Health Care 2016

Here is health insurance info.
Health insurance
Triple S https://www.ssspr.com/SSSPortal Tel. (787) 774-6060
1-877-357-9777 (Toll Free)

MCS health insurance
https://www.mcs.com.pr/es/Paginas/default.aspx

The rates are different per person mainly based on age and smoking or not, contact them for a rate.

I'll let those in the island tell you about their experiences, but there are those with health insurance and those that use MySalud which is the PR equivalent of SSI. Before accepting a bad story check with type of insurance they have, I heard a lot of good other than many doctors are bad about scheduling their time and heading to an emergency public hospital can take all day.

I am not in the island yet so don't know, I could be completely wrong!
Rey

Thanks ReyP

So it doesn't concern you about the quality of the health care?  It doesn't appear, from reading here, what plan you have effects the quality of service you receive. The doctor on this forum works in PR and had nothing good to say about the system as did many others. One of the comments was you'd have to put a gun to my head before I'd go to the emergency room again.  Other countries I've checked into didn't have people bashing the system as people do here. Maybe it's because it's a US property.  Still investigating  Tom

PR doctors are well trained, some by Harvard Medical School where I work.

The complains I been hearing mostly relate to time management and the fact that doctors and nurses are leaving for the mainland for better pay. If they suck they would not have a job in the states.

Too many patients, too few doctors and lousy pay and reinbursment are the issue. Not their capabilities.

A lot of people go to the emergency room for a cold and not an emergency, this stresses the resources and the staff which may not be in the best of moods. Give it a day or two and more people in the island will comment.

I have had multiple first-hand experiences over the past year with emergency rooms and hospitals in Puerto Rico, for myself and a member of my family.  In all cases, the level of care has been excellent.  My last trip to the emergency room at Ryder Hospital in Humacao was about two months ago.  I was treated immediately and received ten stitches in my finger.  The follow-up visit was also a positive experience.  The total cost, before it wast processed by my insurance company, was $250.  I did have to pay about $2 to park my car in the hospital parking lot.

Good know and hear of some positive experiences, frogrock!

I seem to remember that PR has started a medical turism company to attract people from all over the world for medical treatment. It does look limited as to what they are currently treating but they plan to expand those services down the line. I dont have the web site.

Frogrock

Thanks these are the experiences I'm looking to here about from people living the life whether good or bad. 

Thanks again
Tom

I have family in the island. Mostly using the government plan, MiSalud. ER rooms are busy, doctors offices are busy and hospitals are full. This is in part for the over utilization of services and limited funds. As of the quality of care, mi sister in law had gallbladder surgery last year, her procedure was exactly the same that I had done here in Texas.
Expect longer waiting time for services and unless you live in the metropolitan area the hospitals and clinics are not to the same level as in the states. ERs are use as clinics so you will see long waiting times because people go there for simple minor stuff. Minute clinics don't exist so doctors offices are over book. Yes the physicians need to use cutting edge technology and procedures and facilities are old and in needs of upgrades, medicine is not using the latest most modern procedures and a lot of this is because of lack of funds and support from the mainland. But, all medical personnel goes to the same training and certifications as in the mainland. I study medicine in the island and practice both in PR and in the mainland. I compare the practice in the island as the rural practice in mainland. If you live deep in south Texas for example, your probability of surviving a major accident are greatly reduced as if you live in Dallas. Same goes if you are battling a major sickness, you want to be on the city where healthcare is at the vanguard.
If I was battling a major sickness I will stay here in the mainland, for normal routine medical problems I am not afraid to use the services in the island. I may have to wait longer and the medications my not be the latest in the avenue but there are 1.5 million people living in the island and using the services there. You don't hear that they are dying left and right for lack of medical care.

