Fly a little, save a lot: Keeping the monthly share low

Jed Stuber  ·  Feb 01, 2015

Member saves by having kidney stone surgery in Costa Rica

Note: The following is not an endorsement of a particular medical provider or travel service, but is intended to show the benefits of considering many options when seeking health care services. MediBid is available without charge to Samaritan Ministries International members and is a good place to find comparative pricing for medical services. There is no substitute for careful personal research to determine the best approach for your medical needs.

Samaritan member Richard Jordan’s work arranging trips to Costa Rica for people to receive medical care took an unexpected personal turn when he learned that he had a very large kidney stone and needed major surgery. It turns out that Costa Rica was a good fit for his own needs, and after a successful surgery at a fraction of what it would have cost in U.S. hospitals, he wants to tell other members his story.

“It wasn’t pleasant at the time, but looking back now I can see how God was guiding and protecting me,” Richard says. “I feel extremely blessed that God provided for me through Samaritan and Clinica Unibe. I hope my experience will show other members how they could benefit and save as well.”

Richard works for NC Medical Travel, a company founded by his mom, Kathy. They help American clients save thousands of dollars on diagnostic tests and dental treatments, and tens of thousands on surgeries by going to Clinica Unibe in San Jose, Costa Rica.

The average cost of PCNL surgery in the U.S. is $26,000. In Costa Rica, including travel and a six-day stay, it’s less than $12,000.

NC Medical Travel connects with patients through MediBid, a web site which allows patients to post the procedures they need done and then receive bids from providers. Posting procedures and receiving bids are free to Samaritan members when they access MediBid through the Member Web App. NC Medical bids on behalf of Clinica Unibe.

Last September, Samaritan members Tim and Cathy Hohulin worked with NC Medical Travel to save on tests and arrange a vacation in the process. Richard was on the same trip to have some tests done on himself. He was dismayed when a scan revealed a 14mm kidney stone, many times larger than the average of 2-3mm.

Richard has become familiar with medical terminology and procedures in his role at NC Medical, but he soon learned even more than he may have wanted to know. His stone’s size and location made it potentially life-threatening. Stones like the one he had sometimes block the urinary tract, go undetected, and shut down the kidneys. While some stones can be broken up by ultrasound, this approach can lead to complications with the fragments, and was not a good fit for Richard. He was going to need a surgery called Percutaneous Nephrolithotomy (PCNL).

Kidney stone surgeries have been greatly refined in recent decades and are now done by robotic scope. Still, PCNL involves going into the center of the kidney, and is not outpatient. Patients typically need to stay in a hospital for several nights and miss a couple weeks of work. Complications are not uncommon, and infections are a significant risk.

When Richard researched PCNL, he found out that the rate of infection after surgery in the U.S. is 16 percent, but only 5 percent in Costa Rica. The Costa Rican doctors attribute this to the American protocol of discharging too quickly because of the high cost of staying in a hospital.

Aftercare is critical with this kind of surgery. Clinica Unibe overcomes this challenge by maintaining a much higher ratio of nurses to patients in the hospital, and also by discharging to an affordable recovery resort where a nursing staff manages medications and monitors the patient, all for around $100 a night. If a complication develops, the nurses can catch it quickly and get the patient back to doctors before it worsens.

When Richard went back to Costa Rica in December, his surgery went perfectly, and he praises God for that outcome. Richard had the opportunity to get to know the Clinica Unibe staff, and he was impressed that his doctor took the time to pray with him. And now that he has experienced the recovery resort firsthand, he’s even more confident in telling clients it is a wonderful facility.

The total costs including surgery, hospital fees, recovery center stay, meals, and airfare were just under $12,000 at Clinica Unibe. The Jordans did their best to find out what the surgery costs would have been at a hospital in the U.S. and discovered that the surgery alone ranges from $19,000 to $85,000, not including any additional fees that sometimes surprise patients. If that range sounds hard to believe, remember that billing practices in hospitals vary widely and are often very confusing. The Jordans were able to confirm that one insurance company in their area paid out $30,000 for this kind of surgery, even with its discounted rate.

