Any recommendations? Yes google and I have a love hate relationship. I can see the ratings, but it doesn't tell me much on the processing time for claims, what exactly to expect when dealing with certain insurance companies. Any of you that have purchased Expat Medical Insurance, or have a medical plan within Mexico would love to know how it worked for you.
I've written at least a couple of thousand words on this subject of health insurance on this Forum. So what I'm going to do is give you a few "cut and paste" samples. I've tried to fix the dollar amounts mentioned to more closely resemble current exchange rates. You can read through it and find the parts you're most interested in, or you can search for posts on this forum that have talked about medical insurance in the past.
What I've also recommended previously is that when you move to Mexico, take a look at the very best hospital you might go to (close to where you will live). Look for what insurance companies have offices IN that hospital. Pick one of them. (FYI: In Mexico the patient can't leave the hospital until the bill is paid in full. That's why insurance companies have a presence. They have to filter through and figure out what's covered, so that you're presented with what you owe.)
6/16/2014 10:41 EST (and updated)
Do you need truly "international" health insurance, or health insurance in Mexico (specifically).? Big difference. In Mexico, we have coverage with MetLife Mexico. MetLife provides all sorts of insurance coverage in the States -- but does not provide health insurance in the US. In Mexico, In Mexico MetLife 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 7 1/2 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.
[Here's an edit: We paid about $4,500 in 2016, with an exchange rate at the time of 18 pesos to the dollar. As I said, it is now closer to 20 pesos to the dollar.]
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 (now about $250 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 ($800 US).
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 with him.) 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, 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 ($25 US), sometimes 600 pesos ($30). Your "local doctor"/GP outside the big city is typically 200 to 300 pesos ($10 to $15 US). Hospital stays are likewise MUCH lower than in the US. (prices adjusted for current exchange rate 1/2027)
Some people who pay 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.
There was a typo in my last post in this thread when I spoke of what the deductible is for an accident. I said that it was 500 pesos. That amount is now close to $25USD. (In the post it says $250. Big difference.)
What are your recommendations for someone with 3 younger kids (8 yrs, 8 yrs, and 13 yrs). I am 61 and my wife is 58 and we are planing on starting retirement in Merida (Yucatan) Mexico. Is self insuring an option in this case?
Hi Amarandi, Medical Services in Mérida are very good, people go to use their social security hospitals from all the neighboring states. The social security has a good family plan, you can apply for it online and the prices are very low. The downside is that you might have to deal with long waits for appointments and it would be probably better to go out of pocket for minor things, but it would be great in case of an emergency or accident. Here is some research i did a month ago with prices and info you might find handy. http://www.topmexicorealestate.com/blog/2016/10/imss-family-health-insurance-in-mexico-2016-update/?art=BLOG_311016&web=expatexchange Happy New Year 2017 =) Claudia
This is JWinPS, I read your post about the IMSS healthcare premiums. Actually, more than I had expected them to be. Since Dr. visits are such low cost, is the reason for this high premium that hospitalization if needed is not that cheap? Similarly, I don't know the IMSS coverage would include prescription drugs. Again, does this mean that prescription drugs are not that cheap? I"ve heard about how reasonable medical care is out of pocket. It seems that these premiums imply the opposit.
MsAlex: Thanks for the Post. An area I was thinking about subject to any move short term visits-or-otherwise to Cabo San Lucas area. Do you have any input regarding joining the Mexican Health Care System itself rather than purchasing Commercial HC Insurance ? I note the 65 age-related Premium costs assuming one would even be accepted for coverage at that age. The US HC Insurances had me move away from the US as Premiums became too high over time......Deductibles useless as I hardly ever went to a Doctor in the first place and ObamaCare Premiums simply produced the same results.. and I note has increased hugely for 2017 as most people thought it would ! I am used to the 'local' Hospital/Doctors membership-type setups in Colombia, and certainly the National HC system in the Philippines (Philhealth) is extremely affordable for peace-of-mind with any Doctors visits etc..easily paid for out-of-pocket and elements not covered by Philhealth for hospitalization are (or should be) within one's budget.. Many thanks in anticipation :)
Mexico has socialized medicine, which expats residing in Mexico can take advantage of. It's somewhat ironic since our own country doesn't provide such services to its citizens. I am not a fount of information on this however, as we maintain our private insurance policies and have never applied for either Seguro Popular or IMSS.
