BajaNomad

Mexican health insurance

coho - 5-6-2009 at 08:42 PM

Just found out today after a consultation with an IMSS official that access to the Mexican heath care program is available to FM3 holders. Cost for those over age 60 is approx. $200 per year for full coverage. To join, apply at any IMSS office with your FM3...have a brief physical exam with their doctor and within 30 days you are issued your card. You provide the photos for the card. You must sign up as a couple or two people, married or not. Drugs, ambulance, and surgery all included. This is the official public health care program for all Mexican people that are employed. When you need care, you must take your turn in line, but total coverage with no deductibles are included. This could be a good alternative for those who spend long periods of time in Mexico. I plan to enroll next week. Any one out there with experience on this topic?

bajaguy - 5-6-2009 at 08:57 PM

PLease keep us informed of your progess. Do both applicants
have to be over 60???

BMG - 5-6-2009 at 09:03 PM

Both Ana and I were turned down last year. I have an FM3, she is a Mexican citizen.

redmesa - 5-6-2009 at 10:12 PM

BMG...so why were you turned down? I am confused yet again.

David K - 5-6-2009 at 11:15 PM

"...for all Mexican people that are employed"

So, how does an non-Mexican, over 60, retired, FM-3 holder qualify?

jorgie - 5-6-2009 at 11:23 PM

I was quoted $226 for FM3 holder over 60 . Non employed , retiring in Mexico .

Bajahowodd - 5-6-2009 at 11:32 PM

I was under the impression that any permanent resident can qualify. So I, too, would like to hear more from BMG about that.

LOSARIPES - 5-7-2009 at 03:43 AM

Isn't this the plan named Seguro Popular? It is precisely designed for non working and/or self employed people, not covered by IMSS or ISSSTE. Age doesn't matter. They are taking "wait list" names only as their capacity is limited. Pregnant women are given priority and accepted on the spot.
I don't know about the immigration status requirements. I will ask next time I go there. The cost is very low. Symbolic.

coho - 5-7-2009 at 06:09 AM

As I understand, Mexico has two levels of universal health care. IMSS coverage is for Mexican citizens who are working and whose employers pay into the fund. SSA also provides some care for the poor and unemployed, more limited. Any foreigner of any age can enter the mainstream IMSS system, working or not. But must purchase two policies...family or couple. Cost age 40-59: 1,855.21 pesos per person. Age 60+: 2791.78 pesos per year per person. I believe the maximum age to join is 65.

jorgie - 5-7-2009 at 06:20 AM

what happens 65+ ?

BMG - 5-7-2009 at 06:27 AM

Quote:
Originally posted by redmesa
BMG...so why were you turned down? I am confused yet again.


I was told that I was turned down because I have somewhat elevated blood pressure (pre-hypertension range). The nurse that took it came up with a reading of over 100/160. I told her that I had never had a reading that high. We waited a bit and the next reading was 72/125.

Ana was turned down because :?: :?: :?: She takes no medication. She isn't over weight. Her blood pressure is very good. She has no major pre-existing. When we asked, the lady asked her boss and he said they didn't need a reason.

Russ - 5-7-2009 at 06:46 AM

I'm very interested! Just canceled my State side ins. At $1300/mo I couldn't afford it. That's about twice what it cost me to live here. But with pre-igsisting (sp) med concerns I won't qualify. Not a lot do over 60 I think. Please keep the info coming.

schwlind - 5-7-2009 at 07:15 AM

Several years ago I did some research on this and I seem to recall that if you had a pre-existing condition, that they wouldn't cover it for the first 3 years...

As we all know with virtually everything in MX, it is probably a very fluid situation, and any answer you receive may depend upon with whom you speak.

Please feel free to correct me on this if anyone has more up to date or contradictory information.

Linda

coho - 5-7-2009 at 07:16 AM

There are many Mexican private health care providers as well, offering plans. Bancomer has a plan with coverage limited to 40k usd which costs 2318 pesos per year. Private hospitals also offer plans that limit your care to that particular hospital. Currently searching for a private provider that would provide coverage while visiting the States for the summer. The goal is to drop US health insurance completely until age 66 and MedicAid/MediCare kicks in.

CortezBlue - 5-7-2009 at 07:26 AM

We have a neighbor in San Felipe who signed up for it when he turned 60 and had a major surgery for a stomach issue and said it was wonderful.

vandenberg - 5-7-2009 at 08:18 AM

We inquired about IMSS insurance in Loreto years ago and were told we didn't qualify. No reason given. May have changed since then though. Interpretations of the facts seem to be strictly depending on whoever you talk to.:no:
We're inmigrados.

And I do remember that there was a time frame during which they excepted new applicants.

[Edited on 5-7-2009 by vandenberg]

bajabound2005 - 5-7-2009 at 08:49 AM

I have a policy through Allianz. It is not really health insurance, but is Major Medical It covers me anywhere in the world (e.g for emergencies or accidents). If I went for a regular check up, that would be not covered. If they found something wrong during the check up, then both the check up and subsequent treatment is covered. They have agreements with some hospitals for the hospital to bill the insurer directly, otherwise you'd have to go through a reimburnsement. It also covers treatment up to 20 miles from the border into the US. Cost for me is $13,000 pesos per year.

