# IMSS/Seguro Popular



## kliebetanz

Would those of you who have had personal experience with either IMSS and/or Seguro Popular comment on your experience with these systems? Some of the comments I have read over time range from really excellent to near disaster. 
It is perhaps safe to say that services may sometimes be "bare-bones" and not what one might be used to in CDN/US or EU. What I am primarily interested in hearing about is the quality of the medical care itself (diagnosis, treatment, etc.), In other words: even though there might not be the kind of nursing care the way one might expect it NOB or in Europe, and even though one might have to purchase one's own medications for one's treatment at the neighborhood pharmacy, will there be sufficient medical expertise to be helped when one has cancer or a cardiac problem or other severe conditions?
Or is it just simply a case of: don't even consider it?
Any input would be most appreciated.


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## TundraGreen

kliebetanz said:


> Would those of you who have had personal experience with either IMSS and/or Seguro Popular comment on your experience with these systems? Some of the comments I have read over time range from really excellent to near disaster.
> It is perhaps safe to say that services may sometimes be "bare-bones" and not what one might be used to in CDN/US or EU. What I am primarily interested in hearing about is the quality of the medical care itself (diagnosis, treatment, etc.), In other words: even though there might not be the kind of nursing care the way one might expect it NOB or in Europe, and even though one might have to purchase one's own medications for one's treatment at the neighborhood pharmacy, will there be sufficient medical expertise to be helped when one has cancer or a cardiac problem or other severe conditions?
> Or is it just simply a case of: don't even consider it?
> Any input would be most appreciated.


I have had an IMSS membership for 4 or 5 years, but I can't comment on the care for serious illness. I have used it for routine checkups, dental care and, once, the emergency room for an infection. The couple of times I wanted to see a specialist about something, there was a wait of about 6 months.


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## Isla Verde

I think that the quality of the care you receive from IMSS or Seguro Popular depends a great deal on where you live in Mexico. It's probably better in places like Mexico City or Guadalajara than in small towns or cities, but this is just conjecture on my part.


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## chuck846

kliebetanz said:


> Would those of you who have had personal experience with either IMSS and/or Seguro Popular comment on your experience with these systems? Some of the comments I have read over time range from really excellent to near disaster.
> It is perhaps safe to say that services may sometimes be "bare-bones" and not what one might be used to in CDN/US or EU. What I am primarily interested in hearing about is the quality of the medical care itself (diagnosis, treatment, etc.), In other words: even though there might not be the kind of nursing care the way one might expect it NOB or in Europe, and even though one might have to purchase one's own medications for one's treatment at the neighborhood pharmacy, will there be sufficient medical expertise to be helped when one has cancer or a cardiac problem or other severe conditions?
> Or is it just simply a case of: don't even consider it?
> Any input would be most appreciated.


Seguro Popular is for the poor. But - there is no concept of pre-existing conditions.

IMSS - on paper anyway - has a 3 year or so phase-in for coverage. You should check their web-site for the rules. We have an excellent GP who we visit with every 3 months. Some specialties are run better than others. At times they schedule 20 people for the same 9AM appointment. Sometimes they have a shortage of specialists. The cardiologist I saw last year is apparently one of the best in Mexico. We do our lab-work outside IMSS normally. Last year I had sinus issues. Went to an ENT at IMSS and he wanted to fix my deviated septum via surgery. That would have involved a) lab-work b) an EKG c) chest X-rays d) finding someone to donate a pint of blood e) showing up the day before the surgery to confirm f) the surgery itself. All these things probably would have been individual visits to IMSS. I found an ENT outside IMSS who had his own 8 bed very modern hospital. I showed up a 7AM and was done by 10AM - no tests, blood etc. Cost perhaps $700 USD.

At times - when I know what I want at the pharmacy I will walk into one of the free clinics provided by the pharmacy and ask the doctor for a prescription.


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## sunnyvmx

That's true. I first went to a General Hospital which is Seguro Popular in a small city in the State of Veracruz. I had been suffering with a burst appendix at home and after three days in the hospital, I was still suffering with the general doctor and two surgeons arguing over the diagnoses. I pulled the hose out of my nose and the needle from my arm, paid the bill and left. A holistic doctor treated me at home with Fennel tea and after three more days he said he was scared I was dying. I was! Finally a friend found an expert gastroenterologist who did an ultrasound and they rushed me to a new private hospital where he operated on me three hours later. They were so afraid I was going to die that they kept me awake for the entire three hour operation. I became ill on Dec. 5th and I was operated on Dec. 22. I was lucky. I apologized to the doctor for being a stubborn patient, but he said that's probably why I'm still alive. I would have died in that Seguro Popular hospital, laying on a wool blanket because they had no sheets, while my doctors were at their Christmas party.


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## TundraGreen

chuck846 said:


> Seguro Popular is for the poor. But - there is no concept of pre-existing conditions.
> 
> IMSS - on paper anyway - has a 3 year or so phase-in for coverage. You should check their web-site for the rules. We have an excellent GP who we visit with every 3 months. Some specialties are run better than others. At times they schedule 20 people for the same 9AM appointment. Sometimes they have a shortage of specialists. The cardiologist I saw last year is apparently one of the best in Mexico. We do our lab-work outside IMSS normally. Last year I had sinus issues. Went to an ENT at IMSS and he wanted to fix my deviated septum via surgery. That would have involved a) lab-work b) an EKG c) chest X-rays d) finding someone to donate a pint of blood e) showing up the day before the surgery to confirm f) the surgery itself. All these things probably would have been individual visits to IMSS. I found an ENT outside IMSS who had his own 8 bed very modern hospital. I showed up a 7AM and was done by 10AM - no tests, blood etc. Cost perhaps $700 USD.
> 
> At times - when I know what I want at the pharmacy I will walk into one of the free clinics provided by the pharmacy and ask the doctor for a prescription.


Just a note to clarify the "At times they schedule 20 people for the same 9AM appointment."

I have found that to be typical. They schedule a large number of people for the same time, say 9 AM or 1 PM, then they take people in the order in which they arrive. You can go early and wait until the time arrives or you can arrive on time and wait for the people who arrived earlier. Either way you wait, but it is a well organized system.


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## Bobbyb

Having recently undergone an emergency stent/heart attack in Canada I can state that in any small pueblo I would have died. Some of the Seguro Popular clinics do not have an EKG or a defib. Forget Cardioligist the Docs can be barely GP's. I have seen zero hygiene and dirty rusty beds. 3rd world. Perhaps in the big cities the care is adequate. Before relying on IMSS or Seguro Poplular I would visit the clinic in your area. If you can afford private health care Mexico compares well with Canada or the USA. Often better!


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## sunnyvmx

I can't say what everything cost for the two surgeries, hospital, doctors, medicine, hired nurses to stay overnight in the hospital, plane fare for my ex to come after both surgeries to care for me and I bought the scooter, but my savings was $10,000 less when it was over.

I rode the scoot for the first time, 1 1/2 weeks after the second surgery, to town and back. My ex husband knew better than to try and stop me, that's why he was my ex. The stitches were out and my belly was wrapped in an ACE bandage a foot wide holding me together. I put on a good show until he left a few days later and then I went to bed for three days. 

It's my understanding that Doctors are required to give a certain amount of time after graduating and then some keep volunteering at IMSS hospitals after that. I know my Dr. did.


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## lagoloo

This is an important matter to consider when deciding where to settle in Mexico. The little outlying towns are charming until you have a serious medical issue to deal with. At that point, Mexico City, Guadalajara or some of the other large population centers start looking very good. You don't have to live in the city, but being within an hour of excellent hospitals is a real plus.

