I have been living in the Philippines for nearly 17 years now! It’s been a long haul, and a very good life. I have really enjoyed living here, and my eyes have been opened to many things. I have learned a lot, been exposed to other expats from nearly any country you can think of, and of course had a lot of exposure to the Philippine people and culture of the country. The experience has been nearly 100% positive.
Over my years of living here, I have had one nagging worry in the back of my mind. That worry has been medical care and the cost of medical care, if needed. I am not talking about something like going to the doctor for a visit, having a broken arm put in cast, that kind of thing. Stuff like that is dirt cheap in the Philippines. No, what has always nagged at me is the cost of a major medical situation. Unfortunately, that situation has moved from nagging me at the back of my mind to being front and center, staring me in the face.
As anybody who follows the site knows, I had a heart attack in June of this year, and recently found out that I needed a quadruple bypass. The heart attack caused me nearly a week in the hospital and cost me around $2,000. OK, not such a big deal, I could handle that. Recently, I went in for an angiogram test to see if further work was needed to prevent another heart attack, or possible death from my heart condition. The angiogram, other tests, 3 days hospital stay, etc, added another $2,000 or so to my heart care costs, bringing my total outlay so far up to about $4,000. Still pretty manageable for the average westerner.
Bad test results
However, when I had the angiogram, the news was unexpectedly bad. I was not expecting wine and roses from the test, but the depth of the problem was beyond what I expected or what my doctor had expected. That is when I found out that I needed to have the quadruple bypass. If you want to help me out with the costs involved, please visit my GoFundMe page, it would be greatly appreciated.
Now, a heart bypass is a big serious operation, and it is costly. Of course, the cost is much less than it would be in the USA or other Western Countries (most of which have socialized medical care). I am looking at a total cost of between $20,000 and $30,000 for this operation. Now, PhilHealth, the Philippine Government Health Insurance program, will kick in and pay part of that. So far, though, it is unsure how much, we are working hard on that. I don’t expect the amount paid by PhilHealth to be too much, but we will see.
That nagging voice
So, as I said, over my years of living in the Philippines, that nagging voice in my head has been keeping me worried about the day of reckoning. Well, the day of reckoning is here for me now, and I have been doing a lot of things to get past this particular day of reckoning. However, if I am able to work out everything financially and get my heart fixed, it is likely that like all of us as we age, there will be more days of reckoning ahead. We all get sick, it is part of aging. Unless it is something big like another heart problem, cancer or something like that, the cost should be manageable. But, you can’t count on it being inexpensive… those “biggies” do come along as I have recently been reminded.
A plan for the future
I do have a number of ideas and thoughts about how I can better protect myself in the future. When I say “better protect myself” I mean be better prepared, financially, for the coming days of reckoning. These are personal plans for myself and my family. I will be writing about these things, but not today.
Additionally, I have some real serious thoughts and ideas of ways to help all expats living in the Philippines in terms of affordable healthcare. Some expats have good healthcare that is affordable and working well for them. For example, Paul Thompson – another writer on this site – has been going through some health situations this year too. He is a retired vet and has health insurance through TriCare, which is part of his military retirement. That is great for Paul, and I salute his service and the service of every vet. However, for other people who did not serve in the military, we also have a serious need for health care to protect us, both physical protection and financial protection. I have some thoughts about that too, and will be sharing those thoughts over time.
A word of warning
My goal for today, though, is not to spell out my thoughts and plans for health care coverage for the future. My goal is to warn those of you who are planning or wanting to move to the Philippines that healthcare is something that should be at the front of your mind. When I moved here, I was 38 years old, and for a person 38 years old healthcare is not really at the front of the mind… it is something that we know will be needed years in the future. But, you also just never know when the need will arise.
I am speaking of Americans, since I am American, and I know the US healthcare system. I have no experience with the Canadian system, the British system and so on, so I can’t speak to that with any degree of knowledge. For Americans… if you are living in the Philippines for the long term, it is very unlikely that your US Medical Insurance policy will give you any coverage in the Philippines. Now, if you come here for a few weeks vacation, it is likely that your US policy will pay for any needed medical care while you are traveling. There are also travel insurance policies to fill that gap. But, if you are here for the long term, well, you are in a different situation.