I am also looking at another policy from ProtExPlan (formerly MedExPlan) which is specifically designed for ex-pats. You have to live outside the US for at least 6 months a year. It covers MedEvac and allows you to return home for treatment. Premium depends on deductible. For me, 52 yrs old, no pre-existing conditions, $1000 deductible, the premium is about $1500 USD per year
www.protexplan.com

tjBill - 5-7-2009 at 09:03 AM

What I've noticed in Mexico, is that most middle class Mexicans visit private doctors and pay out of there pocket. They use their IMSS coverage as an emergency backup in case they can't afford private doctors.

coho - 5-8-2009 at 05:55 AM

Bajabound, Thanks for the tip on protexplan. After an hour on their site, I think they are a good option and inexpensive. Their PPO network in the States is extensive. I recommend Nomads spending at least 6 months out of the year in Mexico to check them out. You can go to any hospital in Mexico.

BigWooo - 5-8-2009 at 07:16 AM

Here's another option. We've been looking hard at this plan for when we retire and move to Mexico later this year:

Multinational Underwriters

It has pretty good benefits and covers treatment anywhere in the world, including the U.S. and Canada, but you have to live out of those two countries for at least 6 months of the year. It's more expensive than Mexico policies, but seems to be very reasonable when compared to most U.S. policies.

If you have a lot of pre-existing conditions though it may not be a good option as they do restrict coverage.



[Edited on 5-8-2009 by BigWooo]

coho - 5-8-2009 at 11:10 AM

Thanks BigWoo. They... Multinational... seem to be a good fit for me as well. LOTS cheaper than a US policy that doesn't cover me in Mexico. Now I am zeroing in on a good plan for health care. If I can gain access to IMSS...I can use them for smaller problems as they have no deductibles. An additional international plan for major emergency coverage wherever I am located worldwide, the States or Mexico. Total cost for both providers will come in at about 35% of what I am currently paying in the States. Not bad. Hope they approve us at IMSS next week after the exam!

BigWooo - 5-8-2009 at 03:47 PM

Glad you can use it. I've spent countless hours researching insurance options trying to find a good policy we could afford. I found this link to have a lot of options:

Expatriate Insurance

I've waded through just about all of them, and for us I think the link listed above works best, but it seems like there's something for just about anyone somewhere on this page.

cantinflas - 5-8-2009 at 04:26 PM

My wife daughter and I all have IMSS ins. When we were in the trial period they tried everything they could to reject us. After many frustrating dealings we finally had a sit down with the head Doc and administrator. Once they discovered the three of us were all Mexican citizens they explained. Seems there were so many gringos (U.S. and Canada) applying for it in our area they were encouraged by higher ups to deny as many as possible. This was mainly due to the fact most of these gringos were lying about pre existing problems an example being one said gringo must a forgot he had a pacemaker. This was a year ago.
Thank God we were not denied as my wife has been the IMSS hospital here for a week now with pneumonia. It has'nt been the best medical experiance of our lives but she is recovering.

[Edited on 5-8-2009 by cantinflas]

bajabound2005 - 5-8-2009 at 05:51 PM

Cantinflas -- where is "our area"? That would be helpful information.

jorgie - 5-10-2009 at 05:20 PM

an unabashed BUMP.......needs more info via input . much thanks to all .

Keri - 5-22-2009 at 03:12 PM

Coho, Did you ever get signed up. Please let us know how it went,k:yes:

coho - 5-23-2009 at 04:42 PM

Keri, Second visit to IMSS office in Sta. Rosalia we found out that the whole procedure of registration only take a few hours from start to finish. First the paperwork: gringos need a copy of FM3 and small photos for the card to be issued. After that, a brief visit with the doctor which does not involve a blood test. Pre existing conditions will be discussed with the doctor. If the doctor accepts you and your partner....must be two involved, the card is made up, after payment is received. Sound pretty straight forward. Because of time constraints, we decided to sign up in October upon our return. In the States, I will sign up with Multinational or another of the several choices given here on the board. Upon acceptance of that health plan, I will go ahead and cancel my stateside insurance. Will update as we move forward.

BMG - 5-23-2009 at 04:55 PM

Quote:
Originally posted by coho
Keri, Second visit to IMSS office in Sta. Rosalia we found out that the whole procedure of registration only take a few hours from start to finish. First the paperwork: gringos need a copy of FM3 and small photos for the card to be issued. After that, a brief visit with the doctor which does not involve a blood test. Pre existing conditions will be discussed with the doctor. If the doctor accepts you and your partner....must be two involved, the card is made up, after payment is received. Sound pretty straight forward. Because of time constraints, we decided to sign up in October upon our return. In the States, I will sign up with Multinational or another of the several choices given here on the board. Upon acceptance of that health plan, I will go ahead and cancel my stateside insurance. Will update as we move forward.


Didn't quite work like that for us in La Paz.

Paperwork - I have FM3. Ana is a citizen. We supplied small photos for ID card.

Brief visit with nurse - She asked a few questions, wrote down our height and weight, took our blood pressure and did take a finger prick blood test.

Pre-existing and current medications - We had an appointment with a doctor and discussed these.

Issuing ID cards - When we went in to pay the premiums and get our cards, we were told that we had been turned down as explained in post above.

Everything went vary smoothly right up until we were told no.