Review of WEA International Health Insurance


I want to give you a quick update on our WEA International Health Insurance. In 2015, we explored options for Health Insurance coverage in Nicaragua. See my post below:

Part One: Let’s Get Real about Health Insurance in Nicaragua

After much research, we opted for WEA Signature Plan excluding coverage in the United States. See my post below:

Part Two: Let’s Get Real About Expat Health Insurance

We have now completed two years with WEA Signature Plan and are currently renewing for our third year and this is what I have learned.

1. Deductibles
Each year, as we move into a different age bracket, the cost rises, like all health insurance. We counteract the rising cost by increasing our deductible. Our first year, our deductible was $250. Our second year, our deductible was $1,000. This renewal year since we both have moved into a different age bracket, our deductible is $2,500.

Living in Nicaragua, the cost of procedures and hospital care is much less, thus we pay out of pocket for small procedures and apply them to our deductible.

2. Claims
Our second year with WEA ( Nov. 2016-Nov. 2017) was the first time I had to file claims. I had two eye operations at Vivian Pellas Hospital in Managua with a wonderfully competent retina specialist, Dr. Juan Rivers.

After each operation I filed the necessary documents they requested. My first surgery was considered an emergency, so I did not have to be pre-approved. My second surgery, I requested approval and received it before the operation.

Filing the documents was very simple. I took pictures of all the documents provided by Dr. Rivers, including receipts of the costs of the operations. Then, I attached them to an email to the claims department.

I received instant notification that they received my documents and was assured that they would contact me if they needed additional information. So far, so good.

Then, I waited and waited. They say that all claims will be processed within 22 days of receipt. However, that was not the case. I began to worry when we got closer to our renewal date of Nov. 7th because how could we renew and why would we renew if my claims were not approved.

The closer we got to the renewal date, the more I panicked. I sent emails every day to the claims department. Finally, with the help of Robert Tillotson, the Offshore Health Benefits, LTD and my awesome agent, my claims were processed a day before our renewal.

3. Reimbursement

All of my claims were approved and I received almost total reimbursement for everything, except for my initial exam. My exam cost $220, and I was reimbursed for $70 because I had exceeded the maximum benefit for my policy.

My first reimbursement check was sent to my house in the states. All other reimbursement checks are deposited into my bank account.

4. Customer Service

Except for the lateness of my claims, they were efficient, polite, and responsive to my inquiries. If they were not in the office, they responded with an auto message email that said they had received my email. I think the claims department needs  some encouragement to respond to their customer’s requests, but then I had Robert that pushed them into action. Thank you so much Robert!

I know many people interested in getting WEA Signature International Health Insurance asked me about the claims process. Now, I can respond with my assurances that viable and documented claims will be reimbursed, but not with speed! You must keep on top of them.

Overall, I am pleased with their service and grateful to have insurance that can be used in 182 countries, excluding the U.S.

 

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Building Our Way to Hell?


“Excessive gentrification destroys the biodiversity and ecosystem of a community.” ― Khang Kijarro Nguyen

We are in the process of big renovations to our house: a new roof, drop ceilings, repainting, new electrical wiring…the works. It is long past due, however I wonder what our neighbors think? Are they upset or jealous or angry that we have the money for renovations to our house? Do they resent us because they live beside “rich” foreigners?  Will we be less accepted because we may be perceived as flaunting our “wealth”? Are we flaunting, taunting, or demonstrating that we are better people because we are not living in poverty? Do we want to live like Nicas?

The big bad G-word is gentrification. By definition it is the process of renovating and improving a house so that it conforms to middle-class taste, or since we live abroad…to gringo taste. Although gentrification is a term applied to urban areas, I believe extreme gentrification can be used to demonstrate “building our way to hell” all over the urban, rural, underdeveloped and developed world.

I don’t like the words extreme gentrification because it has a bad connotation. Instead, I prefer integration. The difference is that we have integrated into our all-Spanish speaking community. We have simply moved from one place to another. Extreme gentrification on the other hand, is kicking poor people out and replacing them with rich people.

