bluesguy
3/14/2022 22:58 EST
Is any health care provided that the US government pays for?
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elduendegrande
3/16/2022 11:21 EST
No. you can go to the clinic of your choice in the US once a year to keep current with that clinic. You can walk into their hospital as needed. Lately you can go to urgent care but I don't know if it is the urgent care approved by your local clinic or if you can go to any one nationwide.
Make sure you have your VA card.
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elduendegrande
3/16/2022 11:23 EST
There is a pecking order and a needs assessment, but if you are already on VA you have that covered. If you need copays that are minimal.
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bluesguy
3/16/2022 12:30 EST
Thank you for the info. I plan on returning to my primary VA doctor for annual checkups and making sure my prescriptions are being filled and updated. Besides that, I'm a young 65 and don't have any issues yet. Cheers
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elzorro
3/16/2022 13:26 EST
No, there is no affiliation with the V.A for paying any of your medical expenses in Nicaragua. As far as I know, unless you were born here you have to get private medical insurance.
I used to have V.A. but that went away once I moved here.
good luck
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KeyWestPirate
3/16/2022 13:35 EST
Prior to Covid, the idea of maintaining a medical relationship in the US with the idea of jumping on a plane if things went seriously south was a good one.
I have a Humana Advantage plan which costs me nothing. It just sits there waiting for me. A once yearly visit to the US was the plan, blood work, exam and any followup necessary.
Covid pointed out the flaw in that plan. And who knows what will happen if the conflict in Ukraine continues? Not impossible to cross into Honduras or Costa Rica and fly from there for those comfortable with crossing borders,, but not as convenient as going to Managua and jumping on a plane.
A recent RT price from Phoenix to the new Tegus airport, Palmerola, was $343. And arrival and departure times were convenient as well. This was Spirit, so add your bag fee, and a buck to use the airplane lavatory.
Spirit was what Tom Petty was singing about, but cheap is cheap:
https://www.youtube.com/watch?v=fFnOfpIJL0M
Most needs can be met in Nicaragua, but not all. It's important to establish a relationship prior to needing it. A referral is essential.
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dollyd
3/16/2022 18:41 EST
No. Medicare is only for the US. It will not cover anything outside of the US borders. It will not reimburse any expenses incurred outside of the US. If you have a supplemental insurance such as Blue Cross/Shield or Aetna, they may reimburse you for out of country costs but Medicare and Medicaid alone will never go this.
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mikee2
3/16/2022 21:00 EST
IN NICARAGUA!?!?!?!?
You're still thinking with an American mentality.
If you are thinking of moving here, please leave you American way of life there......You'll see.
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elduendegrande
3/16/2022 23:28 EST
Right now some flights are incredible bargains but don't count on it staying that way. As travel/tourism increase so will prices and I betcha the police action in Ukraine will usher in fuel surcharges as a minimum and the cancel culture in the US may dream up even more sanctions. And if the US carriers don't come back to mga we will have limited options.
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JustSomeGuy
3/17/2022 20:33 EST
Yes,
through the Foreign Medical Program but it is mostly for service related problems and other things for eligible vets. You should check with the VA.
https://www.va.gov/COMMUNITYCARE/programs/veterans/fmp/index.asp
Asking questions so you can get information is not uniquely American, I can’t imagine why someone would think it is. In any case there are a number of knowledgeable people who frequent this site and you should feel free to ask any questions you might have.
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Diane622
3/19/2022 18:41 EST
Actually, of note IF retired military lifer (and auto paying into medicare part B) You have free emergency dedicated line to tricare overseas, And if approved in emergency case ... Your coverage will be paid for or reimbursed at Vivian Pelas hospital. That is the only hospital (last I checked) they cover. (However, one can petition with receipts and prescriptions, drs fees, and so on, and submit for later reimbursement possibly any medical emergency anywhere if well documented. Over 24 years I did this twice in Rivas and Tricare accepted it.). No guarantee but thought it might be of help to someone. Again note:. Emergency only. Retired only. With medicare part B only. Tricare Overseas.. might want to check for updates. /db
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KeyWestPirate
3/20/2022 09:38 EST
Mikee makes a good point.
You DO have to start thinking out of the box when you get here.
A knowledgeable fixer to help you navigate the residency, vehicle acquisition process, costs little and really helps. If your Spanish is fluent, you can do it on your own..