I have IMSS coverage because it's impossible to find good private insurance after a certain age. I haven't used it since out of pocket has been reasonable enough, but it's a good alternative "just in case" of disaster. My only experience with the hospitals in Guadalajara was Pueto de Hierro for cataract surgery and I was very impressed with the facility. All of the modern equipment was there and everything was spotless. I doubt you could find a better hospital elsewhere, but it is pricey.


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## Isla Verde

chuck846 said:


> At times - when I know what I want at the pharmacy I will walk into one of the free clinics provided by the pharmacy and ask the doctor for a prescription.


A pharmacy near me has a small walk-in clinic staffed by young, but competent, doctors. The fee is 30 pesos. I have used it for minor ailments plus continuing treatment when I fell and badly hurt my left arm last fall.


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## Raypinciotti

I'm going to have to agree that it depends on where you are going to be living. My wife is Mexican and all her family is subscribed to the Seguro Popular or IMSS. Seguro Popular is not only for the poor, you pay accordingly to how much you have. Seguro Popular is great for minor things and checkups but, from what I have seen, and in my very humble opinion, once you reach certain age Universal health care insurance is simply not good enough. Also, it doesn't cover everything.

Unfortunately, my wife's father died last Christmas under the care of the Seguro Popular. They treated him relatively ok, and in the "best" hospital available in his city, but I feel that... had he been in the US or treated privately he would have survived. He was in an accident so it was completely unexpected, and for the type of injury he had we were strongly advised by every single doctor to not move him. So , we were completely stuck for 22 long days until his passing. 

Since we are very traumatized by the experience, and we will be moving to Mexico this year, better insurance has been my top priority. We are looking into moving our 2 elderly in Mexico into the plenitus program, I found them through Senior Health I CANNOT VOUCH FOR THEM AS I HAVEN'T SIGNED UP, I need to find more information and reviews on them. 

Anyway, that was our experience with Seguro Popular. In the mid time I would definitely not recommend them for anything major.


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## chuck846

Seguro Popular is free if you rent - regardless of what resources you have. Otherwise the costs are laddered based on means. Someone once told me that SP will ask you - is the floor of your house earthen ? Also - I believe that SP (and possibly IMSS ?) provide no nursing services. Family is expected to take care of you (or I guess you could hire a nurse).

Another healthcare option is Christian Healthcare Ministries. I have not yet looked into it - but a couple people speak very well of it.

Christian Healthcare Ministries: Home


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## Isla Verde

Raypinciotti said:


> .We are looking into moving our 2 elderly in Mexico into the plenitus program, I found them through Senior Health I CANNOT VOUCH FOR THEM AS I HAVEN'T SIGNED UP, I need to find more information and reviews on them.


A few days ago I wrote to Plenitus and got a quote. I am 70 and the prices (in pesos) for their three plans were as follows:

1. Annual fee: $67, 004 with a deductible of $16, 824

2. Annual fee: $55,532 with a deductible of $27, 339

3. Annual fee: $58,680 with a deductible of $36,172

In addition, for anyone 65 and over you have to take a physical exam with bloodwork, and if you don't "pass", no policy for you!

In any event, these prices are too high for my budget. I hope that things work out for you and your elderly relatives.


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## AlanMexicali

chuck846 said:


> Seguro Popular is free if you rent - regardless of what resources you have. Otherwise the costs are laddered based on means. Someone once told me that SP will ask you - is the floor of your house earthen ? Also - I believe that SP (and possibly IMSS ?) provide no nursing services. Family is expected to take care of you (or I guess you could hire a nurse).
> 
> Another healthcare option is Christian Healthcare Ministries. I have not yet looked into it - but a couple people speak very well of it.
> 
> Christian Healthcare Ministries: Home


They have nursing care just no reliable nurse call system at bedside so your family or whoever is there 24 hours per day can run to the nursing station when you need it in an emergency and help you to the bathroom etc. They need to monitor you only after surgery, not before. They can come and go before but after are required to be there 24 hours per day. You need to bring your own toilet paper, soap and tooth paste. The romos all have a sofá or usually recliners for every bed to sleep in and you need to bring a blanket for yourself. The food is delivered regularly by staff and requests for extra drinks or some snacks takes awhile but doable. Your family is not really allowed to give you food because the food menú is supposed to be followed for surgery patients.


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## chuck846

AlanMexicali said:


> They have nursing care just no reliable nurse call system at bedside so your family or whoever is there 24 hours per day can run to the nursing station when you need it in an emergency and help you to the bathroom etc. They need to monitor you only after surgery, not before. They can come and go before but after are required to be there 24 hours per day. You need to bring your own toilet paper, soap and tooth paste. The romos all have a sofá or usually recliners for every bed to sleep in and you need to bring a blanket for yourself. The food is delivered regularly by staff and requests for extra drinks or some snacks takes awhile but doable. Your family is not really allowed to give you food because the food menú is supposed to be followed for surgery patients.


Are you describing SP, IMSS or both ?


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## AlanMexicali

chuck846 said:


> Are you describing SP, IMSS or both ?



Both: Seguro Popular and IMSS and ISSSTE have similar requirements for patient care givers/watchers. 

Private hospitals also require the same; patient´s family or someone there for the 24 hour watch after surgery even though their nurse call systems probably work. You might even need toilet paper brought in. It has a habit of dissapearing at a rate institutions cannot keep up with evidently, especially the 2 ply.  .


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## Isla Verde

AlanMexicali said:


> Both: Seguro Popular and IMSS and ISSSTE have similar requirements for patient care givers/watchers.
> 
> Private hospitals also require the same; patient´s family or someone there for the 24 hour watch after surgey even though their nurse call systems probably work. You might even need toilet paper brought in. It has a habit of dissapearing at a rate institutions cannot keep up with evidently, especially the 2 ply.  .


Not all private hospitals, Alan. I was in one a few years ago in Mexico City for surgery for a broken wrist. They asked me if someone was going to stay with me overnight in my room, and I told them no one was. No problem. I was there for 3 nights and when I needed a nurse, I just hit the call button. I certainly didn't need to provide my own TP, soap or toothpaste. This was in a private hospital but not a super-fancy one, just middle-of-the-road.


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## AlanMexicali

Isla Verde said:


> Not all private hospitals, Alan. I was in one a few years ago in Mexico City for surgery for a broken wrist. They asked me if someone was going to stay with me overnight in my room, and I told them no one was. No problem. I was there for 3 nights and when I needed a nurse, I just hit the call button. I certainly didn't need to provide my own TP, soap or toothpaste. This was in a private hospital but not a super-fancy one, just middle-of-the-road.


Just speculating on the TP. Yes, I presume it depends on what surgery the patient has had. Most of the surgeries we deal with are more serious than your´s and yes the hospitals have nurse call systems even the 2 new Seguro Popular and the new IMSS hospitals have them, working at the momento, but still patients need a watcher/aid . The 2 old IMSS and the only ISSSTE hospitals "had" them. Now they are old funny looking metal plates with various stages of missing parts. One even still had the common string and 3 inch chain attached to the switch where my buddy was for 2 weeks after a heart attack. An IMSS hospital probably built in the late 50s or early 60s. Almost everytime everyday when I went up the stairs to the second floor [1st. floor actually] to see him the very last step was about 2 or so inches higher than the rest and I almost fell as I hit it with the toe of my shoe on my first foot going up to floor level. :confused2:


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## sunnyvmx

In my beautiful new private hospital room there was a dresser and the top drawer was for all medicines I needed to purchase during my stay. The doctor gave my friend the list and she had to go to three different pharmacies to fill it. The nurses who were required to stay during the night were University students studying to be doctors. I allowed them to sleep on the couch and when I needed anything (like a new bag for the drip), I woke them up. If you ever need colostomy supplies, pay a friend to bring them from the States. Mexico bags are for $h-t. Pun intended.


