EFAM | Escape From America Magazine

The Real Cost of Health Care in San Miguel de Allende, Mexico

It was almost midnight, and San Miguel de Allende expat Alice Kimsey was watering plants in the courtyard of her 300-year-old home. She yanked on the hose and dislodged a heavy pot from its third-floor perch. Instinctively, she raised her hand to protect her face. That may have saved her life. Still, the pot broke her wrist, leaving a bloody bone protruding from her right arm.

Alice bound up the wound and walked a few blocks to a clinic run by a father-and-son team. Despite the late hour, her knock brought an immediate response. Her wound was cleaned and dressed. Tetanus and pain medication were administered, and the bone was set. Then they put her arm in a sling. And, with that, Alice walked back home.

I saw Alice a few weeks after the accident. Her wrist was bandaged, and her movement limited. But two weeks after that, the dressing was off, and her wrist was a little stiff but otherwise it worked fine, with no pain and no sign of the compound fracture.

Or consider expat Jackie White’s story.  Days before a planned cruise, she had gastric distress. The doctor came to her home within an hour of her call. He took samples (blood and stool), which were returned by the local lab within another hour.  With the lab results, the doctor administered the appropriate shot, returned the next day for a second shot and Jackie recovered in plenty of time to enjoy her cruise.
Talk to expats in San Miguel, and you will hear many stories like these. As the city itself, health care in San Miguel feels like a step back in time. For Americans, frustrated by an impersonal and ruinously expensive healthcare system, San Miguel’s step back in time represents progress.

Consider these “old-time” characteristics of care in San Miguel:

House calls. They are common, and they are inexpensive. Dr. Arturo Barrera, medical director of San Miguel’s private De La Fe Hospital, says that he likes house calls because he sees not only the patient but also the family and home environment.

Dr. Jorge Martinez’s practice is 70 percent house calls for a patient base that is 95 percent expat. He makes himself available “24/7, including Christmas,” and Dr. Martinez schedules his vacations when most of his patients do. (Both doctors are fluent in English.)

Quality time.  A cosmetic surgeon with a nearly 30-year SMA presence, Dr. Manuel Velazquez and his American-born wife Marsha want no part of an assembly-line practice. So, he will do only one full-face procedure per day.

Dr. Martinez allows at least 45 minutes for an initial house call and at least 30 minutes for follow-up visits. Dr. Barrera follows the same practice.

Why don’t Mexican doctors try to see more patients so they can earn more money? First, Mexican doctors’ costs are far lower than those in America. Second, outside the public system, there is no pressure to see more patients. Third, Mexican doctors recognize that more time can mean better care, and they are not willing to sacrifice quality.  What a concept.

Even though SMA doctors spend more time with their patients than doctors north of the border, costs in San Miguel are significantly lower – for all kinds of care.

Prescription drugs. Virtually all drugs sold in America are available in Mexico, Dr. Barrera says, but they are priced 20 to 30 percent lower.

House calls/office visits. Dr. Martinez charges about $60 for house calls, based on current exchange rates. Dr. Barrera charges less than $100 for a house call and under $50 for an office visit.

Hospital rooms. Private De La Fe Hospital (www.hospitaldelafe.com ) charges about $140 per night for a large private room.  The lowest-cost room (three beds) is slightly over $50 per night.

Annual membership in the hospital costs under $30 per person or under $50 per family and provides a 20 percent discount on all services. Dr. Barrera says that De La Fe can handle 90 percent of health problems, the exception being heart surgery. When a patient needs heart surgery, he is stabilized and moved 45 miles to Queretaro.

Home care. Prices range from $4 t0 $10 an hour, depending on factors such as skills and fluency in English.  According to SMA expats, housekeepers and their families often become your caregivers if the need arises. Mexican families typically provide home care for relatives, so they consider home care a simple fact of life.

Cosmetic surgery. A full-face surgery (eyes, face, neck) by Dr. Velaquez (www.lajoyaclinica.com) costs $6800, including transportation to/from the airport, post-op care by the surgeon and private nurse, lodging and meals in a private room for two to three nights. Again, Dr. Velaquez only performs one procedure a day. So, patients have his full attention.

