I went to mexicali for my surgery. It was a very nice hospital and they strive hard to ensure there is no language barrier. All the dr. and nurses know english pretty well. They have free fill for life. The down side is that you have to fly or drive there to get them. As near as my research has shown it will cost me about 300-400 for a fill here in utah. I can fly for 250 round trip so it looks like I will be flying to mexico for my fills. They are so easy to work with that I am not even going to take my husband this time. good luck