# Health Insurance



## STEVOH (Jan 9, 2014)

I am a crossroads and wanted to get opinions of some experienced expats. I am arriving in Playa del Carmen this coming friday to start looking for a place to live. I am trying to decide what my best options are regarding Health Insurance. I previously had a travellers Health Policy for emergency evacuation etc. Pretty high deductible and about $1000 a year.

What advice can I get about waiting to get Mexican Health Insurance, or should I opt in to the travellers insurance policy. 

Also, what Travellers Insurance companies offer the best alternatives regarding pre-existing conditions (hernia) and what reliable Mexican Health Insurance options can I look forward to.

Thanks in advance

Steve


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## Hound Dog (Jan 18, 2009)

You don´t state your age but the older you get the harder it is to get the best major medical insurance which is what you want down here (or anywhere else for that matter). In my judgment. as you age and new infirmities appear like magic - some quite costly even in Mexico - you will find it harder and harder to qualify for non- cancellable major meical coverage even with a large deductible feature; perhaps this critical insurance coverage will be denied you altogether if you have reached a certain age. 

We bought unlimited major medical insurance coverage immmediately upon moving to and establishing residence in Mexico in 2001. I was then 59 and my wife was 54. No problem - not even a serious medical examination upon inception. Today we have been with the same insurance company (AXA) for 14 years now are granfathered in for life albeit with increased annual premiums which are substantial but beat the hell out of the catestrophic cost which we might incur if either of us becomes seriousy ill. I am now 73 and my wife is 68 and were we not already insured for years with major medical coverage, I don´t think we would stand a chance in hell of buying that type of coverage today under new policies. Our deductibles are $30,000MXN per claimed incident wjich is OK by me since the purpose of major madical insurance from a reputable international carrier through a company such as AXA with a local and responsive local agent is critically important to insure you against financial catastrophy in the event of a a truly serious illness resulting in lengthy hospitalization.

Many expats depend on Mexican government sponsored IMSS medical coverage and some opt for Seguridad Popular meant to provide medical insurance for the poor and perhaps you should look into those programs but I would choose neither as, in my opinión, neither can assure you the top medical (team) care you may need someday and hospitalization in the best hospitals with private suites and comfortable in-room accomodations for relatives or friends who choose to visit or stay with you. There are those who may disagree with that assessment and they are welcome to express their opinions but I would never purposely give up my high quality private medical insurance - especially at this stage of my life.

In my opinión. "travellers´ insurance is a chancy risk and, if I were you I would get off of that type of coverage ASAP.


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## Playaboy (Apr 11, 2014)

i have private insurance in PDC. Check your PM's for my agents contact info.


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## Isla Verde (Oct 19, 2011)

Your age is crucial. The other day, just out of curiosity, I checked out the AXA website and found out they will not sell a policy to anyone over 64!


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## Isla Verde (Oct 19, 2011)

Hound Dog said:


> Many expats depend on Mexican government sponsored IMSS medical coverage and some opt for Seguridad Popular meant to provide medical insurance for the poor and perhaps you should look into those programs but I would choose neither as, in my opinión, neither can assure you the top medical (team) care you may need someday and hospitalization in the best hospitals with private suites and comfortable in-room accomodations for relatives or friends who choose to visit or stay with you.


Not all of us can afford the pricey private insurance you have, and so we must rely on government programs like IMSS. _Así es la vida._


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## lagoloo (Apr 12, 2011)

Basic policy of insurance companies:
Only insure those who are not likely to need it any time soon.


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## Hound Dog (Jan 18, 2009)

Isla Verde said:


> Not all of us can afford the pricey private insurance you have, and so we must rely on government programs like IMSS. _Así es la vida._


I understand, Isla and that is the reason I mentioned the governmental sponsored medical ptograms IMSS and Seguridad Popular. Since I know neither the age nor financial capacity of the OP, I cannot further refine my response. If the OP cannot afford the rather substantial premiums the OP will face as the OP ages, a decisión as to the route to take should be considered upon establishment of residency in this country. The longer he/she waits the more problematic later entry into any private programs and maybe public programs as well. The one thing I re-emphasize is for anyone to get off of those tourist health policies as quickly as possible once the decision is made. 

