# US Health Insurance Plan for part of the year in the US, part in Mexico



## Soleado (Mar 6, 2020)

Hello all, new to the forum! My wife and I have a condo in Baja and plan on spending 4-6 months a year there (which we have been doing for a couple of years now). I've used the hospitals in Cabo and San Jose del Cabo and just paid out of pocket - very reasonable and excellent care. We currently have health insurance in the US through my wife's employer, but she's quitting in July, so we'll need to get private insurance. We live in California, and can apply for Kaiser, which will be about $1,600 a month for both of us. I'm 61, she's 53 and in great health, knock wood! I am wondering if there is a healthcare plan that can be suspended while we are in Mexico. It pains me to think that we'll have to pay $1,600 a month for US Healthcare if we are living in Mexico for 4-6 months. I remember hearing someone in Mexico tell me that they have some plan that they can "suspend" when they are in Mexico - it has a very high deductible, but can be "turned off". Can't find it on the internet though! 
Thank you!


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## eastwind (Jun 18, 2016)

My thinking is that you'd want some kind of coverage while in mexico that would cover you for catastrophic expenses, but that it's best/easiest to pay everyday health costs out of pocket. I _think _Kaiser will pay for "emergency" hospitalization when you are "out of network". 

So what I'd do is find out what happens if you're in Baja and have, say, a heart attack and land in the ICU of a Mexican hospital - how much will Kaiser pay? If they cover that scenario, then I think you're fine to just pay them for 12 months. While you're in Mexico, routine stuff you pay out of pocket, and you have Kaiser for catastrophic issues. 

The only thing I might want to add is medical evacuation insurance that would fly you back to Kaiser if you needed that. I think that you can purchase separately, for not an extravagant amount.

Others will have different opinions I'm sure.


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## Takingiteasy (Aug 12, 2021)

If its any consolation, in a few years you will be able to get medicare in the states and its not that expensive at all compared to what you quoted. No good in mx but you can buy insurance for that and if something happens in mx that they don;'t seem to have the experience for or don't have the modern enough equipment, you could fly back to the states on that rare occasion if it ever comes up. In the meantime if I was in that spot I would get a policy in the states for major medical and give them a po box address. 

The difference between major medical coverage and something that covers even small stuff is huge. Not big, huge like it could be 10x as much or more. It also depends on preexisting conditions, and other factors. I used to be in the insurance field but that was years ago. 

I don't care if you are rich or poor, my advice would be the same. Get a major medical policy with a big deductible. That is the bare bones cheapest. But look at it this way, you can pay for the little stuff, right? $100 is little stuff, of course it can be a lot more but ask about programs and plead poverty and they come down to earth. Its a lot better to owe the $2000 deductible and have to make payments because you are short than to owe hundreds of thousands in hospital and doctor bills. Happened to me and I was covered. And if you don't have insurance you may not get all the treatment you need.

Money wise, you save, lets say, $500 a month on ins by taking big deductible. You can do that with a cover all plan too, it will be more expensive than the bare bones but less than the deluxe package. With a spouse, you could save perhaps $1000 or more a month but you get knicked every time you go to the emergency room or for a checkup. 

Sorry for the long winded rant, but someone said 'insurance'...


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## citlali (Mar 4, 2013)

The big differnce is what the insurrance will cover and also the price by age, The private insurrances in Mexico with big deductible are reasonable at 60 and not reasonable by the time you get in your 80s.. the prices go up and up as you age and your wallet does not.


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## Soleado (Mar 6, 2020)

Takingiteasy said:


> If its any consolation, in a few years you will be able to get medicare in the states and its not that expensive at all compared to what you quoted. No good in mx but you can buy insurance for that and if something happens in mx that they don;'t seem to have the experience for or don't have the modern enough equipment, you could fly back to the states on that rare occasion if it ever comes up. In the meantime if I was in that spot I would get a policy in the states for major medical and give them a po box address.
> 
> The difference between major medical coverage and something that covers even small stuff is huge. Not big, huge like it could be 10x as much or more. It also depends on preexisting conditions, and other factors. I used to be in the insurance field but that was years ago.
> 
> ...


Thank you - that makes sense about the bigger deductible, but being covered for something like, god forbid, cancer or some other emergency that requires hundreds of thousands. Hard to even contemplate, but I know people that have had 500k medical bills. Insane. I do business in India too, and you can get excellent care there for 10x less than in the US, or more!


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## Takingiteasy (Aug 12, 2021)

They do similar things in the states with private health insurance. The cost goes up with age and preexisting conditions. Some policies are guaranteed renewable even if you have a major disease, those policies cost more than the policy that can drop you at any time if they think you are a risk. I would never get one of those non guaranteed policies unless it was to bridge a short time, lets say between retiring and getting medicare in the states.

