MsAlex
2/4/2017 14:41 EST
Once again I'll repost what I've written on this forum on this subject. It's a compilation of many posts. Hope it is of service to folks. - Alex
On Health Insurance and other questions
Please note that except where noted, where costs were written in pesos, you should re-convert the dollar amount, as the peso has fallen significantly (now trading closer to 20 to the dollar).
2/8/2016 07:36 EST
I retired when I was 55 and my husband was 60. We were able to get a very affordable MetLife Mexico Health Insurance policy, which has been phenomenal. It also covers us for emergencies (and only emergencies) anywhere in the world, including the US, if we travel (though the catch is that for coverage, you cannot be outside of Mexico for more than 2 months at a time). Buying such a policy is most affordable if you are younger. Though we are permanente visa holders now, when we bought it in 2009 we were on a tourist visa.
If you're in Mexico, go visit any major hospital: What you'll see is that the major insurance companies in Mexico have offices IN THE HOSPITALS. (The way it works in Mexico is that the hospital bill is PAID before the patient can go home!) Having an office there is to facilitate things on site for their clients. So I'd suggest going with an insurance company that has an office in the best hospital in the closest city to where you want to retire. In my experience, the three companies I see most commonly in major hospitals are MetLife, Seguros Monterey and Cigna. I would also encourage you to ONLY go to major hospitals, which in my experience, have been at least as good as major hospitals in the States. (And I'm a New Yorker. I've been in great NY hospitals.) If you're with a doctor in Mexico who only wants you to go to their dinky little hospital, go find another doctor. (One source for referrals to doctors are US Consulates in the big cities in Mexico, They have lists of local doctors who speak English on their websites.)
Enjoy your adventure!
The following post has some medical insurance advice, but is dense with other advice that could be of interest, so I’ll include it too. One of the main questions that had been asked was about mail forwarding and taxes.
6/13/2016 09:47 EST
1. You are going to be amazed how little physical mail you will receive, or need to receive, once you move to Mexico.
2. If you have a relative in the US, use their address as your "US mailing address" for your banking and credit cards. Then once every blue moon, when a new card needs to be sent to you (since you can conduct all your "business" online), you have your relative send that occasional piece of mail to...
3. MailBoxesEtc. or iShopMail... these are two chains of mail service companies that have storefronts operating throughout Mexico (and especially anywhere there is a sizable gringo community). This is the way it works: Your local location of one of these companies provides you with their address in Laredo, Texas. That becomes your "US mailing address". Mail sent there via normal US mail is brought to your local MailBoxesEtc. or iShopMail location. If you pay for a private mailbox (which can run as high as $400US for 14 months of service at iShopMail in Riberas de Pilar at Lake Chapala, for example), when the mail arrives, it goes into your private mailbox, which you can check as often as you like. (BTW: Up to 3 different households can split the price of such a private mailbox.) If you do not pay for your own private mailbox (as I do not), the mail is received by the shop and sits in their "general" pile until you come and inquire whether they have received anything for you. (I make it a practice to request the sender to put my local phone number in parenthesis after my name when they address the envelope to me. Then I just hope the iShopMail person actually calls me, which they sometimes do. Since I need to do this so rarely, and since I'm advised by the sender that the item is coming, this isn't a big deal.)
4. When you do your taxes, use your actual Mexican address and file online. I do this and it's great that by doing so we're automatically excused from carrying US health insurance (since we don't live in the US). I've found that an online tax preparer called www.olt.com (which is free or almost free depending on options you select) has the right forms and I've used it for the last 6 years to file US taxes from Mexico. I either pay my taxes or receive a refund to my US checking account, which has been the same (in the US) for decades. No problem with that as all banking is online, and the bank has my address as being my relative's (per #2, above). Social Security checks get automatically deposited too, and you just use an ATM here in Mexico whenever you need money. Mexico is a VERY cash-based economy, so you'll find that in Mexico you almost always pay in cash, except for unusually large purchases which you can make with your US credit card. (I recommend Capital One Bank's Visa and Master Card credit cards because they're the only ones I know of who do not charge ANY foreign transaction fees.)
5. When it comes time to sign up for Medicare, you can use the same relative's address in the US, or another one's. (It doesn't have to be the same address you use for your taxes, or your banking.) In choosing a Medicare plan you can consider "Medicare Advantage" plans (like the ones offered by Kaiser Permanente in western states, for example) to control the expense of coverage you don't plan on using. (Since we "retired young" we carry an excellent medical insurance policy here with MetLife Mexico which now costs us about $4,000US a year, but goes up significantly each year as we get older. We're currently 62 and 67.)
6. One last piece of advice: before you spend a lot of money moving to Mexico, try house sitting -- even for as long as a year or two. Wherever you THINK you want to move to now, is likely to change. Think of the process of finding "the right place" as a search... which narrows as you learn what you like and don't like about different places. So do your "experiential research" before buying a house or moving all your things. One website you might try for such leads is www.housesitmexico.com (total disclosure: that’s my venture).