As for the age 64 cut-off date at AXA, that does not surprise me. Dawg cannot get a single credit card issued by a Mexican bank because I am over 70 years of age and despite a spotless credit history over some 50 years and demonstated financial capacity even if I kick the bucket. Not one, including Banco Walmart which solicited my business and where I maintain an account, has ever told me the reason for rejection and I really don{t mind since I have a number of debit cards which work fine and with no fees attached. I only found out about the 70 year age limit through a third, disinterested party. There is something to be said about U.S. laws requiring that credit card rejections be for specific legal reasons and revealed to the rejectee.


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## Isla Verde (Oct 19, 2011)

Just to clarify, the Mexican government programs are IMSS and *Seguro* Popular.


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## Hound Dog (Jan 18, 2009)

Isla Verde said:


> Just to clarify, the Mexican government programs are IMSS and *Seguro* Popular.


Thanks, Isla.

Actually, the Seguro Popular facilities in San Cristóbal de Las Casas might be dubbed "La sala de espera de Dios". IMSS facilities in that town are also dreadful and the crowds to endure would kill a mule. Actually, the community's private hospitals are generally so marginal in quality that my health insurance company (AXA) refuses to allow any local hospital to join the company´s hospital membership network and one must pay up front and later submit facturas to AXA for reimbursement. On the other hand, some praise IMSS and Seguro Popular service in some other áreas such as Guadalajara. 

That reminds me that when migrants choose a town or región in which to live while residing in Mexico, those migrants should check out the medical facilities and access to competent physicians in the área in which they have chosen to reside as the quality from town-to- town may vary substantially.

In 2008, when I came down with a diseased gall bladder while in San Cristóbal, AXA offered free emergency airlift service to Guadalajara, Mexico City or Monterrey for the required gall bladder removal operation. I turned any travel down and had the operation performed in San Cristóbal as I was too ill to travel. The local hospital staff did, indeed try to kill me but were unsuccessful in the the endeavor. Later, I spoke with my AXA agent and indicated my pleasure at discovering that that medical emergency airlift service was available to me in the event of dire need. He responded that I should not rely on that feature for future reference. It seems that AXA offered that service as they thought I was on vacation in Chiapas and not at my residence at Lake Chapala. He informed me that now that they realized we had moved to Chiapas voluntarily to reside part of each year in our home there, they would no longer provide airlift services in emergencies and I would have to seek medical help in a Chiapas hospital. After all, they reasoned, if I was dumb enough to actually reside in a place where hospitals were so inadequate that AXA would not accept any of them as members , that was my decisión and, thus, my problem. 

For those of you contemplating a move dwon here to reside and attracted to remote and, perhaps, povery stricken parts of the country, keep in mind these downside risks importantly including rapid access to adequate medical care.


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## STEVOH (Jan 9, 2014)

Hound Dog said:


> You don´t state your age but the older you get the harder it is to get the best major medical insurance which is what you want down here (or anywhere else for that matter). In my judgment. as you age and new infirmities appear like magic - some quite costly even in Mexico - you will find it harder and harder to qualify for non- cancellable major meical coverage even with a large deductible feature; perhaps this critical insurance coverage will be denied you altogether if you have reached a certain age.
> 
> We bought unlimited major medical insurance coverage immmediately upon moving to and establishing residence in Mexico in 2001. I was then 59 and my wife was 54. No problem - not even a serious medical examination upon inception. Today we have been with the same insurance company (AXA) for 14 years now are granfathered in for life albeit with increased annual premiums which are substantial but beat the hell out of the catestrophic cost which we might incur if either of us becomes seriousy ill. I am now 73 and my wife is 68 and were we not already insured for years with major medical coverage, I don´t think we would stand a chance in hell of buying that type of coverage today under new policies. Our deductibles are $30,000MXN per claimed incident wjich is OK by me since the purpose of major madical insurance from a reputable international carrier through a company such as AXA with a local and responsive local agent is critically important to insure you against financial catastrophy in the event of a a truly serious illness resulting in lengthy hospitalization.
> 
> ...


Thanks for the valuable information. I am 60 years old now.


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## STEVOH (Jan 9, 2014)

I am currently 60. So Ill check it out when I get in. Do you happen to have a link to their site?