ReyP

I don't know if you have read all the discussions under this section but you have a doctor, on this forum,  working in the PR system and he seems to have a very different opinion of the qualifications of some, not all doctors working in PR. If you like to look at moving here through rose colored glasses. God bless you. You can to the toughest person on the planet and be humbled by one medical issue very quickly. Just doing my due diligence for myself and significant other.   TOM

Adlin20

It's great to have someone who works in the system respond.  Do I need to bring my own blankets, sheets etc. to a hospital in PR?  I realize living in the country has it draw back, that's where I live. Good hour to the hospital if I drove. All I'm interested in is quality health care not 3rd world. Even US standards would to ok, Sweden would be better

Tom

T_om wrote:

ReyP

I don't know if you have read all the discussions under this section but you have a doctor, on this forum,  working in the PR system and he seems to have a very different opinion of the qualifications of some, not all doctors working in PR. If you like to look at moving here through rose colored glasses. God bless you. You can to the toughest person on the planet and be humbled by one medical issue very quickly. Just doing my due diligence for myself and significant other.   TOM

I am a native, I was born and raised in the island until I was 20. That was long ago before a lot of the new treatments were discovered. My family (grandkids, brother, son, uncles, aunts, and cousins are still in PR and they are being treated well but slowly like Adlin said.

I am not in the least worried, been there, done that.
Rey

I agree with Rey, we are from the island as well. I know there's going to be some draw backs. As per your question, no you don't have to bring your own meds to the hospital. Pillow and blanket not necessarily but most people do for their own conform. Healthcare is not 3rd world country it may be behind and some doctors are questionable but you see that here as well.
Another big difference is in the cost. Same example, the difference between my gallbladder surgery done in Texas and my sister was, hers cost her out of pocket $60. Mine was over $6K with private insurance. Local doctors visit are covered with a $5 copay. And a private consult visit is around $25-40 in her town. Now I will ask you, do you think with those prices they can buy the latest technology? Doctors can't change higher prices because people can't afford it at the same time they can't have the same modern equipment we are used here. Doctors have to take the same training and pass the same federal test to practice in the island since it is part of the US and they can bill medicare. That there are bad ones, yes, same as here. That facilities are outdated compared to US, yes. That it will take you longer to see a doctor or been treated, yes. If you're looking to get the same service that in the mainland, stay in the mainland and pay the mainland prices. My mother pass away this past winter, she suffered from althaimers for over 10 years she was in a bed and I can tell you she got the same or better care in the island than in the mainland plus we did not went bankrupt with her care. If you are considering moving outside of the US you need to realize things will not be the same and there going to be some trade offs. Go visit, talk to the locals and then decide for yourself.

I have never paid a copayment as low as $5
It's always been $30 to $60 for primary care visits . I have health insurance through the va and to say the least .After searching for places that took the insurance after driving around for a whole day .Someone at the va got back to me and told me 1 hospital in San Juan takes my insurance.  Just finally got a statement 11 Months later from my insurance company and my bill was over ,$9000 .And I owe 25% of that bill . I had to drive 2 1/2 hrs to the hospital and was in the lobby for 13 hrs for someone to look at my leg and take some blood.   Sorry $9000 for them to do absolutely nothing.  So to say the least I will die before going to seek medical care here

You are probably worried about this post:

GreggK wrote:

First of all the hospital does not supply pillows. blankets, bedpans, washcloths, towels etc. You or someone else will be responsible for bathing her and taking her to the bathroom and all of her other hygenic needs. Be prepared because the hospital will be about 53 degress. I know from personal experience. Dorado being a more upscale pueblo your medical care may be a little better than some of the other pueblos.

I have no idea, what he went thru, but my family has never mentioned any of that. When my mother was bedridden they would send a nurse to my brother house to take care of her, and bathe her and check her.

This is the ONLY post I seen that mentions being forced to bring blankets and pillows and having the family bathe the person staying in the hospital. All I can think off is that the particular medical plan maybe did not cover those items, but I find it hard to believe. Asking for several blankets and only getting one or two and one single pillow I can easily believe as they only have so many of those and can not have one patient hog all the resources.

Let's hear it from those that had a stay in a hospital in PR, it is unclear if the above is true or somebody being a little cranky.

If you want state of the art health care
International living places to retire in 2016
Has a list of 20 countries at the bottom of the page
Malaysia , Columbia and Mexico .All better cheaper and state of the art
However you have to check into the visa requirements according to yoke situation

Sandra, I was referring to the MiSalud plan my family uses.  I have no idea what co pay are for private insurance in the island.