Gentrification is happening, especially in the coastal towns and colonial cities in Nicaragua.   And some areas have experienced extreme gentrification. Some cities are suffering with growing tourism and no regulations for short-term rentals. Rent prices are completely unaffordable for the average Nicaraguan. Landlords are evicting people to start touristic businesses everyday, and land speculators are buying land for peanuts that has been in families for generations and then selling outrageously expensive housing compounds to foreigners forcing the local people to move to the outskirts of cities or towns.

Extreme gentrification is happening in cities all over the world. Take a look at some of the major cities throughout the world where the G-word is a bad word. “We are building our way to hell”: tales of gentrification around the world.

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Love Your Country or Leave It?


“Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
― Mark Twain

Usually one of the first questions I am asked about being an expat besides the “What do you do in Nicaragua?” or “Are you a missionary?” is “Why did you leave America?”

My response is that I never left America. I am still here. I live in Central America. If that doesn’t piss them off, then I could say that I am a political refugee from the Divided States of America. But, I never say that because first, it is a lie, and second, I love my homeland and I really don’t like to create tension or controversy unless it is a last resort. I am a mediator at heart, I seek peace.

So, when angry people respond to me in a political discussion, “Love it, or leave it!” what is the appropriate response? Why is it that expats are seen as less patriotic than those who stayed in their home country? Can expats be patriotic? If so, how?

Photo credit to Larry Wilkinson

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Can Expats Live Without These Things?


“If all you do is think about what you need, you’re no better than an animal in the woods, and no smarter either. To be human, you’ve got to want. It makes you smarter and stronger.”
― Dan Groat

Ron is always telling me I want too much. But, I agree that to want makes me human. It makes me smarter and stronger.  I remember the argument we had about buying an oven when we moved to Nicaragua. We both like to bake, so why was it so difficult to convince him that I wanted an oven?

Now, I do understand the difference between wants and needs. Yet, as an expat there are 14 things I can’t live without. Tropical Storm Nate convinced me that my wants usually lead to my needs.

1. Shelter

We’ve made a comfortable boomer nest in Nicaragua. But, when Nate roared through Ometepe our roof struggled to maintain its composure. The old tin roof tried its best over years with fruits pounding on the hot tin and constant leaks during the rainy season. But, it is time for a new roof.

If you watched our House Hunter’s International show, you know I like “funky”. A new roof is a ‘need’, but I have many ‘wants’ to paint, redecorate, and spruce up our little nest. We are still debating on whether to sell our place and move to more adventures. Meanwhile, I want a comfortable, low maintenance home base. And if we do decide to sell, our beautiful property will be ready for new owners.

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The Expat Art of Friendships


“We can count on so few people to go that hard way with us,” ~Adrienne Rich

If you are living abroad, how many true friends do you have?  Finding true human relationships is an art that I have yet to master, especially as an expat. I have oodles of acquaintances, expat and local, yet very few that I consider true friends, those that we can count on to go that hard way with us. I guess that is normal, right?

Truth be told, it has been a learning process for me. I have had a difficult time cutting ties with negative, dishonorable people, whether they be expats or locals. Why is that? Because we all want to belong, to be a part of something…kind of like our tribe?

Perspective is necessary for me to understand the depth and breath of true friendship. The illusion of friendship is a frame, a shallow arrangement of shapes on a flat surface..two dimensional. True friendship is the lava deep beneath the crust of daily life…and it takes a lot of digging and peeling the layers back to find it.

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Weekly Photo Challenge: What Are You Waiting For?


“For a while” is a phrase whose length can’t be measured. At least by the person who’s waiting.” ― Haruki Murakami, South of the Border, West of the Sun

The Weekly Photo Challenge is Waiting. 

We do a lot of waiting in Nicaragua. Right now, I am waiting for my eye to heal and there is an epidemic of pink eye on the island, so I am quarantined in my house until the epidemic is over.

We remain in readiness for the next eruption of our active volcano, Concepcion. The last time she awoke was in 2010.

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What’s in an Expat Fridge?


