# National Health Insurance



## PatrickMurtha (Feb 26, 2011)

As an employee of a Mexican concern, I am covered by Mexico's national health insurance. I have not received a card or any other documents from my employer yet; I intend to inquire about that. However, I do have a question for the board. I have been advised by other expats working for my university that the bureaucracy involved with actually *using* the national health insurance is onerous. They have said that it is better to simply choose your own doctor and pay "full freight" - and that is what I am doing so far.

But I am curious about the effect of the insurance on prescription prices. In Korea, when I produced my national health insurance card, I got a huge break on prescription prices. Is that true here as well? I have an ongoing (pricy) prescription that I have already re-established with my new doctor. I notice that when I have it filled, the receipt from the pharmacy shows a 30% discount; I am unclear about the source of that discount. Do I do better on the price when I can show that I am covered by national health insurance, or is that as good as it gets? No one I have asked at the university has been able to enlighten me on this (oddly; I assume that a lot of people these days have ongoing prescriptions).

I am grateful for any insights.


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## RVGRINGO (May 16, 2007)

Please forget your Korean or other experiences. If you don't have a document from 'the national health insurance', then you probably don't have coverage through your employer. Ask for documentation.


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## PatrickMurtha (Feb 26, 2011)

RVGRINGO said:


> Please forget your Korean or other experiences. If you don't have a document from 'the national health insurance', then you probably don't have coverage through your employer. Ask for documentation.


I will ask them for the documentation; I've just been so busy orienting to the job in other ways. The coverage is mentioned in my contract.

I'm still interested in knowing if it will be of any real use to me with the prescriptions, though.


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## Hound Dog (Jan 18, 2009)

Patrick:

What you are referring to is the middle class Mexican health insurance program known as IMSS or Instituto Mexicano del Seguro Social which is for middle class workers and retirees. The poor have an alternative health care plan but, unless you are desperate, you don´t want to submit your body to that charnal house. In fact, I wouldn´t send my worst enemy to an IMSS health care facility. They are broke to the point that you had better take your own toilet paper or you can wipe your butt on the sheets in which you have just slept. If this is what your employer is offering you then that is because under Mexican law they are required to so do. You must be working for some truly Chickensh*t cheapassd outfit.

By the way, forget the prescription coverage, Prescription medication in Mexico is cheap and the term "prescription" is a standard joke unless we are talking narcotics and even that is a one-liner.


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## Isla Verde (Oct 19, 2011)

Hound Dog said:


> By the way, forget the prescription coverage, Prescription medication in Mexico is cheap and the term "prescription" is a standard joke unless we are talking narcotics and even that is a one-liner.


Nowadays, you need a prescription for antibiotics. At least in pharmacies in Mexico City, they do require one.


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## TundraGreen (Jul 15, 2010)

PatrickMurtha said:


> ... But I am curious about the effect of the insurance on prescription prices. In Korea, when I produced my national health insurance card, I got a huge break on prescription prices. Is that true here as well? I have an ongoing (pricy) prescription that I have already re-established with my new doctor. I notice that when I have it filled, the receipt from the pharmacy shows a 30% discount; I am unclear about the source of that discount. Do I do better on the price when I can show that I am covered by national health insurance, or is that as good as it gets? No one I have asked at the university has been able to enlighten me on this (oddly; I assume that a lot of people these days have ongoing prescriptions). ...


I am enrolled in IMSS. When they have prescribed something for me, I get it at their pharmacy for as part of the coverage, without any copay. In fact the whole concept of copay does not apply to IMSS. There is just the annual fee. I don't know whether the IMSS card would get a discount on prescriptions bought elsewhere. An INAPAM (senior citizen) card will get you a 5% discount on medicine sometimes.


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## PatrickMurtha (Feb 26, 2011)

TundraGreen said:


> I am enrolled in IMSS. When they have prescribed something for me, I get it at their pharmacy for as part of the coverage, without any copay. In fact the whole concept of copay does not apply to IMSS. There is just the annual fee. I don't know whether the IMSS card would get a discount on prescriptions bought elsewhere. An INAPAM (senior citizen) card will get you a 5% discount on medicine sometimes.


That is helpful, thanks! 

As for the prescription prices, my monthly supply of a popular med here costs me five times as much as it did in....that other country I refer to sometimes.


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## FHBOY (Jun 15, 2010)

*Getting More Confused*

There are several threads about health care and insurance and I suppose until I get there, it will be difficult to get good answers. I have heard about IMSS and that sounds also too good to be true, yet I read here that care within that health system would horrify a ******.

May I ask specific questions so that we can target in on concerns?
1. Would having preexisting conditions such as HBP, cholesterol control and minor arthritis pose a problem in either getting health coverage, prescriptions or health care?
2. I have read about several levels of health coverage, from the IMSS to rather pricey private insurance. From your experiences, what seems to be the best way go about the health care? Is there a mid ground cost that is cost/benefit advantageous? Will I find an honest broker, or are there just "insurance salesmen" scare tactics like there are here?
3. It seems that some establish de facto HSAs, money kept in reserve to cover medical expenses, sort of paying it forward, which sounds like a good idea. Does any one do such a thing and how do you find your expenditures (of course based on your health issues) with this plan? 
4. On private insurance - what are the benefits to this? What are the alternatives?
5. If one does not foresee returning to the US, except for vacations and to see family, should you still pay for Medicare? I think I mean, in parallel, is the medical care in Mexico (we will be settling at Lakeside) good, as good, better or worse than in the US, for most ailments/accidents?
6. A friend of ours told us about a procedure they had in GDL. Seems there was a cancerous growth, like a melanoma, on the face above the eye. They went to a doctor who diagnosed it, went to a hospital in GDL, had the growth removed, then had in patient plastic surgery to repair the damage and walked out of the hospital two days later with a bill of under $1,000 USD. Is such a thing possible?
7. Is there any place where I could find the costs of common prescription drugs in Mexico on the internet? 

So, this day after Thanksgiving, when our move is just over a year away, such thoughts come into my head. Hope you can help me out, and thank you.