Wishing you well on your adventure! :)
Alex
3/16/2015 14:47 EST
The answer to your question would depend heavily on what your (and your spouse's) age will be when you retire to Mexico. The answer would vary also depending on your financial situation. You should provide this info if you want relevant answers.
For younger retirees, buying good quality private health insurance is a great deal. We purchased policies from MetLife Mexico, which we're very happy with -- but we were age 55 and 60 when we purchased them.
Many older retirees "self insure" in Mexico and go north in the event of greater medical expense.
Other older retirees buy "catastrophic" policies for coverage here in Mexico, and pay as they go for lesser healthcare expenses.
Get multiple quotes before you choose a policy. Also, FYI, it is pretty much "standard operating procedure" in Mexico to not reveal all your prior conditions when dealing with Mexican policies. The insurance companies in Mexico have no power to look at your medical history. We provided our insurer with all our history, and we were later told by other expats we had been foolish to reveal prior conditions (which were then excluded for coverage by our policy). How you choose to handle this situation is obviously your choice... but welcome to Mexico (which operates with a different set of ethics than you may be used to).
6/16/2014 10:41 EST
Do you need truly "international" health insurance, or health insurance in Mexico (specifically). Big difference. In Mexico, we have MetLife coverage. MetLife provides all sorts of insurance coverage in the States -- but does not provide health insurance in the US. In Mexico, MetLife Medical is very big, and the company has offices inside virtually all the larger hospitals (all I've seen, which is several). They have offices there so they can serve their clients when they are hospitalized. (In Mexico, you cannot check out of the hospital until the bill has been paid, which is why it is good that they are there, on site!)
The thing about medical insurance in Mexico is that it gets more expensive as you age. We bought our policy 5 years ago, when my husband had just turned 60 and I was 55. At that time it cost something over $2000 US per annum. The yearly charge goes up between 12 and 15 per cent each year. In this current year, we paid about $3400 US for the year for the two of us. We estimate that by the time both of us qualify for Medicare, the yearly premium will be over $7000 US. (Edit/note: These costs given were based on exchange rate then in effect, about 13 pesos to the dollar. The rate is now closer to 21 to the dollar, so cost is lower than indicated.)
Obviously this is a whole lot cheaper than coverage in the US, but the key is the fact that we bought the policy when we were that young. If you come into the system at an older age, I am sure the policy will cost more.
The way that policies in Mexico work is also different than the typical structure in the US. In Mexico, you pay a one-time deductible per DIAGNOSIS (not per year). If the problem is due to an accident, the deductible is only 500 pesos ($40 US) -- and believe it or not, your doctor can write up virtually anything to qualify as an "accident". (My husband went in for hernia surgery, which we presumed was no "accident". Our agent however told us that had my husband had the surgery within 30 days of the diagnosis, he would have been able to cover the surgery as an "accident" -- so they obviously have some different practical definitions of what constitutes an accident!) The deductible for a diagnosis that is not an accident is 10,000 pesos ($500 US - adjusted for 2017).
My husband experienced a chronic illness in the first year we moved to Mexico. That illness is now covered with no further deductible as long as we have that policy. (What would have been the cost of medications for him alone, is more than the cost of the policy for us, so obviously it has been a great deal.)
Absolutely essential to getting reimbursed in Mexico: You absolutely MUST have a formal receipt called a FACTURA for either drugs or any medical service. For prescription drugs, you have to have the Factura emailed to you (a new rule as of this year), plus you must have the register receipt. Not getting Facturas is the #1 reason anyone would have trouble with this system. This is a must.
Also, FYI, the MetLife policy gives us emergency travel coverage for up to 2 months at a time traveling outside of Mexico. This includes travel to the US, but note that it is only for life-threatening situations, car accidents, etc. and it is only if you have been outside of Mexico for less than 2 months.
If anyone wants a reference to our terrific MetLife agent in Guadalajara, who works directly for MetLife -- not an "agency" -- please contact me directly, but be advised that he does not speak English. (I speak Spanish.) I know that various agencies have English speaking representatives however. I'm sure you can find one.
Just as MetLife has processing offices in hospitals, the other company I've found to have such offices is Seguros Monterey. I believe Cigna is also here, but I haven't seen them in as many hospitals.
Another alternative is to buy catastrophic coverage in Mexico. One company which offers this is Boomer's Insurance, which offers an insurance product through a company called Best Doctors. While many are happy with this policy, just one word of caution about this one: Because they are not a Mexican corporation, if you wanted to sue them for any reason for their services in Mexico, my understanding is that you wouldn't be able to. This situation may have changed, or may change in the future, so please do your own due-diligence.
Other than getting the catastrophic-only coverage for Mexico, what many, MANY expats do is "self insure" for their needs in Mexico, and plan to go north to use Medicare, should something serious arise. Medical services are so cheap here compared to the States, it becomes obvious as to why people do this. For example, a typical price for an appointment with a top specialist in a metropolitan area is 500 pesos ($40 US), sometimes 600 pesos (48). Your "local doctor"/GP outside the big city is typically 200 to 300 pesos ($16 to $24 US). Hospital stays are likewise MUCH lower than in the US.
