BajaNomad

Do you have Mexican health insurance?

EnsenadaDr - 11-18-2012 at 12:29 PM

Hi Folks, just reading the note about the mishap in the Baja 1000 which reminds me to ask once again, how many of you actively living in Baja have Mexican Health Insurance? How many of you just think that if you have a medical emergency you are willing to shell out thousands of dollars on your credit card to get treated at a local private Mexican hospital?

I will once again use this opportunity to encourage all of you to get out there and sign up for Seguro Popular. It's free in most areas of Mexico, and covers basic as well as catastrophic medical needs.

desertcpl - 11-18-2012 at 12:57 PM

point well made,, this sent this off to friends that live part time in San Felipe, you never know

Mula - 11-18-2012 at 01:05 PM

We have Seguro Popular and use it!

Everyone living here should have it!

El Jefe - 11-18-2012 at 01:11 PM

I fell off the ladder and busted my head pretty good last spring and went to Amerimed hospital is San Jose del Cabo. The care was excellent with MRI, plastic surgeon, cardiologist, neuro surgeon etc. and an overnight stay. Total cost $10,000 US paid on credit card. Reimbursed by my stateside health insurance 100%. Glad I have good insurance up there and glad I have good credit limit. No complaints.

But, am wondering if I could have gone to same hospital and they would have take Seguro for partial payment and my credit card for the rest if I had seguro in addition to my USA coverage. Or do you have to go to certain hospitals?

[Edited on 11-18-2012 by El Jefe]

Thanks for the positive feedback Mula!!

EnsenadaDr - 11-18-2012 at 01:16 PM

Quote:
Originally posted by Mula
We have Seguro Popular and use it!

Everyone living here should have it!

DENNIS - 11-18-2012 at 01:16 PM

Quote:
Originally posted by El Jefe
I fell off the ladder and busted my head pretty good last spring and went to Amerimed hospital is San Jose del Cabo. The care was excellent with MRI, plastic surgeon, cardiologist,


A cardiologist for a head injury? Sounds like they were runnung up the bill a bit. Did you get a rabies vaccination before they released you? :lol:

EnsenadaDr - 11-18-2012 at 01:23 PM

I don't believe you will get reimbursement from Seguro Popular. You need to go to one of their contracted hospitals. The point is, who has $10,000 American dollars to tie up on a credit card? The other point is, how long do you wait for reimbursement? And what illnesses or accidents aren't covered?
Quote:
Originally posted by El Jefe
I fell off the ladder and busted my head pretty good last spring and went to Amerimed hospital is San Jose del Cabo. The care was excellent with MRI, plastic surgeon, cardiologist, neuro surgeon etc. and an overnight stay. Total cost $10,000 US paid on credit card. Reimbursed by my stateside health insurance 100%. Glad I have good insurance up there and glad I have good credit limit. No complaints.

But, am wondering if I could have gone to same hospital and they would have take Seguro for partial payment and my credit card for the rest if I had seguro in addition to my USA coverage. Or do you have to go to certain hospitals?

[Edited on 11-18-2012 by El Jefe]

DaGreen - 11-18-2012 at 01:54 PM

Speaking of insurance, I've been searching on this site for the inexpensive Med Vac insurance. Anyone know where/what I am talking about?? I think it was through Baja Insider but I am not locating the information.

vandenberg - 11-18-2012 at 02:22 PM

Quote:
Originally posted by DaGreen
Speaking of insurance, I've been searching on this site for the inexpensive Med Vac insurance. Anyone know where/what I am talking about?? I think it was through Baja Insider but I am not locating the information.


DaGreen, check your U2U

DENNIS - 11-18-2012 at 02:24 PM

Quote:
Originally posted by EnsenadaDr
The point is, who has $10,000 American dollars to tie up on a credit card?


Do you think they'd take an out of state, two party check? :o

DENNIS - 11-18-2012 at 02:28 PM

By the way....what ever happened to this affordable medical care in Mexico?

EnsenadaDr - 11-18-2012 at 02:37 PM

Dennis you more than anyone should get over to your Seguro Popular office in Maneadero with your FM3 and utility bill receipt....It is FREE...I don't want to think you would want to pay out of pocket again..you also need to get reimbursed for those bills...when I get back I will follow up if you haven't submitted them already for reimbursement.
Quote:
Originally posted by DENNIS
By the way....what ever happened to this affordable medical care in Mexico?