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## pappabee (Jun 22, 2010)

FHBOY said:


> There are several threads about health care and insurance and I suppose until I get there, it will be difficult to get good answers. I have heard about IMSS and that sounds also too good to be true, yet I read here that care within that health system would horrify a ******.
> 
> May I ask specific questions so that we can target in on concerns?
> 1. Would having preexisting conditions such as HBP, cholesterol control and minor arthritis pose a problem in either getting health coverage, prescriptions or health care?*yes depending on exactly how is listed on the physical you must take for ISMM*
> ...


Information listed is my opinion or based on actual experences. It is not law or anything else just from me.


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## RVGRINGO (May 16, 2007)

Much of what you have heard is true, but very dependent upon your age and other circumstances.
Pre-existing conditions will exclude you from IMSS and age may make private insurance unaffordable as you get older; if you aren't already too old to get private insurance.
Private medical care is affordable at many levels and the example you gave is entirely possible, though probably a few years old. 
Prescriptions are not required, except for antibiotics and narcotics. Everything else is available by asking. Costs vary and many brands, as well as generics, are easy to find. You will need to familiarize yourself with new names and generic ingredients.


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## Joycee (Jul 22, 2009)

FHBOY said:


> There are several threads about health care and insurance and I suppose until I get there, it will be difficult to get good answers. I have heard about IMSS and that sounds also too good to be true, yet I read here that care within that health system would horrify a ******.
> 
> May I ask specific questions so that we can target in on concerns?
> 1. Would having preexisting conditions such as HBP, cholesterol control and minor arthritis pose a problem in either getting health coverage, prescriptions or health care?
> ...


In order to obtain IMSS insurance there must be 2 family members. In other words a single person cannot sign up for it. My husband and I signed up last May. We were not required to have physicals. I have asthma but that did not disqualify me. We were told the only restriction is that for the first year they would not cover surgery. The level of care varies with the particular IMSS clinic you are assigned to. Some have better reputations than others. The yearly cost is $2307pesos if you are under 60 and $3472 pesos for over 60 years. I felt it was worth the cost for emergencies and prescriptions. I still maintain my Medicare because I plan on seeing US doctors when I go back to NOB. Hope this helps.


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## TundraGreen (Jul 15, 2010)

Joycee said:


> In order to obtain IMSS insurance there must be 2 family members. In other words a single person cannot sign up for it. ...


There is something wrong there. I am single and enrolled in IMSS.


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## Isla Verde (Oct 19, 2011)

TundraGreen said:


> There is something wrong there. I am single and enrolled in IMSS.


You can be single and enroll in IMSS. An American friend of mine in his late forties enrolled a few months ago, and I know he's single.


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## RVGRINGO (May 16, 2007)

Joycee's post is wrong. Single people; individuals, sign up for IMSS.
Perhaps she is confusing individual enrollment with employee enrollment where there may be a lower limit on the number of employees signed up by an employer; if there is such a situation.


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## pappabee (Jun 22, 2010)

Ok everyone,
I am now completely confused and upset. Just on this thread I have heard at least four different answers to the question “can I get IMSS”. 

My wife and I both have diabetes (non-insulin required-controlled by meds). I am 68 and she is 64. When we first came down here we were told that we could apply for IMSS but would have to take a physical (that we would pay for prior to being allowed to apply) we would have to pay for the physicals and go to Guad in order to have them taken. We put it off because we didn’t feel comfortable driving in Guad and had heard that some of the requirements were changing.

Then this May I checked with the IMSS lady who visits at the Lake Chapala Society every week and asked her what was currently needed to apply. I was told not to bother because of our pre-existing conditions (diabetes) we would not be accepted for any coverage. Now I hear about people have pre-existing conditions and getting accepted (some no even having to take the physical). 

WHAT GIVES???????:confused2:

So if we can’t get IMSS what are our options? Yes I have Medicare and no we can’t afford the private insurance even if they would accept us.


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## RVGRINGO (May 16, 2007)

There is IMMSS, Seguro Popular, ISSTE, and probably other plans. It retirees, workers, teachers, other employees, and who knows how many other 'classifications', may be eligible for one or another of these programs. Most expats don't know the difference and are easily confused.
For most of us, only IMSS is an option, although Seguro Popular seems to accept enrollments, even though it is designed for the very poorest with no other options available.
IMSS does disqualify pre-existing conditions, and the quality or availability of services can vary tremendously from one area to another.
The "IMSS Lady" is not an IMSS lady, just a retiree from IMSS who charges expats for advice; which may or may not be up to date. Yes, you pay to apply but there is no refund if you are rejected.
We've lost IMSS coverage, twice, by using 'facilitators'. One provided false documents and another made errors which made the membership void.
We're too old for other options.


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## AlanMexicali (Jun 1, 2011)

*Issste*



RVGRINGO said:


> There is IMMSS, Seguro Popular, ISSTE, and probably other plans. It retirees, workers, teachers, other employees, and who knows how many other 'classifications', may be eligible for one or another of these programs. Most expats don't know the difference and are easily confused.
> For most of us, only IMSS is an option, although Seguro Popular seems to accept enrollments, even though it is designed for the very poorest with no other options available.
> IMSS does disqualify pre-existing conditions, and the quality or availability of services can vary tremendously from one area to another.
> The "IMSS Lady" is not an IMSS lady, just a retiree from IMSS who charges expats for advice; which may or may not be up to date. Yes, you pay to apply but there is no refund if you are rejected.
> ...


I have a post that is above some posts back here explaining what I understand, so far, about the 3 health care systems.

I also can check into the IMSS but the next 2 weeks I am in San Diego. I did find a partial explanation regarding the IMSS not supplying medicines for some chronic conditions that I will translate and post soon. ISSSTE is only for State and federal employees and their dependents and has death benefit for a lifetime for the spouses. As you mentioned I have been told by someone who knows [another post I have here back a bit] that all three are in the process of being overhauled and changes are rapid and sometimes dramatic. As of 2011 Calderon was on TV announcing the Seguro Popular [Federal Secretary of Health] is free now to all citizens regardless of their condition.


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## AlanMexicali (Jun 1, 2011)

*Imss*

Actually the 2 posts of mine I was to referring in the above post to are on this thread near the last posts there, not on this thread.

"International Medical Insurance"



IMSS: patients without medication 
Rodrigo Vera 
July 8, 2011 
Special report

IMSS. Negligence. 