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## Bobbyb

Sounds like there are different qualities of private hospitals. My wife and I have both had surgeries in a private hospital. The room was more like a large Hampton hotel room. 2 huge sofas. Paintings on the wall. A bathroom that would rival the Mayo. There is a university close by. As you walk into the hospital there is an area where students come and play the Grand Piano. The sign says anyone can play! Meds are brought to your room and charged to your account. The operating room is out of Star Wars. The Cath Lab is considered number one in Latin America. Lots of TP! Much nicer than any of our Canadian Hospitals. The Drs. are first class. They all belong to US Dr. Orgs and attend US conferences . Most speak English. Not cheap but far less than in the USA. I had a nuclear scan of my heart and arteries. Cost was 14,000 Pesos. This was 3 weeks ago. Interesting fact: Often IMSS will send a patient to this hospital for special tests. I don't know the criteria for getting a test. I do know that usually you would be sent to another IMSS facility. Probably a long wait as well.


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## RVGRINGO

Such hospitals are available in most major Mexican cities. You indicate “northern Mexico“; are you in Hermosillo, by any chance? It seems a very progressive city, which would fit your description. Of course, so would Monterrey, etc. How about telling us the name or your city; maybe even the hospital.


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## Bobbyb

RV ******: It is the CIMA hospital in HMO. A twin to a hospital in Dallas. They are trying to get into Medical Tourism. An amazing place. I had a prostate op there in 1998. My wife had back surgery 4 years ago. The Drs. are caring. Here is an example. I had my heart attack in Canada in May. A month ago I was having some irregular heart beats. Went to see a Cardiologist without an appointment. In 5 minutes I was in his office and he did an EKG. Yes the beats were irregular. He put in a holter and sent me home. I returned in 24 hours and he read the results. I needed a nuclear scan. It was just after Xmas and all the specialists are on vacation. He got me an appointment for Jan.14. The Dr. who did the test was concerned and called the Cardiologist. His office is right across the street. IN 10 minutes he showed up and the 2 discussed my case. They really care. I could go on. If you ever decide to try this facility please let me know and I will try to help. BTW: I tried to contact my Cardiologist in Canada for that test. I was told to make an appointment for a visit. First open date was sometime at the end of Feb. If he recommended the test wait time could be 6 weeks or more. Unreal!!!


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## WintheWin

No IMSS, No Seguro Popular.
Why?
I don't want to be a guinea pig.
Yes, med students need to learn, but I don't want them to learn by making mistakes on me or my family.


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## chuck846

WintheWin said:


> No IMSS, No Seguro Popular.
> Why?
> I don't want to be a guinea pig.
> Yes, med students need to learn, but I don't want them to learn by making mistakes on me or my family.


From our experience - the quality of care at IMSS is far better than the quality of care we received in the States from the retired military physicians (or recently immigrated Indians) offered up by the PPO (or whatever) we were offered by my employer's ins. company. I can't imagine that situation has improved under Obamacare.

Yes - the IMSS hospital we frequent would seem to be a teaching hospital - but that is not uncommon in the US either.


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## TundraGreen

WintheWin said:


> No IMSS, No Seguro Popular.
> Why?
> I don't want to be a guinea pig.
> Yes, med students need to learn, but I don't want them to learn by making mistakes on me or my family.


My impression is that care is actually better at hospitals connected to a medical school. The care is supervised by senior doctors and they tend to keep up with the latest information about best practices.


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## chuck846

TundraGreen said:


> My impression is that care is actually better at hospitals connected to a medical school. The care is supervised by senior doctors and they tend to keep up with the latest information about best practices.


The dermatologist I visited at IMSS earlier this week had between 8-10 students in his too small office. The urologist I wanted to see in December is no longer available and now my next appt. is scheduled for May (earliest possible date).


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## ClinSpan

< snip> However, I must say that overall - the medical care is very adequate, at least in the larger cities.


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## RVGRINGO

Mining for clients is tedious business, especially if one does not actually advertise in banners or print media in the intended markets. Soon, readers tire of the mining activities and begin to ignore the miner entirely, which is what I intend to do.


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## Howler

*Great info!!*



Isla Verde said:


> A few days ago I wrote to Plenitus and got a quote. I am 70 and the prices (in pesos) for their three plans were as follows:
> 
> 1. Annual fee: $67, 004 with a deductible of $16, 824
> 
> 2. Annual fee: $55,532 with a deductible of $27, 339
> 
> 3. Annual fee: $58,680 with a deductible of $36,172
> 
> In addition, for anyone 65 and over you have to take a physical exam with bloodwork, and if you don't "pass", no policy for you!
> 
> In any event, these prices are too high for my budget. I hope that things work out for you and your elderly relatives.


Thank you so much for this post, IV!! I also inquired of Plenitus from their website, but no telling how long it will take to get an answer - or if they'd even bother with my US-based information.

I suppose for some expats the rates may be reasonable, compared to NOB - but is there a price-break for couples or families? If not, those figures, doubled, would be quite expensive on our retired budget, too. Additionally, I have not been able to get information of what conditions are / are not covered under their plans... did they elaborate any of that for you?

Also, PMs or additional posts are VERY welcome with similar information for GNP, AXS, Alianz or Christian Healthcare Ministries. These are private insurers that have been mentioned in previous thread(s) that I am in the process of researching...

Again, thanks for the detailed information in your post!


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## WintheWin

Howler said:


> Thank you so much for this post, IV!! I also inquired of Plenitus from their website, but no telling how long it will take to get an answer - or if they'd even bother with my US-based information.
> 
> I suppose for some expats the rates may be reasonable, compared to NOB - but is there a price-break for couples or families? If not, those figures, doubled, would be quite expensive on our retired budget, too. Additionally, I have not been able to get information of what conditions are / are not covered under their plans... did they elaborate any of that for you?
> 
> Also, PMs or additional posts are VERY welcome with similar information for GNP, AXS, Alianz or Christian Healthcare Ministries. These are private insurers that have been mentioned in previous thread(s) that I am in the process of researching...
> 
> Again, thanks for the detailed information in your post!


Going through my family's policy with GNP...

There are waiting periods for a series of diseases. 
Particularly, 2 years for any cancer. 
It seems for most chronic conditions, there is a waiting period of varying duration.

Pre-existing conditions have a 5-year waiting period, with a total insurable rate of 100,000$ mex per incidence. 

I chose GNP, in my city, because we get moderate discounts/services at different providers. Particularly, we have free access to a GP, and discounts on the 24-hour pediatrician service.

Some hospitals have arrangements with the insurance providers, and some offer very generous copay/coinsurance/deductible discounts.


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## Bobbyb

I am late in participating in this thread> Be aware that many private hospitals and Drs. do not accept most of the insurers . Too many problems in getting paid. CIMA in Hermosillo has a big sign stating this fact. At one time the major insurers had offices in the Hospital. Not now. So buyer beware. Are any of the expat International insurers any good?


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## RVGRINGO

In Mexico, you must be prepared to pay before being discharged from a private hospital; yes, pay in full. If you have insurance, you may have to submit for reimbursement. Direct payment, especially if delayed by a foreign insurer, as is common with USA companies, can result in the patient being held in the hospital until payment is made. It happened to me once, over a weekend when BC/BS Blue offices were closed, in Chicago, I think. It was stressful.
In the case of the public systems, getting treatment for a terminal condition may be more difficult than an expat may realize. Longevity in Mexico is about the same as in the USA, and there is a much higher “happiness factor“, but there is also a much more realistic acceptance of “the inevitable“, and a willingness to let it happen naturally when intervention would only cause a delay and added expense.


