# MULTAQ and PRADAXA in Mexico



## gudgrief

My US cardiologist has prescribed Pradaxa 150mg. twice a day and MULTAQ 400mg. twice a day. Both are quite expensive but covered under my insurance and I can have them shipped from the US at a fairly reasonable price. My concern is if I should run out under conditions where I can't reorder in time. (Needless to say I'm watching real close and trying to make sure the insurance company will allow me to refill in time to receive the shipment before I run out.

I can't find any source for MULTAQ in Mexico. Does anyone know of one?

Pradaxa-R is available in 70mg. and 110mg. capsules. According to my cardiologist, there's a significant reason to take 150mg. twice a day. Higher doses are extremely risky. Lower doses could make the drug ineffective. Two 70mg. caps twice a day would be the only fallback available. Again, does anyone know of a source for the 150mg. cap of Pradaxa in Mexico?

Thanks, I'll appreciate any info you can provide greatly.


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## RVGRINGO

You should talk to a Mexican cardiologist and ask his recommendation.
Unless you use MBE, you cannot have medicines mailed into Mexico. MBE has a license, but you'll pay through the nose. If you buy locally, you can apply to your insurance for reimbursement.


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## gudgrief

RVGRINGO said:


> You should talk to a Mexican cardiologist and ask his recommendation.
> Unless you use MBE, you cannot have medicines mailed into Mexico. MBE has a license, but you'll pay through the nose. If you buy locally, you can apply to your insurance for reimbursement.


Good thinking and I have considered those options.

I have the meds sent by Estafeta through an outfit similar to MBE. I have a private mailbox for stuff that I don't want to trust to be sent to Mexico by mail.

I asked cardiologists here, but since I still see the US cardiologist, I'm not going to mix and match. My insurance doesn't cover services outside the US and the cost would be prohibitive for me, several times what it costs me travel every 4 months or so.

Thanks.


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## gudgrief

RVGRINGO said:


> You should talk to a Mexican cardiologist and ask his recommendation.
> Unless you use MBE, you cannot have medicines mailed into Mexico. MBE has a license, but you'll pay through the nose. If you buy locally, you can apply to your insurance for reimbursement.


BTW, overnight is $32.00 USD for 1 kilo. That's reasonable compared to the copays I'm paying.


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## Guest

gudgrief said:


> My insurance doesn't cover services outside the US and the cost would be prohibitive for me, several times what it costs me travel every 4 months or so.
> 
> Thanks.


Have you really checked out the cost of a cardiologist in MX? I have an excellent cardio here, and an office visit including an EKG costs 800 pesos (less than US$65). Skip the EKG, and the cost drops to 600 pesos (about US$48). The MX cardio might know equivalent or similar medicines here in MX that will do what needs to be done, and at much lower cost to you (and the Doc here won't be trying to push you out the door in 5 or 10 minutes to get to the next patient).


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## gudgrief

GringoCArlos said:


> Have you really checked out the cost of a cardiologist in MX? I have an excellent cardio here, and an office visit including an EKG costs 800 pesos (less than US$65). Skip the EKG, and the cost drops to 600 pesos (about US$48). The MX cardio might know equivalent or similar medicines here in MX that will do what needs to be done, and at much lower cost to you (and the Doc here won't be trying to push you out the door in 5 or 10 minutes to get to the next patient).


I saw two cardiologists down here before going up to TX. The first one didn't give any confidence at all. The second one had all the modern equipment in his office and as you wrote, the consultation, echo cardiogram and stress EKG was 800 pesos. First cardiologist wanted to do angioplasty with stents, minimum 3, 35000 pesos (approx 3000 US) cash which I didn't have. Second cardiologist recommended trying to treat with meds and follow up in three months. At that point, I applied for Medicare and scheduled an appointment with a US cardiologist as soon as I was approved. The result was triple bypass in July last year and a total out of pocket cost of less than $3500 on my credit card. There's the difference right there. Credit card. And, I suspect, even down here, I would have ended up with bypass surgery at 45,000 to 90,000 pesos.

My cardiologist prescribed Pradaxa to prevent clots and Multaq for afib. There are other meds for these conditions, all of them have potentially severe or fatal side effects. These two have some significant advantages over the others with little increased risk. I'll continue seeing the cardiologist in TX because I have confidence in him and he does not try to push me out the door as fast as he can and in a year or so might just return to the second cardiologist here. Meanwhile I don't think it smart to self-prescribe or mix and match between two cardiologists.


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## gudgrief

GringoCArlos said:


> Have you really checked out the cost of a cardiologist in MX? I have an excellent cardio here, and an office visit including an EKG costs 800 pesos (less than US$65). Skip the EKG, and the cost drops to 600 pesos (about US$48). The MX cardio might know equivalent or similar medicines here in MX that will do what needs to be done, and at much lower cost to you (and the Doc here won't be trying to push you out the door in 5 or 10 minutes to get to the next patient).


BTW, thanks for your feedback.

I'm curious. Have you had any procedures done in Mexico?