A counter to other health institutions, the IMSS refuses to provide drugs considered "life support" and that urgently require thousands of patients living with HIV / AIDS and other chronic degenerative diseases. Beneficiaries Association Living with HIV / AIDS at the IMSS maintains that there are drugs that are not available for over five years, even though the Senate and urged the Director General of Social Security, Daniel Karam, to supply "in a timely manner to medications that patients require. "

MEXICO CITY (Process) .- Although already approved by the Health Sector, the Mexican Social Security Institute (IMSS) is providing 60 drugs listed under "life support" urgently needed for thousands of claimants living with HIV / AIDS, diabetes, cancer, hypertension and other diseases.

Faced with this problem, the general secretary of the association Beneficiaries Living with HIV / AIDS in the IMSS, Luis Castillo Adrian Quiroz said: 
"Since February of last year we held meetings with various officials to ask IMSS to provide the drugs, but to date have not approved the provision." 
- How many IMSS affect this lack of supply? 

-A very large number of its nearly 40 million beneficiaries. You can not make a precise estimate because the institute does not have severed your information. We are confident that the lack of medicines harms more than 23 000 beneficiaries with HIV / AIDS, we represent and who require antiretrovirals included in this classification called "life support". 

"In addition, patients need, among other diseases, diabetes, cancer and hypertension, to name only those who have grown tremendously over the country in recent years." 

Indicates that within these drugs pending approval in the IMSS are also those of fundamental use to combat other chronic degenerative diseases such as leukemia, which requires Nilotinib. Another relevant example is the Bosentian, prescribed for pulmonary arterial hypertension. 
He notes that there are drugs that are more than five years waiting to be approved by the IMSS, as is the case of Lamivudine Abacavir, prescribed to combat HIV / AIDS. 

These 60 drugs considered "life support", he stressed, were allowed gradually, over the years, by the Committee Specific Medicines Agency Commission of the basic inputs of the health sector, the government entity responsible for endorsing the supply of drugs for that sector. 

By endorsing these drugs leave "life support", whose use is uncommon and is used to treat chronic degenerative diseases-the ISSSTE and Popular Insurance began to prescribe and supply them. Only refuses IMSS

- Why is this negative?

-In the IMSS we say they are still reviewing these medications. In February 2010 we held a meeting with the director of the institute, Daniel Karam, to discuss the approval of antiretroviral drugs classified under the heading of "life support". At that meeting turned her instruction to the Director of Medical Services, Santiago Echeverria, to give him up to the point.

"In December of that year, Echeverria made a commitment to our organization to approve drugs came as the new coordinator of the Medical Unit of High Specialty (UMAE), a position which went to the Dr. Jose de Jesus Gonzalez Izquierdo. 
"Last February, says Quiroz castle we met with this officer, thinking that approval was imminent. But he told us that these drugs were still being reviewed by a panel of IMSS. So, despite already approved by the Interinstitutional Commission, which owns the IMSS, it still does not approve. " 

- In the ISSSTE and the Seguro Popular was immediate approval? 
Yes, he quickly in those units of the Health Sector. It is only the IMSS which is putting every possible obstacle.

- What impact this postponement entails? 
-You have very serious health consequences, because by not having these treatments, the beneficiaries who require to increase their income or hospital consultations or relapsing opportunistic infections, which causes them to stop work. This increases the labor liabilities and that carries serious economic effects. 
- And what was the reaction of the title? 

- Imagine! They are desperate to not get the medicines they need. Their complaints are increasing. In response, the IMSS has launched a campaign of harassment against complainants, who threatens to change the clinic to which they are attached. 

"There is the case of a lady who even threatened to take your insurance if you continued to protest. He has a son with hemophilia who can not get your medicine. Finally, it is so severe lack of supply of these drugs that the case was filed in the Senate in mid-April last. " 

Lives at risk 
PRI Senator Maria del Socorro Garcia Quiroz took the case to the Senate and was referred to the Social Security Committee, chaired by Minerva Hernández Ramos PAN. 
This procedure resulted in a "proposition point of agreement" by which the Senate "urges" Daniel Karam to "provide timely and medications to patients classified as 'life support'."

In his written proposal, detailing legislator: 
"It is widely known that both the IMSS and ISSSTE are currently experiencing a difficult financial situation due to the lack of attention by the federal government to the institutions of public health workers. 

"This prevents provide an appropriate and timely medical care and supplies and human resources required for its beneficiaries.

"In the case of the IMSS, these weaknesses have been aggravated in recent years placing it in a more vulnerable situation, thereby threatening the health of the insured and the viability of the institution. 

"This school, unlike the ISSSTE, 60 is not providing drugs classified as 'life support', which were approved by the Committee for Medicinal Products for Specific Interagency Commission of the basic inputs of the Health Sector. 
"This is worrying since it is put at risk the lives of the beneficiaries and can also trigger the onset of other ailments as a result of not following the medical treatment for non-drug specific, affecting the finances of the IMSS. 

"Conscious of the responsibility of the State to protect the health of Mexicans and assist in improving their quality of life, as well as economic growth and competitiveness of the country, we request the prompt resolution of this problem to the authorities IMSS health. " 

In his paper, the legislator highlights the guidelines established by the World Health Organization (WHO) and international agreements signed by Mexico and the legislation itself, which stipulates the right to health. 
Although medications for the category "life support" usually are expensive, says Quiroz Castillo, the government authorities to negotiate with drug companies and get lower prices: 
"In the health sector there is a Price Negotiating Committee, which annually holds meetings to ensure that drug companies to lower prices in high-cost drugs. Hence, many times, prices of government are up to three times lower than the prices that pharmacies are private. " 

Quiroz Castillo has long been evident IMSS attempts not to provide this type of medication. For example, in July last year announced an internal circular signed by Carmen Zepeda Huerta, head of the Management Unit of IMSS, to limit the "buy emerging" drug. Through this mechanism drugs that are purchased in stores are not the institute and whose purchase was planned, so it must be realized immediately outside (Proceso 1759). 

This measure, he said, constituted "administrative discrimination" affecting about 2 million patients with chronic degenerative diseases, seen primarily in hospitals in second and third levels. 

Quiroz Castillo concludes: "It's not worth it, by the mere fact of being expensive drugs or infrequent use is no longer supplied in the IMSS." 