An honest lawyer, if you plan to buy property. As you begin to meet and know fellow expats,, they will guide you in the right directions.
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elduendegrande
3/21/2022 10:56 EST
I did talk to a veteran recently who said that he could get VA out of the country but his medical matter was service connected whereas mine are not. Daine622 above has filled in the details. I also remember some VA care available in the Phillipines so it never hurts to seek more info.
Medicare B is optional, but if you opt out for living abroad there is a penalty for opting back in if you return to the states. I do not know if it is substancial or more like a nuisance charge.
Medicare C is territorial, limited to a specific area in the US. It would particularly fit for snow birds who maintain 2 residences and can stay in the US long enough to get their medical stuff done there.
Signing up for medicare C is a lenghthy process, you have to sign up around October to start on Jan 1 of the following year. I recently read that there is an expidited signup for people returning from abroad so if it applies you might want to check it out.
Signing up for VA can also be a long process. Get it done in advance if you think you might need it. It took me 4 months but that was during Arizona VA's "let them die" period. You are not there until you have the picture ID and a physical.
I also believe that medicare B is required to get C. The insurance company would be the one to know.
Last but not least, VA asks what other insurance you have but I don't know if they require B or if they back charge it if you do.
Net net, the old mochilero tip to have a visa card with 5k available with you always applies.
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elduendegrande
4/16/2022 11:15 EST
Another thing to consider is that US medicine is painfully slow. Even if you phone schedule an appointment for the day after you arrive you may not be able to get things done in a 4 week family visit. I had an excellent dentist who I had been going to for a decade decline to do a crown because I has only 3 weeks left to departure. Not a big problem because unless you have insurance in the US it is better to just get it done here but at the time I had US insurance. I had the same problem with eyeglasses, not enough time to allow for contingencies. Eyeglasses here are not cheap and other than Matamoros I have had severe QC problems.
The VA is a whole different matter. They are big on platitudes about "thank you for your service" but talk does not get you appointments, referrals to specialists, or medical procedures.
Plan on getting a 1 way ticket and a long open-ended stay with your life in Nicaragua on hold.
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elduendegrande
7/24/2022 13:17 EST
Update--
Your mileage may vary, but I go to a rural clinic that has troubles holding onto doctors so then you get referred to a Robo-doctor 100 miles away who has not mastered phone or video conferencing despite claiming to be oh-so modern. They don't treat patients either, they kick everything down to helpers. You will get blood work online in 3 days, but everything else is a crap shoot. I had to go to a hospital and request results from them because the VA can't handle that type of responsibility. Amazed I got the results, AZ used to have a law that they could only send results to the doctor.
Another tip-- this may hurt if you are not a crybaby and don't have a manipulative personality. Before you go for anything except simple bloodwork do a deep analysis of how long you want to wait to get a real appointment or testing or test results or diagnosis , prognosis, or treatment.. If it is more than a week, pump up your symptoms and go to urgent care or the emergency room and tell them to bill the VA. This can save you literally MONTHS of waiting to even get the time of day out of the VA.
Check your VA doctor on the State Medical Board website to see if they are really a doctor and have any complains or restrictions against them. You will not find anything because they are shielded from public scrutiny! VA doctors are accountable to nobody.
Use your cell to copy everything. Have a nice day, week, month!
PS: they do backcharged Medicare A and
B unless this was a doctor error. On a $2000 bill medicare disallowed $1500, paid 250, and billed 250 to me which was forwarded to the VA. Net Net I saved $250 by having the VA delay the procedure by 2 months by endless can-kicking.
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elduendegrande
7/24/2022 13:37 EST
PS; vivian Pellas is not the only show in town. I or family members have been to PROFamilia, Integral, Bautista, and Militar (which is not solely military) with positive results. Not prime First world, but at least equal to VA. I'm checking out Adventista soon.
Note; in public hospitals you should expect to have a relative or someone sit with you and possibly bring food or medicine. In Nic you can pay a taxi to take you to the emergency room, You can get walk-in ultrasound done by a doctor who will give you written and verbal results before you leave the premises. She will also recommend you to a specialist if you need further work. Last time I did it it was 500 cords. You can also get blood and urine done without a doctor referral.
All that being said, if you have major medical concerns, Managua is a poor choice and the rest of the country is a bad choice. Being independently wealthy is a plus.
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