This is a story of unexpectedly having to access medical treatment (which was exceptional, by the way), during our cruise down the coast to Mexico last fall. Like many other people, we had purchased medical insurance for our time in the US, but opted to pay as-we-go for our extended stay in Mexico. Our reasoning was that insurance packages are costly and focus on repatriation to non-existent BC medical services, or at the very best, considerable wait times. This approach also assumes you have a family doctor, which we do not.
Karen and I departed Victoria in mid-August in the company of our son, Michael. This was the culmination of several years of almost daily work and planning to prepare our boat, Next 1 and ourselves for the big left turn towards months of anticipated cruising in the Sea of Cortez. We made our way to San Francisco, where Michael left the boat to return to BC and work. The two of us continued our leisurely way down the California coast, with wonderful stops including Santa Cruz, Monterey, Morro Bay, the Channel Islands, Newport Beach and San Diego.
We were elated to reach Ensenada, Mexico in early October and berthed for the month at Cruiseport Village Marina, a most secure facility. Our intention was to re-group and re-provision while waiting out the last of the hurricane season, then proceed to Cabo San Lucas in early November.
It was here where the tide swept away our best-laid plans and we embarked on a most unwelcome and very rapid journey.
An Unwelcome Medical Journey
For a few weeks, I had noticed a bump in my right chest that was becoming rather sore to the touch. I felt that we should have it checked out before we found ourselves in some remote anchorage with it flaring up, so off we went to a local walk-in clinic. After a quick Google search of my symptoms, I had a horrible suspicion, so I typed “Possible male breast cancer?” on my phone’s Google Spanish translator and showed the startled doctor. He examined the area and immediately directed me to have some blood work and an ultrasound. It was Wednesday, October 25.
From here on, both Karen and I were amazed at how quickly things moved (as opposed to what we knew and had experienced from the BC medical system). We were equally impressed at both the quality and affordability of services we encountered.
Chronology of Events
- October 25 – Ultrasound and needle biopsy of the tumor. The biopsy was sent to a lab in Mexico City.
- October 26 – Blood work at lab.
- October 31 – The worst possible and devastating news: male breast cancer confirmed. This is an exceptionally rare occurrence … lucky me – NOT!
So our cruise south was suspended. Years of work and happy exploration suddenly ripped away. This was overwhelming to both of us.
- November 1 – We met with Dr. Maclovio, oncologist, who referred us to my surgeon, Dr. Quirarte.
- November 2 – CT Scan and consult with my surgeon.
- November 3 – Additional blood work and chest x-ray.
- November 6 – Consult with my anesthesiologist, Dr. Lopez, including an EKG.
- November 9 – Checked into a small private hospital and underwent a radical mastectomy to remove the tumor and lymph nodes.
- November 10 – Back to the boat.
Prior to my surgery, Karen and I had removed the head sail and completed other assorted chores and heavy-lifting to prepare Next 1 for months at the marina in our absence. In essence, we de-commissioned the boat. It was very hard to see the other boats and new friends leave the marina and continue their cruise while we stayed at dock.
Next 1, awaiting our return to Cruiseport Village Marina, Ensenada.
Post-Surgery
As I recovered from surgery, we made inroads to have me referred to BC Cancer. A friend of Karen’s searched the Internet and was able to source out Dr. Charles Lamb, a Victoria-based doctor who has established a website called cancerscreening.ca. Essentially, he takes on cancer patients who do not have a family doctor. Through video conferences with him, I was able to get the referral needed for timely post-surgery treatment with BC Cancer. We had the option to remain in Ensenada for potential chemotherapy or radiation treatments, which were available 4 to 5 weeks post-surgery. However, that would have entailed extra medical expense, in addition to renting an apartment ashore. Once given the OK to travel from my surgeon, and with the boat secured for our absence, we headed back to BC.
Post-surgery with Dr. Arturo Quirarte
Within days of our return to Victoria in mid-December, I received a call from BC Cancer and met with various health professionals at their facility. We’ve been most impressed with my treatment since then. In our view, BC health professionals/support staff are dedicated and exceptional, but they work within a broken system.
Lessons Learned
In terms of lessons learned, they are ongoing. The total cost for all the medical care I received in Mexico was approximately $8,000.00 CAD. Mostly we paid cash, but on occasion, Visa. The hospital was going to charge a 20% premium for using Visa, but the day of my ultrasound, their Visa machine was inoperative. E-transfers were not possible for us from a Canadian account to a Mexican or American account. The US bank account we’d set up prior to leaving did not permit E-transfers and our ATM daily limit on it was $500 USD. What would have been helpful was knowing how to access large amounts of cash from our BC accounts through local banks. What banks can you go into and get a cash advance on your credit card? At what cost and what is the daily limit? So, as a tip, I’d recommend that you meet with your bank manager to organize steps to access your funds, if needed, should you choose not to have medical insurance. We thought we had things sorted out by having a US bank account, but it seemed to fail us once we were in Mexico. All that being said, we learned for ourselves what other cruisers have stated before: health care in Mexico is of high quality.