Proceso


,


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## telcoman (Feb 11, 2010)

I noticed I could not buy Cipro over the counter last spring. I did manage to get it at a pharmacy in a small town. My wife is subject to bladder infections & it works. This year we will bring it from home.


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## FHBOY (Jun 15, 2010)

Like Pappabee, and not being in country yet, I still am confused. But like a lot of what I have heard about Mexico, that is not unusual. I mean we are still waiting to hear about the the procedures for immigration, even though the law was passed in the Spring.

:focus: 
We will be, when we move, 63 and 62 respectively. One of our reasons for living in Mexico is the anticipated ongoing health care spiral in the US. It would be disappointing if the situation is no better there than here.

So, in Lakeside, is IMSS a viable choice? I know that surgery is not covered for a year; thank God we've never had the need for any, as we are reasonably healthy.

What I've gathered so far, _and I hope there is more feedback_, is to go for the IMSS coverage as it does provide some benefits, establish a de facto HSA, and when we get old enough, make sure we keep Medicare just in case. You see we have another dilemma when we move; we will not be old enough for Medicare and we will need to discuss how to handle that., but that is personal.

AlanMexicali: Thank you for the post it is interesting, but I did not find any info pertaining directly to the question. Do you have other references, as they are all informative and I would not know where to look for them.

Lastly, I feel confident that this move fulfills that part of our plan, to be able to afford health care, although like a lot of "stuff" about Mexico and rules and laws, it is only, at this point, a gut reaction. When we come down in April, it will be on my list to look for more answers.


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## RVGRINGO (May 16, 2007)

The only thing 'certain' in Mexico, is that any answer that you find will soon change. We're now entering the third change, in ten years, in immigration procedures. Ten years ago, some folks spent five years on the old FM3 and then gained approval for citizenship. We missed that by a couple of months and gave up, deciding to remain FM3 forever. Now that has become 'no inmigrante', so we changed to 'inmigrante', so that we could become 'residente permanente' on our next renewal. Since implementation is delayed, we may have to pay the higher price again and wait another year. Ni modo; we have our 'burning permit' signed with the crematorium. That date is also uncertain but also inevitable. Everything in between is subject to change.


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## FHBOY (Jun 15, 2010)

*IMSS Denials*

I have read, on a parallel forum, that IMSS has been "clamping down" on who can obtain coverage and care. It seems that the financial crisis may be a cause, but in the discussion, it appears that retirees (they specifically mention Lakeside) have been, as they say, "their own worst enemy", by taxing the system by using it for routine visits and things like, their words, "free aspirin". 

Now, one of our reasons for moving to Mexico is the phenomenal cost of health care in the US. I have HBP controlled by meds and take Lipitor for cholesterol, and I am wary that because of this, I would be denied enrollment into IMSS. I do not see me using IMSS to visit the doctors as the cost is very inexpensive, nor use IMSS to pay for the meds, again because the cost cannot be as high as it is in the US.

I am wondering what people on this forum have experienced in the last few months and any further word on it. I'd be especially interested in info from newly arrived expats. Thanks


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## RVGRINGO (May 16, 2007)

We no longer have IMSS, and never used it when we had it. We buy our medications out of pocket and get generics whenever possible. Visits to doctors are rare, but affordable at prices from $40 to $600 pesos; the latter being top notch specialists.
Americans seem conditioned to have insurance coverage for everything, at all cost. Canadians are accustomed to socialized medicine. Without those systems in Mexico, you have to decide how to fund your own needs. Routine care is very affordable and even major events can usually be managed if you have savings and investments set aside for such emergencies, since costs in Mexico are often about what you would end up paying in the USA for copay and minimums anyway. If not, one should reevaluate a permanent move to another country.


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## FHBOY (Jun 15, 2010)

RVGRINGO said:


> We no longer have IMSS, and never used it when we had it. We buy our medications out of pocket and get generics whenever possible. Visits to doctors are rare, but affordable at prices from $40 to $600 pesos; the latter being top notch specialists.... If not, one should reevaluate a permanent move to another country.


RV - I agree with you on this issue. If the sole reason for re-locating is based on health care alone that is no reason to move. 

People like me see a doc maybe four to six times a year. Same with my wife. If I cannot put away the $700 USD for that, then maybe retiring is not the answer. 

I think the question on health care is more about hospitalization, not routine care, and not even medication costs. US healthcare is "sold" to many because of the fantastic cost of being in the hospital, even for a couple of days. I cited a case a few posts back, and while out of date, it seems to demonstrate that even hospitalization in Mexico should not be as catastrophic as here in the US.

I think what is of concern, to me then, is not the routine but the hospitalization and therefore the question about IMSS, or some sort of private hospitalization insurance. I suppose that at this point, as it is all conjecture on my part, that we will have to wait and see.

In closing: our reason for moving to Mexico is broader than health care. It is really simple: after looking at locations [and money being no factor] to retire NOB, we have found none that interest us.


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## RVGRINGO (May 16, 2007)

Re: Hospitalization.
Unlike the USA, doctors are very flexible and will work with you on your choice of hospitals. You, and they, can determine the medical needs vs. the various hospitals available and the risks involved.
For example, a lot of face-lifts are done in a small maternity hospital, providing them income for an otherwise empty room and the use of a less sophisticated OR. Generally, it is an outpatient situation or just one night in hospital. At the other end of the scale, I've had to have heart catheterization and the hospitals where the cardiology labs are located are world class and more expensive; yet much less than in the USA. So, you always have choices and can negotiate the prices in advance, to avoid surprises.


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## Joycee (Jul 22, 2009)

Sorry if I gave wrong information about IMSS. I thought I read on the IMSS application that it was for families which meant at least two individuals. Also an ex-pat told me she got kicked out of IMSS when her husband died. Must have been a misunderstanding.
As far Seguro Popular, I wouldn't let them treat my dog, if I had one. My brother-in-law suffered a stroke and was intially treated at another hospital. Because he did not have insurance we had to arrange transport to a Seguro Popular hospital, when he got there the doctor said he needed X-rays that were not available at the hospital. So we had to transport him to another hospital for the x-rays, which we had to pay for then transport him back to Seguro Popular. There were no regular beds available so he had to wait several days in an observation bed. Finally someone died so he was admitted to a regular bed which was in a room with six other patients separated by curtains. They required that a family member be with him or available in the waiting area at all times in case he needed tests or medications which the family had to pay for before he received them. When he left 10 days later they presented him with a hospital bill but he didn't have to pay it because he didn't have any money. Several people died while he was there. My husband talked to the family of one of the deceased and learned that Seguro Popular would not release the body to the family until they paid $4000 pesos. Also while my brother-in-law was there, an ambulance brought a young girl who was the victim of a savage knife attack. The hospital asked her father to pay $80,000 pesos before they would operate. He didn't have the money and I don't know what happened to her. What a system!