It is unfortunate that your husband and you are having these issues.
As Adlin20 mentioned, his family is using MiSalud with is the PR sponsored medical insurance program for people on low incomes. As such I would had assumed that the VA coverage should be as good or better.

There been many complains with VA hospitals in the mainland, what you are facing maybe common, don't know. I know your husband is the Veteran, is he Puerto Rican?

Maybe your husband can apply for MiSalud?

All I'm trying to do is get some solid factual information in health care and costs in PR. So far this is the first site I've visited and it's very informative. If you read every discussion in this forum concerning the subject you will not get a good impression of the PR health care system. Who to believe?  On the other hand the same stories exist in my home state, South Carolina.

Lets say PR is good and bad and watch and see who respond to the discussion.

Now how about my original question. What is the cost for insurance in PR for those between 50 and 64 years of age?  In the US the cost is beyond what the average individual can afford. There must be people in PR that don't work in these age ranges. What are your costs. I'm not talking about VA either they should get free health care anywhere they want to live, IMO.

What happens if:  You have no health insurance in PR you have a heart attack etc. or have an accident that requires hospitalization. Will you be admitted and cared for or payment demanded prior to services hence you die?  Kind of third world question but a valid one. 

Tom

For prices, visit or call the sites I send you in my first post.

Nice advice if I wanted to do that. In other words your saying don't ask questions do it yourself. Come on!!!!!!!!!!         Tom

I've been getting a few emails about my doctor in PR post. Here it is:

Kubla April 17th 2014

I would caution anybody with complex medical problems about moving to PR. I am a doctor (internal medicine) here serving my payback time for a scholarship I received from the federal government. I have been dismayed by the healthcare system here, and I'm part of it! You will wait long times to see doctors, get referrals, etc. There are a lot of poorly educated generalists or just out of date doctors here; a lot of older doctors because the younger ones are all moving to the US for better pay and opportunity. There are also some really good doctors, but I find that they seem to be few and far between. If you don't have private insurance, your wait time for specialists will be huge. And you better hope you have no medical emergencies, because the hospitals here are very scary places, and I personally don't ever want to be a patient in them. I have had patients with complex illness who I have sent back to the US because we just couldn't coordinate even medium quality care for them here due to the difficulties of working within the medical system here. It is really crazy.
There are a lot of nice and beautiful things about living in PR, but health care is not one of them. That being said, I live and work in the east side of the island, so maybe things on the west coast are better given there are more gringos over there. If your conditions are pretty stable and self-controlable, you could be just fine, but if you expect to need major procedures, surgery, specialist care, etc. I'd really reconsider moving here.
That's my 2 cents from the inside perspective. Hope it helps.

T_om wrote:

Nice advice if I wanted to do that. In other words your saying don't ask questions do it yourself. Come on!!!!!!!!!!         Tom

No, the cost of coverage varies by age, you asked for a range, different people have different situations, some have medical from the states and also local private insurance to complement each other. Few people will be able to provide you with a valid answer because their situation is different. That is why I asked you to contact those companies to get hard numbers specific to you.

If you go to the ER in any hospital in PR, public or private, by law they are required to render you services just like if you have insurance. That is federal law and PR abide by it. They will bill you just like any hospital in the US.

When i come to the island it will cost me about 800 for me and my wife on a monthly basis until I can get medicare for me. That was a gold plan there is silver and bronce and those are cheaper. Wife only is 350 but she is younger. So there are many variants that afect the cost.

I am 50 and the cheapest I have found was $228 for myself
Triple s insurance .It's in Spanish but also English

sandrarduncan

That sound like a pretty good quote but what are the particulars?  Keep in mind that sites like these are not necessarily impartial. You mentioned earlier about another organization that recommends cheap places to live and retire. They own one of the most popular forums on the web about retiring abroad. Are they honest and forth coming with information? Money is the bottom line?  Even this forum is full of people who don't know what there are talking about; they just like to talk.  Notice how no one answers a detailed question with specifics, always generalities.  Beware of these people.  Look for that honest person who has lived the experience not one who guess at it.   I hope the best for you just keep an open mind.  Money is king and always will be.               Tom