DENNIS - 11-18-2012 at 02:43 PM

Quote:
Originally posted by EnsenadaDr
Dennis you more than anyone should get over to your Seguro Popular office in Maneadero with your FM3 and utility bill receipt....


I suppose you're right.

Pescador - 11-19-2012 at 09:05 AM

Quote:
Originally posted by EnsenadaDr
Hi Folks, just reading the note about the mishap in the Baja 1000 which reminds me to ask once again, how many of you actively living in Baja have Mexican Health Insurance? How many of you just think that if you have a medical emergency you are willing to shell out thousands of dollars on your credit card to get treated at a local private Mexican hospital?

I will once again use this opportunity to encourage all of you to get out there and sign up for Seguro Popular. It's free in most areas of Mexico, and covers basic as well as catastrophic medical needs.


Please discontinue your misinformation about Seguros Popular as being free. It is based on your income and may well be free but it may also have a fee. We have enough Mexico bashing and do not need to add more fuel to the fire when someone expects the premium to be free and then goes in to the Seguros office to sign up and they discover a fee. I have talked to the main office in Mexico City to confirm this and the policy is exactly as I have described. As someone who is involved in the medical system, you have an obligation to get this information straight.

Mexico is a big country and to generalize about the whole country from what may be happening in the Ensenada/ Tijuana area is a dis-service to the program.

greengoes - 11-19-2012 at 09:14 AM

Correct me if I am wrong, if you are over 55 there is no charge to enroll. That should cover 99.5% of the ex-pats living here.

On another matter, when does the information thread begin about the new requirements for FM3s and FM2s the went into effect this past September?

desertcpl - 11-19-2012 at 09:22 AM

Quote:
Originally posted by Pescador
Quote:
Originally posted by EnsenadaDr
Hi Folks, just reading the note about the mishap in the Baja 1000 which reminds me to ask once again, how many of you actively living in Baja have Mexican Health Insurance? How many of you just think that if you have a medical emergency you are willing to shell out thousands of dollars on your credit card to get treated at a local private Mexican hospital?

I will once again use this opportunity to encourage all of you to get out there and sign up for Seguro Popular. It's free in most areas of Mexico, and covers basic as well as catastrophic medical needs.


Please discontinue your misinformation about Seguros Popular as being free. It is based on your income and may well be free but it may also have a fee. We have enough Mexico bashing and do not need to add more fuel to the fire when someone expects the premium to be free and then goes in to the Seguros office to sign up and they discover a fee. I have talked to the main office in Mexico City to confirm this and the policy is exactly as I have described. As someone who is involved in the medical system, you have an obligation to get this information straight.

Mexico is a big country and to generalize about the whole country from what may be happening in the Ensenada/ Tijuana area is a dis-service to the program.




we have friends that live part time in Puerto Vallarta, own a home and have a Fm 3 or 4 cant remember, but they are on the program, his age is 68 and hers is 50,, I think they pay somethink like $300.00 dollars for both for a year, and it covers most any thing, and that is really cheap when you think about it

oladulce - 11-19-2012 at 10:54 AM

Quote:
Originally posted by El Jefe
I fell off the ladder and busted my head pretty good last spring and went to Amerimed hospital is San Jose del Cabo. The care was excellent with MRI, plastic surgeon, cardiologist, neuro surgeon etc. and an overnight stay. Total cost $10,000 US paid on credit card. Reimbursed by my stateside health insurance 100%. Glad I have good insurance up there and glad I have good credit limit. No complaints.

But, am wondering if I could have gone to same hospital and they would have take Seguro for partial payment and my credit card for the rest if I had seguro in addition to my USA coverage. Or do you have to go to certain hospitals?

[Edited on 11-18-2012 by El Jefe]


Jefe- Who is your US health insurer?

El Jefe - 11-19-2012 at 12:01 PM

Jefe- Who is your US health insurer?

