Medical Care in PR
Before we moved, we researched medical care and insurance in Puerto Rico. We read that doctors speak English but support staff does not, doctor offices and other medical facilities are scary looking from the outside but nice and modern on the inside, hospitals are modern and similar to the states but bring your own pillow and blanket, ambulances don't respond quickly or sometimes not at all, and be prepared to wait hours for an appointment (your appointment is at 9am and you'll see the doctor around 2pm). This is because once you're in with the doctor, you are not rushed and have all the time you want to speak with him or her. Puerto Rico has universal health care coverage for its residents, so insurance rates are low and coverage is great.
Jason receives health insurance coverage from his job, and I have to say the plan is affordable and offers great coverage. We have a $10 copay for a visit to the doctor's office, lab work is covered, and some of my prescriptions are 100% covered.
In Texas, our plan was incredibly expensive and we had a super high deductible, so we paid for everything out of pocket. $120 for a visit to the doctor's office, we paid 100% for lab work, and no coverage for prescriptions (until the deductible was met, which was never). Epi-pens were a nightmare - $600 for a 2-pack. The only good thing was that my Depo-Provera shot (birth control, but it's prescribed to me for migraines) was 100% covered under ObamaCare. I loved our doctor, but she was clearly on a strict time table and would watch her watch while I tried to quickly discuss everything I needed to cover.
We visited our new doctor in Isabela this week just to meet him and get prescriptions for our new insurance plan, and it was time for my next Depo shot. The office wasn't so scary from the outside - (It even has a parking lot! That's a big deal here.) - was clean and modern on the inside, and we only waited about 20 minutes. The staff definitely does not speak any English. Making the appointment over the phone was almost impossible - I had to look up some key words and phrases and spoke entirely in Spanish. The doctor was so incredibly nice and friendly and absolutely gave us all the time we wanted to ask questions. He even told us his favorite restaurants and favorite beaches for snorkeling and swimming. We asked about emergencies and he said call 911, but ambulances don't respond like in the states. Sometimes they arrive within minutes, sometimes in an hour, sometimes not at all. What about urgent care, after hours and on weekends? Isabela doesn't have a hospital, but it does have an ER facility in the middle of town. He said if they can't treat you they transfer you to a hospital nearby (about 30-45 minutes away). Noted - if something happens to person A, person B throws person A in the car and drives the 5 minutes to the ER in town. Got it.
Slight change in plans for the Depo shot. He does not have the medication on hand, I have to get it from the pharmacy, bring it back, and then he'll give me the injection. He also orders labs for me since it's been a year since my last physical. Cool. Turns out we have to go find a lab (they're all over the place) and get the work done there. The staff does not speak English, and we don't know how all of this lab business works. Thankfully, a woman in the waiting area overhears us and offers to translate for us. She gets directions to the nearest lab and we pay our $10 and off we go.
The lab looks totally scary from the outside. I hand the woman at the counter the paper from my doctor, and she looks really confused. Also she doesn't speak English. Her coworker speaks a little and my Spanish has improved greatly so we get everything figured out. I don't pay any money at the lab.
Next stop is the Walgreens. The pharmacist hands me my prescriptions and I notice that there's no Depo shot. Thankfully she speaks English and tells me it wasn't prescribed. She was kind enough to call the doctor's office for me (since I don't speak Spanish) and get it ordered. She then informs us that the shot is not covered by our insurance and that will be $200 please. I get this shot four times a year. $800 a year - that's more than my freaking Epi-pens! I ask her to switch it to the minipill (the pill form of Depo) and she has no idea what I'm talking about. Okay, so I'm gathering that birth control options in PR are few and far between. Shit. I hop on my phone and figure out the minipill brand names and YAY she recognizes one. Again she is kind enough to call and speak to the doctor to get the prescription changed and he agrees. And now the big question - how much is it going to cost me? Drum roll... it's 100% covered.
My Epi-pens are good until October, but when it's time to replace them they cost $450 here. Still outrageous. The CVS generic is $110. We'll be driving the 45 minutes to Hatillo to the nearest CVS.
Switching from humans to dogs: Lucy, our dachshund, is almost 13 years old and has really bad teeth. It was time for her teeth to be cleaned. We got vet recommendations from Jason's coworkers and had her dental work done in Aguadilla (about 30 minutes away). The office is a little scary from the outside, and the staff doesn't speak much English. The vet speaks English but with a strong accent. When I called to check on Lucy, I couldn't really get any information due to the language barrier. I'm used to my awesome vet in Texas calling me when she's awake from anesthesia and telling me they are loving all over her and she's fine and she'll be ready to go in a few hours. In PR, no phone call from the vet with any updates all day. I finally called and all I got was she's not ready yet, we'll call when she's ready. DAMMIT! Who's loving on her? Anyone? Is she okay? My anxiety did not appreciate this situation at all. Fortunately she was okay and we picked her up and after a few days of recovery she was her crazy-ass self. I should mention the vet bill was only $200. It would've been closer to $400 in Texas.
When it comes to medical care, are things different in Puerto Rico? You bet your ass. PR is a huge relief when it comes to cost of care, and the care we've received so far has been good. If we ever needed specialized care, we would have to travel to San Juan (about 2 hours), but that's just because it's our nearest big city. If we lived out in the country somewhere in the states, it would be the same. The biggest challenge seems to be emergency services, according to multiple sources (including our doctor) that's a total crap shoot. A bit worrisome, but not enough to make me want to move back. Have I mentioned we have an incredible ocean view? ;)