What Happens in an Emergency?
An accident can happen anywhere. We often assume that because we have full health insurance coverage that we will be protected when we travel. However in a foreign country, this is not always the case.
An unfortunate and quite terrible accident occurred to a tourist in Cabo during July 2014 that brought this to the forefront. A Bakersfield, CA man was visiting Cabo on vacation with his wife. They decided to go on a zip line adventure. They chose an established, reputable company that does a good job ensuring the safety of the participants. However, while speeding across one of the lines at an estimated 40 mph a freak gust of wind caught hold of the man causing him to crash into a rock wall. He suffered a broken neck, back, ribs and a severe brain injury. He is currently back in the US and being treated but remains in critical condition after three surgeries.
After the accident, the man was quickly rushed to a private hospital in Cabo San Lucas where he was put into a medically induced coma to safeguard his life. At that time, the man’s wife had to deal with a hospital bill that spiraled out of control because he was not stable enough to be flown out. Initial reports indicated a bill of $50,000 US dollars and subsequent reports indicated that the bill totaled as much or more than $77,000 US dollars.
The news of the accident was heartbreaking, but the news of the hospital bill drew even more attention. When it was first reported, social network channels were flooded with all types of commentaries. Some felt that it was an example of a hospital taking advantage of an American tourist in a bad position. Others asserted that it was not fair and would never happen in the US.
Whatever your opinion about this horrible sequence of events, one thing should be clear: It is important to understand how the medical system works in the country you are visiting, what happens should you require emergency medical care and most importantly, will your insurance cover it?
First things first: How Mexico’s medical system works. There are public hospitals in Mexico, including in Cabo San Lucas and in San Jose, but the system does not operate like the US hospital system. Stated as simply as possible, Mexicans – as well as expat Americans and Canadians living here – that can afford a private hospital will not go to the public hospitals.
In Los Cabos, the public hospitals are served by the Red Cross ambulances. These first responders are purely volunteers. While it is true that an American or Canadian tourist injured in Cabo will most likely be whisked away by a private ambulance instead of the Red Cross ambulance, that may not be such a bad thing. Whether or not the ambulance driver brought the patient to a private hospital only because he sees dollar signs is not the issue. At a private hospital, the patient will be attended to immediately. In a life or death situation, would you rather have prompt yet expensive care, the whole hospital staff ready to tend to you, or slow but inexpensive care?
As for the final bill, it must always be paid up front in a Mexican hospital. It is extraordinarily rare even for a Mexican citizen with a Mexican insurance policy to have the bill submitted to their insurance company by the hospital. The system doesn’t work that way. You pay out of pocket and then submit documentation to your insurance company for reimbursement. Expect the same as a tourist.
Finally, there is the question of that reimbursement. Check with your insurance provider before you travel so you aren’t left guessing when it matters most. Some plans will cover you, some won’t. Some plans won’t cover all accidents and may exclude activities deemed to be ‘extreme sports’. Again, make sure you know before you travel.
If you discover that your health plan isn’t going to cover you, there may still be options. There are travel insurance plans that cover medical and air evacuation and they may not be all that costly. Air evacuation can be absurdly expensive should you need it and not have coverage.
Bear in mind that not all health insurance plans and not all travel insurance plans are created equal, so make sure you do your homework. Never assume that another country, whether Mexico or elsewhere, has the same system you’re used to.