Anthem Blue Cross. But it costs us over $1,100 a month for the premium. Same plan I had with the city before I retired. We get our usual stuff handled in the states, but emergency use in mexico paid 100% so far for my dumb fall off the ladder and a prior surfboard gash on the same fat head. For routine medical down here we have just paid cash (tummy grief etc.)

BTW, Dennis, the cardiologist was there to make sure I would be OK for going under when the put me out for surgery. But I really think when they get a live one in there with good insurance and an ample credit limit the call goes out to all the specialists in town. I felt very well taken care of....

durrelllrobert - 11-19-2012 at 12:14 PM

Quote:
Originally posted by oladulce
Quote:
Originally posted by El Jefe
I fell off the ladder and busted my head pretty good last spring and went to Amerimed hospital is San Jose del Cabo. The care was excellent with MRI, plastic surgeon, cardiologist, neuro surgeon etc. and an overnight stay. Total cost $10,000 US paid on credit card. Reimbursed by my stateside health insurance 100%. Glad I have good insurance up there and glad I have good credit limit. No complaints.

But, am wondering if I could have gone to same hospital and they would have take Seguro for partial payment and my credit card for the rest if I had seguro in addition to my USA coverage. Or do you have to go to certain hospitals?

[Edited on 11-18-2012 by El Jefe]


Jefe- Who is your US health insurer?

I have always submitted my MX emergency treatments to Kaiser and always got a partial (about 75%) reimbursement. The fist time was $800 Pesos for treatment at the military hospital and they reimbursed me $600 USD but they never made that mistake again.

Alm - 11-19-2012 at 03:16 PM

Quote:
Originally posted by DaGreen
Speaking of insurance, I've been searching on this site for the inexpensive Med Vac insurance. Anyone know where/what I am talking about?? I think it was through Baja Insider but I am not locating the information.

Did you mean med evac? Inexpensive... There was an old saying (back in my old country) - cheap fish, poor soup.

1) DAN Travel Assist - cheap $30 annual, but it only takes you to the "closest capable" hospital, not to the hospital of your choice. So if you get sick in Mulege, and they think that Loreto or La Paz is good enough in your situation, they will take you to Loreto or La Paz, but not to San Diego. You don't have to have a diving accident to be eligible for their evac program - being on the coast and having a snorkel somewhere in a closet is enough. For $45 extra they include $10,000 non-diving accident treatment (lifetime amount). Summary of coverage - click Travel Assist link under the price-list. Download the Member Handbook for all the "small print" info.

2) Med Jet - takes you to the hospital of your choice. Several times more expensive, cost depends on the trip duration or status (more than 6 months or less), and age.

And there are others, I don't see much sense in listing them. Most trip insurance plans and hospital plans include evacuation feature, though usually type #1, when THEY decide where to take you.

The biggest drawback of these "evac" plans is that they will only take you to the hospital, no matter - closest or your choice - after you've already made it to some hospital but need more than they can offer. The only exception that I know is Sky Med. They will take you from the place of accident to the hospital of your choice and/or in your home country, as I understand. No personal experience.

Seguro Popular... Does anybody remember that story posted here, about a guy who had a heart attack in Ensenada? Quite an eye-opener on Mexican public hospitals. If it wasn't for his wife, he wouldn't have probably made it to San Diego and wouldn't have lived to tell the story.

Edit- PS:
I hope you realize that "evac" plans, unless otherwise provided (ex. $10K coverage in DAN) don't include any treatment. They are exactly what they are called - evacuation.

[Edited on 11-19-2012 by Alm]

I am posting accurate information

EnsenadaDr - 11-19-2012 at 04:46 PM

I need your contacts in Mexico City. You may contact my boss, Dr. Isaac Trejo in the Maneadero Clinic who is the head of all of the Ensenada Maneadero area, including Cantu, Zorillo, and Maneadero. I will ask him to contact your source. I have never charged one person in Cantu, Ensenada or Maneadero. I have a feeling you are thinking of Seguro Social (IMSS) and that is based on income. There is not one person that has ever registered for Seguro Popular, including Americans, that has been asked for their income in Seguro Popular. I think you need to discontinue your comments if you are not sure of which insurance you are discussing.
Quote:
Originally posted by Pescador
Quote:
Originally posted by EnsenadaDr
Hi Folks, just reading the note about the mishap in the Baja 1000 which reminds me to ask once again, how many of you actively living in Baja have Mexican Health Insurance? How many of you just think that if you have a medical emergency you are willing to shell out thousands of dollars on your credit card to get treated at a local private Mexican hospital?