There is PhilHealth too. PhilHealth is very cheap – it costs P200 per month to cover your entire family! But, the amount that they pay is not great. I have had situations where PhilHealth has paid as much as 50% of my bill, and other situations where they have paid less than 20%. Their payment depends on a number of factors:
- Your diagnosis – they pay different amounts for different sicknesses.
- Where you get the care. If you go to an inexpensive hospital, they will pay the same amount as if you went to the most expensive hospital. So, if they pay, say P10,000 on the P25,000 hospital bill at the less expensive hospital or they pay that same P10,000 on the P40,000 bill at the high end ultra-hospital, well, it is much different in terms of percentage.
- If you go to the hospital for the same problem multiple times in a single year, they may pay only 1 time. This can be worked around, though, if your doctor knows what he is doing. In other words, he can give you a different related diagnosis for your 2nd visit, etc. If the diagnosis is different, the payment can be made.
- PhilHealth only pays if you are hospitalized. If you have an outpatient procedure they do not pay. If you go for a doctor’s visit they do not pay. If you take daily medications they do not pay for that. For P200 per month, you can’t expect that this will be huge amounts of money for your healthcare. But, what they do pay is fantastic, given the amount that you have to pay for the coverage.
What should you do?
In my opinion, if you move to the Philippines, the first thing you should do is sign up for PhilHealth. If you can get some other coverage in addition to PhilHealth, you should do it! In regards to other coverage, though, I think it is unlikely that you will find something that is both affordable and will offer you the coverage that you want or need. What I really think is that you need to have an emergency medical fund in place to cover you if the worst happens, like what has happened to me.
How much do you need in place?
Well, your emergency fund should be as much as you can do. If you had P2 Million put aside for medical needs, I think you would be sitting pretty good. Combined with your PhilHealth, that P2M would be able to cover you very well in my view.
Problem is, most of us don’t have the kind of money to stash aside “just in case”. In that case, I am not saying you should not move to the Philippines, but I am saying you need to have some kind of fund ready, or a plan to get those funds. Maybe you have a family member who is willing to have some money ready to make available to you. Maybe a friend. Maybe you have a retirement account that you can get into in case of an emergency. Whatever the situation, you can still take positive action. Let’s say that you can put P500k in place, that is roughly about US$10,000. That amount will cover you for a lot of medical needs, the majority of situations you may encounter. Also, if you put together a smaller emergency fund, you can commit to adding smaller amounts to that fund each month until you build it up into what you need to protect yourself.
Final thoughts
In the end, what I am telling you is that you have to expect that these kinds of situations will come up at some time in the future. We all get sick. We all die. If you live in the Philippines, it is a very different situation than living in the USA or wherever your home is. In those countries there will be something in place to cover you in your time of need. Even though PhilHealth is here, you must have other means here in the Philippines. If I had this heart condition in the USA, I would get the operation no matter what the case is. Here, though, if you don’t have the money to put up in advance… you won’t get the medical care. If you don’t have the final money to pay when it is time to get out of the hospital, you won’t be released.
Want to move to the Philippines? I can understand that… I love living here. But, don’t be stupid like I was. Have an emergency plan in place. I have been lucky that I have a lot of friends and followers who have kicked in on my GoFundMe page, but the odds are that you will not have the kind of following that I have due to this website. A lot of people have tried to build a site to compete with this site, but there have been few, if any, as successful. So, don’t count on the GoFundMe route, most people will fail. I am blessed and thankful for that method, and I hope you could get the same level of support too! But, most people don’t see that, so have some other realistic plan in place.
Good luck to all of you!
Kyle Rupp Food for thought….
Excellent article Bob.
Thank you Greg. I think it is an important one for potential expats to read!
There are several (perhaps more than several) International medical insurance plans that provide coverage if you’re living in the Philippines. Many of them cost in the vicinity of $1000/year. But there are some limitations – existing conditions or just plain age limits.
The flip side is that a 65+ person might consider using Medicare for a major needed surgery, although as you know in your case, the doctors might not recommend traveling, depending on a person’s condition. You could return to the US or even have it done in Guam. That being said, just because you have Medicare does not necessarily mean you won’t end up with a big bill at the end; many seniors end up in financial problems, despite Medicare.
Hi Dave – Yes indeed. However, you already spelled out the problem! Pre-existing condition! Most, or at least many people have pre-existing conditions, and that makes getting such a policy impossible at any price. For example, I have been diabetic for 25 years or so, I am not eligible for such a plan. For those who can get such a plan… better go for it! For the rest of us, figure out another contingency plan!