Some people paying such costs directly, feel more comfortable to also have a special medical air-evacuation policy. My opinion about that is that such policies are expensive and provide a false sense of security. I'd like to know the statistics on what percentage of policies are ever used. I bet it is infinitesimal: They won't fly you to a hospital in the US unless your situation is "critical enough" -- but hey -- what are the chances that if you're "that critical" you might not be better off to stay in Mexico in your delicate condition? And the policy doesn't pay anything unless all the planets have aligned: You must be critical enough to qualify for medical air-evacuation, but not too critical whereby the time to fly there and the delicacy of your condition would make it unadvisable.
Borne out by our personal experience: absolutely top-notch medical care IS available in Mexico, particularly in the larger cities. As long as we have coverage here in Mexico, we have no qualms whatsoever in getting our medical care here.
Alex
8/12/2013 00:23 EST
You're right that there are a many different approaches expats in Mexico are taking in regard to health coverage.
Some expats have been able to qualify for Mexico's IMSS (socialized medical coverage). What I've observed is that "little medical problems" are often not worth taking to an IMSS clinic at all. Folks will just go to a local doctor and pay 200 or 300 pesos ($10 to 15 US) to a local general practitioner, and typically 400 to 600 ($20 to 30 US) pesos for a high-end specialist in a major city. When a friend contracted a rare illness however, her IMSS case was "bumped up" the system, and she was cared for in a leading Mexico City hospital. (Costs quoted here adjusted for Feb 2017 exchange rate.)
As has been said however, the door appears to be closing on IMSS coverage for expats, though it has not shut completely. With its exclusions and age restrictions, I doubt it would have been the "answer" for most people any way.
Private health insurance in Mexico, I believe, falls into two basic categories: A: Policies specifically for residents of Mexico (e.g.: MetLife Mexico and NYLife, Mexico), and B: International policies that (speaking broadly) come in two versions: Ones that cover you ANYWHERE you may live in the world, and ones that specifically exclude coverage in the United States. (Including the US drastically increases the cost of such a policy.)
FYI: Quotes from different insurance companies VARY WIDELY.
Once expats qualify for Medicare, they must also decide whether they will pay for supplemental Medicare insurance plans -- just in case a medical emergency forces them to return to the US.
Sometimes such expats also buy air evacuation insurance, as a contingency plan. That needs to be thought through however, as a truly acute emergency may not allow time for a flight to the US -- and on the other hand, unless it is "enough of an emergency" one might not qualify for the coverage.
There is so much that can be said on this subject!
Alex
8/12/2013 09:54 EST
Let me add a something more directly pertinent to the original question about acquiring health insurance for a couple, ages 68 and 70. If you can find a policy that will qualify you, it will cost a fortune. I don't believe however that at your age you can qualify. I believe that MetLife Mexico cuts off at age 64, for example. People who already have the policy can hold onto it into old age, although the premiums will rise. Example: My husband and I qualified when I was 55 and my husband was 61. Premiums have gone up on the average of 12% over the past 5 years. We are now 59 and 65 and our premiums with our excellent MetLife Mexico policy are now about $3,800 US. Our agent shared with us the information (when I asked), that today, a policy held by another couple he serves -- who are 69 and 75, the ages we will be 10 years from now -- costs a little more than twice as much as we are paying now.
I recently had the experience of speaking to an agent who sells a variety of policies. I did not receive specific quotes, as we are not shopping for an alternative. (Once "you're in", you stay "in"!) However, I understood that while we would still qualify for policies at our combined ages (FYI: a young spouse can bring down the "average ages" for a couples policy), to acquire a policy at our ages would be much more expensive (at least twice as much) than our current policy, which we are in the 5th year of.
All this being said, I hope I don't entirely discourage you from a retirement in Mexico. Excellent and affordable medical care is available here. Paying directly for the actual services you receive in Mexico, is likely to cost less than any policy you can qualify for -- if you are willing to go back to the States (and Medicare) if given a diagnosis that is expensive and long term (cancer, for example).
Many thousands of retired Americans, who have Medicare and supplemental policies back in the U.S., live in Mexico. They pay (low rates) for doctors, labs, or therapies out of their pockets. If they get a diagnosis of something that could get more expensive than they can afford, they go back to the States and use Medicare.
There is a movement to try to get medical services in Mexico to be covered by Medicare, much as US Blue Cross/Blue Shield policies have for about 10 years or so covered their US clients for medical expenses in Mexico. However I don't believe Medicare will cover us in Mexico any time soon (or in my lifetime anyway).
Good luck in your new adventure, should you choose to come to Mexico. :)
Alex
PS: My own venture here is www.HouseSitMexico.com. You're welcome to take a look there as well. Sorry if this "plug" for my website is at all offensive to you.
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