I will once again use this opportunity to encourage all of you to get out there and sign up for Seguro Popular. It's free in most areas of Mexico, and covers basic as well as catastrophic medical needs.


Please discontinue your misinformation about Seguros Popular as being free. It is based on your income and may well be free but it may also have a fee. We have enough Mexico bashing and do not need to add more fuel to the fire when someone expects the premium to be free and then goes in to the Seguros office to sign up and they discover a fee. I have talked to the main office in Mexico City to confirm this and the policy is exactly as I have described. As someone who is involved in the medical system, you have an obligation to get this information straight.

Mexico is a big country and to generalize about the whole country from what may be happening in the Ensenada/ Tijuana area is a dis-service to the program.

Seguro Social (IMSS) charges about $300 a year American dollars...Seguro Popular does not go by income

EnsenadaDr - 11-19-2012 at 05:24 PM

Quote:
Originally posted by desertcpl
Quote:
Originally posted by Pescador
Quote:
Originally posted by EnsenadaDr
Hi Folks, just reading the note about the mishap in the Baja 1000 which reminds me to ask once again, how many of you actively living in Baja have Mexican Health Insurance? How many of you just think that if you have a medical emergency you are willing to shell out thousands of dollars on your credit card to get treated at a local private Mexican hospital?

I will once again use this opportunity to encourage all of you to get out there and sign up for Seguro Popular. It's free in most areas of Mexico, and covers basic as well as catastrophic medical needs.


Please discontinue your misinformation about Seguros Popular as being free. It is based on your income and may well be free but it may also have a fee. We have enough Mexico bashing and do not need to add more fuel to the fire when someone expects the premium to be free and then goes in to the Seguros office to sign up and they discover a fee. I have talked to the main office in Mexico City to confirm this and the policy is exactly as I have described. As someone who is involved in the medical system, you have an obligation to get this information straight.

Mexico is a big country and to generalize about the whole country from what may be happening in the Ensenada/ Tijuana area is a dis-service to the program.




we have friends that live part time in Puerto Vallarta, own a home and have a Fm 3 or 4 cant remember, but they are on the program, his age is 68 and hers is 50,, I think they pay somethink like $300.00 dollars for both for a year, and it covers most any thing, and that is really cheap when you think about it

Alm - 11-19-2012 at 08:28 PM

Seguro Popular is not completely "free", income does matter, though the premiums are fairly low. Old Fm3 - whatever it's called now - was a hit/n/miss with Seguro, as I understand.

"The Affiliation and Orientation Modules or the brigades ask the applicant to provide the necessary information to undertake the socioeconomic evaluation of the family called Household Socioeconomic Features Card in order to determine their ability to pay. This evaluation must be carried out every three years."

Source:

http://www.seguro-popular.gob.mx/index.php?option=com_conten...

Where are you getting your information from?

EnsenadaDr - 11-19-2012 at 11:15 PM

I think alot of people are confused between the two Seguros, I will stand by my statement that Seguro Popular is free, and they do not require proof of income.
Quote:
Originally posted by Alm
Seguro Popular is not completely "free", income does matter, though the premiums are fairly low. Old Fm3 - whatever it's called now - was a hit/n/miss with Seguro, as I understand.

"The Affiliation and Orientation Modules or the brigades ask the applicant to provide the necessary information to undertake the socioeconomic evaluation of the family called Household Socioeconomic Features Card in order to determine their ability to pay. This evaluation must be carried out every three years."

Source:

http://www.seguro-popular.gob.mx/index.php?option=com_conten...

DENNIS - 11-20-2012 at 07:44 AM

Quote:
Originally posted by Alm
Seguro Popular is not completely "free",


Ensenada Dr used to work for them on a full time basis. Don't you think she would know what she's talking about?

Mula - 11-20-2012 at 07:49 AM

5 of us from 56 years old to 75 years old got Seguro Popular last spring in Ciudad Constitucion - at no cost.

And the times we have used the clinic - for eye problems, kidney infections, and a variety of other things. . . it has not cost anything for the treatment or the service.

