Recently some boilerplate was posted and I thought I would take a minute to add some factoids.
1) Nic. private insurers can and do deny policies based on age and previous conditions, including minor ones. Apply early and apply often! No obamacare here!
2) Nic policies can expire at age 70, when you may need the insurance the most.
3)The Pellas plan is a discount plan, not an insurance. It also excludes 'terminal' conditions. Kickem when they are down, I always say. Possibly good stopgap for somebody here for a year or so.
4) Medical costs in Nic are often negotiable, and substantially so. How is your negotiating ability when you are unconscious, leaking fluids uncontrollably at both ends, have stabbing chest pain, or just got hauled to the hospital in the fetal position in the back of a pickup?
5) Public hospitals are free except medicines to the limits of the facility and staff, which can be minimal especially in the countryside or on Saturday nights. No medivacs to a bigger hospital to save your life. Plan on having somebody bring fly swatters and mosquito repentant
.
6) Nursing care is not what you are used to. The tradition is you have relatives come sit with you in the hospital 24/7. Lacking relatives, you might bring in the maid or hire a nurse.
7) Side effects/bad combos of medicines are not paid much attention to here, like in the US many decades ago. Suggest you look things up on medlineplus.com before you take them. For fun, ask doctor and see the blank stare and generic reassurance.
8) Nic doctors vary from excellent all the way down to like a bad veterinarian on a bad day. And in the prevailing culture/ legal system the bad ones know they will get away with anything.
9) Nic. traditional folk beliefs generally waste time and make things worse.
10) If you have an emergency medivac plan if may not really cover expats, may not fly you to where you want to go or where you have insurance and relatives. It may just sent you to a hospital in Managua.
11) You do not 'get' medicare at age 65. You get or can easily get Plan A, hospitalization. PlanB, docotors and routine care, you may only start when you are n the US but then can carry it with you by paying the 100 bucks/mo. Plan C and D, which are the preferred choices for most folks, require you to be in the market area 6 months of the year. I am told Canadian provincial care has the same limit. Anywho, Medicare does not pay in Nic and never will. They can't handle the corruption nor the costs in the US, much less going global.
12)If you have medicare C with an allowance for foreign travel, be advised it is only good for the first 60 days of your 'trip'.
13) International policies that pay world wide cost about as much as the average social security check, and look carefully at all the usual bugaboos--copays, etc.
14)Health care is cheap here, pay cash! Well, maybe do the numbers, pookie. If you had an employer paid plan where your copay on a $1000 procedure was 50 bucks and here in Nic the same procedure only costs 200 bucks, you got a bargain, right? Actually, your cost just quadrupled. Your bank account will know, even if you personally are mathematically challenged. Yeah, you will survive the 200 bucks, but get into a big hurt and the bills will add up.
15) the VA only has clinics and hospitals in the US, or at least not in Nic. If you are qualified, sign up and plan on making about 4 trips to the local clinic to get fully in the system. Va hospitals are limited, but big cities like Miami and Houston have them. If you do not live locally and frequent the clinic, you may have no way of knowing which doctors are duds, and few to choose from anyway. I've seen 2--the first one wasted time on unnecessary testing and then gave bad advise on a simple problem and the other was in worse shape than me and one step out of a nursing home. I hope you have better luck, I just report what I see/ don't shoot the messenger. You must get an appointment for anything once a year to stay active with that clinic. Hospitalization is open to you if you have the ID card or are on the computer. They do pay for prescriptions in the US. Whether they reimburse for out-of-the country medical is unknown to me at this time.
16) Do not assume you will be allowed on a flight if you are seriously ill or injured. The airline has liabilities to consider. Long drive to Brownsville.
I'm tired, gonna go look for a cup of joe. Have a nice day.
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