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## horseshoe846

We have IMSS - and I am very happy with it. If we were in the US - I would be very happy if I were to have IMSS like coverage. I don't need a private room with a TV etc. But - there are some things that might surprise someone if they were not aware ahead of time.

I had surgery at IMSS earlier this year which required an over-night stay. When you have surgery at IMSS someone (in my case myself) has to donate a pint of blood before hand. That was perhaps a 4-5 hour thing. They make it an educational thing of sorts. I think the cut off age where you can self-donate blood is 66 (but not sure). You can not buy blood and I don't think you can pay someone off the street to donate for you. What they do in the case of an emergency - I don't know...

Also - when you spend a night in the IMSS hospital you need a family member by your side the whole while. They put you in a bed but they put your family member in a very basic hard chair. In my case my wife rolled my jacket in a ball and slept on the floor by the side of my bed.


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## WintheWin

horseshoe846 said:


> We have IMSS - and I am very happy with it. If we were in the US - I would be very happy if I were to have IMSS like coverage. I don't need a private room with a TV etc. But - there are some things that might surprise someone if they were not aware ahead of time.
> 
> I had surgery at IMSS earlier this year which required an over-night stay. When you have surgery at IMSS someone (in my case myself) has to donate a pint of blood before hand. That was perhaps a 4-5 hour thing. They make it an educational thing of sorts. I think the cut off age where you can self-donate blood is 66 (but not sure). You can not buy blood and I don't think you can pay someone off the street to donate for you. What they do in the case of an emergency - I don't know...
> 
> Also - when you spend a night in the IMSS hospital you need a family member by your side the whole while. They put you in a bed but they put your family member in a very basic hard chair. In my case my wife rolled my jacket in a ball an
> d slept on the floor by the side of my bed.


During emergencies the hospital gives you blood anyways, but makes your family members find people to donate to make up for it.
Sometimes, medical intervention will not occur until a certain quantity of people have donated in your name.
Local FB pages usually have people requesting blood donations in a particular family member's name in order to receive care.


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## Howler

*Difficult... and Sad!*



WintheWin said:


> During emergencies the hospital gives you blood anyways, but makes your family members find people to donate to make up for it.
> Sometimes, medical intervention will not occur until a certain quantity of people have donated in your name.
> Local FB pages usually have people requesting blood donations in a particular family member's name in order to receive care.


Geez! I'm just reminded where I lost a grand-niece several months ago... they didn't discover she had leukemia until very late before finally getting her to a hospital in Xalapa. I remember the complications for her mother (my niece) to get blood together for her transfusions because a lot of the family were practicing Jehovah's Witnesses. Even then, she spoke of paying others to show up to make donations who never did. Very sad indeed - and frustrating to hear about when we were there in February. We would have loved to have done more, if only we had known. We were not even notified of how serious it was until after the funeral!

The blood donation issue sounds like something sorely in need of some kind of capitalistic innovation & management if the Red Cross doesn't function there like it does here.... especially for those over the age of 60 or 70. It's quite surprising that something more hasn't sprung up to fill the need in the spirit of true Mexican ingenuity. 

Back on topic - I'm still doing research on the medical coverage possibility & issues - and fighting with a VERY painful back (out-of-whack). I'll put it all together for you by sometime next week!


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## Bobbyb

Over the years there has been lots of IMSS discussions about IMSS. I would suggest that any newbie go to an IMSS facility in your area. Look around, ask questions. Do not take anything for granted. You may be shocked ! Some areas have hospitals that are OK. Others are scary. Some expats forget that this is not the USA or Canada. Many things are different. Sometimes this is a good thing. Other times it can be a disaster. There is a reason wealthy Mexicans in Sonora go to Tucson for serious medical conditions. However there is a private hospital in Hermosillo that compares with anything NOB. My wife and I have had many procedures in Mexico. Some were emergencies and covered by travel insurance. Others were self pay. In all cases the Drs. and surgeons were amazing. This fall we are having cataract surgery and a torn rotator cuff repaired. The shoulder Dr. speaks better English than I and lectures in the USA. We do not go near any IMSS facilities other than a small clinic for a cut or other small emergency. I looked into expat insurance but found it too expensive. Maybe others could consider a Medvac insurance policy .


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## Howler

*Right On, BobbyB!!*



Bobbyb said:


> I would suggest that any newbie go to an IMSS facility in your area. Look around, ask questions. Do not take anything for granted.


The quality of available IMSS & Seguro Popular (SP) facilities can vary greatly from location to location, usually being better (but often more congested) in larger populated areas.



Bobbyb said:


> ...However there is a private hospital in Hermosillo that compares with anything NOB.


Private facilities also vary in quality, but are usually better than publicly funded places. Even so, some really nice private clinics can be found in surprisingly small or remote places.



Bobbyb said:


> ...In all cases the Drs. and surgeons were amazing.


I have yet to run into a truly incompetent or inattentive Mexican doctor in my experiences. They all seemed really tuned-in when dealing with me or my family, and well-versed in their training. Maybe it's the novelty of treating a "******", I dunno... but, that said, I know that not everyone has had the same experience.



Bobbyb said:


> ...We do not go near any IMSS facilities other than a small clinic for a cut or other small emergency.


So far, thank goodness, this has been my experience with IMSS & public facilities. I've only had need of some stitches, attention for a sprain or two, etc. However, our first child was born by caesarian section in an IMSS hospital with no problems.



Bobbyb said:


> ...I looked into expat insurance but found it too expensive. Maybe others could consider a Medvac insurance policy .


There are other private policies available, some better than others. If it says or is for "expats" or gringos, especially from a country other than Mexico, it's going to cost more. The medivac option is a good one, but again it will usually cost more than a normal policy for treatment in Mexico - and more for it's not being used or needed as much as a regular policy. Still, that's an issue best decided by the buyer according to their need, comfort - and budget.

:lol: Lol, You're stealing my thunder! Seriously though, your comments are pretty much the core of my findings in researching the topic of "IMSS vs Seguro Popular" and other available healthcare in Mexico. It's definitely a buyer beware situation that seriously bears your personal investigation of available facilities according to where you decide to live...! More on this later... :typing:


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## Bobbyb

Thanks Howler. I can certainly understand people that are new to Mexico or just considering a move asking about medical care. Too many make the move and then have problems. They read about cheap medical care and then are shocked at what they get. If you are used to the Mayo or the Cleveland Clinic you are in for a shock! Like many countries with Socialized medicine the IMSS system is vastly underfunded and also corrupt. My wife's best friend lost her husband in an IMSS hospital for no good reason. He had a heart attack and they just left him on a bed until he died. If you are a poor person they do nothing. Others get sent to the private hospitals for emergency heart surgeries. They lack some of the newer drugs that save lives. The system in Canada is sometimes just as bad!!


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## Isla Verde

I have never used any IMSS or SP facilities. However, over the last year or so I have had several medical problems to deal with. All of the private physicians I dealt with and the two hospitals I stayed at were topnotch!


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## lagoloo

There's no perfect solution to the medical issues we face, no matter where we live and what systems are in place. Both my husband and I had very unfortunate experiences in the U.S. medical sytem, so you won't hear any high praises from me. It's always necessary to watch your own back and not believe everything.

In our case, we pay out of pocket to private physicians for routine care and have not needed hospitalalization. This has worked for a dozen plus years. We're lucky with our health. We carry Seguro Popular "just in case". We know what the situation in the hospitals is: that we need to provide our own stay-with-you person 24/7 to provide "nurses aide" services and we won't have a private room with entertainment.