[Edited on 11-20-2012 by Mula]

Pescador - 11-20-2012 at 07:52 AM

Ensenada Dr. You are sure a stubborn little thing, even when you are wrong. You can easily call the director at Mexico City and he will tell you exactly the same thing. Now, it just may be happening that the Ensenada office is not choosing to do the income level evaluation, but please do no assume that is what is happening to the rest of Mexico. Here is the exact page off of the Seguro Popular website.

Las cuotas familiares del SPSS publicadas el 15 de febrero de 2011 en el Diario Oficial de la Federación (DOF), vigentes para el ejercicio fiscal 2011 son:







Cuotas vigentes

Decil de ingreso


Cuota anual familiar (en pesos)


I Level 1

0.00


II Level 2


0.00


III Level 3

0.00


IV Level 4

0.00


V Level 5


2,074.97


VI Level 6


2,833.56


VII Level 7


3,647.93


VIII Level 8


5,650.38




IX Level 9


7,518.97


X Level 10


11,378.86


Un escaso porcentaje (menos del 1%) de las familias y personas incorporadas al Sistema de Protección Social en Salud (SPSS) pagan una cuota de afiliación de acuerdo a su condición socio-económica.

Al momento de incorporarse al Seguro Popular, en alguno de los Módulos de Afiliación y Orientación (MAO´s), se les realiza una evaluación socioeconómica denominada Cédula de Características Socioeconómicas del Hogar (Cecasoeh) cuya finalidad es determinar la capacidad de pago de la familia o persona interesada en afiliarse y con base en la Cecasoeh se establece una cuota familiar que, en su caso, debe cubrirse, o bien, si conforme a la condición socioeconómica del, o lo(a)s, interesado(as) formará(n) parte del régimen no contributivo.

Dentro del régimen no contributivo se considera a:
•Las familias que se ubiquen en los niveles más bajos de ingresos, deciles I y II, así como aquellas hasta los deciles III y IV de la distribución de ingresos.
•Familias beneficiarias de algunos de los programas de combate a la pobreza extrema del Gobierno Federal (por ejemplo, Programa Oportunidades).

Las personas mayores de 18 años que se afilien de manera individual aportarán el equivalente al 50 por ciento del monto de la cuota familiar que corresponda al decil de ingresos en que se ubique.

[Edited on 11-20-2012 by Pescador]

Pescador - 11-20-2012 at 08:01 AM

Quote:
Originally posted by DENNIS
Quote:
Originally posted by Alm
Seguro Popular is not completely "free",


Ensenada Dr used to work for them on a full time basis. Don't you think she would know what she's talking about?


Well, one would think so, but it depends on listening skills I suspect. The web site is very obvious and concrete.

Pescador - 11-20-2012 at 08:13 AM

Here is what the official webpage states:

4. ¿El Seguro Popular es gratuito?

En la mayoría de los casos es gratuito, pero para determinar la capacidad de pago de una familia se realiza una evaluación socioeconómica utilizando la Cédula de Características Socioeconómicas del Hogar (Cecasoeh). Consulta aquí las cuotas familiares vigentes.

http://www.seguro-popular.gob.mx/index.php?option=com_conten...

Now, what may be happening (this is Mexico) is the office that Ensenada Dr. was affiliated with may have chosen to classify everyone under level One through Four and have not done the Cecasoeh evaluation but in other parts of Mexico, even Baja Sur, that is not the case and when I talked to the Directors office in Mexico City they indicated that was not how the system was intended to be done.

EnsenadaDr - 11-20-2012 at 08:42 AM

Un escaso porcentaje (menos del 1%) de las familias y personas incorporadas al Sistema de Protección Social en Salud (SPSS) pagan una cuota de afiliación de acuerdo a su condición socio-económica.

This is a quote from your literature and says less than one percent pay according to their income. I am not going to belabor this point anymore. I don't know why you want to argue about this. Like Dennis said, I worked for the system and the higher ups told me that there was no proof of income needed. I don't like the way you talk to me, calling me a "stubborn little thing." That shows no respect on your part. If there WAS a one percent, I never saw it. Many Nomads have commented on this board personally that they never had to show proof of income and don't pay, and this is by their own personal experience. Like I said, Pescador, give me the name of the person you talked to. Maybe you lost something in the translation. You still haven't given me any names and numbers.

