I am doing a prelim on retiring to Bonaire. Among many questions is the availability and cost of health care. Have any BT members from the United States moved to Bonaire and resolved this problem, and if so, how? Thanks for any help.

Try a keyword search for 'health insurance' etc. I've cut/paste an old answer of mine to a similar question from a 12/2002 posting:

If you have health insurance coverage in the US, do not ever cancel it or let it lapse--keep it even if you live here (Bonaire), in case you need to go back to the US for treatment, specialists, prescriptions.... (and save money for flights, an ambulance flight from here to Miami is about $10k). Our health care is very reasonable, compared to the US, but also limited (and insurance companies here also have exclusions for pre-exisiting conditions, or may refuse to accept you as a client, etc). Blood/lab work and medications can run into the hundreds easily though.

For example, we have no specialists on the island-so if you need to see an orthopedic dr, etc, you must fly to Curacao, or wait until he comes to Bonaire (few times/month/appts scarce-usually reserved for those on national health care plan "SVB"). With local health care coverage, your plane ticket & dr. appt in Curacao would be covered. But not any other expenses, like car-rental, taxi, etc. If you need to be in the big hospital in Curacao (St. Elizabeth's), only the first class rooms have a/c (and these are limited). There are smaller hospitals/clinics in Curacao with nicer rooms (with a/c), but not all surgeries are possible in these. And not everyone speaks English. Also, the latest drugs are not approved/available here until years after they're available in the US.

You must really consider your health situation carefully, and try to predict the future. Ask yourself, if the worst happened, and I had no insurance to go back to in the US, would I want to be put into a long-term care facility here (where few if any would speak English), or in the US?

There's an awful lot to consider, especially the part about not canceling your policies in the US (only because they may not take you back in the future, or only at very high rates & exclusions).

Unfortunately, I speak from much experience above, but also have been lucky to have received excellent care both here and in Curacao.

You need to define 'health care' for yourself & decide what you're willing to settle for. If you think you'll need the EMT truck with the defib. paddles & technichians yelling 'clear' as they jumpstart your heart on the way to the hospital, this is where you have to remember that our hospital keeps doctors on call, not on staff, (i.e. there's not always a doctor at the one hospital).

I have happily had the same insurance agent for the 13 years I've lived here (an American living here too-she represents local insurance companies from whom you'd purchase a health insurance policy)--you may contact me directly if you wish me to forward your info.

I also feel the system here does not handle wellness or preventative care. I would still suggest you have your physicals and regular tests that you might have every couple years done in the states.

Ms. Van Tilburg: Thank you so much for your very informative response. It gives me my first good grasp of the health care situation there. I am much interested in contacting your insurance agent in order to get an idea of health insurance costs. My wife and I will be there for three weeks in early May, when we will be able to explore the issue in more depth. Thanks again for your help. Ron Myers

Her name is Valarie, and she works, representing several insurance companies, out of MCB (Maduro & Curiel's Bank), which has branches in town & at Sand Dollar. I'm sure you'll be able to see her while you're here next May. Her office is in the Sand Dollar branch.

Hi All,

We're finally moving to Bonaire for good..
As a resident, am I entitled to local heath care / and at what cost.
Also, I assume State Side Med Insurance isn't good there anyway... correct?

Thanks,

Brian & Phyllis

Depends on your carrier, I've put in bills from Bonaire. Obviously, your HMO is not going to work there though, you need to have a PPO or similar.

Local health care is paid by your employer. Medium to low salary gets you SVB. This is what my family uses. It is much like an HMO in use. No co-pays, you have a specific doctor you go to that must do referrals for specialists. Most medicine is entirely covered so you just pick it up free at the pharmacy (Botica) even OTC cold meds if your doctor writes a scrip. Emergency care is completely covered. Surgeries and specialists are mostly on Curacao. We don't have facilities for cancer treatment or dialysis. You are covered in the Netherlands Antilles only, although you can get a written permission if you are visiting Aruba or Holland, I believe, to extend coverage.

