I'm so angry I could spit nails!!! Where do I even start??????????
Back in Oct. 2008 I started having a back problem and my legs didn't support me. I could barley walk. So I went to Chiriqui hospital and saw Dr. Emir Perez who I consider to be a great doctor. He felt that I had a pinched nerve or even worse, that it could be cut. If it got worse then I would be paralyzed from the waist down. I of course ask for second opinions and he was happy to set up appointments with other doctors. He told me I should have back surgery because if I happened to step off the curb wrong it could cut the nerve in half and them I"m toast.
He had several test scheduled, one was with another doctor at the same hospital using some kind of electronic equipment. That test also showed nerve damage between L4 and L5 just like Dr. Perez said. Then the two doctors spoke and ordered a CAT Scan which confirmed what they thought, a pinched nerve between L4 and L5.
I told him to schedule the surgery for as soon as possible. He ask if I had insurance or was going to pay cash. I told him I had Med Serve. He told me not to expect much as they don't like to pay. That was my first clue about them. So I went to the Med-Serve office and met with Manual who is either the owner or manager or something. He is the head guy there. I explained to him that I had test done and needed to have surgery and wanted to know how much the insurance would pay. I told him that Dr. Perez said it would cost between $10,000 to $12,000 depending on how bad it was once he was operating. Manual said that this is in line with what the doctors charge for this. I said ok then, you are going to pay 70% of that. Manual told me that since I wanted a private room I had to pay the extra $35 a day for that and they didn't pay for toilet paper, paper towels and personal items. I told him not to worry I would pay that. Then I even wrote down on paper sitting in front of him at his office saying that if the operation cost $12,000 that they would pay 70% of that less these "personal items and the extra charge for a private room. He said that was correct. What a lie that was!!!!
I had the operation done and was in the hospital for only two days. During the operation, I had respiratory failure and another doc had to come in. Also Dr. Perez had another doctor assist him. The operation itself was fine. I thought it would all be OK so I ask to see the bill so I could check out.
Now, I had already paid for the electrical test, the CAT Scan (cost was $1,000) and a $1,000 "deposit" to check into the hospital. When I got the bill I was shocked. Not in the bill itself which was about $12,000 or so. Add that to the $1,500 of test I had done it was up to about $13,500. All these numbers are aproximate as I'm going back three years in memory. But they are real close.
Guess how much Med-Serve was going to pay??????? They only paid $3,500 of the $12,000 hospital bill. I was furious and told the hospital that this had to be wrong that Med-Serve said they were going to pay 70% less the "little extras". They said they did not know anything about that and I had to pay them about $7,000 more. Remember I had already paid them a deposit of about $1,000. I was furious. I think this was on the weekend because I wanted to go see Manual at Med-Serve and see what was going on.
Anyway, I told my friend who was staying with me to pack my cloths and take them to the car and pull the car around by the emergency room and I would be there soon. I ask the nurse for a walker so I could walk "around'. She brought me one and I walked right out of the hospital, got in my car and my friend drove me back to Boquete. About half way home, the hospital called and said that I can't just leave and that I had to come back and pay the bill. I told them I was almost home and wasn't coming back until I felt better.
About a week later I went to see Manual at Med-Serve. To say I was angry was an understatement. I went in his office and he informed me that they only paid 70% of what they "authorized" and they only authorized $5,000. He also told me that they did not pay for the second doctor and that they did not pay for the other doctor who had to be called in when I had respiratory problems. And to add insult to injury the two test I had done, electrical and CAT Scan the first one cost about $200 and the CAT Scan cost about $1,000. Manual informed me that they only pay 50% of these test and they only pay for one test a month!!!!!! So guess what they paid 50% of the $200 test and ZERO on the CAT Scan.
So all in all, the $14,000 or so hospital bill they paid about $3,600, certainly not much more!!!
But wait their lies get worse.
This pas January I had a heart attack and went to Chiriqui Hospital. They set up up with a cardio doc who was there to have a stress test done. I had the test done and he told me I had blockage and needed to see another doctor which I did. This doctor told me that I need by-pass surgery and between 5 to 8 stints and it would coast about $30,000 and ask if I had insurance. I still had the @^$#^&# Med-Serve Insurance and knew they would not pay anything close to 70%.
I decided to have some alternative treatments done call EECP which is done in Panama City, not here in David. The treatment is FDA approved, Medicare Approved, and is about the only treatment they even use in much of Asia. The cost is only $3,000 here but I had to stay in Panama City for about a month and have 35 one hour treatments.
Back to Med-Serve. They said it is not on their list of approved treatments and they did not know anything about it and I would have to have my cardio doctor here in David write them a letter and say that he thinks I need it. That was a major task in itself since the cardio doc here was not that familiar with it. I bought him books, sent him links to websites and had the doctor in Panama who does EECP call him. Reluctantly he wrote a letter to Med-Serve telling them that I need to have this treatment done.
So we take this letter to Med-Serve. They wanted more information about it. We provided that as well as having the doctor in Panama call them and explain what a great success rate they had with it for 1/10 the cost of by-pass.
So back to Med-Serve again. This time the office manager, not Manual took all the paperwork and told us to call him back. Every time Manual saw me he quickly left. I wonder why???? We called them back and they told my friend (I don't speak Spanish) that Med-Serve had approved me to have these treatments done and that they would pay for 50% of the cost. Not great but better than noting.
They told us to just pay for it and bring them the receipts and they would reimburse us. I did just that and they told me it would take about 45 days to get paid. So I thought at least I would get some money back. So on the first of June I called to ask if my check was ready. They told me it would not be ready until the 15th and to come get it then. On the 15th I called and they said it was not ready but would be ready the next day. So the next day I call before wasting a trip to David. Guess what???
