# Newbie asking about medical imsurance



## terrybahena (Oct 3, 2011)

I've been reading many threads and I have a question. What about medical insurance? I understand it's about 1/10 the price and other research says there are 6 hospitals in Mexico that meet US standards and more coming up. 2 or 3 are near where we will be living. I currently pay $500 per month and don't want to keep it up- I go to the dr twice a year only but had breast cancer (completely beaten it) but I'm screwed for insurance. I've been reading that I can get insurance and good care in Mexico, but I'd like some reality check opinions. thnx in advance!!


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## TundraGreen (Jul 15, 2010)

terrybahena said:


> I've been reading many threads and I have a question. What about medical insurance? I understand it's about 1/10 the price and other research says there are 6 hospitals in Mexico that meet US standards and more coming up. 2 or 3 are near where we will be living. I currently pay $500 per month and don't want to keep it up- I go to the dr twice a year only but had breast cancer (completely beaten it) but I'm screwed for insurance. I've been reading that I can get insurance and good care in Mexico, but I'd like some reality check opinions. thnx in advance!!


Your options in México are:
- Uninsured. Just pay as you go. Costs are low compared to the US.
- Private health insurance. I don't know much about this. But I think you can go to any doctor or clinic.
- IMSS. Instituto Mexicano Seguro Social. A national health system with its own doctors and clinics. You are assigned to a clinic. There are no copays or deductible or costs except for an annual premium. I don't know if you pay for prescriptions. I think the level and availability of care may depend on where you are located. Downside rumors: I heard that they an be out of medications requiring you to buy them outside of the system; and, someone on this forum claimed that in Ajijic they kicked all the foreigners out of the system, because there were too many and they required too much care. Upsides: the care I have gotten, teeth cleaning has been quick and efficient. No lines, no appt, just walk in and they do it. The cost of IMSS is mxn $3472/year for those over 60, less for younger. There are some restrictions for the first year or so of coverage. I don't know how it would be affected by your prior condition. The application form asks you to check off what you have had in the past.
- Seguro Popular. Free medical care for people without resources. Probably not of much interest to foreigners. If you are poor enough to qualify, they wouldn't let you stay in Mexico.


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## FHBOY (Jun 15, 2010)

TundraGreen said:


> Your options in México are:
> - Uninsured. Just pay as you go. Costs are low compared to the US.
> - Private health insurance. I don't know much about this. But I think you can go to any doctor or clinic.
> - IMSS. Instituto Mexicano Seguro Social. A national health system with its own doctors and clinics. You are assigned to a clinic. There are no copays or deductible or costs except for an annual premium. I don't know if you pay for prescriptions. I think the level and availability of care may depend on where you are located. Downside rumors: I heard that they an be out of medications requiring you to buy them outside of the system; and, someone on this forum claimed that in Ajijic they kicked all the foreigners out of the system, because there were too many and they required too much care. Upsides: the care I have gotten, teeth cleaning has been quick and efficient. No lines, no appt, just walk in and they do it. The cost of IMSS is mxn $3472/year for those over 60, less for younger. There are some restrictions for the first year or so of coverage. I don't know how it would be affected by your prior condition. The application form asks you to check off what you have had in the past.
> - Seguro Popular. Free medical care for people without resources. Probably not of much interest to foreigners. If you are poor enough to qualify, they wouldn't let you stay in Mexico.


Will be moving to Ajijic when I am 63, your post concerns me about IMSS, can someone else add to your research. Again, conflicting reports - some say that my age will not be a factor, I can get IMSS if I want, some say there are new per-existing rules. Can we get the residents in Mexico to help us clear up what is the status today? (In Mexico, tomorrow may be different )

I also found a USD $1500/yr health policy in my searching the net, unfortunately I cannot recall where I found it. Again, Ex-Pats, please let's re-visit this issue and thank you.


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## pappabee (Jun 22, 2010)

There are a lot of health insurance options available. The problem is the underwriting. Whereas in the states health coverage is "selectively" underwritten in Mexico it's almost 'all or none'. Over the past year/year and a half, coverage has been reduced to only the healthy. That is why they now require all new applicants to pass a physical. 

I was told by a Representative of IMSS that I could not get coverage because I have diabetes. Also in checking with regular insurance carrier I got the same answer. They will not exclude it (as can be done in the states) they just will not issue a police. I was told by a doctor that the reason they do that is because, in Mexico, they do not have the large underwriting and claims departments as they do in the states. 

There has been a continuing problem with the IMSS location in Chapala. But I have no idea if it's been corrected or not.

For you well folks, Bupa has three different levels of coverage the lowest being about $2000 US per year for two. That only covers what we used to call catastrophe only. 