BUT: My major warning to those who might consider the plans of "medivacing" to the U.S. for care is this:
First, none of them will transport you anywhere until you've been "stabilized". That means you'll be treated right here in Mexico until you're up to going. As most of us know, those first minutes and hours following a crisis such as a heart attack are the most important to survival. So..figure that one.

For a long term illness such as cancer, you're going to be in the U.S. for awhile. If you don't have a doctor there already, you'll need to find one who accepts new Medicare patients. I hear that's a big problem these days. Then, if you bring someone with you, there are housing issues and your recovery time. This in itself can become very expensive unless you have someone such as a family member who is both wlling and available to house and care for you.

If you stay put and use Mexican medical care, your life won't be so disrupted. Friends will be there. There are a number of nursing services available at a reasonable price.

That leaves the question of whether you can afford private insurance here: will they accept any pre-existing condition you may have. If you can't (and it's very expensive, especially as you get older) then can you live with what Seguro Popular or IMSS can offer you?

I know many people who have had excellent outcomes using the govt. sponsored health care system, both young and old (as in an 86 year old). Some have described it as "MASH, without incomiing artillery" in terms of the hospital arrangements......but I hope I've added something to help people make that important decision.

There is one other factor to consider: Although the U.S. is rated number one in cost of care by the World Health Organization...it's #24 in quality of care. Not the best as it should be. That's really a shame.


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## horseshoe846

lagoloo said:


> I know many people who have had excellent outcomes using the govt. sponsored health care system, both young and old (as in an 86 year old). Some have described it as "MASH, without incomiing artillery" in terms of the hospital arrangements......but I hope I've added something to help people make that important decision.


In Mexico - I had had one surgery at a private hospital and one at an IMSS hospital. The things one needs to take care of prior to an IMSS surgery can be 'testing'. Let's see : first your GP has to send you to a specialist. The specialist very likely will take some baseline measurements (lab tests) and tell you to come back in 3 months or so. In the meantime - that surgeon may leave IMSS, IMSS may run out of money to pay its doctors etc. So - then the specialist/surgeon decides it is time. Now you have to have more blood work done, you need chest xrays taken. Next you need to visit an 'internist' who will look at all your tests etc and approve you for surgery. Then you need to gather up blood for your surgery (or donate your own blood). Next it is time to take all the things you have gathered so far and try to schedule your surgery. They will tell you to visit the hospital perhaps 2-3 days beforehand. If you are lucky - there will be a surgeon and room available for you. Otherwise - they may tell you to come back in a month - which (depending) may require you to go and repeat some of the things you have already taken care of. 

Having said all that - when I ultimately walked (on my own two feet) into the IMSS operating room it was a modern as any I have ever been in (and I have been in too many over the years). There were perhaps as many as 12 doctors/nurses in the room (must have been some teaching going on). There was good loud American rock music filling the room (I have wondered if they did that for my benefit )

And the food at the IMSS hospital was as good or better than any I have ever had in a US hospital ...


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## Bobbyb

When we use the CIMA clinics and Hospital in Hermosillo the service is beyond belief. Last year I needed shoulder surgery. I am still covered in Canada but the wit period to see a specialist is 6 to 12 months. The another 2 to 6 months for the procedure. I went to see one of the best surgeons in Mexico on a Friday morning. He sent me across the street for the MRI. He read the results and sent me back for a quick medical. Monday morning the deed was done!!! Systems that make you wait add to the illness. Too much stress for me. Of course you need the financial resources to use a private system. We are using what is probably the best Hospital in Mexico. They have the top rated Cath lab in Latin America. The operating rooms are like Star Wars. The rooms are like a Hilton. No sharing and your own bathroom. You are supposed to have someone that stays with you. Big sofa for the care giver.


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## lagoloo

And then there's the matter of whether or not IMSS is being merged into Seguro Popular. That might affect the wait times for procedures. I think it would be a good thing.

Glad to hear of positive outcomes, since frankly, I can't afford private insurance here at my advanced age and also have a pre-existing condition which is the only thing I'm likely to need hospitalization for. So, I have SP and glad of it.


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## AlanMexicali

lagoloo said:


> And then there's the matter of whether or not IMSS is being merged into Seguro Popular. That might affect the wait times for procedures. I think it would be a good thing.
> 
> Glad to hear of positive outcomes, since frankly, I can't afford private insurance here at my advanced age and also have a pre-existing condition which is the only thing I'm likely to need hospitalization for. So, I have SP and glad of it.


IMSS and Seguro Popular are not merging. What is now going on since June 1st. 2016 is if IMSS, for example, doesn´t have treatment for an illnes close to where you live and ISSSTE, Seguro Popular does they give you a referral to, lets say, Seguro Popular for treatment and/or diagnosis etc. It is sharing facilities where one of the 3 socialized medical plans has a facility in the área and the other/s don´t. They will not longer duplicate services where they are not already duplicated or if all 3 have treatment. 

The IMSS wll be billed for the treatment in the case above.

Rumors started they are merging but they are not. This new policy saves patients and their family from travelling for treatment in many cases and saves the federal government the expense of adding treatment in áreas where either of the other 2 or 1 of them already has treatment. They might merge or expand, for example, cáncer treatment in one of the 3 that already has cáncer treatment available in an área and move one of the cáncer treatment centers to another location where all 3 don´t have it etc. ISSSTE now has dialysis in their larger hospitals and IMSS and Seguro Popular don´t.


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## horseshoe846

AlanMexicali said:


> IMSS and Seguro Popular are not merging. What is now going on since June 1st. 2016 is if IMSS, for example, doessn´t have treatment for an illnes close to where you live and ISSSTE, Seguro Popular does they give you a referral to, lets say, Seguro Popular for treatment and/or diagnosis etc. It is sharing facilities where one of the 3 socialized medical plans has a facility in the área and the others don´t. They will not longer duplicate services where they are not already dulpicated or if all 3 have treatment.
> 
> The IMSS wll be billed for the treatment in the case above.
> 
> Rumors started they are merging but they are not. This new policy saves patients and their family from travelling for treatment in many cases and saves the federal government the expense of adding treatment in áreas where either or the other 2 or 1 of them already has treatment. They might merge or expand, for example, cáncer treatment in one of the 3 that already has cáncer treatment available in an área and move one of the cáncer treatment centers to another location where all 3 don´t have it etc. ISSSTE now has dialysis in their larger hospitals and IMSS and Seguro Popular don´t.


We have IMSS insurance - and apparently I have high blood pressure (depending on how much tequila I drink). Late fall last year my IMSS GP wanted me to see a cardiologist. Due to lack of funds the cardiology dept was shutdown. So - the 'big chief' at the IMSS hospital set up an appt for me at an outside private hospital (rather upscale) which brought in a cardiologist from CDMX (for myself and perhaps 3 other people). This guy spent more time with me than any other doctor, anywhere, has ever spent with me. In the end he declared it most likely won't be my heart that will be my demise. IMSS has never suggested that we visit an SP facility for care.


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## AlanMexicali

horseshoe846 said:


> We have IMSS insurance - and apparently I have high blood pressure (depending on how much tequila I drink). Late fall last year my IMSS GP wanted me to see a cardiologist. Due to lack of funds the cardiology dept was shutdown. So - the 'big chief' at the IMSS hospital set up an appt for me at an outside private hospital (rather upscale) which brought in a cardiologist from CDMX (for myself and perhaps 3 other people). This guy spent more time with me than any other doctor, anywhere, has ever spent with me. In the end he declared it most likely won't be my heart that will be my demise. IMSS has never suggested that we visit an SP facility for care.