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## AlanMexicali (Jun 1, 2011)

*Gossip*



Joycee said:


> Sorry if I gave wrong information about IMSS. I thought I read on the IMSS application that it was for families which meant at least two individuals. Also an ex-pat told me she got kicked out of IMSS when her husband died. Must have been a misunderstanding.
> As far Seguro Popular, I wouldn't let them treat my dog, if I had one. My brother-in-law suffered a stroke and was intially treated at another hospital. Because he did not have insurance we had to arrange transport to a Seguro Popular hospital, when he got there the doctor said he needed X-rays that were not available at the hospital. So we had to transport him to another hospital for the x-rays, which we had to pay for then transport him back to Seguro Popular. There were no regular beds available so he had to wait several days in an observation bed. Finally someone died so he was admitted to a regular bed which was in a room with six other patients separated by curtains. They required that a family member be with him or available in the waiting area at all times in case he needed tests or medications which the family had to pay for before he received them. When he left 10 days later they presented him with a hospital bill but he didn't have to pay it because he didn't have any money. Several people died while he was there. My husband talked to the family of one of the deceased and learned that Seguro Popular would not release the body to the family until they paid $4000 pesos. Also while my brother-in-law was there, an ambulance brought a young girl who was the victim of a savage knife attack. The hospital asked her father to pay $80,000 pesos before they would operate. He didn't have the money and I don't know what happened to her. What a system!


Is this the right forum to gossip on?


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## Mexicodrifter (Sep 11, 2011)

You bet.


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## AlanMexicali (Jun 1, 2011)

*Seguro Popular Hospital General*



Joycee said:


> Sorry if I gave wrong information about IMSS. I thought I read on the IMSS application that it was for families which meant at least two individuals. Also an ex-pat told me she got kicked out of IMSS when her husband died. Must have been a misunderstanding.
> As far Seguro Popular, I wouldn't let them treat my dog, if I had one. My brother-in-law suffered a stroke and was intially treated at another hospital. Because he did not have insurance we had to arrange transport to a Seguro Popular hospital, when he got there the doctor said he needed X-rays that were not available at the hospital. So we had to transport him to another hospital for the x-rays, which we had to pay for then transport him back to Seguro Popular. There were no regular beds available so he had to wait several days in an observation bed. Finally someone died so he was admitted to a regular bed which was in a room with six other patients separated by curtains. They required that a family member be with him or available in the waiting area at all times in case he needed tests or medications which the family had to pay for before he received them. When he left 10 days later they presented him with a hospital bill but he didn't have to pay it because he didn't have any money. Several people died while he was there. My husband talked to the family of one of the deceased and learned that Seguro Popular would not release the body to the family until they paid $4000 pesos. Also while my brother-in-law was there, an ambulance brought a young girl who was the victim of a savage knife attack. The hospital asked her father to pay $80,000 pesos before they would operate. He didn't have the money and I don't know what happened to her. What a system!



All patients have to deal with their system . An X-ray will take several days to pick up. You carry your blood work, other lab work reports, MRI and X-rays etc. waiting at each area for sometimes hours, sometimes 15 min. and take these with you around the circuit when you finally pick them up, sometimes in several locations, depending if you are at a Hospital general or a clinic until you are seen and diagnosed. The wait I experienced took 1 day and another 1/2 day. You will not be able to leave the waiting rooms unless someone stays to hear them call your name. It is customary to give your seat up to older or sicker people. They regulate the people allowed in the general Hospital with appointment cards and the waiting room rarely have the whole family, they wait outside the hospital grounds, but this depends on the mood of the security guards at the gate of the property. They realize it could be an all day affair.

If you are in a hospital usually you can have a test or x-ray done that day if it is not late afternoon. The wait is longer in the last part of the day and might be more convenient to make an appointment first thing in the morning. Don't expect to make an appointment at 2PM and not wait for everyone that came in there from a Dr. request that day. You wait first come first serve [going early puts you up in the line]. I know this is not fair but it is the way it is done. You are advised at all stops to ask who is the patient in front of me and if someone shows up after you and tries to go before you get up and say I was here before they were, thank you.

You make an appointment with the DR. requesting tests that day and calculate how many days it will take to do your legwork and they put that date in your appointment card. All clinics have an administration office once you have an appointment card there is no need to return to the same clinic you stared with, this will save a trip. I feel if your friend just went to the large Hospital General [Secretaria De Salud] and stayed there where there is usually 50 or more consultorios with specialists and bypassed the larger clinics when he knows a test is needed. There you would need to be registered first.

Another point it is a free of charge.


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## FHBOY (Jun 15, 2010)

*Knew About This*



AlanMexicali said:


> All patients have to deal with their system . An X-ray will take several days to pick up. You carry your blood work, other lab work reports, MRI and X-rays etc. waiting at each area for sometimes hours, sometimes 15 min. and take these with you around the circuit when you finally pick them up, sometimes in several locations, depending if you are at a Hospital general or a clinic until you are seen and diagnosed. ...I feel if your friend just went to the large Hospital General [Secretaria De Salud] and stayed there where there is usually 50 or more consultorios with specialists and bypassed the larger clinics when he knows a test is needed. There you would need to be registered first.
> 
> Another point it is a free of charge.


When we tourists two years ago, our tour guide told us about this, although we didn't know what it was called. It was a bit disconcerting, until we investigated and found out that is not what we would be involved in. I don't know how many US folks remember the beginnings of HMO's. In NYC for teachers there was HIP - and that, my friends, in the early days was almost a disconcerting. Still and all, Seguro, with it's "horrors", at least affords it's participants one less worry: they won't go bankrupt when they get sick.


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## DNP (May 3, 2011)

Expats should understand is that IMSS does not have the resources to meet all of its commitments. People should also recognize that health care costs are rising, and the population is aging. Duh.