If you have a high salary, your employer pays extra for the "private" insurance. You can get the SVB insurance. I don't know how this works since I don't have it. Probably Fatum, Ennia, or even MCB bank would be able to answer questions about health insurance separate from a job.

So as an American, I also have "US citizen residing in a foreign country" coverage issued through my company. It has a high deductible but covers my travels in the rest of the world and also I can get treatment in the US. This one is more a PPO style with preferred doctors but service anyway just at higher co-pays. If you had something like this, you pay for local treatments and get reimbursed by insurance.

By American standards, the doctor fees are very cheap here. US$20 for a visit. Even emergency care is cheap.

Thank you for the great information. I'll look into the SVB and see if I qualify.

$20 per visit seems really fair considering the doctors here wouldn't even let you take up space in their waiting rooms for less than $100.

Thanks

Brian & Phyllis

You'll qualify for SVB if your gross salary is less than fls 3.800/month (although that rate might be raised slightly-SVB hasn't come out with the 2004 salary-limit yet). And, also consider that SVB and private insurance companies here will exclude pre-existing conditions, and may refuse you entirely, say if there's something you can't hide--like a great big scar down your chest from previous heart problems, etc. Once you're denied by one insurance here, the others may/will also deny coverage. Employers are not obligated to provide private insurance if you're over the salary limit--that's up to the company. SVB patients having hospital stays are put in a general ward; here the hospital is not so bad (2-4/room, some w/no a/c); in Curacao, there are up to 8-16/ward, no a/c). It's definitely worth it if you have SVB, to purchase an SVB "Upgrade" from a private insurance co-this will allow for room/care upgrades if a hospital stay becomes necessary. It's fine here as long as you really don't get too sick. Be very careful before you cancel any of your current policies.

Also, FYI--your specialist/doctor gets paid differently depending upon your insurance coverage. If you are an SVB patient (and get surgery/go in hospital), the doctor receives only a minimum fee. If you're privately insured, they get paid more. Although a lot won't like to hear it, this does make a difference in the amount of attention you get, sometimes.

The rules of SVB are evolving and becoming more "Americanized" (read: the least they can get away with providing/covering they will). I doubt you can get coverage from them if you're just retiring here (but I may be wrong).

Can I get an answer to these questions?

1. Bonaire seems to belong the Netherlands. The Netherlands are part of the European Community (EU). Does that mean that Bonaire is part of the EU?

2. All citizens in the EU are entitled to get the same medical aid as they can get in their own country when visiting another EU country. Is that applicable when a EU citizen for example someone from Sweden) visits Bonaire?

3. all EU citizens are free to move to and work in another EU country provided that they can get a job and find a home. Is that applicable on Bonaire?

4. If so all Bonairians are welcome to Sweden and enjoy clean fresh air, mighty woods and wonderful lakes and friendly people. Anyone interested to stay in (and watch) our home during the six months when we will be on your beautiful island?

Thank you in advance for your answer and "SKÅL" which is what we say when we make a toast before having a drink among friends! But please do not jump into the conclusion that we intend to drink so much that we need medical care after that!

Bonaire is not part of the EU. Bonaire is part of the Dutch Kingdom under the country the Netherlands Antilles.

So that would be a "no" to questions 1-3. And let me guess, the six months in Sweden would be Oct-April-ish? Uh, no thanks! We can talk about August or September though...

Hi Ruth!

Thanks for your answers! I would not dream of to let a Bonairian go through the dark period of Oct-April in Sweden. Imagine a temperature of 2 to 25 degrees Celsius below zero and daylight only a few hours per day..

Sure I will be on Bonaire during this time. But I will also be there during the month of June and July. During these months Sweden is one of the most beautiful places in Europe! The temperature is almost like in Bonaire at this time and it's daylight almost all the time. Have a look at www.visit-sweden.com/ and you will rush to book a flight...

I am on Bonaire during this time because it's vacation time in Sweden and all of our friends can come over and pay us a visit.

Sooo, what do you say???? June or July or both months?

If I don't get to South America to ski next summer, I might take you up on that. I definitely agree, Sweden is very beautiful, even in the months of February & March, when I've visited (it was so cold I thought my face was going to fall off!).