My suggestion to you is that if you qualify for Medicare or can continue your current insurance-----do so. You can cover the current medical needs for much less than in the states. An office visit to a doctor is about $200MX ( around $15.00 US)


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## RVGRINGO (May 16, 2007)

For us, IMSS was both corrupt and inefficient. We don't have it any more and pay out of pocket for routine care. We're too old for private insurance and have pre-existing conditions which would preclude us anyway.
So, we hope to avoid any long hospitalizations. 
"Life is dangerous; it always ends in death."


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## dogtags (Apr 24, 2011)

i read what I think was an official document regarding pre-existing conditions.I'll try to find the link The list was what you would expect (diabetes, hypertension, heart disease, HIV, etc.),

If I recall correctly, these conditions do not make you ineligible for IMSS, but you would never be allowed to be treated for them inder IMSS.

My partner and I have private subsidized insurace thru my former employer, but it ends when Medicare begins. Even in Mexico, I'm not sure I could afford another bypass surgery out-of-pocket.

Sent from my iPhone using ExpatForum


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## RVGRINGO (May 16, 2007)

I doubt that you'll find many that will accept you for coverage, with your pre-existing condition, in Mexico. So, keep an emergency fund or credit card limit high enough to cover a few stents in a Mexican hospital. I've had them installed in the USA and in Mexico. I liked the Mexican experience much better and the cost was about what co-pay and other deductions would have been in the USA, anyway.


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## pappabee (Jun 22, 2010)

dogtags said:


> i read what I think was an official document regarding pre-existing conditions.I'll try to find the link The list was what you would expect (diabetes, hypertension, heart disease, HIV, etc.),
> 
> If I recall correctly, these conditions do not make you ineligible for IMSS, but you would never be allowed to be treated for them inder IMSS.
> 
> ...


I've read the same info but no matter what if you have those, plus many more pre-existing conditions, you will not be able to pass the medical exam and therefore will not be allowed coverage. In Mexico they do not exclude individual coverage when you apply. In the states many health insurance companies will either place a temporary or perminate exclusion rider on a policy. Not in Mexico. 

Again as I said before, the reason is the lack of large underwriting and claims departments. 

If you can't pass the physical, you can not get approved to get the insurance.


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## Mexicodrifter (Sep 11, 2011)

I am a IMSS guy and find it acceptabnle. I am covered under my wifes policy which covers everything for me. You will find that the system is slow but the meds are free. The Dr´s are friendly and helpful but they are restricted by the system itself. Getting to a specialistis not easy, 6 months to see a Dermitoligst, because there are not many of them in the system. Millions of Mexicans use IMSS, as it is a workers health plan. Anyone who has a full time job and their employer pays the monthly bill is covered and the family, too. If you expect to be cared for like you were in the states then perhaps it would be better to go private or just save the cash for the hard times.
It is part of living outside of the US. Mexico is a third world country and that might say it all. We come here cause it is cheap and fun. Sometimes the fun is not so fun.


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## dogtags (Apr 24, 2011)

Thanks for a personal assessment which seems fair enough considering the terrible financial condition of that system. 

I must, however, correct you reference to Mexico as a "third world country". There are many definitions of that label (none are official), but Mexico is not on any of those lists. While most scholars have defined Mexico as a "developing nation", as of 2011, the IMF labels Mexico a "newly industrialized nation". 

The difference in the nuances of these labels may not be of much consequence to some, but I feel pretty sure the Mexicans themselves have stronger feelings on the matter. As a guest in their country, I think we owe it to them to get things right.


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## RVGRINGO (May 16, 2007)

Very true! We have, in Mexico, very upscale shopping in malls where we can only afford to look. There are nearby dealers, in case you need a new Mercedes, Maseratti, or just a smart car, like mine. We can stay in clean and friendly hotels for as little as $25 USD per night, or go for an upscale resort for ten times that amount. We can enjoy eating at a local 'cenaduria' for about $2.50 USD each, or go to any of several more upscale restaurants for world class service, food and prices. 
Our 'autopista' toll road system is excellent, though expensive, and your toll includes full insurance coverage for any eventuality. The government provides 'Green Angels' to patrol the highways and assist stranded motorists with fuel, repairs or a tow; all but the parts are free and the two mechanics are bilingual.
We have internet, telephones, movies in either English or Spanish, cable and satellite TV, propane fuel stations, gasoline stations, daily trash pick-up, taxis and the world's best bus system with luxury buses not seen in the USA. Seniors can get 50% discounts, too.
The private hospitals are excellent, as are the medical schools, dentists and other professions. They are also a lot less expensive without having to answer to insurance companies, lawyers, etc.
Except for narcotics and some antibiotics, you don't need to see your doctor every time you need a refill of your medications. Just go and buy them. Seniors can get discounts for that, too.
What's 'undeveloped' about that?


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