Probably the biggest takeaway from this ordeal has been that we have the ability to cope with unforeseen circumstances.
I am in good health and Karen and I look forward to returning to Next 1 this October to resume our adventure. I am very grateful to the excellent health professionals in Mexico. They saved my life.
Currents PDFs
Dear Glen and Karen,
Thank you for your account of your medical emergency and your treatment in Mexico. We, too, had very good experiences accessing medical treatment when we were cruising, in Mexico, Guatemala, Germany, Tunisia, and Sicily. Like you, we had chosen to self-insure, even in the US where, fortunately, we had only a minor expense for Stephen’s torn knee miniscus. Like you, we had trouble paying in Tunisia for gall bladder surgery. Because of the $500 a day limit on our credit card, we couldn’t get Stephen released from hospital (IV still inserted). Eventually, I convinced the hospital to take the money from the credit card. In Germany, there was no problem, fortunately, because we were both hospitalized with amoebic abcesses and ran up a $6000 bill.
We are glad you have had good post-operative treatment and wish you Bon Voyage in October.
We have also had good experiences when needing health care in Mexico. Your article did not mention it, but did you submit your expenses to BC Health? We have been reimbursed for treatment up to the cost it would be back here, so usually 100%. We always request receipts and submit them once we get back home.
Hi Guys,
We did apply for reimbursement once back in BC. Karen did an exceptional job organizing all the receipts for our submission and we were able to recover some funds.
Cheers,
Glen
Hi Folks, so glad the treatment process worked out well! Re the matter of $$$, when we were out there during a circumnav, we had a good friend as our Biz Manager with access to our online banking. We knew of course that cash was always available from a credit card as a cash advance but at an astronomical interest rate. Thus when we had a need for cash we asked our Biz Manager to transfer X# of $ from Savings to our Credit Card then we hit up the local bank for a credit card advance which now had a positive balance. We never encountered a limit restriction and all such transactions were at no cost. This bypassed the complexity of an account transfer to a foreign bank.
I would add that we never explore what a limit might be for such a transaction but with a quick e-mail to our friend it always worked.
Thanks for this tip Hugh. This is a good strategy.
Cheers for now,
Glen
Hello Hugh,
This sounds like a great idea and when I read it, the thought came to me, “Couldn’t you simply make a payment from your bank account to your visa to put it in a positive position?”
In your case you were lucky to have a good friend who is your Biz Manager, but with the method above, one could easily do it themselves – relieving a lot of stress in the not knowing how to pay for something abroad.
Trusting there is no problem getting a cash advance from the visa in the other country, it seems that would be the easiest solution. Maybe worth checking out for future reference.
Cheers!
Bethanny
Hi Bethanny,
We were going to pay the hospital bill with VISA but they were going to charge a 20% extra fee for doing so. Unacceptable to us so our surgeon paid the bill and we reimbursed him.
Glen
Hi Glen,
Trusting surgeon! – things have a way of working out don’t they?!
Regarding the Visa, I was thinking more of getting a cash advance on your credit card, like Hugh had done at a local bank. In any event we will definitely check with our financial advisor before heading out of the country. Important information needed before traveling abroad – making assumptions about things can steer us down a path that is very unfamiliar. I’m glad it all worked out for you in the end.
Bethanny
Hi Bethanny, it worked well now some 20 years ago. At the time we did have on-board SSB digital email so a quick message to our friend with access to our Web Banking to for example “transfer $1k from savings to VISA” then next day with a positive balance withdraw say $500 with no fee or interest charge. Did this in places like Tonga, NZ, Australia, parts of Asia & Europe. Best, Hugh
Great article, and so pleased you got on that lump quickly.
On the money front, I’d highly recommend a Wise borderless bank account (formerly Transfer Wise). You can link it to your personal bank account and load it with almost any currency. The exchange rate is the bank-to-bank overnight lending rate, so it doesn’t get much cheaper than that. If you get their debit card you can pay with debit anywhere in any country. I have triple citizenship and use it for moving money quickly between 3 countries.
https://wise.com/us/. Check it out.
Thank you for this Christine. Excellent food for thought. We’ll check this out.
Cheers,
Glen
Thank you for this look at how unexpectedly stuff can happen and how you rose to the occasion to make the best decisions for your situation. The story should teach dreamers that there may be unforeseen challenges to meet, even for sailors like you who have diligently prepared, and that the challenges will alter your plans but the dream can survive.
