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david3528

Oct 12, 2015, 8:07 AM

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Medical Health Insurance

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For expats from Canada, what have you opted for medical health insurance coverage when living in Mexico? I spoke with a couple who say they would rather not get hooked with insurance companies and just deal with emergencies on a pay-as-you-go basis, which apparently turns out to be a lot less expensive. However, I am unsure if this is the right way to go? I would really appreciate your input as to what you have been doing.



Maesonna

Oct 12, 2015, 11:15 AM

Post #2 of 21 (9824 views)

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Re: [david3528] Medical Health Insurance

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Pay-as-you go is a good way to take care of small problems – an infection, a sprained ankle, a yearly gyn checkup, etc. In my experience, some typical prices are: a consultation with a GP 100 to 300 pesos; a visit with a specialist doctor, 500 pesos. Lab tests would add another few hundred to a couple thousand pesos, depending on whether we’re talking about a blood/urine test, or a mammogram, bone scan or x-ray, etc. Add also the cost of medications, dressings, etc.

In short, even if you have insurance, you might not want to bother making a claim on something that ends up being only the equivalent of a hundred dollars or less, or at most a few hundred dollars.

But I still think it would be prudent to have some insurance or deep savings in case you end up having a condition or accident that requires hospitalization, perhaps surgery, or expensive on-going treatments.


TedZar

Oct 12, 2015, 3:49 PM

Post #3 of 21 (9778 views)

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Re: [Maesonna] Medical Health Insurance

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For a serious problem, like a stroke or a heart attack, pay as you could end up being VERY expensive. I have a good policy from Allianz for about US$1600 a year (at age 63). About $2000 deductible but then for anything major up to about US$5,000,000, it covers everything. It is probably best to cover for anything catastrophic.


Gringal

Oct 13, 2015, 8:05 AM

Post #4 of 21 (9697 views)

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Re: [TedZar] Medical Health Insurance

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I'd advise checking with any potential insurers about age limits. Pay as you go works as long as nothing catastrophic happens. You can also check out the Mexican general health plans under Seguro Popular and IMSS.


david3528

Oct 13, 2015, 12:52 PM

Post #5 of 21 (9653 views)

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Re: [TedZar] Medical Health Insurance

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Thank you, I have been on the Allianz website and the quote was a lot higher. Do you use a broker that you can share the name/website with me?


playaboy

Oct 13, 2015, 3:33 PM

Post #6 of 21 (9634 views)

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Re: [david3528] Medical Health Insurance

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I just renewed my Allianz policy today. 25000 pesos, age 60. I have had the policy for 5+ years with no claims.


chinagringo


Oct 13, 2015, 3:46 PM

Post #7 of 21 (9630 views)

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Re: [playaboy] Medical Health Insurance

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Granted age 60 and no claims would be factors in the costs. But wouldn't coverage limits, deductibles, coverage exclusions, State or City/Town of residence and which hospitals are allowed under the policy, all have a bearing on the policy costs?
Regards,
Neil
Albuquerque, NM



TedZar

Oct 13, 2015, 5:41 PM

Post #8 of 21 (9614 views)

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Re: [chinagringo] Medical Health Insurance

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To the best of my knowledge I have no limitation on where I may go for doctor or hospital, other than that the coverage is for Mexico. Allianz seems to be a good deal. I don't smoke and I am in super good health. I've had the policy for two years now with no claims and just short of 64.

Of course, if you nickle and dime the insurance company, prices go up. I have a fairly high deductible, my interest is only in covering major health issues. Prices depend on many things.

I am happy to express a few things, but pretty much people need to do their own research on the issue. And certainly ask for references for the agent you choose.


addtocart

Oct 14, 2015, 6:20 AM

Post #9 of 21 (9573 views)

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Re: [TedZar] Medical Health Insurance

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I'm not familiar with these insurance plans and have a question: Is this for coverage within Mexico and therefore you have to go to a Mexican hospital or does it cover air transportation out of Mexico to a hospital of your choosing elsewhere. Follow-up question: If you have to go to a Mexican hospital with these plans, why not sign up for IMSS? Assuming, of course, you live in Mexico, not just a tourist.


CozICan

Oct 14, 2015, 6:47 AM

Post #10 of 21 (9567 views)

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Re: [david3528] Medical Health Insurance

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David... Are you living in Mexico full time or part time ??? If you are full time you might qualify for the FREE Seguro Popular Health Insurance that may be free.


