Questions about a possible move to Nicaragua

Submitted by ESV on 7 April, 2006 - 12:09.

My wife and I might be moving to Nicaragua within the next year. It is most likely that we would be there for just one or two years. I have two questions. 1) How do you handle health concerns in Nicaragua? Specifically, how is health insurance handled? Are there American - or American caliber - doctors in the country? 2) In Managua, what can one expect to pay for rent for a modest but comfortable house in a safe neighborhood?

Thank you.

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Recommendations!

Submitted by Martin on 22 October, 2006 - 20:07.

1. An American insurer (from Florida) that is now operating here is Amedex. If you have and insurance with them, don't worry when visiting known hospitals in the country because I hear they always answer quickly since they even have an office in Managua. Many nica doctors that had their offices in Miami for example have moved back to Nicaragua, many serve out of the Hospital Metropolitano. Other good private hospitals are the Bautista and the Salud Integral.

2. 400 to 600 dollars in a decent neighborhood for example; rental homes have gone down in some neighborhoods like Bolonia, 3-4 bedroom. But, it's harder to get a house with furniture and if you do, it'll probably be more expensive.

moving to nicaragua

Submitted by augietheman on 8 May, 2006 - 06:47.

Have been searching for my dream place to retire. Thought I found it in nica, but read the state dept. blurb which has strong warnings about malaria and dengue fever. These are no trifling diseases.How do the expats now living there deal with these problems??

state dept warnings

Submitted by elnido on 8 May, 2006 - 21:17.

Did you read the one about west nile disease? Oops, thats the US. Malaria and dengue also exist in the US. There are areas here that are more prone to those diseases. Use mosquito netting and bug spray, and/or stay away from areas with malaria and dengue. If there is an outbreak, take a vacation to another part of the country till it subsides. I've been here several years, not a problem. Others I know have come down with both diseases. They went to the doc, were diagnosed and cured. The docs here really know their stuff, especially about tropical ailments. I guarantee they can diagnose it in a snap.

Begin political soapbox: Ignore US State Dept warnings. They're like yellow journalism, sensationalistic and lacking depth. If you need further convincing, look up any country you, personally think or have first hand knowledge of, and be amazed at how dangerous it is (according to the state dept)!! End of political soapbox

state department warnings

Submitted by pieter on 22 October, 2006 - 19:30.

and warnings from foreign affairs canada seem to be designed to protect the warners from ever being accused of having missed any possible problem. if i stayed out of countries which foreign affairs suggest may be dangerous i would have to stay in canada. well maybe i could go to greenland. i should check that one out. i just checked out greenland. foreign affairs deems it a safe place to go.

now when i find my parka..........

oh and for you america lovers/bashers::: stay away from certain areas of certain cities at night. check out the hurricanses that may be on line in florida etc. and stay away from mississippi cause you might get a disease left over from hurricane whatever that fox news told us about. (i was in the phils at the time and fox news seemed to think that new orleans was the only place on earth.)

state department warnings

Submitted by pieter on 22 October, 2006 - 19:24.

and warnings from foreign affairs canada seem to be designed to protect the warners from ever being accused of having missed any possible problem. if i stayed out of countries which foreign affairs suggest may be dangerous i would have to stay in canada. well maybe i could go to greenland. i should check that one out. i just checked out greenland............ foreign affairs deems it a safe place to go.

now when i find my parka..........

oh and for you america lovers/bashers::: stay away from certain areas of certain cities at night. check out the hurricanses that may be on line in florida etc. and stay away from mississippi cause you might get a disease left over from hurricane whatever it was called that fox news told us about. (i was in the phils at the time and fox news seemed to think that new orleans was the only place on earth.)

West Nile

Submitted by Jose721 on 9 May, 2006 - 09:08.

Live in affluent area of Southern California, my buddy got sick last summer, 78th case of West Nile Virus in Riverside County, I told him he should have moved to Nicaragua! He was hospitalized for four months, almost died. I've been prudent in Central America, in 35 years only got one case of intestinal revenge after some Americans served us scrambled eggs that were on the table too long.

Local warnings too...

Submitted by no longer registered on 9 May, 2006 - 05:51.

Altho the MGA Embassy tries to do the "right" thing, the RSOs (Regional Security Officers) are still basically political animals. The warnings on travel to the Atlantic coast are a prime example of a security "issue" actually being a "political" issue -- brought to you by the DEA...

