owned laboratories, reasonably assures you of a familiar quality of care. Coupled with IMSS coverage, you can now be confident that you’re covered in almost all respects. In the event of a protracted hospital stay you can afford to be there for as long as necessary. The best locally available equipment will be used in your diagnosis and treatment, and you have a reasonable likelihood that attending surgeons are those who split their time between private practice and clinic work, and performing procedures in one or more large hospitals.

We maintain IMSS coverage, but rarely use it, preferring to tap our Oaxacan social networks for referrals to specialists to the extent they are required. And in any event, after having been resident in Oaxaca for a few years, those of us who are in our fifties or older have already been introduced to a broad range of specialists. As strange as it still is to be a Canadian and subscribe to the pay-as-you-play philosophy of medical care, it serves our purposes, with the IMSS safety net just in case.

Under certain circumstances you may not want to rely on even the best Oaxaca has to offer. Indeed the stream of Oaxacans traveling to Mexico City flows briskly and wide. The middle and upper classes with contacts in the nation’s capital, there quickly seek out the best in terms of physicians and state-of-the-art equipment, for diagnosis and for treatment of life-threatening diseases.

Even doctors working in Oaxaca at the IMSS and ISSSTE hospitals can make arrangements for patients to receive treatment not available here, to be attended in Mexico City or other larger centers. However, the process can be slow. We know of one case, that of a two-month-old baby with heart problems, who was finally sent to Puebla for surgery at ISSSTE, only to die before the procedure could be performed.

The solution, unless you have quality foreign coverage perhaps as part of your retirement pension plan, is to buy insurance which will pay for treatment in Mexico City, or better yet throughout the world as long as you can make your way to one of the participating top-of-the-line hospitals. In my case, I have a low annual premium, with high deductible which is waived in the event of accident. Again, it’s a failsafe mechanism in the event of, for example, a serious car accident, or cancer, stroke, heart attack, or other catastrophic ailment which would otherwise not be affordable. Oaxaca has less than the best of diagnostic equipment and treatment facilities. My plan provides for a $10,000 deductible, $2,000 annual premium, with member private hospitals in Oaxaca, Mexico City and elsewhere in the republic, and of course abroad including the US, with the Mayo Clinic as a participant.

In summary, my medical coverage and plan for treatment is the following. We have our regular family physician, who, along with our Oaxacan friends, refers us to specialists in which we have the utmost confidence, and to whom we pay per visit. The same holds true for dental treatment. We have IMSS coverage which we reluctantly (because we don’t use it) renew on an annual basis, but believe it’s worth the price in the event we need extended hospitalization, or to have surgical procedures performed not available in private clinics. And I have my catastrophic coverage which hopefully I’ll never need to access.

Medical care and coverage can be inexpensive, and just as easily it can be costly. It’s a matter of the individual or family having a philosophy, or set of priorities, before electing to move to Mexico. You have to determine how you want to lead your life in terms of balancing having less disposable income as a result of medical and insurance costs, with having greater peace of mind in knowing that whatever is thrown your way will be looked after as best possible given your new life in a foreign land. If you cannot achieve a level of comfort in the resolution of these issues and decisions, then perhaps the move is not for you.

 

Alvin Starkman together with wife Arlene operates Casa Machaya Oaxaca Bed & Breakfast
Alvin received his masters in social anthropology in 1978, and his law degree in 1984. Thereafter he was a litigator in Toronto until taking early retirement. He and his family were frequent visitors to Oaxaca between 1991 and when they became permanent residents in 2004. Alvin reviews restaurants, writes about life and cultural traditions in Oaxaca, and tours couples and families to the villages.

The New Housemates

by sherab

The New Housemates

By Sarah Mahoney, July & August 2007

Source: AARP – Women Turn to Alternative Housing to Meet Retirement Needs

“Whether widowed, divorced, or single, more and more women are finding a surprisingly practical living arrangement…”

 

The New HousematesAn old German proverb goes something like this: “Two cats and one mouse, two women in one house, two dogs to one bone, will not agree long.” Well, we can’t speak for cats, dogs, and mice, but these days more and more women are living two, three, and sometimes more to a house. And they’re agreeing on everything from how to split the electric bill to who gets use of the kitchen on Saturday night. Indeed, what was originally thought to be an impossible situation is turning out to be a godsend for many women. Take the case of Penny Bond, 59, and Kathy Austin, 52, two pioneers in what is becoming a hot housing trend for older women—home sharing. The two friends met more than 15 years ago when, says Penny, “we were both coming out of long, difficult marriages. After that, we spent so much time with each other that we’d often talk about moving in together as housemates. But because we both so valued our privacy and independence, we’d always end up getting cold feet.”

Then in 1999 Kathy asked if she could stay with Penny for a few weeks while she had some work done on her house. Because of a long series of contractor disasters, those few weeks turned into nine months. During that time the women got along so well, they decided to make the arrangement permanent. “Living together just made sense, for several reasons,” Penny explains. “As friends, we were already spending time together. And during those nine months we found out we each had as much alone time as we wanted. It just seemed ludicrous to keep paying for two households.”
That was eight years ago. The two are still together and quite content as they share Kathy’s house in Asheville, North Carolina. They even started a business together. Their respective kids—six in all, plus two grandchildren—come and go on a regular basis. “We’ve got a very comfortable system going here,” says Kathy.