“Drink from the cup of life, you will be fulfilled.
Yet…
drink from the milk container in the fridge,
and your wife will make you wish that you had drunk from the cup of life.”
― Anthony T. Hincks

I am on a housesitter’s forum on Facebook because it helps me get contacts for good housesitters. Also, as a homeowner, we sometimes get trashed on these sites because housesitters complain that our homes are too dirty, or our fridges are full of rotten, moldy food, or our pillows are too soft or too hard, etc. Sometimes I feel like I have to defend the homeowners.

A housesitter posted a list of questions she asked prospective owners. Most of the questions were reasonable like, “How many pets do you have? Are they up-to-date on their vaccinations? Is the closest town within walking distance?”

But then I read this, “Post a photo of the inside of your refrigerator.”

Hmmm…So I asked why. And she responded,

It’s something we ask after getting surprised one too many times with refrigerators not sanitary in any way, shape, or form. We’re not looking to see what you have per say, as much as the condition you keep your fridge because we’ve found that to be a good indicator as to how clean you keep your home as well. It really sucks when the first thing you have to do upon arrival to a home is spending 4-6 hours cleaning the fridge just to make sure you don’t get food poisoning. Not to mention, quite often the rest of the home is just as dirty. And we aren’t there to be your house cleaners. After experiencing three like that in a row, we now ask to see what the fridge looks like. 

I thanked her for her response and checked her off my list as a potential housesitter.

Although this post isn’t about housesitters, I became curious to know what is inside expat fridges because they do represent a different way of eating and storing food, especially in the tropics.

So, here is a picture of what’s inside my fridge. Notice, it is clean, no rotten food, no mold, nothing that would cause food poisoning. Although, I have to admit that were notorious for keeping some moldy leftovers in our fridge in the states.  But, living on a tropical island has changed our fridge contents and our respect for food drastically. Let me explain why.


1. Sanitary conditions

 Living in the tropics, nothing is sacred to the infestation of bugs that swarm annually. Everything must be sealed tightly and even then, the tiny insects can always find a way to ruin your prized pumpernickel bread you found at La Colonia. All perishables go into the fridge or freezer.

Currently we have an infestation of tiny book lice. Fortunately they don’t like my food, but they are building nests inside my Kindle. ( And yes, they are really called book lice! ) Their only entrance is through my charger hole, so I had to find a way to deter them. After shaking hundreds of tiny book lice gently out the charger hole, I discovered that a drop of neem oil around the charger hole keeps them at bay.

Things rot quickly in the tropics. We experimented keeping our tomatoes out of the fridge or inside. They rotted within two days outside the fridge, and stayed rock hard inside the fridge. Nicaragua doesn’t have a good selection of tomatoes anyway, so we chose to refrigerate them so they would last longer.

All fruit is either refrigerated, processed and frozen, or canned. We freeze mangoes, water apples, Jackfruit, and Suriname cherries from our trees and bushes. We used to make mango jam and salsa and can it, but unless we started at 4 am, the day was too hot to keep the water boiling on the stove for canning.

Milk comes in cardboard containers and when we open it, the container goes into the fridge. We keep our eggs in the fridge, too. I know that is not custom here, but if we don’t put them in the fridge, we need a safe spot so our kitties won’t swipe them onto the floor. They are little rascals like that!  Continue reading

Tale of Two Surgeries


“If I save my insight, I don’t attend to the weakness of my eyesight.” ~Socrates

 

For six months, I lived in a blurry world. Although it was difficult to attend to the visual world due to weakness of eyesight, I gained an accurate and deeper intuitive understanding of people, places, and things. Instead of relying on outsight, I gained a better appreciation of my world through insight. 

Since I had my first eye operation in the United States and my second eye operation in Nicaragua, I thought it would be interesting to compare the surgeries in two vastly different countries. Both surgeries were similar. I will try to withhold judgment, but I can guarantee that if you are concerned about having a delicate or major surgery in a developing country, I will put your worries at ease.