It depends on cicumstances. Many Expats don´t realize almost all medical specialists work a 1/2 day at a Mexican socialized medical facility and the other 1/2 day have a private practice. Almost all specialist don´t work all day at a socialized medicine hospital of speciality clinic. Most GP don´t either. Seguro Popular contracts Surgeons also to help out when needed. They will also could send you for treatemnt at a private hospital with a private specialist which has a contract with the Seguro Popular on occation. It could happen a person pays for a private specialist to opérate on them and pay for a private hospital to have it done at and this same surgeon works for a socialized medicine hospital doing sugeries for members free of charge to the patient.


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## Bobbyb

Alan: Your last post is not 100% factual. The surgeons at Private clinics and hospitals do sometimes work for IMSS. They do NOT work 1/2 days for the Gov. Some of their patients are sent from the IMSS to a private hospital or non IMSS specialist . Many of them do not work with IMSS. Never! Getting a referral is not easy. Perhaps there is a cap on how many referrals are handed out. Or a $ cap. If every specialist worked 1/2 days for the IMSS private patients would receive horrible care. There is a lot of corruption in the system. I know a local contractor whose wife is a Dr. He gets to see any specialist at no cost.. IMSS pays the specialist. He does pay a small fee to the specialist for that favor! Like most socialized systems $$ are a big problem. IMSS is like Pemex. Almost bankrupt. Utilizing the facilities of the different systems is a great idea. We have friends that have to travel to Obregon from HMO to see a specialist. They pay their own transportation. IMSS has temporary apartments but not enough. Mostly you need a Hotel @ 100P a night. They cannot afford that 100P. If ISSTESON has that specialist the patient would be very happy! My Cardioligist and shoulder surgeon never work at IMSS facilities. My internest d


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## Bobbyb

http://home-sweet-mexico.com/retire-in-mexico-healthcare-imss.html/


Read the above


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## lagoloo

None of that article is news to me. I've heard all about the very basic facilities; the bring-your-own toilet paper, etc. Ultimately, it's the same old issue: Can you afford to pay for private insurance or out of pocket for care at the fine facilities which are available in Mexico, or can't you? If you can't, I say you're lucky that Mexico has provided medical care for all, even us non-citizens. 
It's harsh, but there it is.


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## AlanMexicali

Bobbyb said:


> Alan: Your last post is not 100% factual. The surgeons at Private clinics and hospitals do sometimes work for IMSS. They do NOT work 1/2 days for the Gov. Some of their patients are sent from the IMSS to a private hospital or non IMSS specialist . Many of them do not work with IMSS. Never! d


I re-read my post and can see why you responded as such. I didn´t say what I meant to say. It should have been wtitten: All specialists working in the socialized medicine system , not all specialists as in every Dr. that is a specialist in all of Mexico. Sorry for my very poor description of what I was trying to convey to others.

Of course there are highly reputable specialists who have only private practices and are busy all day long. I know several. My wife owns 2 "consultorios" in 2 medical towers of "consultorios" at 2 private hospitals and we have some friends and her family that are doctors. Several work a 1/2 at the IMSS, Seguro Popular and ISSSTE and a 1/2 day at their private practice, others do not. One of my sister in laws is a Psychiatrist and works full time as the Director of the DIF live in drug and alcohol rehabilitation center, which is large, but also has a "consultorio" for off hours and Saturday patients.

An important thing to remember is if you have a connection in any of the socialized medicine systems, as you and your friends do, you really don´t have to worry about getting a bum deal as they know what is really going on and can advise you to the best place and Dr. to see. Also they all by law have to give you 2 Dr.s diagnosis if you simply ask. One can be from a private specialst you hire if you have no confidence in any of the specialist within the federal government socialzed medicine system. When people say people with money always go to private hospitals using a private specialist I have to laugh. many work the socialized medicine system and pay accordingly. 

In 2017 with advances in modern medicne I bet 99% of all diagnosis and treatment of illnesses does not require a star Dr. at the top of his/her field to fix your problem, almost any specialist can do it. IMO


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## lagoloo

Well put, and thanks for the info.
As you said, most of the things that go wrong with most of us don't need a super genius doc to diagnose and treat.


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## AlanMexicali

lagoloo said:


> Well put, and thanks for the info.
> As you said, most of the things that go wrong with most of us don't need a super genius doc to diagnose and treat.


Exactly and alt right wingers have no clue this is absolutely the truth today and beat the drum that socialized medicine can´t do a danm thing to help you because most illnesses are too complex for them to fix. You might die from incompetence or die waiting for treatment etc. Thinking from 15 years ago and before. IMO

All systems now in Mexico have introduced Triage and if you simply go into an Emergency Room and complain instead of asking you GP for a referral to a specialist, which in the ISSSTE takes 6 to 8 weeks, you will jump to the front of the line as the Dr. in the ER will refer you for immediate diagnosis to any or their specialst when necessary, even call one in in the middle of the night if need be. 

These stories of Expats dying or getting much worse off while waiting to see a specialst is their own fault for not understanding how the system really works in Mexico.


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## lagoloo

...and thanks for that very useful bit of information on "how it works"!!


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## TundraGreen

My experience confirms what AlanMexicali said. If I go to my assigned IMSS GP and get referred to a specialist, the wait is months for an appointment. If I go to the emergency room, I get referred immediately. You do have to wait a couple of hours at the IMSS emergency room if you are breathing and not bleeding. 

On a related note, I took a friend to a Cruz Roja emergency room. There was no wait and the only expenses were for bandages, a splint and xrays, total about 500 pesos.


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## circle110

I may be wrong about this, but I had the understanding that specialists had to spend a certain amount of cumulative hours in the socialized medicine facilities (usually working 1/2 days) but once they reached their quota of hours they were free to dedicate themselves full-time to their private practice. 
My wife was going to Gea Gonzales, a government hospital in CDMX to see her ophthalmologist but he finished his time there and now only sees patients at his private practice. That kind of confirmed what I thought about fulfilling some kind of quota but, honestly, I am not 100% sure how it works. All of the docs at Gea Gonzales are fairly young so that just added to my impression.


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## horseshoe846

So after 6 pages of this back and forth - what conclusions can be drawn ?


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## Haskins

From what I gather, many members here have signed up for either IMSS or Seguro Popular, but you also use private practice doctors and facilities because it's relatively affordable. Also, going to the emergency room can get you relatively quicker results. Do y'all have supplemental private insurance as well?


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## Bobbyb

I should have stated that one can Google and find fault with just about anything from a can of beans to a Mercedes Benz. But healthcare is a serious subject. Never assume anything. If you came to Sonora and I showed you one of the IMSS hospitals in the smaller cities you would be shocked. I know that in some cities the IMSS system works well. My posts are based on either my experiences or those of persons I trust.


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## lagoloo

The usual reason people who pay out of pocket for private physicians and have IMSS or SP as a "backup" is because private insurance is very expensive, especially as age increases, or if they have a pre-existing condition. Using private physicians is quite affordable: in my area, an office visit to a general practitioner is around $300 pesos: a specialist from $600-$800 pesos.


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## AlanMexicali

circle110 said:


> I may be wrong about this, but I had the understanding that specialists had to spend a certain amount of cumulative hours in the socialized medicine facilities (usually working 1/2 days) but once they reached their quota of hours they were free to dedicate themselves full-time to their private practice.
> .


That is not exactly how it works. The time spent during public service is true but they are reassigned to an área where 1/2 day specialists are needed if they want to stay in the system and possibly wait months to a year and a new bach of just graduated specialist come in to do their public service. The GPs do the same thing. 

When hired full time at a government hospital, clinic [only GPs] or specaility clinic they still only work 1/2 a day - all three sytems do this. Next time you go to a specialist look at their hours on the sign on the wall or door of the "consultorio" and you will understand it is shared by the morning specialist and the afternoon specialist. The Clinics also have a morning GPs and and afternoon GPs.