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## lagoloo (Apr 12, 2011)

I did the same tap dance with Banco Walmart, in hopes of acquiring a credit card. First, you must possess *another Mexican Credit Card.* Banamex : just takes your deposits but kicks you under the bus when you reach a magic number. So, Catch 222.

One of the good things about living in the Lakeside area is that even the IMSS and Seguro Popular hospitals are said to be adequate. I've been fortunate enough to not have been in one of them.
A few friends have had good experiences there. In any case, it's a good backup plan to Pay-out-of-pocket.


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## STEVOH (Jan 9, 2014)

If I am reading correctly, My best option would be to go with AXA and not IMSS? AXA offers better hospitalization options instead of the rural type hospitals?

Does anyone have any broker contacts or other ways to look at options?

Stevoh


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## Isla Verde (Oct 19, 2011)

STEVOH said:


> If I am reading correctly, My best option would be to go with AXA and not IMSS? AXA offers better hospitalization options instead of the rural type hospitals?
> 
> Does anyone have any broker contacts or other ways to look at options?
> 
> Stevoh


At the moment, for someone your age IMSS will cost about $4000 (that's pesos) a year. AXA will most likely cost 7 or 8 times that much. 

With IMSS the services you get and the facilities all depend on where you're living. I live in Mexico City, so if I needed to be hospitalized, I would go to an IMSS hospital in the city, where I would imagine things would at least be adequate. If you're living in a smaller city or town or out in the sticks, things might not be so great.


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## MelanieL (Jun 11, 2015)

*Private Health Insurance - Research the Options*

Indeed, IMSS and Seguro Popular are not the best options, especially if private health care is an option.

Traveler's insurance will not cover your pre-existing conditions and is limited to specific periods of travel.

In Mexico, your choices include: Mexican insurance( AXA, GNP, Allianz, etc. - 62 & 64 years max. enrollment age) and International companies (Bupa, Pan American, Met Life - 74 years max. enrollment age). 

As a health insurance advisor myself, I work with most of these companies. It's important to find a bilingual agent who is willing to spend time with you to explain how the different companies operate. He/she should be able to offer you a variety of health insurance options (not just one company), so that you can compare plans, benefits, and premiums.

Hope this helps! ~Melanie


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## LMtortugas (Aug 23, 2013)

MelanieL said:


> Indeed, IMSS and Seguro Popular are not the best options, especially if private health care is an option.
> 
> Traveler's insurance will not cover your pre-existing conditions and is limited to specific periods of travel.
> 
> ...


Hello Melanie,

I would appreciate your additional input & remarks.

In the semi-near future my wife and I will relocate to Los Mochis, Sinaloa permanently, compelling me to begin maneuvering through health insurance options. Currently we carry NOB employer-based insurance via state employment. Coverage is comprehensive but nothing outside the norm. 

Correct me if I am wrong, but my interpretation of _IMSS_ is that thoroughness & quality of care is largely contingent upon available treatment facilities at any one particular location. Los Mochis puts forward a selection of multiple _IMSS_ hospitals, in addition to several private hospitals/clinics that remind me more of boutique hotels than medical institutions. In any event, the consensus of family/colleagues is that available _IMSS_ care is very satisfactory, private care is of the highest quality.

Does the private market offer plans to expats that wrap around/compliment standard _IMSS_ coverage or U.S. Medicare, similar to supplemental plans available NOB? My sense is that _IMSS_ will mostly suffice but I would be interested in supplementing it with catastrophic/ superior coverage in the event one experiences a very serious condition that necessitates, or preference would be for, treatment at a more critical care facility. I would assume what is considered routine monthly cost for health insurance in the states would go a much longer way in Mexico even through the private sector.

Thank you in advance for any comments & opinions.


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## Waller52 (Jun 17, 2015)

MelanieL said:


> Indeed, IMSS and Seguro Popular are not the best options, especially if private health care is an option.
> 
> Traveler's insurance will not cover your pre-existing conditions and is limited to specific periods of travel.
> 
> ...


The bottom line is that age increases practical options decrease. Seniors are left with nothing to rely on other than fate and perseverance.