I agree with you Tom and definitely keeping an open mind .  I currently live in Rincon however I was smart and decided buy a place wouldn't be in our best interest especially considering sales taxes has almost doubled since we have moved to pr in Sept 2014.   With the debt crisis in pr I don't want to be obligated here.
Might I suggest something called workaday program . You pick a country and hook up with families or business and do a couple hrs a day for exchange of a room .Some also fees you and some also give you some money.  This would be a good way to be able to learn more first hand about health care etc.  It's as great program . It's just a thought. 
I am still considering Malaysia ,Ecuador, Panama and Belize .  I would prefer Spain but my husband says Spain is to close to the terrorists
If you want to private message me I have a bunch of links I can share with you

Tom, let me give you my perspective.  I was equally worried about the health care here since I have a couple of challenges. Thankfully I was able to go to the Centro de Salud (Health Center) in my town- Quebradilla and be treated and treated well. Since I did not have medical insurance (I had United Healthcare prior to coming here but it didn't work here so I told them at the center and they figured a way for me to pay Sliding scale fee based on my earnings. It worked out well since they did not count my husbands salary and my is lower than his. It was very reasonable.

Once I reached the age, I received Medicare and joined MCS and have been very happy with it.  The fee is $105.00 per month taken directly from my check and there is no fee for the actual MCS. the only downfall was that I had to change doctors since the centro did not take MCS, however I found a great doctor right across the street from the centro and have very happy with her.

They pay for visits, labs, xrays and even eye exams and glasses(not totally but most cost).  They also cover meds but I do have to pay different amounts for certain meds but not as much as if I had other insurance.

Thankfully I haven't had to be hospitalized or go to the ER so I can't comment on that aspect but my grandson is having surgery tomorrow and I have been told to bring a blanket and pillow for him for his comfort, I don't think that they don't have them there but just to bring them.  We shall see.  He has First Medical and everything is being paid for including dr visits, tests and surgery.

So there it is. I will comment later on how the hospital experience was.  the one thing that you will find here is that there are long waits at dr offices but many doctors are changing to the call in method to list yourself for your appt and they tell you when to come in so you don't wait hours waiting to see the doctor.  It is not as efficient as the VA, my hubby goes to the VA clinic in Arecibo and the hospital in San Juan and they are better with wait times but since we are both retired, we have the time to wait a little bit.

Hope this has helped a little.  Good luck in your journey.


Tonie

ReyP wrote:

This is the ONLY post I seen that mentions being forced to bring blankets and pillows and having the family bathe the person staying in the hospital.

Rey, sorry to disappoint you but here's another post like this.
My wife has been hospitalized twice during my time here on the island, one time in the Centro Medico, one time in the Ryder hospital in Humacao.
Both times we had to take blankets because they were not supplied by the hospital. Sheets and pillows, yes but no blankets. And you need blankets. They keep the temperature crazy low. I had to take a sweatshirt and a beanie when I went for a visit.
Also in both hospitals we had to bring a standard kit including bed pan and some other stuff. It seems to be normal here.
About bathing, both times one of my wife's daughters took care of that. Now, I don't know if a nurse would have done that if the daughters wouldn't have. I seem to recall that the nurses only did a very fast wash in bed and no real bath.

Now, I can also testify that the medical treatment and care was good. No complaints there and that's what counts, right?

Then, but that's more a cultural thing I guess, it is sort of normal here that a family member is with the patient 24/7, something that would not be allowed in Holland and Germany where I lived before I came to PR. I don't think there's a real need for a family member to be present but I see that every time I visit people in a hospital.

As for the emergency rooms, I've been there quite a lot with others. Generally the waiting times are long, very long. Also in many places they work strictly first come, first serve. Unless the patient is brought in by ambulance or is bleeding to death or is unconscious one has to wait for his turn. I was used to a system where everybody who comes in is checked by an experienced paramedic or a doctor and based on that assessment  the urgency and turn is determined.
Once it's your turn you get the treatment you need and again, no real complaints there.

The doctors we (well, not me, when I agree to see a doctor I must be halfway dead)  have been treated by seem to know their trade and  did a good job.
Time management is a problem and a doctor's visit is most of the time taking the best part of the day. This is also because most doctors take their time to talk with the patient. A normal visit can easily take 20, 30 minutes compared to the 5 minutes in and out I knew from Europe.