The two relevant systems in Mexico are Seguro Popular and IMSS. I would search this forum's past information to learn more about them. Long-story-short: they're good for a back-up solution in case of accident or serious illness, if you need a back up plan. For regular medical care, waits can be long and you're better off paying out of pocket and seeing a doctor privately because the cost is so low.
Prices for IMSS depend upon age, and pre-existing conditions are not covered, or may even exclude you from eligibility. Seguro Publico is generally free, or almost free, depending upon your family situation, home, etc., and is for those without any other insurance coverage. Neither are really insurance, but are socialized medical care programs for legal residents of Mexico; citizens and those with residence visas. Quality of care can vary widely from one area to another and waits can be very long; often requiring arrival at 6:30 AM and waiting much of the day, only to be referred to the next day, or another location or provider. Appointment times can take several weeks; even months. That is why most use private MDs & clinics for routine care, which is usually prompt and excellent. That said, we had to move back to the USA, having maintained our Medicare during our 13 years in Mexico. Why? Old age ailments, including cancer, heart disease, COPD, etc., etc., and also the availability of VA Medical Hospitals & Clinics. Private care in Guadalajara was fantastic and generally superior to that in the USA, but we were running out of resources and are much too old for private Mexican insurance.
MsAlex: Thank you. I will of course do more research. The In-country socialized medical coverage may prove good for a back-up or some combination of Public/Private. I currently pay the equivalent of USD$80 yearly which covers a good chunk of any hospitalization.. the excess you pay and you pay out-of-pocket for any visit to a Doctor/Specialist etc. Private insurance schemes are something else of course but are not open to anyone over the age of 62 as a rule and one is dropped at a 'cut-off' age anyway.. If the US had socialized Health Care I would certainly return.
RVGRINGO: Thanks for the additional insight - all of which one has to consider when evaluating a relocation. Just a quick off-subject though.. I note you maintained your Medicare option while in MX. However, I am under the impression that to remain 'registered' with Medicare you are required to be present in the US for 3 months or you get dropped. As you pay into the system monthly anyway and are not using it while abroad I cannot see why they would drop anyone (they need the $$'s). Maybe I'm missing something here ? Thanks.
Like you, I've been puzzled by the somewhat confusing variety of health care coverage options. I just came across this article in my internet surfing today. The article covers feedback from those actually using a variety of the healthcare coverage options. The experiences are recent: 2016, one even as late as November.
I have never heard of Medicare dropping anyone. However, some have dropped Part B, or never signed up for it, and are later hit with permanent monthly penalties if they wish to reinstate it. Getting that done might take some months, but Medicare is automatically charged to your Social Security monthly payment; no choice about that. You have to be in the USA to use it, and will need a USA address; but you do not have to really be there. We used a mail drop for ours.
RVGRINGO: Thanks for your response. I did read on a Gvt Site that if you did not sign up or dropped your Medicare that there was a significant penalty involved should you wish to sign-up/re-access it. Sign-up and letting it 'ride' providing one maintains a US address seems the most rational choice until any other decisions are made regarding HC coverage in MX. My thanks again.
I just read a blog from a woman living in Mexico, who had a medical emergency and had to pay $12,000 dollars (not pesos) to the hospital. Apparently, they will not release you until the bill is paid. I am assuming this is a private system hospital. So, the subject of health insurance is indeed a very important topic, when one is over a certain age. Also, in the public hospitals, you need someone to stay with you like a nurse, because things are not the same as in the US. This system seems fine with ordinary things, but long term severe ailments may require to either return to the US or pay cash.
A retiree who has lived all over the world as a house sitter, talks about packing up and making the permanent move to Lake Chapala, Mexico. She had been there many times before and is thrilled she finally made the move - she appreciates the lower cost of living, expat community, close proximity to Guadalajara.
A retiree who has lived all over the world as a house sitter, talks about packing up and making the permanent move to Lake Chapala, Mexico. She had been there many times before and is thrilled she fi...