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65 and over health insurance

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esga
  2/4/2017 10:43 EST

If you are over 65, I would like to hear what you are doing about health insurance. Do you have private insurance? self-insure? And what does it mean to "keep medicare"? We have just turned 65 but are still employed, so we haven't yet looked at cost of supplemental care if we stay here. Do you purchase supplemental care in the US (in case you have to return someday) and also get private health insurance there? Or do you buy health insurance for Mexico and plan to pick up cost again someday if you return to US (and I am not even sure that is possible). Feel free to private message me if you prefer, and thanks.

RVGRINGO
  2/4/2017 13:43 EST

Mexican medical coverage is different than US health insurance, and is generally not available to those over 65-70, or for pre-existing conditions.
Your options would be to pay out of pocket for routine doctor visits & medications, as most do anyway, and to enroll in either IMSS or Seguro Popular, get established with them, and stay enrolled for emergency hospitalization in the public hospitals; a triaged, socialized system. IMSS has fees and will exclude previous conditions. Seguro Popular is usually free for seniors who rent, for example, and has no exclusions. Quality in the public systems can vary widely. Private care is excellent in the larger cities, often superior to the USA.

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sparksmex
  2/4/2017 14:04 EST

Consider Seguro Popular. No age limit and no pre-conditions check .... and it's free at leas for over 60.

Medicine is free but small towns often run out.

You can always pay the resonable private medical prices or enter a backup plan.

Warning .... here they insist on a Permanente Visa but other locations are good with a Temporal

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.

esga
  2/4/2017 23:40 EST

Thank you all. It appears that we would be looking for catastrophic coverage, about which I know nothing. Does one use an agent in the US or in Mexico? I want to try to figure out what our costs would be, and obviously health care can be big. I have been warned that we will need something in case of major medical events like heart attack, stroke, auto accident. I am not worried about ordinary doctor visits- that has been well explained. Alex's detailed posts are also very helpful.

Where can we find out about eligibility for IMSS and Seguro Popular? Will the Mexican consulate here supply that information?

RVGRINGO
  2/5/2017 13:19 EST

Again; things are different in Mexico. Coverage is different & costs are too. You can select levels of coverage and the cost will depend upon your age. Pre-existing conditions may be excluded, etc.
If you are a legal resident of Mexico with a valid visa (not a tourist permit) you will be eligible for either IMSS or SP membership; not both.
You will need to talk to one or more agents when you are settled in Mexico. Costs can be as low as 10% of what you might pay in the USA if you are 20 and healthy, but will increase significantly as you age. Again; that will also depend upon the coverage, minimums, deductibles that you select in your plan.
Most retirees are self-insured, due to their age. Medical costs are often similar to the amount you might pay for just the co-pay in the USA; but, not always. However, it is possible to create your own medical savings plan if you have good self discipline and good financial resources.
Mexico is not Kansas, Toto. :)

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Click connect to have our partner contact you via e-mail and/or phone.

Welcome Home MexicoWelcome Home Mexico

Welcome Home Mexico occupies a niche in the market as a successful relocation and real estate firm helping expats moving to Mexico! As seen on CBS news, PBS, in the L.A. Times and more, we are one of the leading companies in this field. Welcome Home Mexico offers a wide range of services, multi-lingual knowledgeable brokers with experience, efficient and professional service.
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RVGRINGO
  2/5/2017 13:25 EST

On Medicare:
It is definitely a good idea to keep your medicare after age 65, and to keep paying for Part B, as you may have to return to the USA for some reason in the future. Yes, Part B costs about $110 per month per person; so the only other option is to cancel it, put that amount in a separate account for use in Mexico and cross your fingers. Yhat did not work for us & we had to return. Age, cancer and other conditions will decimate even the well heeled. Only you can make that decision, knowing that you are not likely to be able to find private insurance in Mexico over the age of 65...at any price.

Launia
  2/6/2017 10:37 EST

You are so right on each point.
Refuted B. Cancer striked in the household. No insurance and a house that is difficult to sell. Medical care can be very expensive here in mx as well and only cash can support it.
Feel stuck.

eshieldsga
  2/7/2017 16:55 EST

Launia, I am so sorry.

All: thank you very much. Having traveled to 37 countries, and worked in over 20 (very briefly except for living 2 years in Tunisia), I am very aware of how different things can be. I don't know a better way to pick your brains than to ask questions, even if they do seem naive to you. All of you have given me great information that's helping me understand what I need to do to satisfy myself that a move would be economically sustainable for us in later years. When we visit Chapala in the summer, I will want to meet people well older than myself to see what they are experiencing.

Alex, I am going to clip and save your consolidated information. I don't anticipate we will pet sit, since we have 3 cats and a dog ourselves that we have to work into this. But someday we might be clients seeking pet sitters!