TedZar

Oct 14, 2015, 6:49 AM

Post #11 of 21 (9567 views)

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Re: [addtocart] Medical Health Insurance

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No air evac, coverage is for Mexico. You can do IMSS, but you have limited choices, long waits. With your private coverage you can go where you want and perhaps better care, better specialists, less wait. There are good local private hospitals/doctors that the better off Mexicans use and they provide quite decent care.

IMSS is a tough one philosophically. It is for Mexican people and personally I am not sure that it is right for large numbers of (relatively wealthy) foreigners to add to an already heavily burdened system. I will sign up for it at some point, just to have the time lapse for all the preconditions (about 2-3 years for everything I think) and as a hedge against the possibility of needing it at some point if my private insurance becomes too problematic. Also, I think my private insurance runs out at 70, but I can jump across the border for MediCare then and just use IMSS as a local support.

No easy answers and local conditions will always be determining factor.


Gringal

Oct 14, 2015, 8:44 AM

Post #12 of 21 (9534 views)

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Re: [TedZar] Medical Health Insurance

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To sort out some of the differences: IMSS was originally for working people in which the employer was required to pay the premiums. It was opened to others, but it is not free. Premiums are reasonable, but increase every year until age 80 at which time the rate increases end, but the insurance continues. There are waiting periods for pre-conditions and exams required.

Seguro Popular is the national health insurance plan available to everyone and is not entirely free, depending on one's financial situation. Some of the hospitals for it and IMSS are described as "MASH, without incoming artillery" but many excellent private physicians do spend there. I know people who have had treatment at these hospitals and are very satisfied with the results.

There are excellent private hospitals in Mexico, but I've heard that the main difference is in patient comfort; i.e., private rooms with nicer facilities. Not cheap, but less than U.S. hospitals by far.

If you want to go to the U.S. for treatment, there are companies who do "air evac" for those who buy their policies.
The only issue there is that you must first be "stabilized" in Mexico before they will undertake to fly you "home" for treatment. Since time is of the essence in many emergencies that might not be practical, but if one has a long term care issue like cancer, it can work for them. Before considering that, one might want to check on U.S.hospital ratings as compared to the rest of the world. The result is surprising. They are rated number one in cost, however.

Senor Google can be very helpful here.


roberb7


Oct 24, 2015, 7:48 AM

Post #13 of 21 (9052 views)

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Re: [TedZar] Medical Health Insurance

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I enrolled in IMSS a month before my MSP of BC coverage ran out, and have been on it since. I disagree with TedZar on a couple of points.

1. If your plan is to enroll in IMSS "eventually", IMSS is strict about pre-conditions, so it's better to get in on it ASAP, before one of those pre-conditions develops.

2. I don't have any philosophical problems with being in IMSS. I know from reading the newspapers that IMSS is having financial problems, so extranjeros enrolling and putting money into it is a good thing.

As to the quality of the product, I got a colonoscopy from them last year. Had to go to a facility in León to do it, and I was very impressed with the place (modern and clean) and the people who work there. I'm scheduled for a prostate ultrasound next month. IMSS's policy is that males over 45 and entitled to get one every year.

One other thing that I'll mention, since no one else has, and this applies to both IMSS and Seguro Popular. If you're hospitalized, you have to provide for an attendant of some sort. What people normally do is have a family member do this. If you don't have one of these people available, you'll have to hire a nurse's aide or a person with similar skills.


Gringal

Oct 24, 2015, 9:23 AM

Post #14 of 21 (9026 views)

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Re: [roberb7] Medical Health Insurance

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It's my understanding that you must provide a person of the same sex to be your attendant in the hospital.
Also, you will need to bring along all your personal comfort items, including toilet paper. I've also heard that the food is pretty awful and you'll want to have a friend bring you some from the outer world when you're cleared to eat. (I'm an IMSS member anyway.)

Basic is very basic, but a vast improvement over the very high rates in U.S. hospitals, which, if you check with Senor Google, are not rated #1 in any respect other than cost. They are way down the list from other first world countries. They are #1 by a good margin in cost.


RickS


Oct 24, 2015, 4:08 PM

Post #15 of 21 (8976 views)

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Re: [Gringal] Medical Health Insurance

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"Basic is very basic, but a vast improvement over the very high rates in U.S. hospitals...."

I couldn't agree with you more about the deplorable high cost of medical attention in the US, but..... to suggest a vast improvement over the States is a stretch, both with conditions, care and cost to 'elderly' which is what this discussion is about.