All in all it's not too bad and the locals are used to it and don't complain a lot.
Me, I take it as I take many other things that I don't really like but hey, it's part of the package.

Gary, fortunately or unfortunately it is a cultural thing and a necessity. Most hospitals are over crowded, under staffed. Most families will bring blankets and pillows because they know there not enough. At the same time, family members will stay to help and make sure their love ones are being taken care of. It was not easy for my wife to leave me alone at the hospital here in Texas when I had to have surgery. And the first thing her sister asked her was why she didn't stay.

We are a very family oriented culture, we like to be involved and take care of our family members.  You may have noticed that most old folks live either with their kids or close by. Heck, most of my wife family lives in the same town. I agree with you, facilities are antiquated and in need of new and in some cases modern equipment but the care is adequate. I'm glad you had good experiences with the doctors, even thou you had to wait.

You have the right attitude, look at the positive side and deal with the negative one as part of living in a island. If you let the negative parts eat you up, you will never get to enjoy the positive ones.

adlin20 wrote:

You have the right attitude, look at the positive side and deal with the negative one as part of living in a island. If you let the negative parts eat you up, you will never get to enjoy the positive ones.

Thanks, it seems to work pretty good. Almost 15 years on La Isla del Encanto and I'm pretty sure I'm not going anywhere else to live.

adlin20 wrote:

We are a very family oriented culture, we like to be involved and take care of our family members.  You may have noticed that most old folks live either with their kids or close by.

Yes, I know. It's one of the things I love of this island, the family. The way my new in-laws here took me in was heart warming. Of course in the beginning they kept a close eye on the new husband of their daughter/sister/mother but when they saw I made her happy I was part of the club and it feels good.

I have not experienced it as I have never been hospitalized for more than overnight in the states or PR. But I seen it, staying in the hospital with a sick one is not easy, it takes a lot of love and dedication. In PR there is always somebody in the family that takes care of you and stays.So I guess it works out, short on staff but family is there to help.

Anybody knows why hospitals are kept so cold? - Germs don't care.

Rey, germs needs 2 things to prosper, heat and humidity. Keeping the rooms below 65 degrees takes away both factors, specially with the high humidity of the island.

adlin20 wrote:

Rey, germs needs 2 things to prosper, heat and humidity. Keeping the rooms below 65 degrees takes away both factors, specially with the high humidity of the island.

I beg to differ. Some germs need heat. Others need lower temperatures.
Lower temperatures may slow them down but as soon as they are on/in the human body they will start growing again

If you really want to get rid of many germs you need to keep the place at sub-zero temperatures  or lower and even then some germs survive and will start multiplying when they get in an environment with higher temperatures.

It's even so that when humans are in a lower temperature environment that  they are more sensitive to infections. The human body functions best when it's at 98.6 F (or 37 C).

You may want to read this article by a MD https://www.verywell.com/are-operating- … on-2549274
Also check the sources for more scientific background if you're interested.

Interesting, we were always told that this was the main reason ORs suites are always keep cold. All the hospitals that I worked on are this way. We had to shot down OR suites and cancel procedures due to ACs not cooling  properly.

Well I am here to tell you about my experience with the OR and hospital procedures for us.  As I stated before my grandson had to have Gall Bladder surgery this past Thursday. We did as we were told, brought blanket, pillow, change of clothes and so forth to the hospital about 6a and proceeded to wait.  There is no set time for the surgery and after waiting maybe 2 hours, he was shown inside to change and again wait. 

There is a waiting room for the families with a t.v., and vending machines and when we got there, there were about 3-4 patients and families. My husband kept looking in to see if they had taken him into the OR but no, he was still there.  Now there are the ambulatory patients waiting but on occasion, they would bring in a hospital patient to have some procedure so that shifted the order of things.  After a while, we saw our surgeon escorting a hospital patient into the OR and figured, oh at least he is here and it shouldn't be long.