They told me that they were not going to give me a check that they decided the treatment was not covered!! And this was after they told me it would be covered and to just bring them the receipts.
I was furious and called Manual back. He told me that he was not going to give me a check and that the treatment was not covered. I told him that his own employee had told me it would be covered. He said that didn't matter because the employee doesn't have the right to tell me it would be covered and only he could do that. Every heard of this kind of BS.
I can tell you know that if you have Med-Serve "insurance" (they can't even call it insurance because it's so bad) just be aware that they are a bunch of crooks. Let them sue me if they want to. I've got documents and proof of everything I've written here.
JUST BEWARE OF MED-SERVE. THEY ARE NOT WHAT THEY CLAIM TO BE.
Has anyone else had a similar experience with this "Insurance Company"?
Replies
@ Rick What a shame you are, I'm hundred percent panamenian and I know what this person is going through. I guess you are the perfect man who never face a problem in this country and if you are so tired of being around gringos go to a place where there is none, may be a Island.People are free to complain about anything that happen around so others knows about it and doesn't go through the same that's what this is for. If you are going to act like everything is perfect around, then why you even take the time to write in here. Go head and enjoy your dream world.
I don't understand if people talk abou their problem is bad and if they don't say anything is bad too.
Panama is my country and I'm sorry people that come here sometimes get hit by the bad part of this country. Is like every other country.
Do you know something? don't judge somebody if you don't know What they had been through, people that can't speak the language and that are foreign get rip off because we think they have a lot of money not realizing that everybody have to work hard to earn what they have. I hope you never get to this point. I have a lot of gringo friends and some of them had experience what I should know better went through, but I guess you have to put yourself in his feet or go through all this to understand. but of course you don't. Health is on jeorpardy nobody should fool around.
If you don't like I should know better's complain then why you even bother replying on this discussion. I advice you to do something that can benefit you.
Have a Good Evening.
Well said...but, please let me add that those who wander around with the cloud over their heads, enjoying the constant drip of sadness down their neck, feed off responses like yours. Any attention is better than no attention, and simply encourages them.
Do like what you said about the red, white and blue christian taliban. That's good. And scarily accurate.
@rick
What a rude nasty response to a legitimate tale of being ripped off.
Not looking for a mystical place at all; just one that is not so corrupt. I've lived all over the world including the US, Australia, Europe, China, the Caribbean and with lots of short visits for a month or so to probably 20 other countries. So I don't speak from the point of view of someone who has not been outside of his own backyard.
This could be a great place to live and I hope that no one else has the problems that I've encountered. Maybe it's just not the right place for me and life has an odd way of telling me that I should not be here much longer. But for me it's not the mystical place that I thought it was when I first came down here over five years ago.
My old grandpa told me once that "everything in life have a solution.... except death."
The first way of defense against business malpractice and scams and all the stuff that have been exposed here is, like Juan Carlos has told N times: learn the language. Period. By learning the language you will be capable of communicate, read and understand everything and argue and get heard when you are dealing with any person in any business down here. If you know the language you will be capable of defend yourself for any bad move that any person at any company would like to do. You could ask and fight for a better price and better treatment and avoid the "gringo bingo". Simple.
I have also told you that in Panama it is not bad to bargain and ask for discount. I ask for a discount everywhere I go to buy something. Sometimes I got it sometimes I dont. If I found a price that is not according to what it is expected I simply dont buy it or get the service if there is not a discount and look somewhere else where I could find what I was looking for.
Last advice is always ask for a tariff, price, fee, charge.... first and negotiate. Never take the service or product first and then negotiate.
Finally. The consumer protection law is for everyone living in Panama. It will protect all residents in Panama for bad commercial practices. You will be surprised how this government agency have fought for consumers and if they have a good solid case companies are forced to comply with customers expectative by returning the money or another new product and are also fined.
I understand where you are coming from. But the "owner" of Med Serve speaks perfect English. The lady at Tabor spoke perfect English. The attorneys that ripped me off for thousands of dollars spoke perfect English. So getting ripped off here was not just due to my lack of speaking Spanish. It was due to the fact that I am a Gringo and they all know that there isn't much I can do if they do rip me off.
I even went to two "new" attorneys and ask them if they would file a suit or even call the attorneys that stole money from me. They refused to even call and said that no attorney in Panama will sue another attorney. It's just a code they go by he said!! So I guess your an easy target if you are dealing with an attorney in Panama.
I'll admit though that I would be MUCH better off if I did speak Spanish.
If I sound angry it's because I am.
What can I say. You are no lucky at all. Where did you get those people? You found them on the Paginas Amarillas de Maleantes? I mean the attorneys.
I am not lawyer and I dont know what they did to you and what other attorneys you consulted. There are a lot of litigant lawyers in Panama and let me tell you courts in Panama has several cases of attorneys sueing attorneys. So that argument given by those "new attorneys" is cheap. Probably they didnt want your case by any reason. But even as panamanian I give attorneys, here and everywhere in the world, a very short leash. I have a very bad opinions of attorneys. I have posted here something about them. So I try to be always one step ahead of them. Just as a precaution. In USA there are horror stories of Immigration Attorneys that have ripped of millions of dollars from inmigrants.
I know that it probably have been a very bad experience for you. But I think that your nickname in this forum will tell us better. You should have known better....
When doing some deals private or with government I do my homework. I cover all the corners and take my time to read everything. Never leave anything to chance. At the end we finally accomplish our goals and everybody stays happy.
Sorry for your lost.
Darlene,
I did state that I would look and see. But the fact still remains that I was told I would get a refund on the last month's premium. Then a couple of days later they said I would not. Same thing for the medical reimbursement, hospital bills, doctor bills, etc. They say one thing and do another. To me that is NOT the way to do business. But it seems like that is "business as usual" for them or at least that has been my experience.
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