In preparation for my move to Bonaire from NC in the US, the only medical insurance I've been able to get quoted to replace Medicare has been from IMG. The quote seems to be priced as if they were going to have to pay out at US levels.

What are normal medical costs on the island? How much does an annual physical cost? Or an ordinary visit to a doctor's office? A trip to the emergency room? An average overnight stay in the hospital?

Are medicines priced at US levels, European levels or 'other?'

Many thanks for the help.

A doctor's appointment is Nafl 35 or US$20.

Emergency room was about Nafl 50 plus medicines, etc. (Not anywhere near US prices. I took Bas to the outpatient clinic in NH in January and it was US$200 just to see a doctor.)

Medicines are covered completely by our local insurance so the doctor's even write scrips for cough medicine and bandaids. So I have no idea what they cost.

Linda,

Thanks for the quick reply. The price levels seem 'more like it.'

Is the local insurance to which you referred employer provided or did you get it yourself? If the latter, could you provide contact info?

Many thanks.

Pete

SVB Bonaire, our national 'hmo' is provided by your employer if your salary is less than fls 3,800/month. It includes Rx's, dr. visits, 3rd class hospital room (as in big general ward with no a/c) etc. If you don't have insurance & have to pay, name brand drugs & lab visits are expensive, almost near US level prices. And not all the latest drugs are here. I'm still waiting for Immitrex.

Private insurance is also available, but unless you're moving here for life, you shouldn't give up your US insurance, as you may never get it back. I wrote more about this before-I forget where, but search for 'insurance' and you should find it.

I will e-mail my agent's info to you directly.

Ruth,

SVB Bonaire sounds great! Is there a pool plan for people who are retired and/or privately employed (as in owning and managing rental properties) or do you have to be employed by someone else?

I'm retired and US Medicare doesn't cover out of country so it's either private insurance or 'self ' (ie no) insurance.' And I do hope the move is 'for life!'

I appreciate your emailing info on your agent to me. Many thanks.

Pete

Pete,

I'm pretty sure (based on all the forms I have) that SVB only covers workers and their families. If you have an N.V. (corporation) here on Bonaire, you could pay yourself a salary and get SVB coverage that way (the SVB premium is about 10% of the gross salary, incidentally, for non-dangerous activities - much higher for construction workers, etc., as SVB has a disability component). But, as someone who has IMG insurance in the U.S. as well, I agree with Ruth - don't try to do it on SVB or local insurance alone. The health care here isn't bad, but it's very general - if you need a specialist or catastrophic care you're much better off in the U.S., but it can be really expensive without any insurance (and SVB only covers claims in the Antilles, not in the U.S.).

Jake

Jake,

This is really interesting. Quality basic health care is going to be good enough for us (we think). That's all I really expected to use Medicare for. Medicine is too overly specialized in this part of the US for me.

I am going to talk to an accountant when I go down to look at properties, and will inquire further about this. But wouldn't it seem to make sense (if allowable) to set up an NV to own rental property we might buy to replace the rentals we own up here? I wonder how small a salary would stand up. One place we are thinking of looking at grosses about 45-50,000 NAF. If the NV paid me a management fee of 5000 NAF, would I really get SVB for 500 NAF a year?!? I wonder what the additional cost to that corporation would be in order to effect that..

Thanks very much for this extra input.

Pete

I've been told that NAF 1000/month is pretty much the minimum a managing director of an N.V. can pay themselves (if they pay themselves at all). Mind you, you then need to get a work permit, and that's a hassle (doable, and probably worth it, but a hassle to get going and hassle to renew every year). Plus, once an NV has employees, you have all sorts of other fun paperwork to fill out every month. Definitely talk to an accountant here.

Jake

Jake, Yeah,

I get it. but good to know.

Pete

Linda,

Was that 35 NAF doctor visit cost a co-pay under insurance or the total cost for the visit?

If it was an insurance deal, what was the local company f not SVB?

Many thanks,

Pete

Pete, that was the total cost for the visit.

Jake

Jake,

That's great! As Linda pointed out ---10% of what a trip to the doc's costs here.

Thanks,

Pete

Pete: Just read your questions re medical insurance. Last December 19th I asked some questions re the same and had responses from both Jake and Ruth, both of which were very informative. Michael Gaynor also had a comment. Take a look at EVERYTHING ELSE BONAIRE under Tax Question - dated 12/21. Carol

Carol,

Thank you. Will do.

Pete

FYI, 60 Celebrex (200mg) costs US$100.

Ruth,

Hmm. I thought the only place Big Pharma did its gouging was in the US. Silly me.

(Actually I don't know what Celebrex costs in the US. To date I've only used doctor sample handouts.)

Pete

Pete:

60 200mg celebrex is $179.90 here in the U.S. I take them, but fortunately have good health insurance that pays 80%.

Carol

Carol,

Well then, $100 would be a 'bargain' for those of us who don't have that good medical insurance. Now, if prescription coverage ever became covered under Medicare.... No, too much to hope for.

Before my wife Peggy passed away, we were paying between $8,000-10,000 a year for medicines she needed but which of course Medicare did not cover. What a system!

(I'm a believer that basic health care should be available to all, like public education (but funded differently). More power to those who can afford better, but basic health services should be a right, not a privilege.)

Oh well.

Pete

Pete: Isn't it disturbing that the most powerful, wealthiest country in the world cannot provide a decent basic health insurance program for it's citizens. Aah, politics. Oops, maybe I should keep my mouth shut! Carol

By the way, Pete, best wishes to you and your daughters on your move to Bonaire. I know it will be for "life." Fantastic little island isn't it. I'm green with envy. We're not scheduled to go again until next year. Much too long a wait. Carol

Carol,

The national inability or lack of will to address a social need like universal medical care is but one of the many reasons why we are pulling out of the good ol' US of A. Don't get me started on preemptive strikes and unilateralism.

With some luck, we'll be 'in residence' by the time you get down next year.

Pete

Pete: Read an article in The Bonaire Reporter (online), Page 2 re availability of Worldwide Medical Insurance for U.S. citizens (ages 19 to 74). Don't know if you subscribe to this or not. In the event you don't, the contact is Hugo Leter at 717-4101 or hujode@bonairelive.com. Seems like this is something new in cooperation with USA Medical Services. Carol

Carol,

Thanks. I'll try to check it out. That age range reference makes it sound like it might be IMG. Their rates for my age bracket (soon to be 68) are in the 6000-7000 USD range (ie, ten times Medicare's premium level).

If so, I'll probably be ahead of the game paying for regular care locally out of pocket and going back to the States for something really serious to be covered under Medicare.

Pete