My husband and I have birthdays just a few days apart and we were born in the same year. We just passed another pair of birthdays, and as our individual retirements loom nearer and nearer, we more often discuss what things are most important to us when we retire.
Climate has always been an easy decision: warm and sunny with no snow, ever. We have outlined the environment fairly closely: not a major metropolitan area, but near one. We feel it is important to have good medical care available, although having a hospital in the same town is not necessary. We will be enrolled in Medicare before we retire, so ensuring our doctors accept Medicare patients is critical.
I’ve recently sought out a few articles about healthcare costs for retirees, and some of them are just plain scary. Stories abound of our senior citizens having to choose between food and medicine. I was shocked to learn that some two thirds of U.S. bankruptcies now are related to medical expenses. What is wrong with this picture? No other nation in the world has citizens going bankrupt because of medical expenses.
Then I read of countries in the tropics where U.S.-trained doctors provide high quality care for a fraction of the cost here in the states. There seem to be no long waits; no denials, exclusions, or limits from health insurance companies; no stacks of forms to fill out; no endless numbers of redundant tests. To my surprise, retirement outside the U.S. begins to look attractive, even though Medicare will not pay for procedures performed out of the country.
A few warm countries have become destinations for “medical tourism,” so to speak. Over a million and a half people are expected to take such trips in 2010, according to the Deloitte Center for Health Solutions. Available procedures include any type of dental work, from fillings to implants or dentures at savings of 65-75%; cosmetic surgery at savings of half or more; orthopedic procedures such as hip or knee replacement at savings of tens of thousands of dollars; and even cardiac surgery, plus a wide variety of others.
Costa Rica is one of the closest and most popular, but Mexico, India, Malaysia, and Thailand offer similar opportunities, as well as several places in Europe. In Costa Rica and most other countries, surgery is followed by a stay in a private recovery hotel connected to the hospital. The stay includes three meals a day, plus monitoring of your condition, as needed.
These “medical tourism” destination countries have universal, nationalized healthcare. If you are a retired American living in Costa Rica, for example, you can join their national CCSS for a small monthly fee. If you are just a visitor, their services are also available to you. The option for residents is private insurance, which is reported to cost around $50 a month. Many doctors are members of both services.
I have found a few stories written directly by the patients. Such narratives described all the processes in detail and claimed savings of up to 90% over U.S. costs. One patient described his hernia operation, saying he saw the doctor the day after he called and had his surgery one week later. His pre-op tests and lab work took place at three separate locations. At each, he paid cash and the results of his tests were placed in his hands. After his week of recovery in the hotel, he returned to the U.S. When it was time to have his stitches removed, his local U.S. doctor refused. He went to an urgent care center, which took care of him promptly. The patient claimed that two years earlier, the same operation had cost ten times as much in the U.S.
Although we are in good health and take few prescription drugs, healthcare has to be a concern for us, as it is for all retirees. Is it a strong enough concern to cause us to retire in the tropics? That remains to be seen, but it grows in importance with each friend I visit in the hospital.
Copyright 2010, Linda Manley