I have been taking my wife´s aging family members to many of the specialists at all 3 systems for over 8 years as many live out in their home town and don´t have people to take them as they usually arrive by bus. Others here in the city don´t have cars and taxis are expensive for them and I help them as a general rule get in and out fast. If you are over 80 you can ask if the other people who arrived before you mind if we go ahead of you. Most say OK. 

The system is first come first served usually. Appointments are done about 5 patients every 1 or so hours apart but given the same appointment time, example: 9AM, the next appointment time might be 10:15AM. Expats that don´t ask who is the last person to see Dr. **** when arriving for their 9AM appointment and get on the list with a number beside your name as that person to arrive before others, you line up accordingly, no cuts, by the assistant who comes out and asks "Who is here to see Dr. ***. 

If you don´t do this you will wait until everyone before you and after you arrived to be seen. Some Drs. don´t do this but many do. Some call your name as he/she has stacked the files on their desk especially at clinics where they are not seen in blocks someplaces ISSSTE clinics have 15 minute apart appointmets but IMSS and Seguro popular do not at their clinics. Seguro Popular clinic have you come in the morning between 8 and 10AM to get an appointment the next day or 2 or that afternoon. They also make you take your referral to the hospital where the specialists are in person, ISSSTE and IMSS also do this, to get an appointment. ISSSTE and IMSS you can call their 800 # for clinic appointments to get your monthly medicines or go online to make an appointment at their clinics. IMSS in Jalisco gives 3 months of medicine between GP appointment, ISSSTE and Seguro Popular it is still 30 days, unfortunately. If you are newly diagnosed and given medicines by a specialist he/she will usually see you for many months and give you 3 months supply and have you come in every 3 months until they are satisfied the medicines are working and give you a document to take to your local clinic GP and he/she then can write the prescriptions.


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## Haskins

lagoloo said:


> The usual reason people who pay out of pocket for private physicians and have IMSS or SP as a "backup" is because private insurance is very expensive, especially as age increases, or if they have a pre-existing condition. Using private physicians is quite affordable: in my area, an office visit to a general practitioner is around $300 pesos: a specialist from $600-$800 pesos.


How are IMSS/SP when it comes to covering catastrophic illness? Also, if an expat is still not eligible for Medicare, should they still have some kind of American insurance? My wife and I are about to retire from teaching here in Texas, and our State legislature and governor just increased our Teacher retirement system insurance premiums drastically. We're debating whether to forego accepting it in light of getting IMSS when we move to Mexico.


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## TundraGreen

Haskins said:


> How are IMSS/SP when it comes to covering catastrophic illness? Also, if an expat is still not eligible for Medicare, should they still have some kind of American insurance? My wife and I are about to retire from teaching here in Texas, and our State legislature and governor just increased our Teacher retirement system insurance premiums drastically. We're debating whether to forego accepting it in light of getting IMSS when we move to Mexico.


If you drop your retirement system insurance would you be able to pick it up again should you change your mind about staying in Mexico?


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## Haskins

TundraGreen said:


> If you drop your retirement system insurance would you be able to pick it up again should you change your mind about staying in Mexico?


I would not be allowed to pick it up until I turn 65 when I'd be able to get a Medicare supplement through our retirement system. At ages 60 and 58, we'd be out of American insurance for a while.


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## circle110

Haskins said:


> How are IMSS/SP when it comes to covering catastrophic illness? Also, if an expat is still not eligible for Medicare, should they still have some kind of American insurance? My wife and I are about to retire from teaching here in Texas, and our State legislature and governor just increased our Teacher retirement system insurance premiums drastically. We're debating whether to forego accepting it in light of getting IMSS when we move to Mexico.


I would think that it would only make sense to have American insurance if you are going to spend a lot of time there. 

Since I have to go to the US several times a year and sometimes my family comes with, I buy an international policy that covers us when we do travel there (we have to spend less than 160 days per year each in the US or the policy becomes null and void) but it also covers us in Mexico. As of yet we have never reached the $1000 annual deductible -- even though we go to excellent private facilities and doctors most of the time -- so we are essentially self insuring in Mexico but it is nice to know that if we had a major expenditure here it would be covered after the 1000 deductible.


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## Haskins

circle110 said:


> I would think that it would only make sense to have American insurance if you are going to spend a lot of time there.
> 
> Since I have to go to the US several times a year and sometimes my family comes with, I buy an international policy that covers us when we do travel there (we have to spend less than 160 days per year each in the US or the policy becomes null and void) but it also covers us in Mexico. As of yet we have never reached the $1000 annual deductible -- even though we go to excellent private facilities and doctors most of the time -- so we are essentially self insuring in Mexico but it is nice to know that if we had a major expenditure here it would be covered after the 1000 deductible.


Our new Teacher Retirement System insurance will have a $3000 deductible. Premiums will begin at $200 each and will increase over 4 years to $370. Over the last couple of decades the insurance had been free for teacher retirees. We would probably return to the States 4-6 times a year for a few days at a time to shop and check up on our rental properties. Your international insurance sounds great.


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## LMtortugas

Other than $$$, I simply do not see a gulf of difference between healthcare options in the U.S. and Mexico, particularly for us aging expats! Indeed, NOB unquestionably puts forward 2nd to none care & service, but the vast population of people in the U.S. that have insurance, and pay a whole lot of $ for it, are not treated at top tier centers, they go to the ordinary local provider. Further, at age 65 it’s _Medicare_ only with the option of purchasing a supplement and RX plan, none of which are cheap.

Both countries observe that quality and availability of care rise as population centers increase. Many times specialists serve both the private & public sectors. My Rheumatologist in Albuquerque charges me more than patients she treats under Obamacare; similarly a close friend of my wife who’s an internist in Los Mochis maintains a private practice while also regularly attending to her public service. 

When we permanently relocate we’re severing the umbilical cord and engaging the best options Mexico puts forward; joining _IMSS_ and banking all the $$$ not spent toward_ Medicare_ B,D, add-ons, deductibles, co-pays, etc. to self-insure and pray for the best.


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## lagoloo

Suggest that before you commit to IMSS, you look into the other govt. sponsored program: Seguro Popular. The latter doesn't have pre-existing condition restrictions that IMSS has. It is a program with rapidly expanding facilities all over Mexico.


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## Haskins

lagoloo said:


> Suggest that before you commit to IMSS, you look into the other govt. sponsored program: Seguro Popular. The latter doesn't have pre-existing condition restrictions that IMSS has. It is a program with rapidly expanding facilities all over Mexico.


Unless high cholesterol levels and high blood pressure are considered pre-existing conditions in Mexico we have none. If no pre-existing conditions exist, which program would you consider? I've been hearing good things about both, IMSS and SP.


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## TundraGreen

lagoloo said:


> Suggest that before you commit to IMSS, you look into the other govt. sponsored program: Seguro Popular. The latter doesn't have pre-existing condition restrictions that IMSS has. It is a program with rapidly expanding facilities all over Mexico.


I didn't know about Seguro Popular when I signed up for Instituto Mexicano Seguro Social. But I can afford the annual IMSS fee and am happy to contribute something to keep the system running.


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## Haskins

TundraGreen said:


> I didn't know about Seguro Popular when I signed up for Instituto Mexicano Seguro Social. But I can afford the annual IMSS fee and am happy to contribute something to keep the system running.


Are prices and rules different for expats vs Mexican Citizens? I happen to have dual nationality but my wife is American only. In any case, I think we could afford IMSS fees. They have to be more reasonable than the $200-$370 per month we will each be paying for our U.S. insurance.


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## Haskins

Also, thank you all for sharing your very valuable input! I'm learning a lot from y'all.


