Health Insurance and Doctors......

Although a doctor's visit here in Panamá costs much less than the U.S., it's still a good idea to have health insurance.  Last month we met with an insurance broker to discuss our options.  She suggested a plan that she liked, because they are good about paying claims and also have good coverage.  She helped us fill out the forms since they're all in Spanish and she submitted them to the insurance company.  A few weeks later the applications came back denied on both of us due to pre-existing conditions. 

Clyde is 57 years old and I'm 51.  Neither of us are on any prescription medication, we're in good health, exercise regularly, both non-smokers, and are both a normal body weight.  They denied us both due to the surgeries that we've had in the past, and the fact that we used to be obese.  We understood that they will not provide coverage for any of those pre-existing conditions, but to deny us for it was a surprise.

One of the things mentioned on Clyde's denial list was that his heart rate is too low and he might need a pace maker.  Doctor's nowadays see a low heart rate as a good thing, since it means that the heart does not have to work as hard at rest.  When Clyde did the stress test on the treadmill last month his heart rate was in the 40's (a normal resting heart rate is 60-80) while walking fast with an incline.  He was instructed to run at the highest incline in order to get his heart rate up to it's max. 

After the denial the insurance broker said not to worry, there are many insurance companies and we could try another with less strict guidelines.  So yesterday we were back at the doctor's office to fill out new paperwork. First they did an EKG only on each of us, then a visit with the doctor.  During my visit with the doctor he looked over my list of pre-existing conditions and admitted that there was no reason we should have been denied since nothing on the list is serious.  Since the new insurance company required me to have a pap smear also I asked the doctor where I could go.  Apparently here in Panamá, a pap smear can ONLY be performed by a OB-GYN doctor, whereas in the U.S. general practioners could also do these.

He suggested a place and told us to walk down the street, and over the bridge to Royal Center.  Once inside find the floor with the OB-GYN's and ask if someone could see me.  We did as instructed and were told that all of the doctor's there work only in the afternoon.  But one doctor just happened to be sitting in his office and he was willing to see me. 

We entered a small office where the doctor sat behind a desk.  He introduced himself as Dr. Carlos Montufar Rueda, and offered us both a seat in front of his desk.  He looked professional in a crisp blue dress shirt with black slacks and spoke decent English.  With a head of curly black hair and a big smile, he made us feel comfortable immediately.  After we chatted a few minutes he looked at me and said "go into the bathroom and take off your clothes."  As I walked into the bathroom there was another door to my right that led into the exam room.  A young woman dressed in scrubs came into the bathroom as if to hurry me up. As I took off each garment of clothes she grabbed it and put it down. She stood there watching me undress and then handed me a gown.  I followed her into the exam room and climbed up onto the table as instructed to assume the position.

The doctor walked in and said "ah Theresa".....prounced in Spanish as "ta...resa" but in English it's "ta...reesa." He made an attempt at a joke by asking me if my mother is Mexican since he'd never heard this name before.  He performed the exam with the nurse in the room, just like in the states.   Once we were finished I got dressed and joined him and Clyde who were chatting in his office.  As we were getting ready to leave the doctor shook Clyde's hand. Then he walked around his desk and gave me a big hug and a kiss on the cheek, which caught me by surprise.  As we left we joked about the hug and kiss and I almost felt like he should have bought me dinner too, considering where he'd been poking around.  Panamanians greet women with a hug and kiss on the cheek but I've never seen a doctor do it, until now.  We even kiss and hug our female lawyer here, although I think Clyde enjoys it just a little too much. 

The cost for the visit with the specialist was $60.00 ($30 for the pap test and $30 for the visit) but with our pensionado discount we paid $51.00.  A bit pricey I thought, but then the same visit would have been two to three times that much in the U.S. And my GYN in the U.S. never kissed me, so I guess I can't complain.  But Clyde is jealous since the hot female opthamologist he saw a few months ago didn't kiss him, although I'm sure he tried. 

We are enjoying our new life in Panamá a little more each day.  The weather is perfect, the people are friendly and even the doctor's get up close and personal. It's a tropical paradise with so much yet to be discovered here along the gringo trail.  (we are sorry to report that we have no photos of the pap smear to post here, and maybe that's a good thing)