My ladyfriend's aunt had hernia surgery at a very reasonable cost, excellent care in a small private hospital. Even there, I just don't have the cash. If I get a cash advance, the interest is 3 times what it would be just putting the bill on the credit card. In either case, it'd take several months to pay it off.


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## Guest

gudgrief said:


> BTW, thanks for your feedback.
> 
> I'm curious. Have you had any procedures done in Mexico?
> 
> My ladyfriend's aunt had hernia surgery at a very reasonable cost, excellent care in a small private hospital. Even there, I just don't have the cash. If I get a cash advance, the interest is 3 times what it would be just putting the bill on the credit card. In either case, it'd take several months to pay it off.


I've had surgery ( but not cardio) and other procedures. Both hospitals I used accepted foreign credit cards without blinking.


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## RVGRINGO

I had two stents installed in the USA and four more installed in Guadalajara. The Guadalajara experience was superior in all respects. In the USA, I had to fight for my insurance coverage and it was very stressful at a very bad time. I finally won and they paid me 100% to shut up. The games they play!
In Guadalajara, I paid by credit card, submitted the bills and the credit card receipt for payment by my US insurance company and, surprise, they paid 66% without a word. My Mexican cardiologist, who lives nearby, is Houston trained (still goes there on request), known from Tokyo to Moscow and know the insurance 'games', so that the 66% just happened to cover what I actually owed him in Mexican pesos. 
By the way, the better hospitals in Guadalajara are more like 5 star resorts; good food, waiters in tuxedos, DVD library at no charge, lots of personal care and support; not at all like in the USA, where I spent much of my career in hospitals every day. Infection control is better in Mexico's private hospitals, which must compete for 'business' and the best doctors vie to practice at the best hospitals and maintain offices there. Since there is no malpractice insurance or culture of 'ambulance chasers', the poor doctors end up in the villages or out of business. It works!


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## gudgrief

RVGRINGO said:


> I had two stents installed in the USA and four more installed in Guadalajara. The Guadalajara experience was superior in all respects. In the USA, I had to fight for my insurance coverage and it was very stressful at a very bad time. I finally won and they paid me 100% to shut up. The games they play!
> In Guadalajara, I paid by credit card, submitted the bills and the credit card receipt for payment by my US insurance company and, surprise, they paid 66% without a word. My Mexican cardiologist, who lives nearby, is Houston trained (still goes there on request), known from Tokyo to Moscow and know the insurance 'games', so that the 66% just happened to cover what I actually owed him in Mexican pesos.
> By the way, the better hospitals in Guadalajara are more like 5 star resorts; good food, waiters in tuxedos, DVD library at no charge, lots of personal care and support; not at all like in the USA, where I spent much of my career in hospitals every day. Infection control is better in Mexico's private hospitals, which must compete for 'business' and the best doctors vie to practice at the best hospitals and maintain offices there. Since there is no malpractice insurance or culture of 'ambulance chasers', the poor doctors end up in the villages or out of business. It works!


I probably shoulda thought of going to Guadalajara or Aguascalientes, at least. Too late now. My insurance is a MediGap plan. I'm not sure I'd have wanted them to know I was having that kind of surgery in Mexico. I mean. you're supposed to be resident in the US. The insurance company, I'm sure, would be happy, they'd save money. The chance may be small, but I wouldn't want Medicare to have gotten wind of it.

Am I being over cautious about Medicare?


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## gudgrief

GringoCArlos said:


> I've had surgery ( but not cardio) and other procedures. Both hospitals I used accepted foreign credit cards without blinking.


Where was that at?

Did the doctors accept credit cards too?


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## Guest

gudgrief said:


> Where was that at?
> 
> Did the doctors accept credit cards too?


The doctors' fees (3 of them) were included in the hospital's bill. I asked the primary doctor upfront.


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## gudgrief

GringoCArlos said:


> The doctors' fees (3 of them) were included in the hospital's bill. I asked the primary doctor upfront.


Would be good to know where. _Por si acaso ... ._

I have two things hanging over my head, so to speak.
The bill I ran up in NYC along with attendance at my 50 year reunion and my part of the bypass surgery plus motel and meals for my significant other for three weeks. There's no "Ronald McDonald House" where I was. I'm whittling away at it slowly, but if I need emergency care, being able to use the credit card down here might be a lifesaver.


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## RVGRINGO

I'm required, by my retirement insurance, to keep both parts A+B Medicare, at a cost of $100 per month, even though I can't use it in Mexico. However, it keeps my BCBS managed state retirement health package alive and, though it wants to be secondary to Medicare, it reverts to Primary in the absence of Medicare coverage outside of the USA. So, up to certain lifetime limits and the usual US insurance procedures, it can work. "Insurance" doesn't really exist in the USA any more.
If you can buy insurance in Mexico, you can decide the deductables. There are no 'co-pay' or 'minimums', etc. in many cases. In fact, the insurance often covers everything, even transportation and follow-up care, medications, etc. Of course, the premiums increase with your age, until you can't afford it any more. You must also buy it when you are younger; often younger than typical retirement age. However, if you retire to Mexico early, it is the way to go; at least until 65 or 70.


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