Clinica Unibe works on the basis of payment up front with most of their American patients, but for members of health care sharing ministries, they allow for payment to be made after shares have been received. Richard’s need is being published this month, including the travel costs, because he could document the significant savings that resulted (see Guidelines Section VIII.B “Travel Expenses” and when making your plans be sure to call Member Services for details). Perhaps you will be assigned to send him your share.

Many patients have reported good experiences with Clinica Unibe and Costa Rica’s highly regarded health care system. Many Costa Rican doctors and medical facilities meet the same standards as in the United States. Clinica Unibe is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities.

While some may have doubts about going to Central America for medical treatment, Costa Rica has earned an excellent reputation. Often referred to as the “Switzerland of Latin America,” Costa Rica received that nickname for several reasons, starting with the basic political stability it has always enjoyed, dating back to colonial days and continuing in modern times, with strong ties to America and no standing army. One-third of the population lives in the capital city of San Jose, including a good number of American and European expats and tourists.

Clinica Unibe is well set up for minor surgeries that are basically outpatient, similar to an Ambulatory Surgery Center in the U.S. The Clinica Unibe doctors also have privileges and connections to Costa Rican hospitals, so they can transfer a patient there if necessary. They can also sometimes arrange for significant savings on major surgeries at the hospitals.

Even on the minor outpatient surgeries, the savings can be in the tens of thousands of dollars in comparison to the same procedure done in a U.S. hospital. In some ways, Clinica Unibe is similar to the “radical price honesty” surgery centers in the U.S. we reported on last month, which can also offer significantly lower prices than many hospitals. Common surgical procedures are scope surgeries on shoulders, elbows, wrists, hips, knees, and ankles; eye, ear, nose, and throat surgeries; hernias; gynecological surgeries; and urological surgeries.

In the case of surgery, you’ll usually have your primary care doctor refer you to a surgeon, and provide the relevant medical records and background. The doctors in Costa Rica are familiar with this process and can do video consultations via Skype with you and/or your primary care doctor.

The CEO of Clinica Unibe even took the time to write Samaritan a letter stating that it is the clinic’s policy that “we do not do change of sex surgeries, do not perform any medical procedures which involve risk for pregnant women or babies, and not only for legal reasons, but for our own values, under no circumstances perform an abortion process.”

The Jordans hope more members will take advantage of the savings that MediBid and Clinica Unibe offer. However, they do caution that not everyone should go to Costa Rica for medical procedures. NC Medical Travel or Clinica Unibe doctors do turn people away if their condition would be better treated in the United States or health concerns preclude them from traveling. The Jordans have heard about people ignoring such basic guidelines and having a bad experience.

The Jordans have also seen problems develop with scheduling connections, medical paperwork, consultations, a contract with the provider, accommodations in Costa Rica, etc.—all concerns they can help with through their agency. They are happy to answer any questions about the services they provide.

It is not surprising that Americans are comfortable going to Costa Rica for medical treatment. I spent a semester in San Jose in college, and felt safe as I rode the public buses every day. I was there to meet requirements for a minor in Spanish, and one difficulty was constantly running into “Ticans” who spoke English, so I couldn’t get enough practice speaking Spanish! Many could even discuss American pop culture with me.

It is also not surprising that Costa Rican facilities can provide care of comparable quality with American hospitals, while being much less expensive. The causes of problems in the American health care system are beyond the scope of this article, but suffice it to say that Costa Rica does not suffer from quite the same level of counterproductive governmental interference.

The internet continues to improve the options and information available to patients, making a trip to Costa Rica feasible. The most difficult part is getting prices to compare from your local providers. But if enough patients use services like MediBid and NC Medical Travel, maybe even hospitals will have to start providing better pricing information.

I too would be happy to see more members seek high-quality medical treatment at competitive prices, including possibly traveling to Costa Rica. If you do, please let us know your experience so we can tell other members.