Healthcare without insurance
When you get sick in Nicaragua you will experience what it was like in the era that predates insurance companies. During your time in Nicaragua you can glimpse for yourself a life where people can manage to pay out of pocket for their medical care expenses by having any modest savings or income.
While there do exist a few insurance companies in Nicaragua they are largely connected to an employment plan or a private hospital. Most Nicaraguans do not have health insurance, nor do they need it. What does this mean for you as an expat in Nicaragua?
You will have direct personal access to doctors, laboratories, pharmacies and hospitals that you would never dream of having back in your home country. You will pay them directly and you will be the intermediary between all of these parties. It will be inexpensive and liberating to see how a system works when the system gets out of the way.
I will give you an example to show you how accessible and unbureaucratic Nicaraguan health care really is.
Two days ago, we realized that Aiden had some kind of digestive issue that was not going to work itself out on its own. I stopped by a nearby laboratory and picked up a sterilized glass jar for Aiden to capture a stool specimen back home.
30 minutes later, I dropped off the sample at the lab and paid 170 cordoba ($5.60) for the lab to run general stool and cytology examinations. They told me that the lab results would be ready for me to pick in 3 hours. When I have I ever had this kind of direct contact with a lab in the United States?
Now these results belong to us and we can take them to any doctor that want. (Note that you can also start this process by visiting the doctor’s office first and he will send you to the lab with a list of exams to order, but you still pick them up yourself and can take them wherever you want.)
So we open the lab results and find that Aiden is suffering from a case of amoebas and so we travel over to our pediatrician’s office where we wait about 40 minutes to see Dr. Jose Correa Morales. We tell the doctor that Aiden has been suffering from diarrhea and hand him the lab results.
The doctor types in the results and the case into Aiden’s profile and gently gives Aiden a lecture about hand washing before he eats. Dr. Morales writes a prescription for a week’s worth of probiotics and anti-parasite medicine. We pay him 400 Cordoba ($13.30) and set out for the pharmacy to complete our journey.
We chose to go to La Praga pharmacy on Calle La Inmaculada but there is an enormous choice and healthy competition amongst pharmacies in Nicaragua. You will find them run out of your neighbor’s living room or something more elaborate with a dedicated building. The anti-parasite medicine at La Praga came to 99 cordoba ($3.30).
The probiotic on the other hand was well over $40, which is excessively expensive for what it is worth. I think that probiotics are still a kind of novelty item here and difficult to source. I declined to buy this item at the pharmacy because I order my own probiotics directly from the United States and we also had a fridge stocked with kombucha and Braggs Apple Cider Vinegar. I will talk about the necessity and ease by which these items are imported in another article!
Freedom lovers note: the prescription for the pharmacy stays with you even after it has been filled and in theory can be reused. Not that you need a prescription from a doctor in the first place! Had I known exactly what we needed (and I didn’t and wouldn’t presume particularly with a child), the pharmacy would have been equally happy to sell me the medicine without a doctor’s prescription.
So in a relatively short amount of time, our family was able to inexpensively resolve a health issue in a very personal and direct way.
Let’s take a look at those numbers:
I will continue to write about health care in Nicaragua because I know that many tourists and would-be residents want to understand what they are in for if they take the plunge to move to Nicaragua.
I know that many of you will ask what we plan to do if something catastrophic should happen, so stay posted for that article coming up!