Any of this sound familiar?

There are no free rides.

Sent from my iPod touch using ExpatForum


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## TundraGreen (Jul 15, 2010)

DNP said:


> Expats should understand is that IMSS does not have the resources to meet all of its commitments. People should also recognize that health care costs are rising, and the population is aging. Duh.
> 
> Any of this sound familiar?
> 
> ...


Is the population aging? I found a pdf from CONAPO that shows the aged (over 60) to be about 10% of the population. And it has been almost flat at that level for much of the last century. The mortality rate has fallen but the birth rate has fallen at the same time. Their projection is that the percentage of old people will rise over the next 40 years, but that rise is just starting now. It doesn't look like it is old people that are causing IMSS problems yet, although that will become a problem in the future. Apparently areas with lots of retired people from up north may be causing local problems, but it is not clear that is the source of IMSS problems everywhere.



CONAPO pdf


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## RVGRINGO (May 16, 2007)

Those statistics are valid, but they fail to address the fact that the elderly require much more medical care, while the young may go 40 to 60 years and hardly ever see a doctor or be admitted to a hospital. I made it to 61 with little demand on the medical system. Then, the first heart attack, stents, more heart attacks, more stents, other surgeries, a collapsed retina, eye surgeries, more dental visits, etc. I'm not young any more.


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## AlanMexicali (Jun 1, 2011)

*Demographics in Mexico*



TundraGreen said:


> Is the population aging? I found a pdf from CONAPO that shows the aged (over 60) to be about 10% of the population. And it has been almost flat at that level for much of the last century. The mortality rate has fallen but the birth rate has fallen at the same time. Their projection is that the percentage of old people will rise over the next 40 years, but that rise is just starting now. It doesn't look like it is old people that are causing IMSS problems yet, although that will become a problem in the future. Apparently areas with lots of retired people from up north may be causing local problems, but it is not clear that is the source of IMSS problems everywhere.
> 
> 
> 
> CONAPO pdf


I thought [ I might be wrong] that the demographics a few years ago that over 50% of Mexico's population were 15 years old or less. Wouldn't this indicated if when of working age these people would be paying taxes that support socialized medicine in Mexico at a high rate of non user to usurer patients, except child birth and infant/child care and secure their system for decades to come?

The Lake Chapala IMMS might have a problem related to this but if federal money supports ALL IMSS through Mexico wouldn't this particular IMSS be starting to be engaged in age discrimination?


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## DNP (May 3, 2011)

AlanMexicali said:


> I thought [ I might be wrong] that the demographics a few years ago that over 50% of Mexico's population were 15 years old or less. Wouldn't this indicated if when of working age these people would be paying taxes that support socialized medicine in Mexico at a high rate of non user to usurer patients, except child birth and infant/child care and secure their system for decades to come?
> 
> The Lake Chapala IMMS might have a problem related to this but if federal money supports ALL IMSS through Mexico wouldn't this particular IMSS be starting to be engaged in age discrimination?


That 10% represents a lot more people in absolute numbers.

Sent from my iPod touch using ExpatForum


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## AlanMexicali (Jun 1, 2011)

DNP said:


> Expats should understand is that IMSS does not have the resources to meet all of its commitments. People should also recognize that health care costs are rising, and the population is aging. Duh.
> 
> Any of this sound familiar?
> 
> ...


I guess that goes for all countries. One point you might have overlooked when stating your view is that the IMSS has always been ever expanding and modernizing nationwide with better educated administration, technicians, DR.s, nursing, in house education, modern and more availability to equipment and improved systems federally due to the overhaul and needs as they are discovered. With limited liability in Mexico's socialized medicine costs are not as high as the US. . Standards are focused on taking this into mind and money is distributed nationally discriminatory for various reasons. One example of this this is that when Dr.s or administrators or other heath care workers are found to be unsatisfactory in a certain situation instead of being fired, like in the US they will be forcible transferred to another location, usually the boondocks if they refuse to retire or quite. The unions and labor laws in Mexico are for the benefit of employees. There can be instances of incompetence in poorer suburbs of cities or in towns, even states where this will affect the level of heath care and a blind eye is given to it because of the limited liability. The overall system has faults and the recent overhaul and upgrading is slowly affecting all the parts of it's massive system and it will be some time until it will be settled. To compare US's system to Mexico's system is not going to get you anywhere in Mexico. This would be discriminating to Mexicans whose hard earned money takes care of it's own, instead of the US system that is geared to exploit sick people and make educated heath care administration and staff above middle class status when in Mexico they are the middle class. This also pertains to the educated justice dept. employees, govt. civil engineers, educators and their administrators and politicians in Mexico. Thank Mexico for cheap higher education and rewards for excellent students. You are taking advantage of living in a real social democracy, quite complaining. [not you in particular]


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## johnmex (Nov 30, 2010)

The problem for the IMSS is not an _aging_ population, the problem is an _overweight_ population. Health problems caused by being obese, such as diabetes, are straining the system to the breaking point. Especially when these problems present themselves in the younger population....

Thanks Bimbo!


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## TundraGreen (Jul 15, 2010)

johnmex said:


> The problem for the IMSS is not an _aging_ population, the problem is an _overweight_ population. Health problems caused by being obese, such as diabetes, are straining the system to the breaking point. Especially when these problems present themselves in the younger population....
> 
> Thanks Bimbo!


And Coca Cola.


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## Mexicodrifter (Sep 11, 2011)

And all the candy that is sold inside and right outzside the doors of the schools. Drive by any public school at the end of their day and watch where the kids line up. Education begins at home but too many folks ignore the results of sugar. Mexico is 65% overwieght, avcording to my source, and there is no end in sight,


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## AlanMexicali (Jun 1, 2011)

*Candy stores*



Mexicodrifter said:


> And all the candy that is sold inside and right outzside the doors of the schools. Drive by any public school at the end of their day and watch where the kids line up. Education begins at home but too many folks ignore the results of sugar. Mexico is 65% overwieght, avcording to my source, and there is no end in sight,


You have said something that clicked for me. My house in Mexicali has a secondary and primary school one block east and a primary and kidner one block west. The OXXO has a huge candy selection 2 or 3 blocks from all 4 schools. When hanging at the OXXO sometimes it is at 2PM and the lines are so long with students getting their sodas, drinkable yoghourts , juices and candy it fills the store up and sometimes a line outside for about 20 minutes. If someone put a large candy store close it would most likely attract a crowd. This might be the reason so many parents like to walk over and pick up their children so they don't ruin their appetites for the 3 PM large meal of the day. It explains a few things [why so many parents go to get their children when it is safe to walk in my neighborhood] I noticed but didn't give it much thought. I didn't put the two things together.