As for Medicare – I am only 54, and not eligible for medicare. I am in the gap and can’t get an expat policy, nor am I eligible for medicare. It is a tough spot.
Bob;
For quite a few years TriCare was not an option for me here in the Philippines due to rampant corruption that went unchecked by the FBI even when the cases were reported. Local Doctors were riding a gravy train filing false claims and getting rich because of mismanagement by the US Government. Then when it was found that one Doctor received $ 80,000,000.00 in bogus claims that the program was shut down. During that period I had to hoard money in what I called my; “Medical Get Out of Dodge Fund!” that would get me to Guam, Hawaii Japan or Singapore where TriCare was still working here in Asia.Then the US Government contracted a firm in Singapore to manage Philippine claims. They are very strict, and have placed their people in key areas-with a high percentage of US Military retirees. This is why you find us (US Vets) clustered together around the Philippines.It is still not a perfect system, but after what I went through this year, I’m damn happy I have it. I don’t understand why Medicare could not be folded into this program for our non-military Americans living outside of the US. Here is a factoid that makes me smile, I can only be covered by TriCare if I purchase medicare from Social Security, where does that unused money go? But Bob is 100% right, some form of a plan is needed, even if it’s a speed run to Guam, where they will treat you no matter what.
Hi Paul – Everything you say makes perfect sense! Unfortunately, our government makes no sense at all. As you said, about being forced into medicare, but not allowed to use it! With Obamacare, if it continued in the future, why don’t they offer a reduced rate plan for Americans living abroad, make it where medical care in the USA is not allowed, only in foreign countries where care is much cheaper anyway? I would buy that plan if it were made available to me!
Thanks for chiming in and sharing your experience, Paul.
Bob;
Obamacare was designed by insurance companies to cover the cost of Hospital emergency room visits by the uninsured, it was never meant to help any US citizen. It was costing the insurance companies a fortune to fund those visits. So if you can sign up three working citizens in the AHC system which will fund one for free, the emergency room cost decrease, saving the corporations millions. (Dare I say billions?)
Since the law was written by insurance companies, then you can figure out that the main benefit will go to the owners of insurance companies. A few years after the program became law, in a country with a population over 300 million, and only 20 million have signed up, tells one that it has failed, as all the democrats who rave about how good the program is for you (Not them)
Shouldn’t there be at least 150 million already enrolled? The math is not working out on Obamacare except for the insurance companies. I could be 100% wrong, but then I’d need a new calculator.
I concur completely, Paul.
Hey Bob
Why dont you fly back to US?
Hi Jim, firstly, it is not for sure that I won’t go back to the United States for the surgery. It is unlikely, and I hope that I can do it here in the Philippines. There are some reasons why I might need to go back to the us though. For the most part the reasons I want to do it in the Philippines is that it is going to be much less costly to do it that way, and the main reason is I want my family to be around while I recover. That is very important to me.
That is very important to me.
Hope you understand.
I forgot to mention, I have also been advised that medically, it is not a good idea for me to fly that distance.
Bob, I just moved to Cebu from Chicago. I have been enrolled in Obamacare and plan to continue enrollment in the future, even though it does not provide coverage in Philippines. I will use a relatives address in Chicago for enrollment so I can take advantages of the subsidies. The Obamacare plan I have is appox $1,000 a month and the government subsidy is over $900 a month. I think it’s worth $100 out of pocket so my wife and I have coverage in U.S. in case we travel back on vacation or have medical situation such as cancer where travel is still possible.
That sounds like a great deal, Mike. I would keep it if I were you as well.
Hi Bob.
I do hope you can sort yourself out, as you are still a relatively young man.
Also want to point out as to how courageous you have been in publicising your condition and, to something we ex-pats have to consider.
I presume that Stents have been ruled out, to open up your arteries, I ask because if you can travel back to US its medical facilities are world class.
If you cannot travel then you will have to pay, money won’t matter compared to your well being.
Has PhilHealth payed for any treatment you already have had for your heart ?
My plan for myself would be to return back to UK where I can be treated by NHS for any serious medical condition, but it may not be possible if I could not travel that distance. Then its important to have the funds or insurance in place to pay. The treatment would not cost if you are a resident of UK or receive a UK state pension.