Launia
  2/9/2017 09:39 EST

Hello. We must have some things in common like living overseas, around the world and in Tunisia. My husband often worked there in
Sfax for oil companies. Tunisia one of my favorite countries for the people, history and their welcoming.
Take care

bluewater1
  5/30/2017 21:02 EST

I find this thread timely as I will be retiring at the end of this year and my wife and I plan to be snowbirds for a couple years and then perhaps move to Mexico (we already own a home outside Playa Del Carmen).
I am 62 and my wife is 60. I will not qualify for Medicare for another 1.5 yrs after retiring and I am researching health care a bit more now, although I can't get quotes from some insurers until within 6 months of retirement.
Once we have Medicare we will keep that for any possible eventualities, but in the meantime we will need insurance coverage in the US and Mexico, and that is quite expensive. We've budgeted for this expense of course, I'm just trying to get a better handle on the costs but it's difficult. But good info here and I'll refer back to it as we get closer...

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Welcome Home Mexico occupies a niche in the market as a successful relocation and real estate firm helping expats moving to Mexico! As seen on CBS news, PBS, in the L.A. Times and more, we are one of the leading companies in this field. Welcome Home Mexico offers a wide range of services, multi-lingual knowledgeable brokers with experience, efficient and professional service.
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MonicaRixPaxson
  5/30/2017 22:47 EST

When I was doing research about various types of health/medical/hospitalization insurance, what each type typically covered, the pros and the cons, etc. I soon found the data that I was gathering was a challenge just to organize, not to mention make it easily understandable. So, I started to organize it in a spreadsheet and the resulting “Insurance Grid” as I would eventually call it, became the basis for getting the overall picture and being able to make comparisons easily. So, while I devoted a whole chapter to talking about various strategies for paying for medical care in Mexico, I also published the grid because I know it helped me.

While I don't think there is anything like a single strategy that is going to work for everyone, I certainly don't agree with everything that has been put forward here as universally true. For example, many of the private hospitals in Mexico are very small, but that doesn't mean worse than larger hospitals. In fact, I would simply say that things are done differently here.

Here is a story that illustrates the point. An expat in our community awoke with symptoms that were very serious, most likely a stroke. There was a quick family discussion about whether to have him evacuated to the US or treated by his local physician. A call was placed to the local doc who told him to call an ambulance and meet him at the hospital in five minutes.

This hospital was small by comparison to most hospitals in the US; only 13 beds. Yet within minutes of the ambulance's arrival an entire surgical team showed up and he was in surgery within minutes of diagnosis. The patient told me that he was absolutely certain he would not have survived a trip to the big city American-style hospital an hour away, not to mention evacuation to the US, Entirely coincidentally, that same doc very possibly saved the life of someone very near and dear to me as well.

While we American's tend to believe that bigger is better and more equipment and tests are superior medicine, that is only one way to see things, only one part of the medical equation. When my girlfriend recently delivered her baby at a small private hospital with only four beds, part of an obstetrical practice, she was the only patient. Everyone was there to serve her, care for her. She was only a few blocks from home and family and friends all showed up to celebrate the new baby. Would she have been better off going to the biggest hospital she could find? I doubt it.

When you move to Mexico, you are changing cultures. And here medicine has been practiced for centuries longer than in the US. The first hospital built in North America, located in Mexico City, it is still a functioning hospital after 500 years. But Mexicans were practicing medicine long before that.

Medicine, more than we realize, is culture bound. Many of us who have been treated in Mexico, whether in a public hospital or a private one, a large one or a small, have at times been surprised (and frequently delighted) by the cultural differences.

I figure it is simply a good idea to know what those differences are and why they are different. So, the first fundamental question you may want to to answer is: Will you be relying on private or public hospital care? The answer to that question will begin to clarify what kind of coverage you'll want to pursue. But there is a lot to consider with just that one question. So much, in fact, that I wrote a whole book about it.

—Monica Rix Paxson, medical researcher and author,
The English Speaker's Guide to Medical Care in Mexico, 4th Edition, http://relentlesslycreativebooks.com/?mbt_book=the-english-speakers-guide-to-medical-care-in-mexico-4th-edition

MonicaRixPaxson
  5/30/2017 22:47 EST

When I was doing research about various types of health/medical/hospitalization insurance, what each type typically covered, the pros and the cons, etc. I soon found the data that I was gathering was a challenge just to organize, not to mention make it easily understandable. So, I started to organize it in a spreadsheet and the resulting “Insurance Grid” as I would eventually call it, became the basis for getting the overall picture and being able to make comparisons easily. So, while I devoted a whole chapter to talking about various strategies for paying for medical care in Mexico, I also published the grid because I know it helped me.