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## gudgrief (Jun 20, 2011)

All I can tell you is about my own experience and comments from one expat I know.

He has used IMSS in the past and was satisfied. I think it was a hernia operation.

I'm retired and using the retiree equivalent of IMSS is not possible for me because of pre-existing conditions that are not covered even if not pre-existing. Your coverage under IMSS is based on what's covered by law limited by budget, which means some services and meds might not be available at times.

After seeing an Internist, Cardiologist and Dermatologist down here, I realized having an address in the US and going back for treatment under Medicare would get me the best treatment at lowest cost.

Doctors and hospitals down here want cash up front. Something like angioplasty can easily run $10,000US. If you are at risk for serious conditions and can't afford to put out a large amount of cash, get your status with IMSS straightened out soonest. IMSS provide prescription meds that they have in stock. If they don't stock them or are out of stock, you have to buy at full price from a retail pharmacy. Farmacias Similares is a good source for generics which usually cost less than retail price in the US. Brand name drugs vary but usually come in less than retail and, sometimes insurance, price in the US.

Brand name drugs are sold by "brand name" pharmacies and they almost all offer discounts off retail price. You need to do your own comparison shopping. I get all my scripts filled at one pharmacy, not even a national chain, because it has the overall low prices even for generics.

For instance, discounted price for Crestor is less than my copay would be with insurance in the US. Generic Lasix and Lopressor here are about what my copay would be at Walmart.

Are you working in a remote area? That may make a whole bunch of difference in availability of service and meds. If you have any specific questions, I'll try to answer or get the answer from a friend.

I worked for a US company in Saltillo 82 to 85 and have been retired in another city since 2008 in case you're wondering about my experience,


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## Jim45D (May 27, 2011)

Hound Dog said:


> Patrick:
> 
> What you are referring to is the middle class Mexican health insurance program known as IMSS or Instituto Mexicano del Seguro Social which is for middle class workers and retirees. The poor have an alternative health care plan but, unless you are desperate, you don´t want to submit your body to that charnal house. In fact, I wouldn´t send my worst enemy to an IMSS health care facility. They are broke to the point that you had better take your own toilet paper or you can wipe your butt on the sheets in which you have just slept. If this is what your employer is offering you then that is because under Mexican law they are required to so do. You must be working for some truly Chickensh*t cheapassd outfit.
> 
> By the way, forget the prescription coverage, Prescription medication in Mexico is cheap and the term "prescription" is a standard joke unless we are talking narcotics and even that is a one-liner.


Exactly, and as far back as 25 years past, some of the older Mexican's referred to this particular insurance,,,(I.M.S.S.) as.....*Importa Madre Su Salud!*


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## FHBOY (Jun 15, 2010)

*New IMSS Rules*

I am revisiting this thread to ask a simple question - after an exposition. 

I have been read about IMSS here for since I joined up. I have read both good things and horror stories about it. I have recently read some things that have caused me concern. I know that no one here is an expert on IMSS even though the knowledge of it displayed is impressive.

So, here is my question. Is there a definitive place, either online or when we are in Ajijic for a week in April that I can go to to get eligibility questions answered? I do not read Spanish all that well, but what little I have read online does not seem to answer the simple question: What medical conditions will exclude me from coverage? What documentation does IMSS require, or do I just fill out a form?

I hesitate to contact an insurance agent because, if (s)he is an insurance agent (s)he will want to sell me something.

Can any of y'all give me a clue here? I mean I saw a table at LCS with a guy sitting there that said IMSS questions - but who is he and does he have the answers?


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## Detailman (Aug 27, 2011)

FHBOY said:


> I am revisiting this thread to ask a simple question - after an exposition.
> 
> I have been read about IMSS here for since I joined up. I have read both good things and horror stories about it. I have recently read some things that have caused me concern. I know that no one here is an expert on IMSS even though the knowledge of it displayed is impressive.
> 
> ...


Your second sentence is not up to your standard. Were you distracted? What were they wearing when they walked by?


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## pappabee (Jun 22, 2010)

FHBOY said:


> I am revisiting this thread to ask a simple question - after an exposition.
> 
> I have been read about IMSS here for since I joined up. I have read both good things and horror stories about it. I have recently read some things that have caused me concern. I know that no one here is an expert on IMSS even though the knowledge of it displayed is impressive.
> 
> ...


There is a rep at LCS on Mondays from 10.00 to 1.00 but I am told that they don't have all the answers. The best bet might be to actually visit IMSS in Chapala. What you read on line does not cover the actual fact. If you have almost any health condition you will probably be denied coverage. But it's sure worth the effort.


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## gudgrief (Jun 20, 2011)

pappabee said:


> There is a rep at LCS on Mondays from 10.00 to 1.00 but I am told that they don't have all the answers. The best bet might be to actually visit IMSS in Chapala. What you read on line does not cover the actual fact. If you have almost any health condition you will probably be denied coverage. But it's sure worth the effort.


He makes a good point.
When it comes to migracion tramites, I've never found the INM website accurate enough to rely on. Why should it be different for IMSS or Seguro Popular?

Anything dealing with federal government, I call or go first, Zacatecas is pretty compact so a 3 peso bus or 30 peso cab gets me anywhere in a half hour or less.

If you're not confident in your Spanish, bring a friend who can interpret. Even here in Zac where there's no expat community, a surprisingly large number of officials speak English; you could just take a chance you'll run in to one.


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## RVGRINGO (May 16, 2007)

The answer to the question is ....... "No"


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## FHBOY (Jun 15, 2010)

Detailman said:


> Your second sentence is not up to your standard. Were you distracted? What were they wearing when they walked by?


Wouldn't you like to know - it is 70 degrees and sunny in Baltimore today - and it's March! Oh yea, and windy also!

So, RV, the answer is NO (he is such a curmudgeon!) - so here's another question: What should I do?