My personal preference when traveling to any new country is to read Foggy Bottom's drivel, then find in-country sources who can clarify the real-time situation on the ground.

As always, YMMV...

Disease Risk

Submitted by Jose721 on 8 May, 2006 - 10:18.

I have been travelling to Nicaragua for 16 years, no problem. Bring or buy a mosquito net. Last trip I was bitten everywhere the sun shined, other than the irritation, no problem. Away from the better restaurants, avoid vegetables with high water content, ie lettuce, that can carry bacteria into the edible parts. In the more impoverished areas, its not uncommon for someone to dump waste products in their gardens. Over the years, they become immune, an outsider might not fare so well. Bottom line, if you are prudent, don't worry. I have more concerns eating in downtown Los Angeles than Nicaragua.

We don't...

Submitted by no longer registered on 8 May, 2006 - 07:13.

Speaking for this ex-pat only, with 2+ years in-country, I never even think of malaria nor dengue, even when the zancudos are munching away on me...

Thought more of dengue on Maui than I do in Nicaragua.

FWIW

Simple Care

Submitted by sklopfer on 7 May, 2006 - 20:30.

Health insurance really drives up fees for everyone. It sounds like the "simple care" model (small $fee for services) is alive and working well in Nicaragua. We are also moving (hopefully to Granada) in the next few months. I need to find someone who can explain the licensing procedure for clinical psychologists. Anyone know where to go? Requirements? What to expect? Thanks, Susan

Professional Licensing...

Submitted by Jose721 on 8 May, 2006 - 10:50.

Each Department has an MD totally in charge of healthcare services. Your best bet is to locate that person and become their buddy. They can authorize practice by an outside practitioner. But like other postings have said, other than a few overstressed ex-pats, not a great market for psychologists.

Scarey thought ! .

Submitted by Willow on 7 May, 2006 - 23:17.

Hopefully you move to Nicaragua without expectations of people "needing" your services. To be blunt...I hope your services are not needed there...on site/in country. If any expats need help...I hope there will be a community/environment supportive enough to avoid paying for guidance. Sorry..that's my dream/manifestation. Willow

Bello Horizonte

Submitted by Miskito Alan on 7 May, 2006 - 12:10.

Miskito Alan &#174

In Managua, I would recommend barrio Bello Horizonte. Nice houses are available for around U$300/month. The houses usually have a garage and a security fence. Also, night watchmen patrol your area and check your house for a very small fee/month.

USA (America) fast foods such as "McD", "Pizza Hut", other great restaurants, and large supermarkets are in the neighborhood. "Dominoes" & "Pizza Hut" both deliver.

The barrio is also close to the airport, the major open-markets, and the other major shopping areas.

Housing and health care

Submitted by Jose721 on 7 May, 2006 - 11:42.

Look for housing outside of Managua, lots of availability, even brand new modest homes for about 25K. Lots of rentals, check bolsanica.com. Count on most,if not all, US health insurance to be invalid outside of US. I had a friend move to Nicaragua with health problems, he was admitted to the Vivian Pellas Hospital, they immediately diagnosed a problem undetected here in the US for three years, he ended up passing away, but his wife, who is an RN, commented that the care was excellent, in par with US. Cost $200.00 day with doctors, medicine, diagnostics, and room. If you don't have a chronic illness, don't worry too much. Like the other postings say, keep $1000.00 handy for emergencies, and you will be OK. If you really want some insurance coverage, check the internet for international coverages, pricey, does not cover pre-existing for the most part.

insurance and s'moore questions

Submitted by Billy Bob on 7 May, 2006 - 14:45.

I have an HMO in the states. Used it once in Mexico. (Pay cash and get receipt). Hmo took 3 months and I had to submit receipts twice for them to pay less than 50%. Better than nothing, especially because I had the HMO anyway and wasn't paying for foreign coverage. Good news: the Mexican (private) hospital treated me better than "my own" HMO!

Talked to my HMO recently about foreign travel. They said it's a 60/40 plan out of the area. I'll keep it for a couple of years because it covers preexisting conditions and covers me stateside. And a $1000 in travelers checks handy when in Nicaragua soulds like the plan. A nuisance that I can't get a bank account without a Cedula.

question 1: how good is the hospital in Esteli. Guidebook says it is new, south of town, donated by Spanish aid. Any good?

question 2: Any first hand info on hospitals in northern Nic? Madriz, Nueva Segovia?

