Thursday, May 16, 2013

Navigating the Medical System

I actually started to think about this post quite a while ago but given that between the kids and I, we've been to the doctors countless times in the last few weeks, I thought it was long overdue.  What's it like to navigate the medical system with socialized medicine???  Well, it's great... overall... if you speak Spanish :)

But wait, that's not just it.  It actually IS great.  But I "think" it's because we have private insurance.  Here, everyone is entitled to medical care and it's free.  You need to have a medical card that is issued from the government to receive this free care.  We don't have these cards but could, if we wanted to, get them.

What's the benefit to having a medical card if I already have insurance?  Well, as I found out last year when I tried to go to a hospital just down the road from us... if you have insurance you can't go there.  What do you mean you ask?  Well, I went in, showed them my insurance card and they said, oh, you need to go to your insurance's (Sanitas) hospital.  If you come here, we have to charge you.

And so off I went with one more tiny bit of knowledge of how the system here works.  I now understand that there are approved hospitals, like the kids go to - Hospital de Nens (Childrens Hospital) for their appointments.  So while they are not a Sanitas Hospital, they are approved by our insurance company.  And my appointment for my bone scan today - was approved at another hospital because my insurance doesn't have a machine that does this at their hospital.

The fact that our insurance has their own hospitals and clinics is interesting in and of itself, but I also wanted to point out a couple of other things that are interesting here compared to back home.

Ease of Appointments
The kids and I are going home in August for vacation.  I made appointments for them and myself for the dentist and doctors (we go here as well but I like to cover my bases) for August back in February.  No joke, I got the only appointments available - more than 6 MONTHS in advance.  This is just ridiculous.

Last year I went to my gynecologist here for a regular annual exam.  She asked if I had had a baseline mammogram yet.  My response was no.  So she said, well, let's just do it right now.  And 30 minutes later I was getting my mammogram done.  No muss, no fuss.  Easily this would have been months to schedule an appointment at home.

With our Sanitas insurance we also have an English speaking customer service support team.  So when we want an appointment, we call them up and as long as it is within one of their hospitals or clinics, they will actually set the appointment up for you.  Never have I been asked if I have a referral for an orthopedist or an eye doctor from our primary care.  Never.  I called up today to make an appointment to review the results of my bone scan and she just said, what kind of doctor do you need an appointment with?  So easy!!!

On Time Appointments
This one is particularly important to me.  Doctor's offices that run on time!  Now they don't spend the same quality time with you as they might at home but I think other than one time, I have always been taken on time, if not early.  I remember our first dentist appointment for the boys... we arrived early and Aidan ended up needing a cavity filled and a tooth pulled.  All of this was done and completed BEFORE our scheduled appointment was even slated to begin!  Seriously, I kid you not.  Oh and this was before we had local insurance (at the time we only had global insurance where we would get reimbursed for our expenses) - so the whole appointment for a cleaning, tooth pulling and a cavity filling cost me something like 70 euro.  And that was WITHOUT the insurance.

Cost of Appointments
There is no co-pay here.  You make the appointment, go to the appointment, hand them your card and leave the appointment without paying a dime.  That's it.  The only time I have paid is when the kids needed shots that were only needed in the US and the shots cost me all of 60 euros and we only had to do it once.  I submitted it to my other insurance and all was good in the world.

Cost of Prescriptions and General Medication
This one will kill you guys.  First off, a side note that most veterinary medicine is the same as human medicine in different dosages.  Jake takes thyroid meds here that he would use at home but I get it at the regular pharmacy.  Unless it is specifically made for animals, there is no problem with pets using some human drugs here.  Jake's thyroid script used to cost me $80 a month at home.  Here it is 4 euros (no, I didn't forget a zero) per month.  Yes, FOUR EUROS.

The same goes for my birth control.  At home, my co-pay is $15 a month - so let's guess how much it would cost without the co-pay?  Here it is 15 euros without insurance (pharmacies don't take insurance, prescriptions are just paid as anything else would be) and it is considered to be on the expensive side.  I pay about 2 euros for a box of ibuprofen.  I paid less than 2 euros for eye drops for the boys for their upcoming eye appointments.  Rarely do I pay more than 5 euros for any prescription I have ever purchased here.

The point is, medicine here is beyond inexpensive which makes me wonder, if I'm using the same drugs as I was at home... why are they so expensive there and so inexpensive here?  Something to make you go hmmmmm.....

The Downside...
There really hasn't been a downside except I haven't figured out how to get myself a primary care physician.  But then, I do that at home so I haven't needed one.  The kids have one and that's most important to me.  The only other downside is that my Spanish isn't medical lingo fluent.  I've found in the last few weeks that it's much better than it used to be, but of course, when dealing with anything medical, especially with the kids, it's important for me to do it in my native tongue.  For example, the problem with my leg - I was told the doctor spoke English but he didn't.  But let's also remember, we live in Spain, so I can't set any expectations that the doctor would speak English here no more than I can expect every doctor at home to speak Spanish.  But it does certainly make navigating the system a little more difficult.

Anyways, those were just a few tidbits I thought I would throw out there since the medical system is on my mind...


No comments:

Post a Comment