We were into the third month of our stay here in Merida when I broke my arm that required surgery in México & put to the test the advantages of having medical insurance while traveling! Prior to this trip, The Big Guy did his due diligence & purchased travel insurance for this trip so we were covered, right?
I knew I would write about having surgery in Mexico & the process of getting reimbursed from medical insurance while traveling but I really wanted to wait until all the dust had settled. I think I naively thought it would be a somewhat smooth process but again thats on me. In this, I will share my account of surgery, cost of surgery & how U.S. travel insurance works here in Mérida, Mexico. Be assured, my arm is healing far better than I would have dreamed of especially being a senior.
I have been known to ramble so I will definitely try not to make this personal BUT it is a pretty serious issue. Pardon me if I lapse here or there. Here we go!
1] The Fall that Caused the Surgery in Mexico
A perfectly lovely day until I tripped over my own two feet & ended up having surgery in Mexico! It had been a much needed walk to one of our favorite coffee cafes. I normally let The Big Guy take the lead but for whatever reason on this particular morning I was in the lead with not a thought in my head. None.. Not paying any attention period..Next thing I know I am face first on the sidewalk. A piece of stone stopped me from full facing the walkway catching my forehead instead. Blood pouring down my face. I do know when I raised my head & looked at my left arm & saw the very not natural way it was bent that this could be bad.
It seemed to happen pretty fast but this is just my recollection. Within moments an Angel stopped & was helping The Big Guy get me setting up against a pole. I’m holding my dangling arm the best I can but it hurt so bad. Ever prepared, The Big Guy had a towel & cold water from his thermos to try to stop my forehead from bleeding & the Angel was busy on her cellphone calling an ambulance. Several cars stopped & asked if they could help but the Angel had it under control & The Big Guy was helping as much as he could. An officer stopped & stayed with us, I think, until I got in the ambulance. He told The Big Guy that he recognized us from seeing us out walking every day.
As a side note: The Big Guy told me later that the Angel informed him she was calling a government ambulance as it was free. Otherwise, we would have been charged for the ambulance ride! The Big Guy also old me later he tried to get her name from her so we could properly thank her later but she was just happy she was able to help…Love Merida neighbors.
Second side note: The Officer had evidently asked The Big Guy to see our passports. I only had my passport card & that was not what he wanted but I did have my Texas drivers license on me… The Big Guy always carries the required documentation. So point taken: I always carry my passport or photocopy of it with me now when I leave the casa.
2] Star Medica Hospital
To all of you who have heard conflicting information about the health system & surgery in Mexico, let me set you straight – at least about Star Medica Hospital here in Merida. I can say from a patient’s standpoint, I could not have been treated better. Honestly! A male bilingual nurse was by my side the entire day from emergency room to operating room later that evening. He explained why & what they were doing all along the way from the trip to cutting my shirt & sports bra off to trip to the x-ray room to translating for the nurse who pulled blood & put needle into my arm for drip. The hospital was clean. Dr. Cheng, the anethiologist, explained in great detail what his part would be in the surgery & how he would be numbing, my arm, etc. The entire team of my trip to emergency, operation, recovery & dismissal treated me great, from my one sided view.
Dr. Diaz, my surgeon, was there shortly after I made it to emergency room & he put my arm into a soft sling to keep it still & for x-rays. Afterwards, he explained to The Big Guy what he saw & that I would require surgery. I had a (Helicodial fracture, distal third of the left humerous displaced &an internal rotation of the distal fragment) badly fractured humerus & my elbow had technically rotated around leaving nerves caught in the bones. Yikes. Yes, it hurt. I don’t know if it was because of the nerves caught in the fractured bones but I can only describe my arm as feeling like it was flapping in the wind & I would without looking move my right hand to hold it still against me when it was actually still but the nerves were going crazy.
Dr. Diaz was awesome! He checked in with The Big Guy after the operation to fill him in on what he found. The waiting game was the morning after surgery when Dr. Diaz came in to see if I could move my fingers & wrist! Yes! No nerve damage! My follow up appointments with Dr. Diaz have been smooth sailing & scar is fading a little more each day!