EnsenadaDr - 11-20-2012 at 08:59 AM

Ah now I see why you are fighting me wich a vengeance. On your member info listed here in Nomads, you are affiliated with http://medjetassist.com/. It's an air ambulance service. You won't make any money now will you, Pescador, if people sign up with local healthcare and don't need to be transported by your company, now will they?

Pescador - 11-20-2012 at 09:50 AM

Quote:
Originally posted by EnsenadaDr
Un escaso porcentaje (menos del 1%) de las familias y personas incorporadas al Sistema de Protección Social en Salud (SPSS) pagan una cuota de afiliación de acuerdo a su condición socio-económica.

This is a quote from your literature and says less than one percent pay according to their income. I am not going to belabor this point anymore. I don't know why you want to argue about this. Like Dennis said, I worked for the system and the higher ups told me that there was no proof of income needed. I don't like the way you talk to me, calling me a "stubborn little thing." That shows no respect on your part. If there WAS a one percent, I never saw it. Many Nomads have commented on this board personally that they never had to show proof of income and don't pay, and this is by their own personal experience. Like I said, Pescador, give me the name of the person you talked to. Maybe you lost something in the translation. You still haven't given me any names and numbers.


You only get the respect you deserve. You are the one who stated " all coverage is free", and now you have at least admitted, after reading some of the literature, that there is a fee for those who qualify.

And now, even with the information from the website, you stubbornly hold on to your original statement, that is free for everyone, which is not an accurate statement. And then you call it my literature, which is completely off of the wall as it is the website developed and maintained by the Government of Mexico.

The number is very easy and comes from the website. 01-800-7172-583

Pescador - 11-20-2012 at 09:57 AM

Quote:
Originally posted by EnsenadaDr
Ah now I see why you are fighting me wich a vengeance. On your member info listed here in Nomads, you are affiliated with http://medjetassist.com/. It's an air ambulance service. You won't make any money now will you, Pescador, if people sign up with local healthcare and don't need to be transported by your company, now will they?


You remind me of a battleship that is sinking and it strikes out trying to cause some damage to surrounding ships. When my wife was sick with terminal cancer, and because I was an insurance agent, we examined all of the evacuation policies available and found that MedjetAssist did not require medical underwriting and was available to someone in her condition. Since I am retired and no longer active, I give all my referrals to an active agent and do not need to sell policies. I left it there only so that someone who was looking might find something that would serve them.

For some reason, which escapes me entirely, you want to hold on to the notion that there is not a sliding scale of cost for coverage with Seguros Popular, but it is there, in black and white. The office you were or are presently affiliated with may bypass that regulation and offer coverage for free for the applicants served by that office, but that is not the intent or the regulations followed by the rest of Mexico.

Leo - 11-20-2012 at 11:12 AM

very interesting conversation/battle to follow.
But where can I get Seguro Popular, free or not, in my area; Todos Santos. And what do i need to bring other then FM3 and water/electric bills?

Pescador - 11-20-2012 at 11:31 AM

Leo, you can either do La Paz or Cabo.

La Paz is:

08/10/2012 2:10 pm

Jurisdicción Sanitaria La Paz "Velodromo"

Av. los Deportistas y Carabineros la Paz B.C.S. 23000

Baja California Sur

Teléfono: (612) 1254376

modulolapaz@hotmail

Lunes a Viernes de 8:00 a 3:00 hrs. Y durante las afiliaciones de 8:00 a 1:00 y de 3:00 a 6:00 hrs.

VER MAPA APROXIMADO


Módulo de Afiliación y Orientación La Paz "Torre"

Nicolas Bravo #1010 Esq. Josefa Ortiz de Dominguez 23000

Baja California Sur

Teléfono: 6121256734 EXT 105

moduloLaPazTorre@hotmail.com

Lunes a Viernes de 8:00 a 3:00 hrs. Y durante las afiliaciones de 8:00 a 1:00 y de 3:00 a 6:00 hrs.

