Health Care in Nicaragua: A Hypochondriac’s Story

Nasty ant bites, swollen foot

Last September, I was hauling brush away from the beach, when I felt a strange tingling sensation. It started at my toes, and like a super charged lightning bolt, the sensation passed through my body to the top of my head. I began to itch like crazy, then my upper lip swelled and became numb, as if I had just received a shot of Novocaine.

Living on a tropical island, we have learned to take charge of our own health care. There is a hospital in Moyogalpa, the port town; however, I have been there with Marina, and I don’t want to return. EVER! Our workers, propped my foot on two cement blocks, and gave me a little cap full of…I think it was Benadryl…because I fell asleep upright on the only piece of furniture we had in our house at the time. (a purple plastic chair)

My foot swelled to the size of a small papaya and I was unable to put any weight on it for a week. I’m not one that likes to be incapacitated, so I began to research ant bites and allergic reactions. The locals know the insects, plants, and animals intimately. They all agreed that I had a horrible allergic reaction to ant bites.

Thank God for the internet! Once I determined the cause of my swelling and the treatment, I hobbled to the closest pharmacy armed with an array of new Spanish words..swollen foot, allergic reaction, numb upper lip, cortisone cream. Prescriptions are unheard of in Nicaragua. One only needs to discuss the symptoms with the pharmacist and the pharmacist will dispense one pill, or as many as one needs or can afford to buy.

Six years ago, Ron thought he had parasites. We went to a little shack…literally…where they had the only centrifuge in town. A man handed Ron a little plastic cup and said, “I need poo poo.” Then he directed him to the outhouse. As the centrifuge whirled the poo poo around and around, we waited patiently on the front porch, watching a long string of leaf cutter ants hauling their loot to their nests to make a fungus for the queen.

“Poo poo white,” he announced. “No parasites.” So, because of the white poo poo, he sent us to the pharmacy with a little scrap of paper that told the pharmacist what we needed to buy. All for the cost of one dollar.

Health care is cheap in Nicaragua. Even at the best hospital, Vivian Pellas Metropolitano, in Managua, expect to pay much, much less for all procedures. For example, a hip replacement in the USA is approximately $53,000. At Vivian Pellas, a hip replacement will cost $8,700… hidden costs. And, that price is without purchasing their insurance plan. With the Silver Insurance plan, take an extra 40% off the total cost of the hip replacement. I know you are wondering how much the insurance costs for Vivian Pellas….$26 a month!!!!

When we retired and moved to Nicaragua, we could have continued on our group health insurance, Cigna. However, the monthly cost of $500 would have been taken out of my tiny teaching pension check. Too young for Medicare ( which isn’t accepted in Nicaragua), and too poor to have $500 deducted from my pension, we really didn’t have any options. Before Vivian Pellas started to cater to expats, we had to take charge of our own health and care for our own aging bodies. Plus, we were at a disadvantage because of living on an island…with a one hour ferry ride to the mainland.

After my allergic reaction to the ant bites, I became a hypochondriac. Every sneeze, every ache, every insect bite, everything kind of out of the ordinary…I researched. Most of the little health issues were just due to an aging body. Yet, due to the fact that we are growing our own food, walking and swimming everyday, and always active, we are healthier than we have ever been before.

A retired RN lives close to us, now. I have become friends with a homeopathic doctor, who has a clinic in Moyogalpa. We found a great chiropractor in San Juan Del Sur, and an acupuncturist in Moyogalpa. Soon, we will have an airport a quarter of a mile away from our house. Should a medical emergency arise, we can hop on a flight to Managua for less than $50. Vivian Pellas hospital is getting better all the time, with international awards, U.S. trained doctors, and medical tourism programs.

Now, the only thing we have to worry about is health coverage in the states. Fortunately, we don’t return to the states often. But, when we do, the only health coverage we can get is on our car (stored in our garage back in the states). We upped the medical coverage for accidents in our car. So, if I break my leg, or anything else that requires immediate medical care, I have to do it in the car to be covered. What a shame! Health care in the USA is a mess. But, that’s another story for another day. A story I have no control over.

Here in Nicaragua, I have control over my own health, and a wonderful group of professional friends, and locals who can help us identify and treat the minor problems. If we need immediate medical attention, Vivian Pellas is only an hour’s flight away. What more could we want?





15 thoughts on “Health Care in Nicaragua: A Hypochondriac’s Story

  1. Greetings! I see that you briefly mentioned having found a great chiropractor in San Juan del Sur. I am in SJDS right now, taking part in a Spanish language immersion program. I work up in need of a chiropractor… Might you share the name of the person with whom you had good luck? Many, many thanks.

  2. Hello, I hope you still check this blog. I was wondering about the EpiPen you mention having in Nicaragua. Did you get a prescription for that filled there? I will be headed to Nicaragua with my children one of which is allergic to nuts and cashews being prevalent in Nicaragua I’m duly concerned. We always carry the EpiPen with us, but have been trying to figure out if we need to, can we get it refilled there. Best as I can tell, we can’t find it anywhere. Appreciate any advice/comments you might have.
    Thanks you

  3. You have an excellent web site! I joined last month, September 2011 when I read about you on Yahoo.

    Reading comments from your “internet neighbors” I am even more impressed. The accurate and honest discussions from you and the readers are helpful for those exploring transitions into retirement, like myself and wife. It’s like having good neighbors whom you meet while walking. The talks and sharing of tips reads as natural as if I was actually there.