While I don't think there is anything like a single strategy that is going to work for everyone, I certainly don't agree with everything that has been put forward here as universally true. For example, many of the private hospitals in Mexico are very small, but that doesn't mean worse than larger hospitals. In fact, I would simply say that things are done differently here.

Here is a story that illustrates the point. An expat in our community awoke with symptoms that were very serious, most likely a stroke. There was a quick family discussion about whether to have him evacuated to the US or treated by his local physician. A call was placed to the local doc who told him to call an ambulance and meet him at the hospital in five minutes.

This hospital was small by comparison to most hospitals in the US; only 13 beds. Yet within minutes of the ambulance's arrival an entire surgical team showed up and he was in surgery within minutes of diagnosis. The patient told me that he was absolutely certain he would not have survived a trip to the big city American-style hospital an hour away, not to mention evacuation to the US, Entirely coincidentally, that same doc very possibly saved the life of someone very near and dear to me as well.

While we American's tend to believe that bigger is better and more equipment and tests are superior medicine, that is only one way to see things, only one part of the medical equation. When my girlfriend recently delivered her baby at a small private hospital with only four beds, part of an obstetrical practice, she was the only patient. Everyone was there to serve her, care for her. She was only a few blocks from home and family and friends all showed up to celebrate the new baby. Would she have been better off going to the biggest hospital she could find? I doubt it.

When you move to Mexico, you are changing cultures. And here medicine has been practiced for centuries longer than in the US. The first hospital built in North America, located in Mexico City, it is still a functioning hospital after 500 years. But Mexicans were practicing medicine long before that.

Medicine, more than we realize, is culture bound. Many of us who have been treated in Mexico, whether in a public hospital or a private one, a large one or a small, have at times been surprised (and frequently delighted) by the cultural differences.

I figure it is simply a good idea to know what those differences are and why they are different. So, the first fundamental question you may want to to answer is: Will you be relying on private or public hospital care? The answer to that question will begin to clarify what kind of coverage you'll want to pursue. But there is a lot to consider with just that one question. So much, in fact, that I wrote a whole book about it.

—Monica Rix Paxson, medical researcher and author,
The English Speaker's Guide to Medical Care in Mexico, 4th Edition, http://relentlesslycreativebooks.com/?mbt_book=the-english-speakers-guide-to-medical-care-in-mexico-4th-edition

bluewater1
  5/31/2017 09:09 EST

I analyze data as part of my job working for a medical device manufacturer, and after starting to try and organize the heap of data I'm collecting I realized I need to get it all on a spreadsheet where I can compare the data. So I'm glad to read I am not the only one thinking that way!

If we are just snowbirds and frequent visitors to our home in Mexico during the next few years, since we will not yet have Medicare we are going to need private health insurance for the US, and I think some coverages for Mexico (medivac at least). I don’t see any way around that.

Once we are eligible for Medicare I assume we will still need a supplementary health insurance policy. And although we can return home for any medical issues and use Medicare, we will still need the medivac for Mexico for security (will look at that in more depth).

Public or private?
If we then move to Mexico we will have permanent resident visas and own a home so we would qualify for IMSS and it is very inexpensive. But I need to better understand if it makes sense for us with all of the "realities" or limitations of the program (from a cursory review still). We would no longer have Medicare.

Right now, with the “snowbird” scenario for the next few years I'm thinking a private health insurance policy with coverage for both the US and Mexico is the only way to go for our situation. Make sense???

MonicaRixPaxson
  5/31/2017 12:01 EST

I have Medicare and I tend to think of it like a major medical policy that I have never used. I might someday, but Medicare is only usable if you can get to the states. Some people kid themselves about how workable that is forgetting that if you are seriously ill or injured you aren't going to hop on a plane. Basically, you can't fly on a commercial flight if you are ill.

Medical evacuation insurance can get you from a hospital in Mexico back to the US, but you need to be very clear about the terms of the policy you are considering. They vary a lot. I have researched MedEvac and written articles about them and personally am convinced that they offer a solid and workable solution. (I am not being paid a dime for this endorsement.) However, you have to buy the insurance before you need it because otherwise air evacuation is very expensive.

By the time we expats are actually dealing with serious illness and end-of-life issues, many of us are so well established in Mexico — with friends, family and pets here — that it would not be thinkable to go to a country where we haven't lived for a long time for medical treatment. Medicare Schmedicare.

It isn't all that easy to make good decisions while your life is in flux. You are going to need treatment locally from time to time and then there are many things to consider. While you are a snowbird, travelers insurance with hospital benefits may be an option, but you should know the ins an outs about how to use it and it is not safe to assume that hospitals in Mexico will accept an assignment of benefits. Most won't. So you'll need to file your own claim. Best to talk to an insurance broker about that. Paying out of pocket is sometimes more convenient even when you have insurance.

