Living a Decade in Baja California Sur – Part 2
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For many retirees in Baja medical services are an important consideration. Medical costs are about 10% of that in the US and even folks without health care insurance can afford to stay well. Many doctors, I might even say most in my travels, speak English. Every specialist I have encountered communicated well enough to meet the need.
A recent moderately delicate surgery and one night stay in the hospital cost $21,000 pesos or about $1650 US dollars. Often times you purchase the list of required surgical items yourself and provide them to the doctor including sutchers, drugs and instruments.
Dental care is also a fraction of the cost of the US. I recently compared my crown work in Mexico to a ‘chop shop’ dentist ad on TV in New England. My quality one on one work was done for about 25% of the impersonal chop shop’s advertised price. Plastic surgery is less expensive and general surgery about 10% of that in the US.
My health/dental/eye insurance equal to the best plan my employers provided in the US is less than $75 USD per year, based on age and income. It is available to immigrants with an FM2 or FM3 and a CURP card. (Comparable to your Social Security card) Your insurance price is based on age and income amongst other factors, unless you have a wiley Mexicana negotiating for you as I did, you might pay a little more.
A consultation from what we call a ‘Doc in the Box’ for a prescription for say the flu or strep throat will cost you as little as $35 pesos or $2.75US. Prescriptions are now required for the dispensing of antibiotics.
Why is it so cheap? Two simple reasons. As one doctor I know put it, “In Mexico a good doctor expects to drive a new Buick, not a new Mercedes.” The other reason is malpractice claims. Don’t expect to win the lottery for a forgotten surgical sponge, it won’t happen.
The down side is the waiting. For your initial consultation on a more significant problem you must arrive early and take a number. You sit in the lobby with dozens of others some coughing and sneezing and others with limbs dangling. Patients are triaged and the worst taken first. Appointments are then made with specialists or your primary care physician, phone appointments are rare. On the other hand I have had stateside doctors keep me waiting more than once despite having an appointment.
Sometimes the medical treatments, drugs and equipment in Mexico can be more advanced than the US as the approval process is 3 instead of 5 years as in the states. I myself was recommended to a Tijuana doctor for lasik surgery as the German made machine there was more advanced than San Diego.
The price of drugs has risen sharply over the last 7 years and although still cheaper than the US on most products. The bargain days are history.
Los Cabos has two hospitals and a wide variety of doctors and dentists. The cardiac care unit in Los Cabos is reputed to be well equipped.
La Paz is where you go for major medical care for most of Baja Sur. There are five hospitals in La Paz. IMMS, Salvatierra, the catholic hospital (which is mainly s surgery ward for independent doctors) the military hospital and Fidapaz.
Fidapaz has long been a favorite of gringos in La Paz as it was clean, un crowded and a variety of specialists are available. It is a private hospital and personally would be my second choice in La Paz. Beware of “Gringo Pricing”.
IMMS is mainly for government insurance holders although they do accept other patients. The doctors are often the same ones that practice at the other hospitals but the facilities are probably the most rudimentary.
The military hospital is excellent. The new facility is located on the military base on Unlike the US where often the doctors that couldn’t get residency anywhere else go to the military, often the top of the class becomes military doctors in Mexico. It is a pay as you go hospital with a menu at the front desk. Waiting is nil, most doctors speak English and I’ve heard tales that if you present your US military ID you do even better.
The new Salvatierra Hospital in La Paz. When opened by President Caldarone in 2010 he called it one of the most advanced hospitals in Mexico.
The best hospital is the brand new hospital opened in 2010. The new Salvatierra Hospital is located in the Civic Plaza near Soriana. When President Felipe Calderón opened the hospital he declared it one of the most advanced in Mexico. With more than double the capacity of the old Salvatierra some of the new equipment is still being unpacked as of December. This is the hospital of the Seguros Popular, my insurance carrier. I would recommend this facility.
In the event of a rare or difficult treatment process you might still consider being airlifted to the states or Canada, Guadalajara or Mexico City. I suggest this because Baja is still ‘the sticks’ and a specialist in a big city may be more experienced in what ails you.
Let’s touch on working, immigration and citizenship. We have several articles on the Insider regarding this, and since I’m not an immigration attorney I’ll leave the legal specifics to them and discuss the ‘end user’ affects.
Some general tips; You may want to use an expediter your first time through the Immigration process. This is fine if you don't understand the forms, process and language. But, if you are going to remain in Mexico for any number of years you should learn to process the yearly forms yourself. The process usually involves three or more trips to immigration and a little over a man-day of your time for a non working FM and slightly longer for a working FM, which must include Mexico Taxable earnings payments. The folks at Immigration are usually very helpful and the process simply isn't that difficult. Developing a relationship with the folks at immigration can be helpful when you run into processing problems and delays.
A few years back the period for attaining Mexican citizenship changed from 5 years with FM documents to 10. This was in part a response to the large number of North Americans who came to Mexico, attained citizenship and purchased real estate, avoiding the usual protections and taxes. Also, Mexico also has its own immigration problems from Central American countries to the south. You now must hold a FM3 for 5 years and an FM2 for 5 years, although there are legal short cuts to this process, this is the norm. If you marry a Mexican you are not automatically a Mexican. The process can take a year or more following your marriage. Children born in Mexico are automatically Mexican. FM documents limit the time you may be out of the country and still qualify for citizenship. Being gone too long can reset the clock.
There are two types of FM’s, working and non-working FM documents are issued. If you are retired and do not plan to work you must provide evidence of income abroad and bank statements along with other documents. With a working FM document you must state your intended occupation in Mexico and provide evidence of your qualifications. The cost of the FM documents has risen about 70% since I first applied. There are services who can take you through the process the first time. I do recommend you learn how to handle it yourself, particularly if you intend on staying a while. The folks at Immigration are helpful and friendly.
Work for example as a construction laborer, bartender or real estate agent has been limited or denied in the past. Working in a degreed field is almost a slam dunk under NAFTA agreements, but again that is not a guarantee. I have been told there is a recertification required for medical professionals, and strangely enough to that list add beauty professionals..
The definition of your employment scope has widened in the years I have been holding a document. I was once limited to “computer web design” on my booklet style FM document. My last documents defined me simply as a “marketing technical”. Before you could only supervise in many professions, including restaurant owner. Today you may work in your own restaurant. As an immigrant there are few limitations including never being able to become president or attain a captain’s license.
In the third segment we look at Transportation and Recreation in Baja.