If a visitor to UK has a heart attack, stroke or breaks a bone or has a sprain,(basically an emergency) then you will be treated for free including drugs, but if you go to UK needing an operation you will have to pay.
Hi Gerry – My heart disease is far beyond anything that can be fixed with stents. If they tried to do it with stents, I would probably need at least 20 stents, ant that is just not feasible. A stent costs between $2,000 and $3,500 each for the device, so we would be talking serious money, but it would not fix my problem anyway. No, I have to have a quadruple bypass it is the only thing that will save my life.
I am currently working with PhilHealth and it is looking like I can get much better coverage than I expected, they have a special package that might be applied in my case. Next week, I have an interview with a medical board, at which time the final decision will be made about PhilHealth. It is looking good, though.
Thanks for your concern.
Bob,
You are spot on about having a supplement to Philhealth. I was fortunate to be able to get a private policy from Blue Cross Philippines that covers 100% hospitalization and all tests and procedures associated with the hospitalization for $500,000 per year. It does not cover outpatient, doctors visits, etc. My annual premium was approximately $1300.00 But that depends on age. It does not cover pre-existing conditions the 1st year, but it will after the 1st year at a higher rate. I was fortunate that i had it for my gallbladder surgery last April. The total bill was P160,000 which Philhealth paid P40,000 of it. I had a very positive experience as far as care goes. Only problem i had was at discharge.
That is really interesting and helpful information Randy, thank you for sharing that. I’m glad everything worked out for you with your gallbladder surgery. All the best.
That is a great article.
Thank you Matthew.
I can’t understand the logic there of if you can’t pay they make you a prisoner in the hospital! My wife’s sister in law had to have a c section and they wouldn’t let her leave until the family could pay, meanwhile they just keep racking up more costs that a poor person can’t pay. I guess because no credit system in PI. Here your credit rating is damaged if you don’t pay your debts.
Hi Jim – I agree that it is not an ideal system, but neither of us are going to be able to change it. Just like we would be unable to change the system.
To be honest, I have other things on my mind, I want to do what is necessary to save my life… If I decide to wait until the medical system in the Philippines works.. well, I’ll be dead by then!
I think the PH government passed a law a few years ago that hospitals can no longer hold patients hostage until the bill is fully paid. From what I recall this only applies to ward patients and not for those having a private room. I think one of the reasons hospitals want to be paid before discharging a patient is that otherwise they would never see or hear from the patient again if money is owed.
Hi Bob, yes indeed that is the law, but as we probably both know, what the law is and the way things actually work in the Philippines are rarely the same.
Here is the link to that law.
http://www.chanrobles.com/republicacts/republicactno9439irr.html#.V_7QtaMRWTk
In Canada if you are not away for more than six months a year, you keep your government medical insurance. That really is a big thing, summers in Canada can be wonderful, depending on where you live.
Good luck bob,sorry to hear things are so serious.
Thank you, Greg, I appreciate that.
I sent you a pm Bob… Quadruple by pass is not what you need.. ?
I did not get any message Ed. Sorry? Are you a doctor?
Hi Bob,
Many times you have reminded people that in moving to PH you have to bring your money with you instead of making a living there. I guess in a lot of ways that applies to catastrophic medical insurance as well. I think some USA insurers have international plans but I am sure the cost is through the roof for them. At the moment I am still under my employers insurance plans but I have to co pay one third of the cost which at the moment the total cost is about $16,000 USD per year which one third is deducted from my pay check. When I was hospitalized there in PH with pneumonia in 2012 my medical cost was near fully covered by my health insurance and travelers insurance which I buy for every visit. I always recommend travelers insurance for those like myself that come to PH for a visit or vacation. I understand though that living there presents an entirely different set of options or lack of them. So in addition to bring your own money with you for those that wish to move there, it is also a case of bring your own insurance as well. Good luck to you Bob and I hope your gofundme continues to work for you. I have made several contributions so far.
Good article Bob and its true people need a plan in place. For me one of the main reasons for moving back to the US after 3 years in PI is the medical issues. I need constant pain management which means spinal oblations every 3 months just to walk pain free. The almost funny thing is my pain management doctor is Filipino haha hi dad was Mayor of Cebu for several years.
