Healthcare on the island

We are seriously considering moving to PR to live out retirement.  Our major area of concern is the level of specialty healthcare available.  What is the general impression of the insurance availability and the level of care available in the major hospitals and with the accessability of specialty physicians.

I hope that other members can help also, but this has been my limited experience with the medical care here....
First let me say, that my husband is active duty military, so we have great insurance and a doc on base that we see for routine care. However, we do not have access to speciality care military doctors here, being that it is an island, like we would in the States. I have heard horror stories about having to wait all day to see a doctor here, and still sometimes not being seen. So, I usually only go to the doctor once a year for my check-up, and I go back to the States when I am on holiday visiting family. I have been with my husband to the doctor when he needed a MRI and we did have a long wait, and the equipment seemed really old. They didn't have up-to-date technology and the ability to send the MRI work to the doc, they gave us huge images to take back. But, it did get the job done! Anything I have heard about the medical has been that is is not what it is in the States, which is why most military dependents do chose to go back to the States to give birth and for other speciality care appt.  One other thing to consider is that we do live in the NW section of the island, so I am hoping that San Juan has better options, but again I have not heard good things. My husband job often requires him to drop patients off at the hospital that are in critical care and I have heard that the hospitals are not run up to U.S. standards.

All of this being said, I do realize that my experience with the system here as been limited. So, I do hope others will chime in. I am sure that there are good doctors here and I also would hope that there are better option closer to the metro area of San Juan, as we are a bit isolated over here. So, please other members, let us know your experiences.

There are two things to remember about Puerto Rico in general that also apply to health care.

1. We've managed to copy a few good things about the American system, but also most of the bad ones.

2. Things work, sort of, most of the time.

As a result:

Insurance is private but relatively cheap. If you can't afford it you can either pay exorbitant fees to the doctors or try to get on the government's "Reforma" health care initiative after you become residents. (It kind of sucks and it is kind of difficult to get.) The cost of medical care is closer to the cost of medical care in the USA than it is to Mexico's. I have private insurance and pay about $150 per month but it only covers a small part of the cost of medicines. And while the plan works in most medical offices and hospitals on the island it only covers emergency room visits on the States.

http://www.ssspr.com/SSSPortal/ProviderSearch.aspx

That link is the directory of specialists that accept my private insurance. It is in Spanish but you can figure out the names. For example, pediatrics is pediatra, nephrologist is nefrólogo, radiologist is radiólogo. Especialidad is specialty, Pueblo is town and Buscar is search. You can get a better idea of the doctors that are available from that list than from just about anywhere else. Just pick a specialty and a town and search.

Waiting times are long. It is not unheard of to have to wait 4 hours at a doctor's office. Not all doctors are like this. Try to get a doctor that works with appointments instead of one that works on the first-come first-served principle. Remember to bring something to read.

Some hospitals are better than others. In most hospitals equipment is modern, but not state of the art. You won't find a local John Hopkins but you won't find leeches in jars either.

The island has more people than 23 states of the USA while only being the size of Connecticut. This indicates that there are no major problems in giving birth. Life expectancy is at par with the rest of the United States.

Some areas have more and better hospitals than others.

Doctors in general are well trained. Many studied abroad. Because they are highly educated most young doctors will be at least somewhat bilingual.

There are no witch doctors... unless you really want one...

I don't personally have any experience with the health care in PR yet. But I can relate some things. I have a friend in California and his sister and her husband own a house in Ponce. They are in their sixties and reasonably well off financially and they often go to PR to take care of their medical needs. It's much more affordable than what they can get in LA and they are obviously comfortable with the level of care they receive. My wife is from Mayaguez and she will tell you about the long waits to see a Dr. and the facilities aren't always up to what we have in the states but it's not like scarce medical care in some remote part of Africa either. It just boils down to this, if you really want to live in PR then there will be a lot of trade-offs to consider compared to where you are currently living. I just recently qualified for Medicare so I can do that in PR. But before Medicare I couldn't get health coverage because my pre-existing conditions would make my premiums so high that I simple couldn't afford it. But I can go to PR and purchase health insurance that I can afford and the trade-off is that the facilities may not be quite as good as in the states and I might have to wait a little longer, but at least I can get taken care of.