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## TundraGreen (Jul 15, 2010)

LMtortugas said:


> Hello Melanie,
> 
> I would appreciate your additional input & remarks.
> 
> ...


I don't know about plans that supplement IMSS. Someone else will have to address that.

I have been a member of IMSS for 4 years. In that time I have used them for teeth cleaning, occasional visits to an assigned General Practitioner for a general checkup, one emergency room visit for an infected elbow, and one or two visits to a specialist for consultation. The specialist visits required a long lead time, about 6 months, for an appointment, the other visits required no wait. Frequently the IMSS Farmacia has not had a prescribed medication, but they did for the infected elbow. 

I have heard that IMSS quality can vary. i am in a large city with lots of medical schools and it is probably better here than in some other places. I am not sure what I will do if I ever need treatment for some major problem. So far, that has not happened.


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## LMtortugas (Aug 23, 2013)

thank you TundraGreen


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## tbh (Apr 11, 2015)

For those over 70 I see that Focus on Mexico is pushing a group plan called Best Doctors Group Health Plan. However, I haven't been able to find any credible information about the plan. Does anyone know anything about it?


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## mattoleriver (Oct 21, 2011)

tbh said:


> For those over 70 I see that Focus on Mexico is pushing a group plan called Best Doctors Group Health Plan. However, I haven't been able to find any credible information about the plan. Does anyone know anything about it?


Sent a PM


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## lagoloo (Apr 12, 2011)

Here is a link:
Boomers in Paradise | Health Insurance in Ajijic-Chapala, San Miguel de Allende, Puerto Vallarta, Mexico for expats
Age limit: 75


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## Waller52 (Jun 17, 2015)

lagoloo said:


> Here is a link:
> Boomers in Paradise | Health Insurance in Ajijic-Chapala, San Miguel de Allende, Puerto Vallarta, Mexico for expats
> Age limit: 75


Thanks for the link. I haven't read a medical insurance policy in a while but these two offerings appear, at first glance, to be pretty decent for the Chapal/Ajijic ex-pats.

http://boomers-in-paradise.org/wp-content/uploads/2015/06/2015-BD-Summary-of-Benefits_0615.pdf

http://boomers-in-paradise.org/wp-content/uploads/2015/06/2015-WEA-Summary-of-Benefits_0615.pdf

“Group” FAQs | Boomers in Paradise


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## tbh (Apr 11, 2015)

lagoloo said:


> Here is a link:
> Boomers in Paradise | Health Insurance in Ajijic-Chapala, San Miguel de Allende, Puerto Vallarta, Mexico for expats
> Age limit: 75


Thanks, Lagoloo

Also, another member pointed me to a thread on a local Lakeside forum that discussed those and related plans, and gave some local input from doctors and patients who had experience with them. I may not be allowed to post that link here but it's easy enough to find on that local forum.

Again, thanks.


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## eastwind (Jun 18, 2016)

Resurrecting an old thread to keep information together.

I'm 56 and have retired early to Cancun. I have US health insurance at the moment, but it is tied to my old home in Washington state which I am selling. For 2017 I need something else. I will be traveling back to the US a couple times a year and need a policy that will cover me while there. I would like one that includes expat evacuation insurance too, if possible. 

Handling routine expenses in mexico out of pocket seems fine for me. 

I did one internet search that took me to Novamar. I thought this was an insurance company, but it turned out just to be a broker. I'm not convinced of the value such an intermediary provides - would anyone like to tell me why I need a broker and not just insurance? Is their main value in providing bilingual communication?

I also found that I can go straight to a Cigna site and get an " indicative per year" quote. 

The AXA site I found for mexican health insurance was all in Spanish, so I don't know if that's going to be targeted at people living here full time or expats that travel NoB.

Any links or steering in the right direction much appreciated.


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## maesonna (Jun 10, 2008)

You don’t necessarily need a policy that also covers you in the U.S. You can think of Mexico as your home if you are a resident here. You can get travel insurance for trips. The same as if you were living in the U.S. and took occasional trips to Europe, you wouldn’t need a insurance that covers both U.S. and Europe full-time.
It would be prudent to have some Mexican health coverage, whether public or private in case your health changes or you suffer an accident and you need a longer hospital stay and/or extensive surgery.


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