Well, that must've been about 10a and they finally called us to go to the recovery room about 130p.  the nurses in the recovery room were very attentive considering there were about 10-15 patients there that they had to attend to.  They usually leave you there about 1 hour from the time of surgery and then you either are released or admitted.  Well they told us that my grandson would be admitted.  Keep in mind that the surgeon never came by to speak to us or see how he was doing. I understand that he has about 4-5 surgeries daily and was operating th rest of the afternoon.

Then of course, we had to wait until they found a bed for him and then after about 2 hours, he had a room and was set up. He had been awake but was still in pain and they gave him some meds for that.  There was nothing that we could do, so we left about 630p and left him to sleep.  One thing is that I am very glad that we brought his blanket and pillow since they don't provide one there or in the recovery room. Another point is that they had told me that he needed these special type of stockings to be put on so that he would not get blood clots in his legs and they cost $35 there in the hospital. I asked the lady in admitting if I could get them somewhere else and she said sure. So I got a type of stocking in the local drug store in his size because they measured his leg and thigh.  Needless to say they were not the right one even though they cost less and eventually had to go get the right ones in the hospital. Then I saw why they weren't the right ones, they had these little plugs which are then plugged into this machine that stimulates the legs. So my advise, don't try to save a buck and just get the stockings there at the hospital if needed.

We were a little hesitant to leave my grandson alone since he doesn't speak Spanish and understands but not perfectly. I was told by the Anesthesia nurse and the Anesthologist that if everything turned out ok, he would go home that day but he made it through the night and he said that it was rough since he couldn't get out of bed and needed to go to the bathroom and he would push the button and no one would come but he would sit up and do what he had to do. So he was very happy when we got there.

The visiting hrs weren't until 12p but there was no way I was going to wait until then and when we got there we told the guard we were going up to the OR and I was my husband companion. They give you a sticker for your jacket.  By the way, yes bring a jacket for yourself and wear long pants. It is very cold both in the waiting room and the patient's rooms are like igloos. I can understand the fact about the germs and such but come on, you can't think when you are that cold.

Anyway, when we go there, he was glad to see us and they had brought him some breakfast which he only drank the milk and nothing else, I had told him that they usually give you something light like broth, jello, farina stuff like that. He had pain when he ate so he didn't want to eat.  He slept alot and we had to wait for the dr to come.  A young female dr. came to see him and check out his incision and said that she would sign off on everything but we had to wait for his surgeon to come and take out the small drainage tube and then he could go hom and this was about 1pm.

We went out for lunch and came back and still no dr., Finally about 430p, I had gone down to get something in the gift shop and outside to get warm and I saw his dr., so I followed him upstairs and told him that we were waiting for him. He said, yes he would be to his room soon.  I went back to the room and waited again, meanwhile my grandson had gotten up earlier and the nurse helped him take a shower and get dressed and my husband helped him walk around a bit. The dr. came in took out the tube and checked him out and was in and out in less than 10 mins and said he would sign the papers so he could go.

It took maybe another 1/2 hour since they had brought dinner and my grandson wanted to eat then to get an escort to take him down. Whew what an experience.  I must say through all this, it is a pretty good hospital Hospital Pavia in Arecibo.  BTW, we never got t.v. service since the guy came until when we were leaving. He was asleep most of the time anyway. There are no phones in the rooms because mostly everyone has cell phones.  It is not a new hospital and there are many flaws but in the end, they treated him well and thank God, he is recuperating at home now. 

If in the future, I have to be hospitalized, hope to God no, I would not mind being in this hospital. They have some cafes downstairs and two t.v.s in the lobby.

This is my experience here in a hospital, hopefully not any anytime soon.

Tonie

So mostly it was inattentiveness to the button when he had to go to the bathroom and a lot of waiting around. Your story shows some things that gives me pause, specially the fact that your grandson needed to go to the bathroom and they were not paying attention to the button he was pushing. What if he had broken a stitch and was bleeding?

The waiting is bad, but the inattention to the button does concerns me.

I think that if I or my wife would have to go thru that, I would hire a private nurse to sit in the room and watch for our needs.

ReyP wrote:

...the inattention to the button does concerns me.

That's exactly why many  if not all locals make sure there's a family member with the patient 24/7. They either help with what has to be done or go out and get a nurse.

Welcome to Puerto Rico!