On another note… the new law about them holding you hostage for payment is indeed enforceable. My Filipino partner was in Makati med 2 years ago and after 4 days in the hospital his insurance claimed it would not pay the bill. They had to put him in a ward ( sad thing indeed. Paint coming off the wall, meal size cut in half and poor nurse service.) I was mad to say the least. After his heart doctor released him they tried the hostage thing. Lucky for him i am a stubburn American who likes a challenge. After 24 hrs, copies of the actual law that states the penalty they would have to pay, and working my way to the top of the chain so to speak I gave them an ultimatum. Take the 40,000 peso he had for down payment so he could go back to work at the call center or i would use the 40 thousand to hire an attorney and he would still walk out and they would get nothing. Two hours later we walked out of the hospital:)
Hi Roger, thank you for sharing your thoughts. I do think it’s a good idea for anybody planning to make the move to have a plan in place.
Roger,
I had a problem when i was getting discharged after my gallbladder surgery. My bill was all settled by Philhealth and my private Blue Cross Policy. Than my surgeon decided he wanted to add P30,000 more to the bill after it was already settled. To say the least i was not happy. On top of that Blue Cross refused to pay the extra P30,000 until my wife told them she would sue them for non-payment. They changed their tune and decided to pay. They said they would not cover any surgery done by that surgeon again.
Great article Bob & thank you for the great advice. You’ve definitely given me something to think about as I do plan on staying here…God willing.
Hi Michael – Nice to hear from you. Yes, it is something to carefully consider, I think. I should have considered it more carefully, that I know!
Excellent article, Bob. I get so exasperated when people ask me advice about living in the Philippines and when queried about their plans for health insurance answer me with somehting like, “Oh I don’t have to worry about that, I’m in good health.” Hello, everyone suffering from a medical condition today was also “in good health”, — until they weren’t.
Hi Dave, thanks, glad you liked the article. Yes, I agree that some people are real stubborn (I am one of them!) and don’t want to be hassled with “facts”. 🙂
Any US citizen that needs major medical care, and is not covered by Medicare, Medicaid or similar plan, should at least consider taking full advantage of what the Affordable Care Act (Obamacare) has to offer you. Consider it as temporary relocation back to the US.
As most are aware, if you live in the US, you must enroll for coverage under the ACA if you are not covered by Medicare/Medicaid or another qualifying plan. Since you are moving back to the US, you qualify for special enrollment. Ensure you enroll at least 30 days prior to returning to the US. They cannot deny coverage for pre-existing conditions. Choose the state where you will receive treatment and temporarily reside, enroll in a plan on the state marketplace exchange (or federal site). Confirm coverage, pay your premium and you are covered.
Ensure you coordinate your treatment with the insurance company to ensure maximum reimbursement based on their in-network coverage, deductible and co-pays etc.
It seems like a hassle but if you are talking about a couple hundred thousand in reimbursement for paying a few thousand in premium, it can be worth it. I know this may seem like taking advantage of the system, but everything else in the “system” (taxes, medicare et al) is so stacked against US citizens living overseas, you should not feel guilty about taking advantage of what is offered.
Hi Todd – I considered going with ACA very carefully. It was a close decision. In the end, with travel expenses considered, it would cost me more to go back to the USA for treatment, and also I would probably only be able to bring my wife on the trip. I want to have all of my family around as much as possible.
That’s kind of my plan, if something catastrophic would happen to me, health care wise. Why not? I didn’t vote for the screwed up incentives of Obamacare but I’d be stupid not to take advantage of them, until the system collapses that is.
The incentive is for healthy retirees in their 50’s, like me, to get out, and only come back if they need health care. Sign up, get your health care, then leave again.
I either take advantage of this or stay in Minnesota and pay $1,800 per month for Blue Cross, for two, plus all the co-pays if actually used. That is until Blue Cross left the market leaving other carriers raising their rates 50-66%, for the coming year.
I had also strongly considered going back for a one time thing, signing up for Obamacare, getting the treatment and then returning to the Philippines. It is all legal to do. But, circumstances worked out where that would not be the best way to go about it in my case. I would probably be looking at 3 to 6 months in the States. I would at least want my wife to be with me for my surgery/recovery. So, two of us traveling, needing a place to stay, all of the required costs while we are there. And, really I would hate to be away from my kids for the time involved too. After all considerations it is at least as cheap to just do the surgery here and pay for it. The costs is virtually the same, and I do have full confidence in the treatment I would get here… so this was the best option in my case. Every case is different though. Add the fact that such travel is medically unadvised for me at this time.
