# health Care



## baja4us (Aug 4, 2015)

Hello,

We currently live in Seattle but are 3 years into our 7 year escape from the rat race plan. 

we have visited Todos Santos/ La Paz/ L.B. a number of times over the last 5 years and the area meets all of our needs. Our housing is handled and we are familiar with the cost of living etc.

The detail that we still struggle with is not, where to find good health care,clinics, hospitals, but how and with who we should research for insurance when we retire.

Due to pre-existing condition we will not be excepted on the National plan. We will have to use a private provider.

Does anyone use a U.S. company that covers expats in Mexico? Is there any other option?

Thanks for any advise.


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## AlanMexicali (Jun 1, 2011)

baja4us said:


> Due to pre-existing condition we will not be excepted on the National plan. We will have to use a private provider.


The Seguro Popular socialized medicine accepts legal residents with pre-existing conditons. The other one the IMSS might accept some pre-existing condtions with a waiting period, depends on what they are. I suspect La Paz being the state capital of Baja Sur has both of these socialized medicine plans´ facilities that are pretty good.

Private Mexican medical insurance with pre-existing conditions might be unavailable or if it is at a high cost, depending on what they are.


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## baja4us (Aug 4, 2015)

thank you so much! we will research Seguro Popular.


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## mes1952 (Dec 11, 2012)

Useless to pla now as things will certainly change in 5 years.


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## MJD13 (Aug 11, 2014)

I respectfully disagree with the idea that it's too early to plan. Figuring out your options as they exist today and, then, following any changes to private or public insurance availability is never a bad idea. 

First off, with pre-ex conditions, you probably won't find any private plans that will cover those conditions although you may find ones that will cover everything else. A Mexico based insurance agent should be able to assist you as the time draws closer. It won't be cheap.

You didn't mention your ages. If you will be entitled to Medicare around the time of your move, look into a Medicare Advantage Plans (Part C) that covers emergency care outside of the USA. Humana is one carrier that is pretty liberal in that regard. And, some Medicare gap type plans allow for emergency coverage while traveling. 

If you are under 65 and will have individual insurance or group type insurance, make sure you understand their policy re: emergencies while outside of the USA as those can vary. 

If you can maintain a permanent address in the USA (friends or family), so much the better as much of the emergency coverage is based on the idea that you are traveling outside of the USA and not residing outside of the USA. You need to take this into account when communicating with insurance providers.

My main point is that you will probably want coverage for emergencies but should be able to pay for routine care out of your own pocket or, as mentioned in another post, obtain coverage through one of the adequate Mexican public plans that generally have good care but the waiting times and general condition of the facilities can sometimes raise an eyebrow. We have friends covered by the public plans but only as a backup.


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## lagoloo (Apr 12, 2011)

Good advice.
The two public plans are IMSS and Seguro Popular. The IMSS plan will take you, but any pre-existing conditions are not covered for the first three years. Seguro Popular will take you, regardless. These are definitely no frills coverage. Someone described it as "MASH, without the incoming artillery." Better than nothing, though.

However, I'd strongly advise that you be prepared to pay most of your medical expenses out of pocket with one of the public plans as an emergency backup. Fortunately, medical care is much less expensive in Mexico than in the states. A visit to a general practitioner is around $250 pesos; a specialist, from $600 to $800 pesos.
There are some private plans, but the conditions depend on your age. Some have a cutoff age.


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## Isla Verde (Oct 19, 2011)

lagoloo said:


> There are some private plans, but the conditions depend on your age. Some have a cutoff age.


Most private plans here won't take you after age 65, and the few that do charge astronomically high rates.


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## mes1952 (Dec 11, 2012)

You don't think healthcare in the U.S. will change within the next 5 years as well as in Mexico??? You must be living in an enclosed environment. If you read the news there is now a debate going on about raising the SS retirement age as well as early retirement age. So dream on if you think things will remain the same in the U.S. or in Mexico. I understand that the average person is often very resistant to change but change will happen.


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## maesonna (Jun 10, 2008)

Anyone relying on Seguro Popular should know are limits on the conditions that it covers, never mind whether pre-existing or not. For example, hemodialysis for liver failure is not covered.

I don’t know how many or which other conditions might not be covered, but this is one I recently came across in some editing work I was doing.


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## lagoloo (Apr 12, 2011)

maesonna said:


> Anyone relying on Seguro Popular should know are limits on the conditions that it covers, never mind whether pre-existing or not. For example, hemodialysis for liver failure is not covered.
> 
> I don’t know how many or which other conditions might not be covered, but this is one I recently came across in some editing work I was doing.