 

“Data from the U.S. Census Bureau indicate that about 500,000 women, or a little more than 1 percent of women 50 and older, currently live with a nonromantic housemate…”

 

Data from the U.S. Census Bureau indicate that about 500,000 women, or a little more than 1 percent of women 50 and older, currently live with a nonromantic housemate. And experts predict that eventually women like Penny and Kathy will be the norm instead of the exception: think Golden Girls meets Kate & Allie. Fueled by simple demographics, financial reality, and the resilience demanded of living on one’s own, these women are finding the housemate option to be an attractive one as they ease into retirement. A recent AARP Foundation Women’s Leadership Circle Study found that more than a third of the 1,200-plus women 45 and older surveyed said they’d be interested in sharing a house with friends or other women—as long as it included private space.
Though it’s nice to have company when you want it, the bigger incentive for home sharing is this: it just makes good financial sense. Two can usually live more cheaply than one. And many of the 25 million single women over age 45 are not only single—they’re absolutely unapologetic about it and have accepted that, at least in the foreseeable future, “Prince Charming isn’t likely to arrive bearing gifts of real estate,” says Candace Bahr, cofounder of the Women’s Institute for Financial Education and a managing partner of Bahr Investment Group, which specializes in financial planning after divorce. Many of these single women also realize that they’re less financially prepared for retirement than their married counterparts, and that they haven’t been able to earn as much money during their working years as most men. Often these women are divorced or widowed and know firsthand how hard it is to maintain a one-income household. They are willing to consider any option, as long as it allows them to hold on to their freedom.

 

“After all, we’re from the generation of women who lived in communes back in the 1960s,” says Connie Skillingstad…

 

“After all, we’re from the generation of women who lived in communes back in the 1960s,” says Connie Skillingstad, who launched Golden Girls Housing in Minneapolis several years ago. The nonprofit service helps women look at nontraditional options for housing that meet their financial, social, and emotional needs. Skillingstad says it’s tough for some women to think seriously about shared housing, and many don’t know where to start. “In our culture, living communally with people who aren’t related to us certainly isn’t considered the norm,” says Jacqueline Grossmann, copresident of the National Shared Housing Resource Center and a housing specialist at the Interfaith Housing Center of the Northern Suburbs, outside Chicago. “So when women decide to do this, there’s usually a pretty compelling financial need—a divorce, a job loss, an illness, or even the realization that they don’t have enough of a nest egg.”
And, of course, not every house-sharing experience is a positive one. There can be personality conflicts, says Grossmann. There can be minor squabbles about anything from too many out-of-town visitors to who should clean out the fridge. And there can be major disasters: a landlord who seemed shy and sweet turns out to be psycho, or a dear friend is revealed as a deadbeat. All that said, many women are releasing their cultural hangups and their fears of the roommate from hell and venturing down this new path.

 

“This is the wave of the future,” Skillingstad predicts.
Here’s why…Financial Security!

 

Though shared housing can initially feel like a regression to younger times (not that there’s anything wrong with that), most grownup housemates quickly begin to appreciate the financial benefits of the arrangement. Mortgage holders find themselves breathing easier about paying the bills. And renters often get more square footage—not to mention a bigger break on utilities—than they’d find solo.
And then there are the women who are pooling their resources not just to make ends meet but to build wealth. Ann Beavers, 61, and Ruth Sorensen, 58, decided to be housemates and bought their first place together—a condo in Anaheim, California—in 1988. Both were school administrators. “Ann had financial savvy, but I didn’t,” says Ruth. “I had lots of student loans, and then I traveled a lot using credit cards. By the time I was in my 30s, I realized that with my debts, California housing prices, and a school salary, there was just no way I’d ever be able to afford a house on my own.” So when Ann suggested they buy a condo together, Ruth knew it was a good idea. Four years later the two were so pleased with the arrangement that they bought a second property, a smaller condo in Oceanside, California, for weekends at the beach.

Soon after, they sold the Anaheim property and bought a larger home, also in Oceanside, and moved Ruth’s frail mother into the little condo. When it became clear she needed more care, Ann and Ruth sold both properties and bought a dream home that could accommodate all three of them. Ann and Ruth are convinced that if they hadn’t combined their money, they would have never been as financially secure as they both are now. “And because we shared all our costs over the years—the mortgages, insurance, furnishings—we were able to save enough so we could both retire early,” says Ruth.

 

Time to Think

 

Some of life’s lowest moments come with a cash bonus. “Whether it’s from a life insurance policy or a divorce settlement, many women who find themselves suddenly single also have a lump sum of money, and they are tempted to dive into a real-estate purchase,” says Bahr. “But often a house just isn’t the investment women expect it to be.” Sharing housing with another woman during such transitions can be ideal, Bahr says, because it buys the new single some time before she has to make any big decisions. “Sometimes it takes a few years before a woman can admit to herself she really can’t afford to keep that marital home, and to make the emotional decision to sell it and move someplace smaller,” she says. Having a housemate provides a financial cushion so a woman doesn’t have to make any rash decisions.