Dr. Diaz stressed the need for us to be satisfied with him & his team. The hospital administrator & financial office checked in with us on release day to be sure we were happy with their services & their team. Just spectacular customer service!
3] Cost of Surgery for Seniors Traveling in Mexico
While I was in emergency room & waiting for room to open up, The Big Guy along with Elsa was dealing with the payment for the cost of surgery in Mexico! Yes, the hospital wanted to be sure they were getting paid before any surgery, etc. We were foreigners so I totally get this. As a side note, Elsa had text us during the ‘fall’ to see if we wanted to meet for lunch later. When The Big Guy told her what was happening, a short time after we made it to the hospital Elsa was there! She reviewed every single charge on the hospital invoice, stopping & asking the accounting office detailed questions about each individual charge on the six page invoice of charges. The hospital stated that the initial payment was only a deposit & additional charges would be posted to the bill. Elsa made it clear to the hospital that she was going to carefully review each charge. We cannot begin to thank Elsa for spending basically the day with us being the accountant, translator & holding the hospital accountable for anything put on the billing invoice. The Big Guy said that Elsa was amazing. Not being fluent in Spanish was definitely a weight on his shoulders that day.
Since the Hospital could not work out a direct bill agreement with our Travel Insurance, The Big Guy had to pay all potential hospital charges in advance. The Big Guy & Elsa asked the hospital accounting office for a discount on hospital expenses since they could not work something out with the U.S. Travel Insurance provider to have the charges direct billed to the U.S. Travel insurance company. The hospital staff stated the Big Guy & Elsa would need to talk with the surgeon & the hospital management. The Big Guy was advised that the hospital would not start treatment until they received the initial payment for hospital expenses.
The hospital accepted our credit card for the initial charge, however I don’t think they were expecting the Big Guy & Elsa to head directly to the hospital administrator’s office to begin negotiating for a discount to the hospital charges. The estimated hospital bill was given to The Big Guy on release day [& I’m sure with Elsa’s presence] one person started adding additional charges to the initial bill.
Elsa took the now eight (8) page invoice & began questioning each charge. As she was doing an item by item review of each charge a person from the hospital administrator’s office came over & took the eight (8) page invoice, After she reviewed the invoice she reprinted an invoice that was back to six (6) pages, but contained a 35% on certain services and supplies. The final bill was reduced to $55,000 MXN for the hospital and $50,000 MXN for the surgeon and his staff.
The hospital required payment in full before they released me. The last bill we had to pay before release of me from hospital was for the titanium plate in my arm. The Big Guy negotiated with the surgeon to pay the company directly for the titanium plate. It was initially $32,000 MXN but they reduced it to $20,000 MXN making our grand total for emergency room, x-rays, labs, surgery, meds, recovery & overnight in hospital – less than $130,000 MXN. Let me state for the record Elsa was not being paid & we only met her a few weeks before the accident. Elsa’s took us under her wing & showed us what true friendship is all about.
During this time frame, The Big Guy was in constant contact with our travel insurance provider. More on that below.
4] My Personal US Medical Insurance
We have recommended from day one that you really must have medical insurance while traveling. For a little more info seniors traveling & the need for travel insurance, check out this article. This section will be short & sweet. Medicare did not cover anything. My secondary insurance would have covered if accident had happened within first sixty days out of the states. This incident happened around the 77th day or so day so no help on that insurance.
Thank goodness we had the travel insurance right? After all, emergencies are the reason you purchase travel insurance – correct??
5] Was Purchasing Travel Insurance While Traveling Worth It?
Bless The Big Guy for being a patient man since dealing with the travel insurance while traveling has not been smooth sailing. On top of that his worrying about me…
The Big Guy contacted the travel insurance company immediately & they were concerned with my care since we were in Mexico. I believe if I remember correctly, they asked The Big Guy more than a few times if he wanted the insurance company to ‘send down their jet to get me back to the states?’ The Big Guy told them that the surgeon was going to do surgery & again the insurance company asked if they needed to send a plane down to get me back to the states.