A Tale of Two Surgeries Through The insightful Observations of an Expat 

A look at my island from the taxi window as I was on my way to the hospital in Managua.

Surgery in the United States

1. Facility

The facility where I received my vitrectomy in the U.S. was modern with all of the latest equipment. Johnson City Eye Clinic Website

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Gypsytoes or Stickytoes


This says it all about our lives on Ometepe Island. We want the best of all worlds. How does one decide to stay or go? Is it possible to have Gypsytoes and Stickytoes  together? If so, how does that work?

Here are some of our considerations in deciding to stay or go.

Financial

 

We grow a lot of our fruits and vegetables.

In 2016, we traveled to Colombia, Fiji, New Zealand, Las Vegas, Tennessee, and Pennsylvania. We accounted for all of our expenses and income for 2016, and we actually saved money and came out ahead when we balanced income vs expenses.  We own two homes, we have no mortgages and no expenses for our home in the states. Our trusted friends live in our house, collect our mail, and they even took care of our old cat, Tokyo, until she passed away this year. The small amount of rent goes into a special account which we use to pay our property taxes, rental insurance, and for repairs on the house.

If we were to sell our house on Ometepe Island, we would be free to travel the world, but it would come with a price. We would continue to live only on our monthly income, and try not to dip into our savings, yet it would be difficult because we would have to pay a monthly rental fee, which we don’t have to now. Traveling is expensive. We aren’t backpackers anymore, and we like to stay in Airbnbs throughout the world. It is doable, but will take some work to stay within our budget.

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Random Rants about My Country of Birth


Random ranting is always good for the soul. It is like a pressure cooker value releasing steam. A good rant is cathartic. Sometimes ranting keeps me sane. And living in Nicaragua as an expat, I have some frustrations about my country of birth. It has been a while since I’ve ranted, and Anita of the blog No Particular Place to Go inspired me with her rant-a thon, so here are a few of my random rants.

U.S. Health Care Rant

Don’t get me wrong. I appreciate having Medicare, but we can’t use it abroad! With my first eye surgery in the states, single payer was quick and easy. I paid 20% of the total cost of the doctor, facility, and anesthesiology. When I told my doctor that I needed to fly back to Nicaragua, he said he would have to replace the vitreous in my eye with silicon oil, which necessitates a second eye surgery to remove the oil.

“I am going to see if a doctor in Nicaragua can remove the oil in my eye,” I said to my surgeon. “Good luck with that,” he responded. “I doubt that you will find anyone as competent in Nicaragua as eye surgeons in the states.”

What is it with doctors’ arrogance? Waiting for surgery in the gurney, I watched as a train of gurneys were moved in and out of the operating room. “How many retina surgeries do you do here in a day?” I asked the attending nurse. “Usually 15 per doctor per day,” she said. I quickly calculated that the doctors each made $1750 per surgery X 15 surgeries a day = $26,250 a day!!! That is just the doctor! It doesn’t include the facility or anesthesiology fees.

I made an appointment in Managua at Vivian Pellas Hospital to see a retina specialist. Dr. Juan Rivers gave me a through exam and patiently answered all of my questions. When he said my eye was still extremely swollen, he asked, “Why didn’t the surgeon give you steroid shots to reduce the inflammation before injecting the oil?” I said that the doctor told me oil and water don’t mix, so he couldn’t put steroid shots in my eye. “Well, that is what we do before we inject the oil or gas,” he said kind of irritated. He shook his head and said that I would have to keep the oil in my eye for three months, which could have been avoided if they reduced the swelling first.

Through my tears… in only one eye… I thanked him for his patience and his TLC and scheduled another eye appointment for the end of August. His initial consultation cost $160.89. The surgery to remove the oil and replace my corroded lens will cost $3,000 for everything. Since we have international health insurance, we weighed the cost of airline tickets, a rental car, and at least two weeks of expenses to repair my eye in the states in a train of gurneys vs the cost of surgery with Dr. Juan Carlos Rivers at Vivian Pellas. I opted for a competent, caring doctor in Nicaragua. I can file claims with my international insurance and get some of my money back.

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