Medicare will take you no matter the preexisting condition. It goes up each year but not that much. Medicare supplements do not have to take you if you have conditions because they are issued by private companies. If someone thinks his health will hold out until medicare age he could get a bare bones policy and take a chance that there will be some out of pocket expenses. Some people go 'bare' and drop all coverage for a while which is quite a gamble

I know very little about health insurance in mexico beyond what people tell me or what I read here. But the general principals will hold true anywhere. Big deductibles will save money unless you have a chronic condition that needs constant treatment. Insurance companies are required to hold reserves in the states, I'm not sure if they go bankrupt sometimes in mx and can't pay. The govt issued policy will not go bankrupt but a small company might


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## citlali (Mar 4, 2013)

Axa is one of the private insurrance company in Mexico and so is Met life they are both very large international companies.. with Mexican arms..They are no small Mexican fly by night outfit. They are in no danger of going bankrupt soon and when they are you will read about it in the paper.


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## ludekcompany (5 mo ago)

When my wife and I had a similar situation. We were really puzzled. You know, it’s said you should never ask for medical, law, or money advice on the Internet because people are not usually responsible for what they are saying. So, I think it would be better for you to find a specialist who could offer you professional help.


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## ludekcompany (5 mo ago)

ludekcompany said:


> When my wife and I had a similar situation. We were really puzzled. You know, it’s said you should never ask for medical, law, or money advice on the Internet because people are not usually responsible for what they are saying. So, I think it would be better for you to find a specialist who could offer you professional help.


When we had our issue, we were lucky to have a friend who helped us compare plan g vs plan n. Anyway, keep us updated on your issue. I hope everything’s gonna be alright. Best wishes!


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## mhfnet (2 mo ago)

I currently have regular insurance with international emergency coverage as a retiree benefit from my employer until 65 until Medicare kicks in. When that happens I will get medicare advantage that includes better prescription coverage and international medical emergency. I am already going back to the US 4 times a year to my Son’s place (and use his US address) to get my prescriptions and non-emergency medical like check-ups and will continue that under Medicare. It’s really the best solution I have come up with as I have type I diabetes and need the best coverage.


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## Jerry01 (2 mo ago)

I read the previous posts in this thread quickly. So I may have have missed some points that make this post moot. To the OP - does your current US insurance include emergency coverage while traveling? If yes, since you will be at least as many months in the US as in Mexico, then it is much less expensive and better if you just keep your US insurance. If you have urgent issues that do not fall under emergency status, then just fly back to the US for that treatment. The flight costs will be less expensive than purchaseing some additional insurance.


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## mhfnet (2 mo ago)

Jerry01 said:


> I read the previous posts in this thread quickly. So I may have have missed some points that make this post moot. To the OP - does your current US insurance include emergency coverage while traveling? If yes, since you will be at least as many months in the US as in Mexico, then it is much less expensive and better if you just keep your US insurance. If you have urgent issues that do not fall under emergency status, then just fly back to the US for that treatment. The flight costs will be less expensive than purchaseing some additional insurance.


The problem is a medical emergency requiring immediate care can get really expensive even in Mexico so it’s a risk not having it but if you have pre-existing issues or over 70 you can’t get it in Mexico and having Medicare Advantage with International emergency that can’t be denied for either of those issues seems the best solution to me.


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## eastwind (Jun 18, 2016)

I think I agree, I'd keep the US coverage until 65 and just self-insure non-emergencies in Mexico if you have the financial flexibility to absorb a sudden large hit. That could be a pile of money in a cash-like investment, cash in a bank account, or just a credit card with a high limit. 

One tip that might not apply to you but is helpful for those living in tourist areas. The private hospitals (which are very good) have multiple rate tiers - and they charge tourists more. It's worth it to go to that hospital for some kind of ordinary care, and get yourself categorized as a resident vs a tourist. Once you're in their system as a resident, they'll (probably) continue to give you the resident rate. 

QRoo Paul has a video about this where he recommend negotiating the rate before treatment. But I recommend hooking up with a preferred hospital and negotiating the rate even earlier, before you need any services at all. It might not help, but it can't hurt.

For people living where there are few tourists, I don't know that this applies.


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## greeperfi (10 d ago)

Here is what I do. I buy a temporary policy in a red state (I use Utah, you can use TX as well). I use National General which is an Aetna PPO and very good. I pay 200/mo but have a 1000 deductible so it will be way less as you up that. It does not cover pre-existing or prescriptions. Then I buy an annual global travel insurance (not health ins) policy that provides for medical evacuation. This way I pay out of pocket for healthcare in Mexico but if I get cancer or something I just go to Utah and use my short term insurance. If I had an emergency like a heart attack I could get medic-ed home using the global policy


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