I wish I could find the link, but someone found the website for S.P.with details on what's covered.


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## AlanMexicali (Jun 1, 2011)

lagoloo said:


> I wish I could find the link, but someone found the website for S.P.with details on what's covered.


https://translate.google.com/transl...p://www.seguropopular.org/&edit-text=&act=url


Seguro Popular


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## Isla Verde (Oct 19, 2011)

Seguro Popular was founded to help poor Mexicans without health insurance to receive health care. It seems wrong to me that expats would take advantage of a program not designed for them and thus indirectly reduce the help it can give to the truly needy. Just my opinion, of course.


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## lagoloo (Apr 12, 2011)

Isla Verde said:


> Seguro Popular was founded to help poor Mexicans without health insurance to receive health care. It seems wrong to me that expats would take advantage of a program not designed for them and thus indirectly reduce the help it can give to the truly needy. Just my opinion, of course.


I happen to agree with you on this. However, an even worse situation, IMO, are the people who don't have ANY health coverage or personal savings for emergencies and then have a fund raiser wanting the rest of us to pay for their medical misfortune.

Since I signed up with IMSS for emergencies years ago, pay up yearly in increasing amounts and have never used it, I figure I've made a decent contribution to their general fund.


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## sixcats (Aug 1, 2015)

Isla Verde said:


> Seguro Popular was founded to help poor Mexicans without health insurance to receive health care. It seems wrong to me that expats would take advantage of a program not designed for them and thus indirectly reduce the help it can give to the truly needy. Just my opinion, of course.


I agree. But the first year we were here we had no idea what we were doing. I have high blood pressure - nothing extreme. Within the first month here we waited in line (in the rain) to sign up for SP. After perhaps a few hours (when we got to the front of the line) they said we needed a CURP (which of course we did not have). Ultimately we did get a 2 year SP contract (which was free because all renters in Mexico are considered equal). We have never set foot in a SP hospital since. But I should mention - had we not been 'renters' SP would not have been free.

Shortly thereafter we found about IMSS. The sign-up process was once again rather grueling but much more modern. We had indoor chairs to sit in while we waited and we were assigned a number where we could watch the overhead display to get a sense where we were in the queue. I'm not sure of the exact cost of IMSS at the moment but I'll throw out 17,000 pesos for the two of us on the 'family plan'. Sometimes the lines can be very long (hours) especially for 'specialists'. We love our GP but some of the 'specialists' - well we often seek outside (private) care (out of pocket).


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## TundraGreen (Jul 15, 2010)

sixcats said:


> I agree. But the first year we were here we had no idea what we were doing. I have high blood pressure - nothing extreme. Within the first month here we waited in line (in the rain) to sign up for SP. After perhaps a few hours (when we got to the front of the line) they said we needed a CURP (which of course we did not have). Ultimately we did get a 2 year SP contract (which was free because all renters in Mexico are considered equal). We have never set foot in a SP hospital since. But I should mention - had we not been 'renters' SP would not have been free.
> 
> Shortly thereafter we found about IMSS. The sign-up process was once again rather grueling but much more modern. We had indoor chairs to sit in while we waited and we were assigned a number where we could watch the overhead display to get a sense where we were in the queue. I'm not sure of the exact cost of IMSS at the moment but I'll throw out 17,000 pesos for the two of us on the 'family plan'. Sometimes the lines can be very long (hours) especially for 'specialists'. We love our GP but some of the 'specialists' - well we often seek outside (private) care (out of pocket).


For an individual of about 70 years, IMSS is around $3500 mxn/year now. I have had to wait months to see a specialist.


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## sixcats (Aug 1, 2015)

TundraGreen said:


> For an individual of about 70 years, IMSS is around $3500 mxn/year now. I have had to wait months to see a specialist.


Ok - only because my wife keeps really good records - we spent exactly 10,400 pesos this year for our IMSS coverage. For us - it isn't so much the time to get an appointment as it is the time to see the doctor on that day. The various 'departments' handle appointments differently. The cardiologist I was hoping to see had perhaps 20 people scheduled for the same 10AM time-slot. 

I had to set up an appointment with an ENT perhaps a week in advance and he took me in 15 minutes after our scheduled time.


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## mattoleriver (Oct 21, 2011)

Isla Verde said:


> Most private plans here won't take you after age 65, and the few that do charge astronomically high rates.