Assisted living to 24-hour care. Outside SMA is Rancho Los Labradores (www.rancholabradores.com), a planned community with stand-alone villas, performing arts center and other common buildings for independent living and Cielito Linda (www.cielitolindaassistedliving.com), a facility for people needing 24-hour care including Alzheimer’s patients. The brainchild of Sergio Chazaro, it has landscaping, pools, villas built around lagoons and mountain view. Monthly rates for full-service patients are $2250 for single occupancy. Those who do not require this level of attention may opt for components of an a la carte package on top of a $650 monthly charge for a furnished room. For independent living, two-bedroom villas can be rented for $1100 monthly or purchased for $144,000 to $169,000.

How long will SMA doctors retain patient-friendly practices like house calls? No one knows. But Dr. Barrera makes this point. “For better or worse, Mexico copies everything the United States does,” he says, adding, “I hope I am retired before we copy your health system.”

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2 Comments

  1. JOn Friederichs October 11, 2013 at 10:36 am

    After reading this article i am a bit skeptical. Why? Becasue there are no facts or figures as to HOW to go about getting (signing up for, exactly how one qualifies for this “cheaper medical care”, etc). I have been living in Los Algodones, Mexico for about a year now. Yes, medical care is a bit cheaper, still it does cost a substantial amount. My wife and I have learned that on needs to become a resident of Mexico and get a permanent visa (not tourist) in order to qualify for significant reductions in medical care. (after paying for ones visa it is about a three to five year wait to actually qualify for lost cost/nearly free medical care.
    Perhaps you can enlighten EFAM readers as to the steps/process they must go through to actually get cheaper medical care, as it seems a bit “glossed over”.
    Thank you. Jon.

    • dobe October 23, 2013 at 3:32 am

      I’ve been living in a medium-sized city (130,000) in Michoacan for about 2.5 years. I applied for & received an FM-3 visa when I moved. The visa required proof of income of about $1000/month from outside Mexico and a letter from my local police/sheriff’s office stating there were no warrants for my arrest. It cost about $130, does NOT permit me to work for monetary gain in Mexico, and was good for a year. My understanding was that eligibility for membership in IMSS (Mexican National Health Insurance) began once I’d begun my 2nd year of residency. I applied for that membership a year ago; the paperwork was a hassle; bureaucracy is live and well in Mexico. I had to have my birth certificate translated into Spanish & certified. The cost for IMSS is $240 a year under age 60; $360 a year 60+. Like many Mexican friends, I don’t use it for minor medical complaints, but my understanding is that it covers whatever is necessary. If I need to see a doctor, I’m supposed to check in at the local facility in the morning, and will be seen by a doctor that afternoon.
      There seem to be a range of healthcare options in Mexico. Many pharmacies have a doctor onsite, and a consultation/exam runs about $2-4 (yes, that is two – to – four U.S. dollars). If medication is required, the doctor writes the prescription & the pharmacy fills it. I usually go back to my regular doctor in the U.S. twice a year for checkups & medication adjustments & refills. However, for less than $1 a day, I have the peace of mind of knowing if I have something urgent, I have local facilities for health care.
      I believe IMSS is is not an option for those on tourist visas. It seems Mexico is in a transition period regarding residency. FM-3 (residency, no work for $) and FM-2 (required a couple of years of FM-3, offers more privileges) seem to have been phased out. My most recent renewal = I was offered Residente Temporal (somewhere around $250-$300 USD), or Residente Permanente ($350+ USD). I met the qualifications for the Permanent Resident; though the financial bite was sizable, not having to do the annual renewal means a big savings in time (3 trips to the state capital, usually requiring most of a day each), and ultimately a big savings in money.
      Disclaimer: this is my experience. I’ve learned, repeatedly, to never say, “here’s how it’s done in Mexico.” Rules & procedures & costs seem to vary from state to state, city to city, and staff person to staff person. Talking to neighbors, other expats, Mexican friends, etc., is highly recommended. Good luck!

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