VER MAPA APROXIMADO


And Cabo is:

08/10/2012 2:10 pm

Módulo de Afiliación y Orientación Cabo San Lucas

Av. 12 de Octubre E/ Ocampo Y Zaragoza, Cabo San Lucas B.C.S. 23410

Baja California Sur

Teléfono: (624) 143-00-03

modulocslBCS@hotmail.com

Lunes a Viernes de 8:00 a 3:00 hrs. Y durante las afiliaciones de 8:00 a 1:00 y de 3:00 a 6:00 hrs.

VER MAPA APROXIMADO


Jurisdicción Sanitaria. 04 San José del Cabo

Manuel Doblado No. 39, Col. 5 de Febrero, San José del Cabo B.C.S. 23400

Baja California Sur

Teléfono: (624) 1307787

modulosjc@hotmail.com

Lunes a Viernes de 8:00 a 3:00 hrs. Y durante las afiliaciones de 8:00 a 1:00 y de 3:00 a 6:00 hrs.

VER MAPA APROXIMADO

redmesa - 11-20-2012 at 11:39 AM

I want to thank Pescador for letting me know about Medjet because it is the only service I could find that would be of assistance for my husband.
I have looked at getting Mexican medical but the one I read had a pre-existing condition exclusion in the policy. This may not have been Seguros Popular???
We have never been asked to pay at the clinic we have gone to but I have always given the Dr. a donation for the clinic.
It would be good to hear from people who have acquired Mexican Health Insurance?

No pre-existing conditions.

EnsenadaDr - 11-20-2012 at 12:19 PM

Absplutely not. I had an American patient a few months back who had asthma, congestive heart failure, and diabetes. He came into the clinic in Cantu as a new patient and required hundreds of dollars of medication per month. There is no pre-existing condition clause with Seguro Popular, however there is with Seguro Social (IMSS).
Quote:
Originally posted by redmesa
I want to thank Pescador for letting me know about Medjet because it is the only service I could find that would be of assistance for my husband.
I have looked at getting Mexican medical but the one I read had a pre-existing condition exclusion in the policy. This may not have been Seguros Popular???
We have never been asked to pay at the clinic we have gone to but I have always given the Dr. a donation for the clinic.
It would be good to hear from people who have acquired Mexican Health Insurance?

How much of a cut do you get Pescador?

EnsenadaDr - 11-20-2012 at 12:44 PM

How much money do you make Pescador for each policy you sell? Is it a weekly, monthly or an instantaneous reimbursement? I see also in your company's literature that only Americans or Canadians are accepted as members. So this is very misleading information to sell this insurance on Nomads, since some are Mexican citizens here.
Quote:
Originally posted by Pescador
Quote:
Originally posted by EnsenadaDr
Un escaso porcentaje (menos del 1%) de las familias y personas incorporadas al Sistema de Protección Social en Salud (SPSS) pagan una cuota de afiliación de acuerdo a su condición socio-económica.

This is a quote from your literature and says less than one percent pay according to their income. I am not going to belabor this point anymore. I don't know why you want to argue about this. Like Dennis said, I worked for the system and the higher ups told me that there was no proof of income needed. I don't like the way you talk to me, calling me a "stubborn little thing." That shows no respect on your part. If there WAS a one percent, I never saw it. Many Nomads have commented on this board personally that they never had to show proof of income and don't pay, and this is by their own personal experience. Like I said, Pescador, give me the name of the person you talked to. Maybe you lost something in the translation. You still haven't given me any names and numbers.


You only get the respect you deserve. You are the one who stated " all coverage is free", and now you have at least admitted, after reading some of the literature, that there is a fee for those who qualify.

And now, even with the information from the website, you stubbornly hold on to your original statement, that is free for everyone, which is not an accurate statement. And then you call it my literature, which is completely off of the wall as it is the website developed and maintained by the Government of Mexico.

The number is very easy and comes from the website. 01-800-7172-583

Thank you Mula for your information..

EnsenadaDr - 11-20-2012 at 12:58 PM

Quote from Mula, one of the Nomads posting here:

5 of us from 56 years old to 75 years old got Seguro Popular last spring in Ciudad Constitucion - at no cost.