Cuban angle sounds interesting. Do you think they take VA? jaja, couldn't resist. Brain fart: is there any VA stuff left in Panama from the colonial days?

SOME DAYS YER THE DAWG, SOME DAYS YER THE FIRE HYDRANT

Esteli Hospital

Submitted by Jose721 on 7 May, 2006 - 17:34.

The new one replaced the old one downtown, which I provided many donations of equipment and supplies. Poorly paid doctors, no supplies, you have to supply your own medications, the ER had patients on a morgue table. I understand that the new one is the same in a newer building. Doctors underpaid, no equipment, lacking supplies. There was a private 10 bed hospital across the street from the old building run by a local doctor, much cleaner and better equipped, I still would't put much faith in them fixing anything major. Most serious cases are moved to Managua, though I do remember the ambulance being stopped, robbed, and pushed over the side one night.

dang

Submitted by Billy Bob on 8 May, 2006 - 20:46.

Esteli on a bad day sounds like L.A. everyday! I'll give it a try anyway! SOME DAYS YER THE DAWG, SOME DAYS YER THE FIRE HYDRANT

LA Healthcare

Submitted by Jose721 on 9 May, 2006 - 09:16.

Here the average wait to be seen in the ER is 16 hours. You'll receive treatment that may keep you there another 16 hours. If you need a bed, you might lay in the ER hallway for a day or two. The best thing to do is to make friends of the Doctors in advance, since the Director runs the Department's (of Esteli) healthcare. Maybe a nice bottle of FDC once in a while.

Medical Advice

Submitted by nicaus on 8 April, 2006 - 02:05.

1. Do not live in Managua – unless you need medical help

2. Have $1,000.00 USA dollars to pay a hospital bill on hand

3. Do not eat at road side eateries if the Nicaraguans are not eating there

4. If you swerve to miss a dog on a motorcycle, hit a ditch and break your arm, leg and noise make sure you have a American missionary coming down with a school bus load of medical supplies for the local hospital to cover your charges. (Personal experience)

. If you swerve to miss a dog on a motorcycle, hit a ditch!

Submitted by Che Guevara on 8 April, 2006 - 08:24.

Hope you are fine. Do you know why the dog was on a motorcycle? Circus in town? In here (pointing to my head,) i'm already there! crawling through 500 yards.....

Dogs and motorcycles

Submitted by nicaus on 8 April, 2006 - 13:30.

I was on the bike, the dog was doing his dogly duty of barking at the wheels. I, being a great humanitarian did not want to injure my four legged friend so I swerved and hit the ditch. That was 20 years ago, I have recovered but I do not swerve any more.

Not too uncommon!

Submitted by Jose721 on 6 May, 2006 - 19:26.

I was driving south of Esteli on my way to Managua, a dog jumped out, I slowed down, and was hit by a sleepy Nicaragua, rear ending my truck. He almost went down the side of the mountain! We pulled him back on the road and towed him to the next town. Though he caused about $5000.00 in damage to my truck, he didn't have a pot to urinate in. I gave him $20.00 and wished him luck, since his car was heavily damaged. Later that day, at a meeting with the Interior Minister, they offered to go back, find him, and arrest him for damaging my truck. My insurance paid for repairs on my return to the US. BTW, I delivered a whole trailer full of supplies to the Esteli hospital.

that was a kind and gracious act,

Submitted by Che Guevara on 7 May, 2006 - 07:15.

so i tip my hat to you.

i used to swerve too,

Submitted by Che Guevara on 8 April, 2006 - 21:08.

but not anymore, too dangerous. sorry thought you were miskito alan, or would not have put up that terrible joke.

me too

Submitted by Billy Bob on 7 May, 2006 - 14:15.

I swerved years ago when the cow in Veracruz or some place hit my left-side rearview mirror. Last time I ever drove at night on a Mexican highway.

I thought I was being smart to follow a Mexican semi, thinking it would make a dandy cow-catcher at night. Wrong! My little six-banger didn't have a chance to keep up with the Mexican truck and I was left in the dark in the middle of "nowhere". Lesson learned.