A very real consideration. Hope you are up and around soon!
Thank you Jerry. I am going to recover from this, I am a fighter! You can put money on that!
Ho bob and everyone i would suggest to get a second insurance, like medicard or intellicare. Search whats best for you. Philhealth will only cover a small chunk of yoir bills and in most cases only serious illness are accredited. Unlike private health insurance some are only less than 1k per month which is not too costly because they cater good and private hospital
Hi Jack – Did you read the article? That is what I wrote about! 🙂
Thats good then. Wishing for your good health . I didnt finish reading as my kid is trying to steal the phone and fell on her face haha.a
Something else to take into account is blood type. If you have O-, you are possibly going to encounter problems here in PI. That type is extremely rare here.
We had an expat here who desperately needed that type, but unfortunately none of us locally had that. He ended up having to be medevaced out for treatment.
So, knowing your bloodtype and checking availability would be prudent.
I have an extremely rare blood type for here – A+. I am working on finding donors right now. I need 10 units.
Ouch! Which unfortunately reinforces my suggestion. Hope the expats can help out.
Luckily I have my daughter, she has my blood type. Still checking my other kids. We have a few other possibilities too.
Very excellent…article…
I kept my Obamacare policy my 1st year here…..and now on Medicare..NO..it will not cover me here…if something happens I hope they can stabilize me so I can get on a plane ..because I am covered anywhere in the US…
Hi Will – This is a plan that could help you out to some extent. But, you may be running up against problems if you have a situation where you simply cannot be stabilized enough for transport. For example, in my current condition it has been advised that travel over that distance is dangerous. So, that is just something to consider.
Bob Martin thanks and I read your comments about that..unfortunately..life isn’t guaranteed .. and I would have to weigh ..risk / reward..in any situation…..
I don’t have a choice as to carrying the insurance…
Our fate in life…is above our pay grade….
Thank God you caught your problem in time…hope your treatment is successful ..and your recovery speedy…
Understood.
One thing to consider, Will, is that many medical conditions can’t be “stabilized” for air travel… common example, many types of aneurysm. And many airline will refuse carriage to severally ill patients. It’s very expensive for an airline to deal with an onboard death, and no one can force an airline to carry you if they refuse to accept you. Also, when you arrive in the states, finding a doc and a hospital who will accept first time Medicare patients is not always assured in a timely fashion. A lot of US expats here talk about going to Guam. Medicare will cover you there, BUT Guam has ahuge problem with insufficient Medicare docs and hospitals. Serious cases from Guam are often sent here to the Philippines. Catch 22 I think they call it 😉
Good points all around, Dave.
I don’t disagree with anything you or Bob have said…in any way…I’m prepared to live..or die with the decisions I’ve made…
We have little choice unless we have the money for insurance that would cover us here… I live on SS so that’s out for me…
That’s a great article!!!
Thank you!
Your welcome friend Bob Martin
I would suggest you go to the states sign up with Obama care and stay with a relative while you recover. I had Quadbypass in 6 years ago and the care in the states is the best for that kind of thing. I think my insurance got billed 100k and I had to pay the $35 copay a visit for my rehab which was every other days for 6 weeks..
Thanks for your suggestion Wally.
Mr. Bob Martin, I can only make few words of encouragement. I had quadruple by-pass in 1997, had that “big one” in DC and didn’t even know it! Hang in there and think positive. I made it and was able to retire from “uncle sam’s world wide civilian service” in 2011 (while in Asia) after 42 years of service. We’ve met a couple times in Davao City while I was assigned in Mindanao – and I know you are a “tough cookie” and I am very sure you will be fine. Just be prepared to take a handful of medications for the rest of your life. I got pissed during my first two years post-op for taking so many pills, I barged in my doctor’s office without an appointment, my wonderful doctor was reading his newspaper, and I rudely asked him, “how you long do I have to take these damned pills?” Without taking is eyes off from what he was reading he politely shot back, “how long do you want to live?” 🙂 I have only missed a few dosage since then. You will make it, I am very sure. Take care of yourself and will keep reading your column here so I can get updated. Seguir luchando, mi amigo. (Keep fighting, my friend)
Ha ha… hi Jose! Nice to hear from you. I had to chuckle when you told about barging into your doctor’s office! He was so matter of fact, it sounds like he was just waiting for you to show up!
Thanks for your words of encouragement.