Assuming that one is insurable how do Mexican rates compare to U.S. rates? I'm already paying 550USD/month for mid-level coverage for one 63 year old person NOB. Is Mexican insurance apt to be higher?...same?...lower?


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## TundraGreen (Jul 15, 2010)

sixcats said:


> Ok - only because my wife keeps really good records - we spent exactly 10,400 pesos this year for our IMSS coverage. For us - it isn't so much the time to get an appointment as it is the time to see the doctor on that day. The various 'departments' handle appointments differently. The cardiologist I was hoping to see had perhaps 20 people scheduled for the same 10AM time-slot.
> 
> I had to set up an appointment with an ENT perhaps a week in advance and he took me in 15 minutes after our scheduled time.


They do schedule everybody for the same time then just take people in the order in which they arrive, at least that is my experience with Hospital Ayala in Guadalajara. If you show up early and put your booklet in the tray early, you are taken early.

But my experience has been like yours. I always budget a whole day for renewing IMSS. Apparently, there is no way to do it on line. I go to the office, take a number, then wait hours for my number to come up.

My annual cost has gone up every year: $3472/$3604.50/$3733/$4400. I don't know but am guessing it is a combination of inflation and age. I seem to get older every year, in spite of my best efforts to deny it.


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## sixcats (Aug 1, 2015)

mattoleriver said:


> Assuming that one is insurable how do Mexican rates compare to U.S. rates? I'm already paying 550USD/month for mid-level coverage for one 63 year old person NOB. Is Mexican insurance apt to be higher?...same?...lower?


If you are talking private insurance (which I don't have) you might find the concept of health insurance much different from the US. The whole concept of pre-pays and out-of-pocket, maximum, etc differ


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## sixcats (Aug 1, 2015)

For clarification - both my wife and I are much younger than 70. Perhaps we are simply victims of having only the two of us in the 'family' plan - perhaps the cost would be the same if we had 10 kids ?? Either way - we are not complaining.


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## Isla Verde (Oct 19, 2011)

sixcats said:


> For clarification - both my wife and I are much younger than 70. Perhaps we are simply victims of having only the two of us in the 'family' plan - perhaps the cost would be the same if we had 10 kids ?? Either way - we are not complaining.


It sounds like you and your wife are paying way too much for the "family plan". Why not see if you can each purchase a plan separately?


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## AlanMexicali (Jun 1, 2011)

Isla Verde said:


> It sounds like you and your wife are paying way too much for the "family plan". Why not see if you can each purchase a plan separately?


https://translate.google.com/transl....gob.mx/tramites/imss02014&edit-text=&act=url

Asegura a tu familia para que puedan recibir servicios médicos en el IMSS.

Google Trnaslation:

"Validity

• You can purchase insurance at any time of year 
• Once you've included, medical services IMSS will start the first day of the following month 


And take note ... 


Age range 

Annual Quota * 


0 to 19 years $ 1,900.00 
20 to 29 years $ 2,250.00 
30 to 39 $ 2,400.00 
40 to 49 years $ 3,400.00 
50 to 59 years $ 3,600.00 
60 to 69 years $ 5,200.00 
70 to 79 years $ 5450.00 
80 and more $ 5,500.00 


“ * Prices in effect February 1, 2015 to January 31, 2016 
”

• The annual fee is anticipated and is determined according to the age group you belong to every member of the insured group and is updated every year in February 


• The benefits provided are hospital medical-surgical care, pharmaceutical and 

• Non insurance are people who have: • Malignancies, chronic degenerative diseases (late complications of diabetes mellitus), hoarding diseases (Gaucher disease), chronic liver disease, chronic renal failure, heart valve disease, heart failure, ischemic heart disease sequels: a pre-existing, such as illness (arrhythmia, angina or myocardial infarction), chronic obstructive pulmonary disease with respiratory failure, among others 

• Chronic systemic connective tissue diseases, addictions like alcoholism and other substance abuse, mental disorders such as psychosis and dementia; congenital and acquired immunodeficiency syndrome or Human Immunodeficiency Virus positive diseases (HIV) 

• You can renew your Health Insurance for the Family, 30 days before the due date 
• In any case, the IMSS will reimburse all or part of the payments made, so it is very important that all information provided is correct and complete, especially referring to pre-existing conditions "


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## baja4us (Aug 4, 2015)

thanks everyone for the advise. We will be 57 and 52 when we retire so looks like a private insurance plan and pay out of pocket for our routine care will be our best option.
saludos


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