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## RVGRINGO (May 16, 2007)

Forget IMSS. Use private care for routine stuff. Consider signing up for Seguro Popular for major contingencies. We've had IMSS & lost it twice. Now, we're out. We're too old for private insurance, but couldn't afford it, even if we had started when younger. There comes a time to stop worrying and pull the plug, if necessary.


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## gudgrief (Jun 20, 2011)

FHBOY said:


> Wouldn't you like to know - it is 70 degrees and sunny in Baltimore today - and it's March! Oh yea, and windy also!
> 
> So, RV, the answer is NO (he is such a curmudgeon!) - so here's another question: What should I do?


For what it's worth, I decided before I came to Mexico I'd just roll with the punches.
If I have it correct, an inmigrante or inmigrado are eligible for IMSS, a NO inmigrante is eligible for Seguro Popular. That may have changed since they stopped collecting premiums for Seguro Popular. If you travel on a Tourist Card, you're probably not eligible for either.

The website salud.gob.mx has a lot of broken links and the only thing clear is that you have to be a resident. The old FM2 & FM3 qualified. Who knows what the new classifications will be called?


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## Detailman (Aug 27, 2011)

pappabee said:


> There is a rep at LCS on Mondays from 10.00 to 1.00 but I am told that they don't have all the answers. The best bet might be to actually visit IMSS in Chapala. What you read on line does not cover the actual fact. If you have almost any health condition you will probably be denied coverage. But it's sure worth the effort.


When I talked to the reps at LCS I explained that I had a heart attack a number of years ago but I was now in good health and in fact a long distance runner able to run a ten kilometer race in 56 minutes. They told me that based on what I had just said that I should apply and not mention the heart attack on my application.

With a little checking and further thought I concluded that as with any insurance I could be disqualified thereafter for not supplying the correcct information on the application. To not include the fact of my heart attack on the application would be fraudulent.

And once I include that information I do not qualify for the insurance due to the pre-existing condition. So no IMSS for me.

So be careful with any information that is supplied by the reps at LCS. They can tell you what you want to hear.


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## Detailman (Aug 27, 2011)

RVGRINGO said:


> Forget IMSS. Use private care for routine stuff. Consider signing up for Seguro Popular for major contingencies. We've had IMSS & lost it twice. Now, we're out. We're too old for private insurance, but couldn't afford it, even if we had started when younger. There comes a time to stop worrying and pull the plug, if necessary.


The one day seminar that includes much information about Lakeside and hosted by a lady (that I have again forgotten her name) triggered a thought process that I felt more than paid for the seminar.

I had been concerned with health care due to my previous heart attack. Due to that I felt that I would not qualify for the government plan. Private health insurance that could be obtained with the pre-existing condition would be very expensive.

What about self-insuring? If a person has the money to do this it makes sense. Take say $25,000 which should pay for something like triple heart bypass surgery and invest it in secure dividend paying companies like Macdonalds. You should be able to get a 5 - 10% return on your investment over time. If you require the major surgery you have the money to do so. If not your investment grows over the years and if you didn't require the major surgery for say ten years you would find that your medical fund had grown to the extent that you would be able to take $25,000 out of it for your surgery and still have that amount left in your account due to its growth over the ten year period. That made up my mind that I could move to Mexico without worrying about any major surgery problem. Money would not be an issue and of course the expertise of the major hospitals is a known fact.

That worked for me. It might not work for others who do not have the funds to put aside or are uncomfortable with the stock market.


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## Detailman (Aug 27, 2011)

FHBOY said:


> Wouldn't you like to know - it is 70 degrees and sunny in Baltimore today - and it's March! Oh yea, and windy also!
> 
> So, RV, the answer is NO (he is such a curmudgeon!) - so here's another question: What should I do?


Of course, I would like to know! More detail the better. After all, I am detailman.

Of course my critique of your sentence was in fun. I enjoy many of your posts as they are very well thought out.:clap2:


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## FHBOY (Jun 15, 2010)

Detailman said:


> Of course, I would like to know! More detail the better. After all, I am detailman.
> 
> Of course my critique of your sentence was in fun. I enjoy many of your posts as they are very well thought out.:clap2:


Thank you, thank you and thank you! All this bowing, someone get me an ice pack for my back!!!! Like Isla I am now going to beg for REP POWER, add a Thanks to a message of mine 

Seriously, RV, you gave me an idea as did Detailman. I will look into Seguro coverage, and talk with "my people" about making a virtual HSA with a set aside corpus. Whether I have the risk tolerance for the Market is another thing. Look, a $20 office visit, even a $400 procedure is within budget, and goes a lot further, so I will talk a lot about these ideas in the future.

So, I have added Rep Power to Detailman and RV - what a childish competition - but what the heck - why not have some fun!


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## gudgrief (Jun 20, 2011)

Around here, an office visit to a specialist is a pretty much standard 800 pesos.
Chest X-ray 300 pesos (at a hospital with up to date equipment.)
Full blood work up 500 pesos.
Cardiac ultrasound, stress test 500 to 1000 pesos each unless the cardiologist has his own and includes them in the office visit fee. Go figure!

My friend's aunt had hernia surgery last year in a private hospital in a small Mexican city. The hospital was 15000 pesos and the surgeon around the same. Around $2500 USD for hernia surgery, cheap compared to the US.

An angiogram cost $400 out of pocket under Medicare, around here about $2000 USD.

A lot of factors need to be weighed starting with your general health.

One thing we don't hear about is the types of ailments expats with Seguro Popular have and the outcomes of treatment.


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## Detailman (Aug 27, 2011)

FHBOY said:


> Like Isla I am now going to beg for REP POWER, add a Thanks to a message of mine QUOTE]
> 
> Don't do it. It is demeaning. You already have "a reputation beyond repute."
> 
> ...


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## FHBOY (Jun 15, 2010)

Detailman said:


> FHBOY said:
> 
> 
> > Like Isla I am now going to beg for REP POWER, add a Thanks to a message of mine QUOTE]
> ...


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## Detailman (Aug 27, 2011)

FHBOY said:


> *I believe that if you are worthy*
> *of praise and respect, *
> *you do not ask for either, *
> *it is bestowed upon you.*
> *And earned.*


A wonderful quote. Thanks FHBOY!


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