Example: several months ago wife (in US) has a 'horse accident'; taken to the emergency room with severe concussion, 2 broken ribs and detached lung. Pretty serious stuff. After excellent care/diagnostics in Emergency room, admitted to nice private room w/bath (they all are!) where she stayed for 3 days, 2 nights with continuing and constant care by doctors and nurses using the latest equipment and drugs.

All of this cost her/us.... $250 in co-insurance with our Medicare Advantage Insurance (which we pay $0 in monthly premiums).


chinagringo


Oct 24, 2015, 4:49 PM

Post #16 of 21 (8969 views)

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Re: [RickS] Medical Health Insurance

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Rick:

Knock on wood, I have been quite lucky to have only used Medicare once since graduating. Mine was far less serious and I too have the $0 pay Advantage Plan. I wlked into a Presbyterian urgent care center which does not take appointments and paid a $5 copay. I was seen by two different nurses and then a physician who had results from a lab test in hand. Start to finish was 26 minutes.

In talking to others, it is about your provider and geographic location from what I have been told?
Regards,
Neil
Albuquerque, NM



Gringal

Oct 25, 2015, 9:03 AM

Post #17 of 21 (8892 views)

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Re: [RickS] Medical Health Insurance

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The "vast improvement" referred to the population in general, not to those with Medicare Advantage. Many people under 65 couldn't be covered by any insurance due to a pre-existing condition. The new legislation, if not dumped by a new Congress, will have changed that, at least.

Glad your wife got the good care without the outrageous cost.

We who live in Mexico have fewer choices. It's down to private insurance which kicks some folks off the bus at a certain age, IMSS, Seguro Popular and out of pocket.

I don't believe that those who live outside the States can get Medicare Advantage type plans, even if they are willing to pay for evacuation by air plans in Mexico. Wrong, right???


RickS


Oct 25, 2015, 9:15 AM

Post #18 of 21 (8887 views)

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Re: [Gringal] Medical Health Insurance

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You are right, Gringal, that to enroll in a Medicare Advantage program, one must live 'in the locality' within which it is offered. If I were to move even 100 miles away, I might would have to enroll in that localities Advantage program... which might be different. And they are certainly different, but not necessarily better or worse, between regions or states.

Of course the Advantage programs are only one option. One can still, and most folks do, use 'Original' Medicare with a Supplement (often called a Medigap policy). It just costs much more each month for that gap... but usually pays all costs that Medicare doesn't.


Gringal

Oct 25, 2015, 10:08 AM

Post #19 of 21 (8876 views)

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Re: [RickS] Medical Health Insurance

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....which sounds good.........but not for us in Mexico.


RickS


Oct 25, 2015, 10:13 AM

Post #20 of 21 (8872 views)

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Re: [Gringal] Medical Health Insurance

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You are absolutely correct... and this thread IS about medical care IN MEXICO.


Gringal

Oct 25, 2015, 1:21 PM

Post #21 of 21 (8843 views)

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Re: [RickS] Medical Health Insurance

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Back to Mexico.
If you're a newbie here and you're under 70, there are a number of private insurance options available. Check them out for the best deal for you. As someone else suggested, get in to some plan before a "condition" gets going and gets in the way.
People who are in great health tend to put off getting some insurance..........and then, they get sick. Insurance companies really only want the people who won't be likely to use the policy. (grin).

If you can't afford the private plan, by all means, get into one of the public ones. I have been contributing to IMSS for a number of years, never used it and don't feel a bit of guilt about having it. They're way ahead of the game on me.

Medicare, Part B: Lots of differences of opinion about keeping or dropping it when you move to Mexico. You can't use Medicare of any kind here, so you'd need to go back to the USA to use it. This means finding a doctor who will take a new Medicare patient, spending the money to go back as well as staying somewhere and hanging out there until you don't need treatment anymore. The alternative has an element of risk, since penalties for dropping Part B and then picking it up again are high. My spouse and I dropped Part B over eleven years ago upon moving to Mexico. Multiply a minimum of $200 a month times eleven years and you have one nice, substantial medical savings account.

Naturally, it's up to the individual whether they expect to stay here no matter what and use Mexican doctors and hospitals, but that's my approach.

Above all, have SOMETHING to cover your expenses if you get sick. Don't be the kind of slimeball who expects their friends and neighbors to have a fundraiser to pay THEIR medical bills. Trust me: this happens.
 
 
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