Hi Bob,
Excellent post and extremely informative and above all else, I sincerely hope your treatment program goes well and that before you know it, it’s all a distant (although most probably, not pleasurable) memory.
Personally, I would advise newcomers to the Philippines to plan well and plan early. My case, as I am sure draws similarities to other readers, we come, here we do our thing, living is cheap, it’s all happy days and when your young and apparently healthy, the last thing on your mind is aging, illness, assurance, insurance and protection and support for our families, in the event of future ailments.
As you rightly say, primary care (broken bones, bouts of fever, infections etc) are all too common here and are dirt cheap to treat successfully and rapidly.
Expats who have vested interests here (I am Davao based, 50 years of age, married with 4 kids and been here for 23 years and live in Matina) need to plan for a totally different scenario of eventualities and risks. Insurance costs for these are very affordable providing that you take them with overseas insurers as an expat in the Philippines, and are prudent in your selection of required cover. In my humble opinion and in my own situation, I can afford the cuts and bruises stuff, but I do need cover for the big ticket stuff, such as organ transplant, chronic disease treatments etc, which would most likely financially destroy myself and the best of us here. PhilHealth may be suitable for some folk, but let’s be honest with ourselves, it’s a far cry from proper medical cover that many of us are used to, and would expect to receive for serious medical conditions.
The point here is, that taking out such critical illness cover early ( early as in 20 years ago in my case) will keep premium renewals low and will not carry all the “pre-existing” conditions of which I am sure we are all aware that develop as we age.
Get in early and maintain your plans, regardless of what nation you hail from, as our home countries can change policy at any time they wish, and that includes all of us expatriates, thus potentially invalidating any expected legacy cover whether fully paid up or not. (Hindsight is a wonderful thing I can imagine readers thinking)
If living in the Philippines as an expat, expect nobody to help you in times of need, regardless of how much we may have helped others over the years, because IMHO, we will get very little or credible support, not due to selfishness or lack of care or interest, but due solely to inability to help.
Over the years, have had major spinal surgery and many other procedures, all done in Davao, and therefore can vouch for quality and professionalism. I have also had relatives here for palliative care due to terminal illness, and can categorically state that I do know the nation’s hospitals well enough to make rational decisions based on the patient and their respective illness. The quality here and the costs are extremely competitive compared to alternatives.
My advice to readers is either insure early and wisely or plan ahead to self-insure in times of future need – or indeed, if one if of a different outlook, do nothing and enjoy life as long as its pleasing to the individual concerned.
My overriding message here is – If you intend to stay here or elsewhere in Asia (or many other countries) please incorporate the pros and cons.
I am not associated to the medical profession in any way at all, it may be worthy of mention – What I do for a living is not worthy of mention.
Regards to all,
Cheers,
Phil
Hi Phil – We live near each other… I am also in the Matina area.
You make some valid points. I do disagree with one part of your comment… about not expecting anybody to help you. I have been helped by a lot of Filipino friends… In this medical case I have been helped both financially and in other ways. So, it can happen, and does happen.
Other than that, though, I am in agreement with everything you said. Thanks for joining the conversation.
Thanks Bob and hope that all goes well in the long run, as we know, the medical experts these days are seriously skilled and highly competent.
All the best.
Insurance is always good to have. Emergency fund is good, too. Something that is great overlooked is really taking care of your health to begin with. Eating the best naturally nutritious veggies/fruits, clean water or fruit juices. No processed foods, No sugar, No flour. Organic crops preferable. Exercise, Mental attitude…etc. No one has ever died of natural causes. There is always disease. The saddest part today is the amount of misinformation regarding health/food/medicine and everyone needs to do their own research on that. Best wishes to everyone.
Good thoughts there Mel. Thanks for sharing.
Bob Martin, pm sent. I have A+ if there is a way we can get it to you.
Hi Mel. That is a very nice offer, thank you
I spent most of the day at the doctor’s office and when we talked about blood they seemed to think we would be ok. I will know more soon and will pass along what I find out.
bob, hope your health gets better. all expats should have an emergency back up plan. as other have said no money in PH no healthcare. those expats that are always complaining about US, might want to think about what happens when their atm runs out of cash because of medical expenses. as for Paul Thompson who lives in a glass house, fox news talking points are not factual. he does not need a calculator just some common sense about how laws are written in legislature branch of US government. president can not write laws only sign or veto. check out schoolhouse rock videos to learn. that should be simple for him to understand.