When it comes to choosing a long-term options, I suggest that those are best made on the ground. Visit the local hospitals and make your decisions, to the extent that you can, based on what the best local options are. Vast national systems like IMSS and Seguro Popular show up differently in different places, and private hospitals are each unique.

—Monica Rix Paxson, medical researcher and author
The English Speakers Guide to Medical Care in Mexico, 4th Edition, http://relentlesslycreativebooks.com/?mbt_book=the-english-speakers-guide-to-medical-care-in-mexico-4th-edition

bluewater1
  5/31/2017 15:10 EST

I was considering Medicare (and Medigap) insurance in that way as well, a chip in my pocket if needed, you might say. But I understand it may not be feasible to get back to the States if we become ill outside the country. MedEvac can fill a scary void when needed.

I use travel insurance every time we fly anywhere today to have the medical and evac coverages, and trip delays which we’ve encountered on 4 of our last 6 trips. We’ve spent their money very well when stuck at our connecting airport, but we want to be in Mexico!
I have read several policies thoroughly, and I would always need to pay the claim up-front and be reimbursed later, except in some cases where the insurer May coordinate an assignment of benefits when the cost is too much to pay via credit card. If we were just visiting Mexico and other areas for a month at a time I would just purchase travel insurance, that would be so much easier…

So I will be 63 ½ when I retire at the end of this year and I will be without Medicare for 1.5 years. My wife will have another 5 years before Medicare kicks in. So a private health insurance policy is in our near future and they do vary.

I do agree that longer term, when we are living in or about to move to Mexico, we will want to look at the best options there and visit local hospitals and clinics.
Thanks for your feedback, much appreciated. I’m sure I’ll be ordering your book soon…

seoulguy
  5/31/2017 18:06 EST

Glad I stumbled onto sparksmex post. And I was just thinking today of what could go wrong. Well, what could go wrong is me holding a temp visa and then not qualifying for SP. Just another reason to expect the unexpected. As to the original post, I can't imagine how anyone turning 65 in Mexico could apply for a U.S.-based supplemental. First, you'd need to consult with an agent, sign papers, give a check. Also, if you expect to get Medicare while in Mexico, that's it. You'd get Part A/B, and you'd be on the hook for copays and that nice little overcharge called "excess" physicians and surgeons like to charge. You couldn't get into an Advantage plan either.

bluewater1
  6/1/2017 06:06 EST

Why would you choose to get a temporary resident visa anyway, unless you are there 4 years or less?

RVGRINGO
  6/1/2017 12:08 EST

Some folks choose Residente Temporal so that they can continue to use their US or other foreign plated car for a few years longer. Others, because the financial qualification requirement is lower than it is for Residente Permanente, but one can transition from temporary to permanent after 4 years without further qualifications, and do it in Mexico.

bluewater1
  6/1/2017 13:59 EST

Yes, we were considering the temporary for the vehicle but decided to go with the permanent (based largely on your input, thank you).
I had just seen that the poster was already retired in the US and looking to continue retirement in Playa or Coz and wondered...

bluewater1
  6/1/2017 15:10 EST

Launia I am very sorry to read of your situation, that is terrible...

eshieldsga
  6/2/2017 09:11 EST

Bluewater, can you recommend an insurer that provides both travel interruption and travel health insurance? I have looked at some that do one or the other. OM me if you are more comfortable sharing privately.

Dharmadidi
  1/15/2018 05:44 EST

Keeping my Medicare Part B and switched from a $214 per month Medicare supplemental to a zero premium Medicare Advantage plan. Joined the IMSS. The Seguro Popular hospital in my area literally ran out of every kind of supply recently....some glitch in the funds coming from the Mexican government. Locals have had donation drives and supplied the hospital, at least for a while. The private hospitals and clinics where I was (until a few weeks ago) living in Puerto Vallarta are excellent, but can be pricey. You have to get on the Facebook forums for your area and ask for recommendations, costs, etc. Anyway, I feel the IMSS up front cost is worth it in case of an in-country catastrophy, and Medicare Part B is still going to be a necessary expense in case of something that requires more sophisticated or sooner treatment.

Rodrigo1974
  1/15/2018 12:57 EST

Greetings:

I can tell you horror stories, but it's better to be brutally frank, indeed. you better make sure that your insurance company will cover you for immediate entry into the hospitals of your choice in your vicinity, without first having to come up with a cash deposit. when and if having a coronary or stroke, this can be devastating. contact the hospital administrators of several places and even verify that they will honor your insurance company's commitment, indeed. get them even to sign something and carry it around in your wallet. i wouldn't trust social security hospitals and i have many mexican friends that wouldn't, as well.

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