SOME DAYS YER THE DAWG, SOME DAYS YER THE FIRE HYDRANT

MA / Nicaus

Submitted by nicaus on 9 April, 2006 - 20:31.

People get us confused at times.

I do not see it as a terrible joke, but the dog did.

I told him what you said and he and his other friends (20 of them) are coming over to your house to talk to you.

You will know its them because they will be in a 1972 VW Bug.

Life is too short JR, have fun.

Nicaus

life is too short and that's why i always try to have fun.

Submitted by Che Guevara on 9 April, 2006 - 21:13.

no, i don't, if i did i would already would have moved down there! i was worried MA and 20 of his friends are coming to get me. but then i reread your post and figured out it is the dog and 20 of his friends. i will get them the job at that circus. hope they don't mind a 10% agent's fee. Oh, i thought you were MA, because that story sounded like his.

Medications

Submitted by Pete on 8 April, 2006 - 07:35.

Hi I took Cealixs before getting on my flight to Managua. Now It seems I've been suffering from a listed side effect:

Contact your doctor or seek emergency medical attention for any erection that lasts longer than 4 hours. A sustained erection can damage the penls.

I just arrived and it's been about 4 1/2 hours. Should I try getting treated in Managua, how much will that cost. Do you think I sould get the next flight back to Miami? What about flying to Cuba for treatment. How much time do you think I have. John I think you wrote about having some kind of problem like this, did you go to Hospital Vivian Pellas? Was it the private section or pubic? Thank you.

No No No..sorry

Submitted by Willow on 7 May, 2006 - 23:24.

I am so sorry I am not yet in Nicaragua to correct your problem. Next time...in a few months...just call...and I will "arrange" help. You poor thing. OMG you a guys are just too much !!! I refuse to become offended....because....Heh heh.....I enjoy listening !!!! What a hoot !!!! I will change the names in the novel... Luv ya all, Willow

Natural works too......

Submitted by Willow on 9 April, 2006 - 12:34.

You woul'd get it if I spent days trying to explain.Male meopause is "cure" by these crazy drugs ??? NO....Natural aphrodesiacs REAlLY work.

n

Natural Aphrodisiac?

Submitted by Jose721 on 7 May, 2006 - 11:55.

"The best aphrodisiac for an old man is a young women."

Joke

Submitted by Pete on 9 April, 2006 - 12:37.

Willow, it was a joke.

Joke

Submitted by Willow on 10 April, 2006 - 11:24.

I know that ..Never Mind Rosanna Dana signing off

Health insurance

Submitted by Huehuete Bob on 7 April, 2006 - 18:50.

I havent seen any health insurance that covers Nicarague except the one I have through the SF Retirement system. the company is United Health Care, and it is international. You have to pay first and depending on the plan they can pay 85% and prescriptions are 5 or 10 dollars a month.

United Health Care

Submitted by Jose721 on 7 May, 2006 - 12:05.

This plan has been penalized many times for poor performance. They take your premium, but pays claims poorly.

Doctor visit costs

Submitted by fyl on 7 April, 2006 - 19:07.

They seem to run C$200-C$220 here. The most expensive was an ear, nose and throat specialist. Virtually everyone else (including the Vet) is C$200. My first dentist visit was a bit more (C$300, I think) but that included a cleaning and one X-ray.

I was also just told that for all the tests I am supposed to get to humor the government (don't bother asking) which included throat swab, uranalysis and a third one it would cost C$90.

Basically, this reminds me of when I was a kid and you "just went to the doctor". I think the prices are about the same too.

Worst case, if you need really excellent medical care, a trip to Cuba is like $300.

Cuban Medicine

Submitted by Miskito Alan on 8 April, 2006 - 04:11.

Miskito Alan &#174

I think that we need a Book Page or a Blog on this subject of medical treatment in Cuba. I think for this investigation that somebody should do this thing that has more skills in Spanish than my "Babble" skills.

Airplane fares, hotel rates, hospital costs, doctor's cost, treatment charges, and drug costs should be posted.

My wife's (Marisol) niece from Waspam is in her 5th(?) year of medical school in Cuba. I will check with Marisol for more details on this niece.

I have known quite a few people here from the Atlantic Coast who have been to Cuba and received medical treatment. My accountant/lawyer (Esteban Gamboa) studied in Havana for 2 years; but, I think that he drank more rum and partied than he studied.