“I’ve had a couple of marriages, two kids, and lots of different living arrangements,” says Leah Song, 65, who is in the midst of contemplating some big changes—including whether she should move to Santa Cruz, California, where she’d be close to her daughter, as well as the possibility of a new career in financial services. So renting out part of her Weaverville, North Carolina, house to a friend, also in her 60s, makes perfect sense right now. While Leah and her friend (who is in the midst of buying a condo) make plans for the future, Leah earns an extra $525 in rental income that affords her some breathing room.

 

Peace of Mind

 

For Zenaida Yap, in her early 50s, making the decision to move in with another woman—in her case, someone almost 40 years older—has given her an entirely different perspective about her own future. She has lived in the San Francisco area for years, and while she still dreams of owning her own home someday, she came to realize that—given the current cost of housing—it just might never happen. And increasingly, she found herself worried about her future: “I started thinking, ‘What if I lost my job? What if I got sick?'”
Zenaida considered home sharing. The more she thought about it, the more sense it made: between her long commute to her job in apparel production, 12-hour workdays, and trips to the gym, she figures she is away from home about 15 hours a day anyway. Because she has a cat, it took more than a year and a half before she found a “match”: 91-year-old Helen Holmelund, who’d been in California’s San Mateo area since 1940 and who’d been renting out space in her home for more than 20 years.
Helen, a wheelchair user, and Zenaida clicked right away. Turns out Helen loves Coco the cat, which alleviates Zenaida’s guilt about leaving her furry pal alone for such long stretches. And the configuration of the house, where Zenaida has two bedrooms and a private bath, allows for plenty of private time. Still, it was a big adjustment sharing the common spaces. “I work such long hours, and there are just days when I cannot talk—I just don’t have it in me,” she says. “And since Helen has been alone all day, I can sense that she wants to.” So Zenaida makes more of an effort to make that connection. “As I move toward retirement, the reality is that I probably will find myself in some sort of co-op for seniors—I think it’s healthier, and a better social environment. So I think this is a good transition for me,” she says. “Unfortunately, when you live by yourself, you can get very set in your ways.”

 

Companionship

 

For some women, living with other women—whether an old friend or a complete stranger—offers a perk that goes beyond extra money or someone to go to the movies with. It is the spark that some women need to move to a higher sense of living. “Sometimes all it takes for a woman living alone and just existing to rev up her life is reconnecting with another human being,” says Joan Medlicott, author of the popular Ladies of Covington series of novels about the adventures of three older women sharing a home (see The Covington Chronicles). “All of a sudden the women find themselves sharing their interests and strengths and, eventually, helping one another reinvent and reinvigorate each of their lives.”

Maggie Glaros, 50, who now lives in Plant City, Florida, experienced this firsthand. Several years ago she rented a basement apartment from a stranger, and it turned out to be one of the most important friendships she’s ever had. “My roommate started out by saying, when I first moved in, what a private person she was. And I kept saying how private I was. But we became close friends, and within weeks we both came out of our shells, not just with each other but also with neighbors. She’d been in that housing development for five years and had never met any of them. All of a sudden we were throwing brunches and baking cookies,” says Maggie. “We both just needed that kind of close, safe friendship to blossom.”

Of course, sometimes hoped-for friendships don’t develop. Merle Bentley, 60, of Milledgeville, Georgia, had a nasty experience with a woman who advertised for a housemate and seemed friendly enough, but who got hostile once Merle moved in. “She was just so scared about getting behind with her mortgage that she would have told me anything to get me to move in,” Merle recalls. “And at that point I was so desperate for a place to stay that there wasn’t much I could do.” Even women who have known each other for years can discover that living together is very different from meeting each other for lunch and a chat. “That’s why it’s so important to discuss expectations before making this kind of a move,” says Janet Portman, an attorney and coauthor of Every Landlord’s Legal Guide, 8th edition (Nolo, 2006). Having a plan B is essential. “If you’re moving in with someone you’ve known a long time,” she advises, “think of the worst-case scenario: am I willing to lose this person as a friend if it doesn’t work?”

For all the potential pluses of moving in with your girlfriends, there’s no denying that it can be scary. All that explains why, for many women, the housemate thing remains more appealing as a plan for the future. Susan Katz, 62, a consultant with Brecht Associates, which specializes in senior housing issues, says she and her four closest friends have cooked up an elaborate retirement scheme. Two of the five will sell their homes to create a travel fund, so all of them can shuttle back and forth between the three remaining homes. “All five of us are still married. But we know—statistically, anyway—we’ll probably end up widows. If that happens, we have a plan.”

Frequent contributor Sarah Mahoney lives in Durham, Maine. Her article “The Secret Lives of Single Women” appeared in the May & June 2006 issue.