John, there is really no reason to be rude. In fact, Presidents do write laws all of the time. Perhaps that is not the way that the Constitution calls for, but it happens. The White House writes laws, sends them to their political allies in Congress and it goes from there.
I would be happy to expand on these points in a full blown article or articles. 1. I agree with Bob’s article 100%. Also, about going back to the US, what if you were in a motor cycle wreck? Heart attack, stroke, TB? And what is your wife or non-American citizen kids were the ones with a medical problem? 2. Bob knew the right doctors. Do you? Even in the best hospital in the Philippines, St. Luke’s in my opinion, there are dud doctors. If you live in a big city, which doctor do you turn to? Will he/she be at the hospital when you arrive at 2am with chest pains or a smashed hip? 3. Let’s say you don’t live in/near one of the big city so the choice is limited, who are your “go” to doctors. If a major operation (e.g., on your heart) or an irreversible operation (removing your thyroid) do you have the go to doctor in a Cebu, Davao, or Manila lined up? 4. And what about your wife and kids after you die? Are they provided for if they get bad sick? 5. Here is a related piint. I see many older expats with a much younger wife and kids (me). Have you made financial provisions for them if you die and your SS, gov. or militaty pension, or other pension dies with you? 6. Have you registered your children as citizens of your home country? What about children by your wife/gf’s previous relationships to whom you have become a father?
These are all very important points to consider, without a doubt! If you want to write and article or series of articles, we have our article submission form which you may use! I’ll be watching!
My health has been something I have thought about often since moving to the Philippines. I am from the school of hard knocks and think nothing of sewing myself up or setting a broken bone but obviously can’t tend to my innards.
Sadly my mother passed away Sept. 6 which required a rare trip back to Canada. One of the first things I did was make an appointment with a doctor who worked me over. A suspicious mole on my back that was removed and tested benign and I got a clean bill of health.
I have now returned back to the Philippines and feel better having gotten a check-up. Back to worrying about the NPA in my backyard. 😛 Wish you all the best Bob.
Hi Jim – Sorry abut the death of your mother. That is tough!
Good, though, about having a good clean bill of health! Keep your health good! You don’t want to get hit like I did!
Thanks for your kind comment Bob. My mother had a good long life with no regrets.
I married a much younger woman who wants me to live forever and doing everything in her power to make it happen. If I had never met my wife I am sure I would not be as healthy as I am today.
Thanks, Jim. Best of luck to you! I feel the same about my wife!
Bob. When I have clients who are temporary visitors to the PI I really push The medivac portion of travel insurance so that in major health incidents they can get home by medical ambulance to where they live in the States.
My best friend in the Philippines needed unbelievably expensive chemotherapy and I helped him on some of the treatments but couldn’t do very many.
U.S. Medicare would be wise to negotiate with 2 or 3 hospitals throughout the Philippines for services to retirees so pricing was lower and it could pick up most of the cost. It would be a win-win for expats.
And I’m not sure I would pick st. Luke’s the way they handle fiancée shots – giving as few as possible for the fixed fee.
The problem with that is there would be no kickbacks to politicians from the healthcare industry I don’t ever see it happening, even if we could get those claiming to be fiscal conservatives to admit that it would be cheaper without calling a big bad unamerican idea.
Exactly. The insurance/Heath care companies rule in the US. They must profit or nothing will happen.
Example : The insurance companies only allowed +18 year old to remain on their parents policies because Obama agreed to the mandate.
St. Lukes hospital in Manilla is awesome. I would talk to them (before too late) and ask which insurance pays them the best. Get that. That’s my plan for living in Tagatay. My 401k is about 500k and I have some rental income, so I should build wealth while retired. Healthcare should be your #1 concern in retirement, and lifestyle second.
Hi Bob,
Have you applied for Philhealt Z-package? I think it covers up to 500k pesos for coronary artery bypass.
Hi Orlando. We found put about that around a week ago and ate going through the application process now.
That’s one reason I keep my S.S. and haven’t built but rented. Yes, it is up to everyone whether to rent or own.
Some pay off, or pay outright, their car. Nothing wrong as far as I’m concerned with doing either.
I’m just glad that I didn’t build. Found out there is a huge lack of water in our area. Before there was too much water. All of a sudden with el nino the surplus of water went south quickly.