Lets try to put some solid info together.

_________________________________________________________________

Good Idea !

Submitted by Willow on 10 April, 2006 - 12:29.

Just from gleaning info....right on. I'd love to do this "project" but my Spanish is kindergarten still. It's my field...and been through it all here in USA from good old days to hatchet HMOs. Did some basic research for papers on state of health services yada...that's when I realized how bad USA track record is (proved my gut feeling). High cost does not mean good outcome. Insurance compaies are a rip-off and most execs today are noting more han wallstreet highrollers. I have a basic philosophy...if you haven't held a dying person in your arms...nor had to wash up after being spewed with body fluids...or comforted parents of a dying child (there is no comfort)...or felt the high and thrill of working to utter exhaustion and saving a life...you don't belong running any health care institution nor deciding what to pay for. Insurance/HMOs gatekeepers.Well they pay very good salaries for nurses to do nothing but sit at computer . OK...off my soap box. Thanks for listening..and I will be looking into this subject. With both cost and care in mind...and few statistics to show I am not just "emotional'. ! Ampassionate...and good for me.

Health

Submitted by fyl on 7 April, 2006 - 13:05.

This is such a common question--answered so many times. Just search for "health" in the Search box.

health isnurance web site

Submitted by timetogo on 8 April, 2006 - 17:13.

Here is a website with international health insurance plans:

http://www.internationalplan.com

Groan

Submitted by fyl on 10 April, 2006 - 11:41.

If you can't stand the idea of personal responsibility, look into insurance thru INS in Costa Rica. That is the government agency that does insurance. The sane option would be to just get regular CR insurance which costs about $40/mo and clearly pays more than things will cost in Nicaragua.

But, they also offer an international option. For me it would have been about $200/mo and seemed to be about equivalent to the $300/mo plan I had in the U.S.

Groan ?

Submitted by Willow on 10 April, 2006 - 12:43.

Fly.. I don't understand ? This is insurance available to non-residents of Costa Rica ? INS...I will try and research this. Obviously you did and know the system. Seems unbelievable. When you talk about "international" insurance at US $300/month..that sounds like cover you anywhere (except USA of course). Yes ? Costa Rica has been said to have the best health services coverage in the world ??? I have looked at those international plans and think...same old hype. Could you please expand info on this $40/Costa Rican insurance ? I think self -responsibility is fine...but.....for $40/month...the average retiree could benefit greatly. As Medicare (USA)refuses to cover outside of US. Being addressed by Iternational Ex-Pat Organization...but...hello..we all know how that will go. We'll all die in the process of protest. Me...no more taking on the future...

Research, yes

Submitted by fyl on 6 May, 2006 - 19:57.

The $300/mo coverage is everywhere on the planet. So, that includes the US.

$40/mo is a lot of money. But, yes, I joined the plan when I was in Costa Rica. The coverage just says something like they pay 80% of the fees of approved providers and 70% of normal Costa Rica prices for other charges.

You would need to go to an INS office in Costa Rica to sign up but that's about it. The policy is designed for Costa Rica residents (even though coverage is international) so you will need to come up with a Costa Rica address.

When I had a policy it was thru Garrett and Associates. See http://www.segurosgarrett.com/ Their web site does have all the information and prices.

Business Opportunity?

Submitted by Jose721 on 7 May, 2006 - 11:47.

I've been a nurse for 35 years, mostly dealing with healthcare finance and insurance contracts. Maybe I can contract with Vivian Pellas Hospital for a package deal for ex-pat healthcare. I would have to calculate rates and risk. Anyone interested?

Already exists...

Submitted by no longer registered on 7 May, 2006 - 12:05.

They already have their own "branded" health care coverage available to all (resident, non-resident, Nica, ex-pat).

You can find the details here.

Note the discounts on services provided here.

Note the above links are in Spanish only.

Pretty decent for about $100 per year, eh??

I see it...

Submitted by Jose721 on 7 May, 2006 - 12:14.