After numerous calls, The Big Guy continued to send the insurance company what they asked for. Dr. Diaz & Star Medica Hospital were very accommodating & assured The Big Guy that they would complete whatever paper work insurance needed & they did EVERYTIME. Initially, I believe The Big Guy was told we would have response in ten days from the insurance company. Then another ten days. We are now told that they should have answer for us next week. Almost two months since the fall & they are silent.
There was no way I could have traveled with my arm fractured with the nerves caught…
Bottom Line for Seniors Traveling Internationally
It is so above my scale of making any sense why the travel insurance company didn’t think twice about offering to come get me to take me back to states in their plane but seem to be looking for a reason not to reimburse us for any of what we thought was covered? I don’t get it but I’ve always thought of insurance (of any kind) as a ‘necessary’ evil so my take on this whole saga is tainted by that. Thank goodness The Big Guy has the patience of a saint!
Anyone can fall & hurt themself, correct? But as we all age into senior traveling, the risks mount. I was simply walking with The Big Guy to a coffee shop when I had my fall. Lesson learned? I will definitely keep my mind on what I am doing instead of day dreaming!
I am in the midst of ten (10) physical therapy visits (Travel Insurance company told us upfront they do not cover) right now so that I at some point will be able to straighten my arm. I started my therapy at the Cruz Roja Mexicana Hospital de Ortopedia here in Merida which cost $120 pesos per visit which was very affordable BUT the distance we had to Uber was costly when you add up three trips per week round trip so I am now back at Star Medic for physical therapy. A few pesos more but I can easily walk to the appointments. I am happy with results that I am seeing in just this short period of time!
At posting of this, we are still waiting to hear back from the US Travel Insurance company. IF, they decide to deny our coverage, I will be posting their name in an update as an insurance company that is not – in my eyes – worth the ink on this paper. IF, they decide to reimburse us, anything, I will be happy to post their name as an insurance company who is worth that salt. Right now it is still a waiting game! I’ll update when there is a final decision from the travel insurance company!
Take care & until next time, Happy Travels With The Big Guy!
Oh my gosh Holly! What a horrible experience. But it seems y0u are in good hands and will recover well. So disappointing about your insurance company. Thank you for posting about this and thank goodness Elsa was there to help you both through this. She truly is an angel, but of course, you and Horace would do the same for a friend of yours. Your posts are wonderful and informative. I look for them every day. Bless you both in your travels!
Yes, I am healing very well! I am in good hands with both my doctor & Horace! Fingers crossed on the insurance end!
Holly, I am so sorry about all this. I hope the insurance company helps you in the end. Perhaps they wanted to fly you back to the states so that Medicare would pay and they would be off the hook.
Years ago my mom fell in Acapulco and broke her humerus bone. You seem to have gotten much better care than she did.
I hope you continue to heal and to enjoy Mexico.
Hi Susan! You are probably 100% right on your thoughts re insurance! And, yes, more than one person here told me I was lucky to not have been at a beach town when this happened….I am healing well & being well taken care of. Take care!
OMG Holly! Such an adventure you could have lived without! As the person that tripped in your driveway I know how easily this can happen. I’m glad you salvaged your face but man, that arm couldn’t handle another screw.
I’m so glad you have made good friends and that there are “angels” everywhere. You have restored my faith in people and validated my fears of bureaucracy at the same time.
Love to you and The Big Guy. You are sorely missed.
Cynthia! Hello and happy to hear from you! I consider this to be my one fall & I’m done. Ha. Arm is really healing well & yes the fracture was worse once surgeon got into my arm to a longer metal plate was necessary! I will have a bionic arm when we leave Mexico in one month. How time flies! From Here to Colombia! Loving this traveling with The Big Guy & he is fine!!! Tell all hello.