    Your reactions to ant bites could just as easily happened to someone in California (where we are) in a visit to a remote part of Louisiana where the insects are “different”.

    Living in an island and buying/building your own home overseas is a big commitment. I’m “guessing” you initially rented in the larger cities with access to stores and theaters and other expats and libraries and explored the area for a year or two before making that choice. I’ll have to search your blogs of the last few years and see if I can find stories about that before you felt it was the “right thing” to do. I’ll have to quickly learn Spanish myself as I’m sure it helps a lot. My wife is fluent in Spanish so that helps.


    • Hi Steve,
      Thanks for the reply. Actually, it was a serendipitous moment that led us to Nicaragua and Ometepe Island. We had no desire to live in a big city. We’re country folks at heart. (Click on Gypsytoes to see how we ended up on the island.) When we first arrived on Ometepe Island in 2004, we were the only foreigners on this side of the island. Well, except for older expat. He got Dengue fever, almost died, and decided that island living was not for him, so he moved to Granada.
      How does one know that moving abroad is the right thing to do? Good question. I devoured travel essays, searching for answers. Should we move? Where should we move? What do I do with all of my ‘stuff” I’ve collected throughout a lifetime of living? I never found any answers in any books. It looks like another post is in order. Stay tuned. Thanks for giving me more food for thought. I love reading the comments I receive.

  4. Just to add one other thing (since I’m giving all this unsolicited advice :-)), I really would recommend you keep an Epi-pen (or some form of injectable epinephrine) on hand. Not to sound overly dramatic, but your next ant sting or bug bite could well not stop at just swollen lips! This is probably something you’ve already thought of, but you didn’t mention it so I thought nosy Sharon would!

      • Isn’t that the way it always is! Best-laid-plans and all that…
        BTW, I really enjoy your blog. It’s a good combination of your life on Ometepe, humorous anecdotes, and thought-provoking philosophical meanderings. Keep up the good work!

        I hear what you’re saying about the U.S. health care (sick care?) system in the U.S. But I can’t help but wonder if that $8,700 hip replacement isn’t just as far out of each for an average Nicaraguan as a $53,000 one would be for the average U.S. citizen. Or can the Nicaraguan get it free if they can’t afford it? (Of course, in actual fact, over half the medical care in the U.S. is already paid for by the government, so, yes, you can get it ‘free’ here too, despite what all the media outlets say.)

        You said:
        “There is a hospital in Moyogalpa, the port town; however, I have been there with Marina, and I don’t want to return. EVER!”

        Is that what a Nicaraguan would have to settle for if they can’t afford to pay? Or can’t afford to go to Managua. (Of course, the problem of accessibility exists in the rural U.S., too.)

        I don’t mean to sound like I’m challenging you on this, ’cause Lord knows, you can’t do what I do and not get frustrated with the whole complex payor system in the U.S.!! I’d just love to understand more about how it all works down there, and whether it really is ‘better,’ or if it just appears better because we’re looking at costs through a U.S. dollar lens.

        Thanks for your insights! (And I’ll shut up now, finally :-/)

        • Sharon, describing health care for the local Nicaraguan citizens is going to be another post. Their care is free, but not without many problems. I went with Marina to the local hospital because she had a lump in her breast…what an experience. I’ll write a post about the experience, soon. At the end of October, a young friend of ours is having a baby. She asked me to go with her to the hospital for the birth. Now, that will definitely be an experience to describe. 🙂

        • Can’t wait…love hearing about your thoughts and adventures! (Somebody else’s life is always way more exciting than your own 🙂 Of course, in your case, it really is!)

  5. Just so you know, you should be able to buy International Health coverage for when you travel to the U.S. I no longer sell it (just not a market big enough for me to bother with in my little agency) but here are some folks that are experts:

    I really would recommend your getting it when you are traveling to the U.S., where even an appendectomy could set you back $25 – 30k!

    • Thanks for the link, Sharon. I’ll check into it. We spent the summer in the states and we looked everywhere for a temporary health insurance policy. No one would sell us a temporary policy for less than 6 months. So, our only option was to increase the medical coverage on our auto insurance. I laughed because I said if I needed to have a hysterectomy, I would need to crash our car into a tree or something. Pitiful. Thank God I already had my appendix removed. State Farm has always been good to us. We can suspend our car insurance and pick it up at anytime. When our son was too old to be on our health insurance, he got State Farm.
      health insurance temporarily. Sounds like a plug for State Farm, but they have been wonderful to work with us on insurance needs, since we still have a house and a car in the states.
      Until we are both 65 years old, we’ll be in health insurance limbo when we return to the states. I really feel more comfortable in Nicaragua, which says a lot for the health care system in the states.

    • Yes, Rod. Things are improving in Nicaragua. We knew the risks we were taking when we moved to Ometepe Island. We brought a suture kit. syringes, and anesthetics in case of a bleeding emergency, good respiratory hospital masks, in case the volcano erupts, and lots of baby aspirin, for a blood thinner. We tried to think of every medical emergency we would encounter, so we have a well stocked medical box. Plus, before we lost our health insurance in the states, we had every test available and every injection and vaccine available. So far, so good. It’s one of the risks we take to live on a tropical island.

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