I looked at their website and saw the various plans, notice several problems, rates and coordination of care with non-spanish speaking ex-pats. One of the first questions I get from potential retirees is the healthcare issue, because its on everybody's mind here. You'll notice that the hospital's website is only in Spanish. I will contact them for particulars. MediCare does not offer international coverage, if a senior is on a MediCare HMO, it is required to pay for emergency care anywhere. I also personally have an international evacuation plicy, $99.00/year, which will pay for critical care evacuation from anywhere in the world. If they can't evacuate within a certain time limit, they will send a specialist to the patient.

Personal experiences

Submitted by no longer registered on 7 May, 2006 - 12:32.

I have had extensive personal experience at Hospital Metropolitano, primarily with my baby (Alyson) who was severally burned (2d/3rd degree/24%) last September. I have been throughout this facility thrice-weekly over the course of several months.

Vivian Pellas personally funded the burn unit at "her" hospital and created the first and only accredited burn therapy unit in Central America. We have met on two occasions and my wife has Vivian's cell number. A truly remarkable woman.

Within the last 90 days, a NL member was visiting me in MGA and needed medical attention. We went to the ER at Hospital Metropolitano where we waited approximately 32 seconds for triage and maybe all of 2 minutes before being seen by a doctor, a PA, and an RN.

Over the course of the next 1.5 hours there were 5 different blood panels run, a urine test, a stool test and an IV administered. (note the test results took less than 1 hour) At no point was our NL member ever without at least the PA and the RN being at his side. The doctor (educated in Chile) spent approximately 45 minutes total with his patient. He spoke fair English but continually asked if the patient would prefer to have some other doctor more familiar with the language attend as well.

Long and short, our NL member (a pharmacist by training) was given extensive tests, had an IV, and better attention than he would have received in most US-based ERs. Cost? $71.

I don't really understand your "hang-up" about it being in "Spanish" only. Um, last I looked (like right now out my window), Nicaragua is a Spanish speaking country? Ex-pats who move here would benefit greatly from learning the native language, donchathink??

As to the medical plan, for me, paying less than $90 annually for coverage that offers significant discounts on medical care (at a HIGHER level of care than the US) is great, even if it is only offered in Spanish. Combine that with the fact that the cost of care is ABSURDLY LOW compared to the US. Throw in the fact that almost all pre-existing conditions (which I don't have unless we are talking mental health) are also covered, tho at a smaller discount.

Please tell me why this isn't one of the best deals going?

"Hang up?"

Submitted by Jose721 on 7 May, 2006 - 15:05.

I have no hangups, I speak fluent spanish, having travelled to Central America for 35 years. Don't be so quick to make assumptions. Just the average inquiring retiree who doesn't speak Spanish would be lost in searching for health care options. Its a great deal, but lets say you have to stay in the hospital for a couple of weeks, not unlikely for a senior, you are looking at 2 to 3 thousand dollars, for what is obviously great care, no question.

There are very successful hospitals in other parts of the world that cater to US citizens, everything from plastic surgery to heart transplants. They maintain websites in english, have fluent english speaking intermediaries, and are booked solid. A little entepreneurship by the hospital could have a positive effect.

Don't count on all technologies being available there, for example, my specialized equipment can only be checked in San Jose, so I'd have to go there every four months. Most hospitals here in the US can't monitor my equipment.

Its a deal, but only if more people are made aware of it.

My apologies

Submitted by no longer registered on 7 May, 2006 - 16:06.

I certainly did not mean to offend you. My badly made point was that just because the information about a great program is only available in Spanish doesn't diminish the value of the plan itself.

And the antecedent of the point is the numerous people who come to Latin America and speak next to zero Spanish and anticipate/expect/want the world to be laid out for them in English.

And if you look back almost five years, I spoke next to zero Spanish as well but knew that I had to learn it as quickly as possible for my OWN well-being.

We're scheduled to go to Hospital Metropolitano on Tuesday for the monthly check-up with Aly. I'll poke around and find out if they have any intentions of providing info on the program in English, OK?

Again, my apologies for any offense...

More personal experience

Submitted by elnido on 7 May, 2006 - 12:43.

I totally agree with Marty. Our experiences at Metropolitano Hosp have all been extremely positive. My wife and I both agree that the level of care was at least as good as the states (personally, I think it was much better). The costs basically came to what our CO-PAY would be from our incredibly expensive healthcare insurance in the states - which we have since cancelled. We were treated as patients, not bodies in a numbers game. I could go on and on, bottom line, you won't be disappointed.

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