It’s great as well to see this story prompt the discussions regarding health care abroad and related finances.
Well done Glen and Karen and Happy Sails in October
Thanks for this Al and cheers to you. Karen and I are really looking forward to our return to Next 1.
Thank you for posting your story, Glen! I am so glad to hear you were able to receive great medical attention in Mexico and that your story has a positive ending – temporarily, being the middle of it – you and Karen are off to continue your journey in October – hoping the worst is behind you. You two have been amazing troopers in all of this – Congratulations! I wish you much success in your travels. You both deserve it!
Hugh Bacon,
Hi. We are in Mexico and about to have some expensive dental work done. The dental office charges a 4% Visa card fee. I front end loaded our Visa card in an attempt to avoid the cash advance and user fees. Visited two local banks but in order access a cash (pesos) advance I was directed to use the ATM machine credit card option. In addition to a nominal ATM service charge, there is a transaction fee (somewhere between 2.5 – 7%) . As I understood it, you did not experience a limit or service transaction fee. Have I got that right ? Thanks,
Glen Middleton
That is correct Glen but all of our transactions where in the Pacific, Australia and Asia plus it was 20 years back. I ended up doing this because at the time particularly in Tonga they had no ATMs. Later in Australia and beyond ATMs were available but were limited to Credit Cards.
Hi and sorry to hear about your dental work.
We’ve discovered that front end loading your credit card really doesn’t help. We have a large VISA credit limit but for us the problem was accessing it. In our situation we clarified that the hospital took VISA but we only learned later through having our marina office call them that they charged a 20% fee.
For us we had a friend that Karen had worked with who lived in Ensenada lend us $5000.00 cash and we reimbursed her via wire transfer from our RBC account to her US account.
Looking back we could have gone the ATM withdrawal route, with each of us taking out the daily maximum and continue to do so over several days. We found that we couldn’t wire money from our Canadian or US accounts to doctors or hospitals in Ensenada.
So, to simplify your situation, you could use your credit card and eat the 4% fee. It seems that there will always be steep ATM withdrawal fees.
Best of luck with your dental work.
Glen
Thanks all for the info. On top of whatever user fee an institution might have (dental office I am using adds 4%) Visa charges an additional Foreign Currency Fee of 2.5%. This fee is contained within the Foreign Exchange Rate so does not appear as a separate line item charge. These fees add up, but there does not appear to be a work around. We are commuter cruisers spending about 5 months each winter cruising up and down the Mexico Pacific coast. So our plan is to try and park the credit and debit cards (3.5% user fee) and bring down an extra suitcase full of pesos. This nice warm weather costs money! We carry high deductible medical insurance.
As someone who moves frequently between countries I find the only solution is to get an international borderless bank account through Wise (formerly Transferwise). You can keep balances in many currencies like pesos and link them to your bank account. The exchange rate is the bank-to-bank overnight lending rate (the best possible exchange rate). I would suggest you look into this and get their physical debit card as you can’t use your phone to pay everywhere. You can also pay bills in foreign countries by obtaining their banking details.
Michael Goodman New West . The Henry G. 52 ft Tayana, I am staying close to the coves in home and native land
Friends Wise has been in the news recently, Beware”
https://www.expatforum.com/threads/anyone-else-having-problems-with-wise.1546417/
posted 11 month of 2023,
I’ve been using Wise for several months through my credit union to send funds to the checking account in France that we use to pay expenses for the house. It worked great until this month. Last night I noticed the French account has not received the last two transfers. Going back to the credit union app, it showed the transfers dated 3 October and 9 October were “refunded”, although my credit union balance has not been updated with the refund. (Supposedly it takes 5-10 business days to do this—fingers crossed!)
Then this message started popping up periodically:
“We’re currently experiencing delays with some Wise transfers if further verification is required. Wise is unable to notify members about the necessary verification and [my financial institution] is unable to view the delayed transactions. Wise is actively working to resolve the issue, however if you have an urgent wire please use our normal International Wire Transfer process.”
So it’s not working, and there are NO NOTIFICATIONS to that effect. Right now I’m jumping through the usual hoops to get funds to the French account asap via other methods, but I’m wondering if anyone else has had this problem or similar. Also, has something changed recently related to “further verification is required”?
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Hi Michael! Sorry to hear of your troubles with WISE. We used our WISE card extensively in France and Croatia this fall without any problem. We regularly transfered funds from our Canadian bank to our WISE CDN account (it took a couple of days to go through so we had to plan for that) and then moved the funds / did the currency conversion from there to the WISE Euro account. We last used it at the end of October, so perhaps something has changed since then, but overall we were very happy with the card and the minimal fees. I seem to recall we had to provide photo ID when we set up the WISE card but the whole process was smooth and fast. Hope you get things straightened out soon!