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## lagoloo

Several questions from posters:
You can find out about which pre-existing conditions are named by IMSS by doing a Google search. It's quite a list. Some are covered after a waiting period, which varies in time of wait.

About prices: expats and Mexican citizens pay the same for IMSS. It increases with age, but is still much less than the U.S. insurance you named.

Seguro Popular has a sliding fee scale, but it is very generous, and costs less than IMSS. I have a three year policy with them at present.

IMSS has been experiencing some financial problems due to their pension system and the Mexican govt. "seems" to be investing more heavily in Seguro Popular in the last few years. That's strictly rumor and hearsay based, so not to be relied upon. Smile. There are Google-able articles about this.


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## TundraGreen

lagoloo said:


> Several questions from posters:
> You can find out about which pre-existing conditions are named by IMSS by doing a Google search. It's quite a list. Some are covered after a waiting period, which varies in time of wait.
> 
> About prices: expats and Mexican citizens pay the same for IMSS. It increases with age, but is still much less than the U.S. insurance you named.
> 
> Seguro Popular has a sliding fee scale, but it is very generous, and costs less than IMSS. I have a three year policy with them at present.
> 
> IMSS has been experiencing some financial problems due to their pension system and the Mexican govt. "seems" to be investing more heavily in Seguro Popular in the last few years. That's strictly rumor and hearsay based, so not to be relied upon. Smile. There are Google-able articles about this.


To supplement this response, I believe most Mexicans in the IMSS system get it through their work and it is paid for with a contribution from their paycheck. I don't know if it is deducted from their pay or if it is a company contribution. In addition to health insurance, they qualify for a pension at some point as well. Foreigners that join IMSS pay for it with an annual fee. The annual fee is about 6000-8000 pesos ($350-450 usd) depending on age.


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## Bobbyb

Employers are supposed to pay Seguro on behalf of the employee. It is not a deduction. However many employers cheat. They hire you for 6 months. No Seguro required. Or they pay as if you were making min. wage. It also covers something similar to Workers Comp. I don't know where people are getting info that IMSS is great? Our friend goes once a month to the clinic that is 30 miles away and waits a half day to get her prescriptions. If they are out of your med. You may have to wait until next month. Or you can pay a "tip" and magically the drug appears. Most of today's high tech meds are not on their list. The last time my wife accompanied my friend the head nurse was throwing out an indigenous patient who was pregnant as she was not married. The nurse was a staunch Catholic! Like I have said before. In some areas the system is OK. In others it SUCKS big time. Not for me. I still say you should visit the facility in your locale before signing up. Yesterday I was thinking that none of the NAFTA nations have a good public health system!! I could write a book on the problems in Canada. Just turn on the cable news to see the difficulties in the USA! At least Mexico has a 2 tier system. If you can afford the fees the private system can be excellent. Still far less than in the USA. The ISSTE has an excellent reputation. If I were younger I would have expat insurance.


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## WintheWin

Bobbyb said:


> Employers are supposed to pay Seguro on behalf of the employee. It is not a deduction. However many employers cheat. They hire you for 6 months. No Seguro required. Or they pay as if you were making min. wage. It also covers something similar to Workers Comp. I don't know where people are getting info that IMSS is great? Our friend goes once a month to the clinic that is 30 miles away and waits a half day to get her prescriptions. If they are out of your med. You may have to wait until next month. Or you can pay a "tip" and magically the drug appears. Most of today's high tech meds are not on their list. The last time my wife accompanied my friend the head nurse was throwing out an indigenous patient who was pregnant as she was not married. The nurse was a staunch Catholic! Like I have said before. In some areas the system is OK. In others it SUCKS big time. Not for me. I still say you should visit the facility in your locale before signing up. Yesterday I was thinking that none of the NAFTA nations have a good public health system!! I could write a book on the problems in Canada. Just turn on the cable news to see the difficulties in the USA! At least Mexico has a 2 tier system. If you can afford the fees the private system can be excellent. Still far less than in the USA. The ISSTE has an excellent reputation. If I were younger I would have expat insurance.


With regards to your local facility:

In many cities, it varies, IMSS will assign you a clinic, not necessarily that one that is closest to you.

Also, it really depends on who you know.

My grandma, a former ER nurse at the IMSS system loves it, she has virtually no wait times, gets all her prescriptions on time, gets to see the specialists when she needs to, and has all her surgeries assigned in a timely manner.

My girlfriend, while pregnant, was treated very poorly in the IMSS family clinic, until my grandma made a quick visit with her one day to chat with her buddies. 
The way my girlfriend was treated changed dramatically, other patients wouldn't be placed in front of her during wait, if she was late to an appointment, the clinic coordinator would see her, and he personally also got the pregnancy leave papers in order.


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## Bobbyb

That sure sounds like the Mexican way!!!


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## LMtortugas

lagoloo said:


> Suggest that before you commit to IMSS, you look into the other govt. sponsored program: Seguro Popular. The latter doesn't have pre-existing condition restrictions that IMSS has. It is a program with rapidly expanding facilities all over Mexico.


Thank you Lagoloo. I am not very familiar with _Seguro Popular_, neither its focus nor operation. However in Los Mochis, in addition to the city’s 2 _IMSS_ hospitals, a 3rd facility, a modern very presentable hospital, is dedicated to _Seguro Popular_. I will do my homework.


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## quinta

Yes, it does depend on where you live, I've heard Puebla, Jalisco and some other areas are excellent and of course, these are wealthier states. BUT, to work in any clinic you have to be an MD and the medical schools are very good (Merida's University is one of the best in the America's and UNAM in DF is amazing), my father had open heart surgery in Guadalajara and his doctor had been named Best in the Americas, a wonderful caring man, same for our doctor in Merida, trained in France and had an office in his home and he would come by and call to see how we were.... When we lived in Vallarta, we had the best doctor as well. 
For minor issues you can always go to the SIMI pharmacies which usually have a doctor on call next door, hardly any waiting and a $30 peso cost, I've had some amazing care there once I fell and dislocated my shoulders and my American doctor said there was nothing wrong with me and the young Mexican doctor couldn't believe it and had me pain-free and better in under an hour! Yes, doctors have to give a certain number of "pro bono" work each year so you can get an experienced professional next to a recent grad and some of our private doctors also treat people at the IMSS clinics.... We have no concerns as far as medical care in Mexico is concerned, we've found more caring doctors and better care in Mexico and in Europe but not in the US


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## Mary-J

*Me too!*



sunnyvmx said:


> That's true. I first went to a General Hospital which is Seguro Popular in a small city in the State of Veracruz. I had been suffering with a burst appendix at home and after three days in the hospital, I was still suffering with the general doctor and two surgeons arguing over the diagnoses. I pulled the hose out of my nose and the needle from my arm, paid the bill and left. A holistic doctor treated me at home with Fennel tea and after three more days he said he was scared I was dying. I was! Finally a friend found an expert gastroenterologist who did an ultrasound and they rushed me to a new private hospital where he operated on me three hours later. They were so afraid I was going to die that they kept me awake for the entire three hour operation. I became ill on Dec. 5th and I was operated on Dec. 22. I was lucky. I apologized to the doctor for being a stubborn patient, but he said that's probably why I'm still alive. I would have died in that Seguro Popular hospital, laying on a wool blanket because they had no sheets, while my doctors were at their Christmas party.


I thought I'd been suffering from appendicitis attacks according to my internet searches but no one else was convinced of this. I was traveling and living all over Europe during the appendicitis attacks. Finally it was the last day of my life and I happened to be in Andorra. The doctors in that fine hospital also did not believe me and finally I was ready to give up the ghost when ultrasound and my pointing at the pain led them to my ornery appendix hiding in the back. Finally I was relived of the thing.


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