I am a retired T1D planning to move to Mexico from the US but have some concerns and did a little research on buying diabetic products there.
I am on MDI and use Tresiba and Lyumjev insulin pens and a Dexcom G6 CGM. I found Tresiba for $150 USD/box of 5 pens at Pharmacia Guadalajara but I couldn’t find Lyumjev or Fiasp ultra-fast acting insulins anywhere only Novolog or Humalog, which is disappointing. Also Dexcom products are not available in Mexico only Freestyle Libre CGM at a cost $60 USD per sensor.
However I was looking at only buying my supplies in Mexico in case of an emergency as I have good insurance in the US until 65 and will transition to an Medicare Advantage plan (both have excellent prescription and emergency International coverage) in a few years and found it is still cheaper to get my medical care and prescriptions in the US. The plan is to go to Mexico with a 6 month supply of all my prescriptions and then go to my Son’s place in the US every 3-6 months to see my primary care Physician and get my mail order refills, which will be automatically filled and shipped to my Son’s address that will also become my US address, every 90 days (I am allowed a 90 day supply) and bring it back to Mexico.
Hopefully this will all work out without much issue and would appreciate any thoughts people have and problems I might encounter with this plan? Otherwise I really like the quality of life and cost of living in Mexico after trying it out by renting places for a few months at a time then going back and always miss leaving. Thanks!
You can use a mail order pharmacy
You have an exciting plan for retirement in Mexico. It was an option I considered back in 2013. I even visited the Lake Chapala area near Guadalajara. It definitely is a beautiful spot with lots of retirees from North America and Europe.
I have done a fair amount of reading and watching videos about standard Medicare with a supplement plan compared to Medicare Advantage. Did you know that MA plans can change the terms of their plan whenever they want?
Do you realize that after a year or so on a MA plan, you can change back to standard Medicare but then you will have to go through medical underwriting for the supplement plan and you may not qualify? Diabetes is definitely a disqualifying condition.
You qualify to be automatically accepted to a supplemental plan, no questions asked, for a period time right around your 65th birthday. Once that window closes, you’ll never again be considered for a supplemental plan without a trip through medical underwriting.
This could make you financially responsible for copays of 20%, for a significant and expensive diagnosis like cancer. You could find yourself in a situation that you cannot reverse.
I encourage you to do more research on the MA plans and not limit the information source to the marketing arms of the big and very profitable MA firms
I have no financial connection to any of these insurance companies and I hope that you will do your due diligence. Good luck with all your planning for an adventuresome retirement!
I’ve known students who have pulled this off pretty successfully. Although, typically, its a limited time interval while they are in school. Usually they are foreign students who don’t want to deal with the US medical system (not the other way around). Family would UPS insulin in emergencies, but you can’t let your stockpiles get super low.
Good information thanks!
The same employer I get my retiree medical until 65, which then I have to transition to Medicare (I am 63 right now), allows my wife to continue on the plan until she is 65 (she is 57 right now) if I continue with their Medicare supplement plan that is currently about $300/month. I think it is worth it as both plans offer excellent coverage and both are managed by the same Blue Cross Blue Shield group. I will not only have excellent prescription coverage for my Diabetes but also emergency international medical if I have a medical emergency in Mexico, which to me is a big concern as I found out emergency medical coverage is impossible for me to get with a preexisting condition like Diabetes and my age.
One thing as you point out I need to check on is whether the Medicare supplement is really a Medicare Advantage plan and could be denied coverage if I change to back to standard Medicare with or without supplemental coverage, which is very important being a T1D!
Thanks, Mike
@Mike_F Once you reach age 65 (Medicare age) you may select traditional Medicare coverage or a Medicare Advantage plan. You are permitted to switch back and forth each year.
A Supplemental Plan (only used in conjunction with Traditional Medicare, not with a MA plan-you can’t have both) only permits one no-questions-asked sign up period around your 65th birthday. Miss that opportunity and you, as a diabetic, will be shut out of that forever.
A person with Traditional Medicare, but no Supplement Plan, will have to pay 20% of possibly very large bills as can be the case with situations involving diagnoses like cancer, Alzhiemer’s or Parkinson’s.
A person with a MA must live with the changing coverage of that plan, be it the participating doctor list, hospital network, and changing drug formulary. MA plans make extensive use of prior authorizations.
In Standard Traditional Medicare (with Parts A & B), if the doctor accepts Medicare then the Supplement Plan follows. I had over $40,000 in bills from my stroke this year and between Traditional Medicare coverage and a Supplemental plan, I paid $0.
I have standard medicare A&B and take the best supplement plan BCBS offers (Platinum) It is not that expensive and covers 100% of hospital bills worldwide as well as my Dexcom 20% not covered under part B. For part D I take a $103.20 (per year) plan from Wellcare that covers low-end medications. For insulin, I order it directly from Canada and pay out of pocket as that costs me less than the copays alone for Part D plan that pays for insulin.
Medicare Part D Insulin will only be $35 for a month supply starting Jan 1st. It does not guarantee you if your insulin will be one of the insulins on your plan so it ends up covered.
Insulin from Canada delivered by mail order is about $20 per 300 units for Humalog, so $35/month would only buy you about 525 units per month. Picked up at a pharmacy in Canada, it is about 1/2 that price. I will likely still need to go that route as my Humalog is not on my Part D formulary and I prefer to pay more rather than switch insulins.
I pay $34 CA per 1000ml vial for Novolog (Novorapid) in Canada. That’s 3.4 cents per unit. Humalog is about the same price (that’s retail over the counter - prescriptions are no longer required for insulin in Canada).
The Canadian pharmacies that deliver insulin by mail to the US require a prescription. They claim it is to avoid cross-border hassles at customs. That started about two years ago and, to the best of my knowledge, has not yet changed. My prescription for my last order ran out, and I was pretty impressed that the Canadian pharmacist ordered a new prescription from my US endo without any legwork required on my part.
There might be a limit to how many bottles/boxes per month, it’s just not as easy to find that out. I haven’t wondered as I get my insulin cheaper anyways under my plan. But I believe the new law covers multiple bottles/ etc, it’s a month supply, not per bottle or box etc supply. It might be as simple as whatever the prescription says you need for a month is $35. But it does not require for all the insulin’s out there to be on your formulary to get covered. I would want to keep my preferred insulin too and used to pay a little more for it years ago for a couple of years when it wasn’t a preferred drug to get it. I’m not sure you will even be given that chance now with the way the law is written? And the insulin for a non disposable pump is covered differently.
@Terry4 has some good points on using advantage plans. They fit usually for a cheaper cost up front, but are more limited in who you see, what you get etc, to make up for it. Plus there are some costs/penalties attached when you try to go to regular plans later.