And the times we have used the clinic - for eye problems, kidney infections, and a variety of other things. . . it has not cost anything for the treatment or the service.
Quote:
Originally posted by Pescador
Quote:
Originally posted by DENNIS
Quote:
Originally posted by Alm
Seguro Popular is not completely "free",


Ensenada Dr used to work for them on a full time basis. Don't you think she would know what she's talking about?


Well, one would think so, but it depends on listening skills I suspect. The web site is very obvious and concrete.

Alm - 11-20-2012 at 05:30 PM

Dr, you ship's mast is under water already :)... Firing guns in this situation would be simply useless.

There are "nomads" that used SP for free, alright. There were also "nomads" who paid premiums, and I recall extensive discussion that followed, on the ethics of using the system intended for those poorest. Official website says it is not free, and income evaluation is required. These are the facts. I hope everybody here has got enough gray matter to interpret the facts himself.

1% of paying customers has quite a logical explanation: 1% of customers based on predominantly Mexican crowd. Because the system was designed for Mexicans without means to pay, and most of them fall into this category. Gringos may or may not, and even when they are not, the premiums are low - from the gringos' perspective - because again the system is designed for Mexicans.

Correcting myself: the evac service that I meant in the earlier post, was not Sky Med, but Global Rescue. They do both rescue from the place of accident (if necessary) and evacuation to the hospital of your choice. For those in remote locations this would make sense. This is a good news. Bad news is that it costs more than Med Jet, and pre-existing condition clause does exist - the condition must be older than 45 days (or older than 1 year for those aged 75-85). Also, they have one weird condition: they transport to a hospital of your choice located in your home country. Don't know how much freedom they allow in specifying the "home country", read the fine print yourself. I read it that "home country" is either what I chose on the contract OR what my ID says. But I'm not insurance agent.

[Edited on 11-21-2012 by Alm]

EnsenadaDr - 11-20-2012 at 05:57 PM

I am not here to fire guns..I am here to try and help and give people alternatives. I am only giving advice from my experience working for the system. If someone wants to use the Internet to back them up, then so be it. It appears that they feel they know more than a health care employee. I would respect an opinion from personal experience than from reading google search. You guys claim to know more, so I say have at it.

Pescador - 11-20-2012 at 07:12 PM

Quote:
Originally posted by EnsenadaDr
I am not here to fire guns..I am here to try and help and give people alternatives. I am only giving advice from my experience working for the system. If someone wants to use the Internet to back them up, then so be it. It appears that they feel they know more than a health care employee. I would respect an opinion from personal experience than from reading google search. You guys claim to know more, so I say have at it.


I am glad that you are promoting Seguros Popular and I support your efforts. All I have been asking from the very beginning is to not mention that it is free. The premiums are on a sliding scale that has changed significantly in the last 4 or 5 years. I have helped over a dozen friends do their applications and get signed up and because they read on this site some time ago that it was free, they felt like they were being set up for the "mordida" when they were told that there was a cost. I have no information about what happens in Tijuana / Ensenada area and will defer to your experience, but when it comes to Baja Sur and some states on the mainland, where I do have first hand experience with helping people do applications and obtain all of the necessary things that they need like a Utility Bill and CURP card, then I do not appreciate it when they hear from someone who should know better that the coverage is free when, as we have shown repetetively, there is a cost that was set up by the Federal Government in DF. Every case that I have helped with has had some type of evaluation and in some cases there have been coverage issued with no cost, in others there have been a cost, and the whole thing is supposed to correlate with your financial position. My personal policy with Seguros Popular cost $1037.40 MN for the yearly policy, which, in my opinion, is a great deal and I was more than happy to pay. My classification level was V (5). and that fits with the website exactly.

[Edited on 11-21-2012 by Pescador]

EnsenadaDr - 11-20-2012 at 07:35 PM

I do know that Baja Sur does pay extranero interns, while Ensenada and Baja Norte does not. The cost could be incorporated in that surcharge. Each estado is different.

Alm - 11-20-2012 at 08:06 PM

Quote:
Originally posted by redmesa
I want to thank Pescador for letting me know about Medjet because it is the only service I could find that would be of assistance for my husband.
I have looked at getting Mexican medical but the one I read had a pre-existing condition exclusion in the policy. This may not have been Seguros Popular???

Seguro Popular has no pre-existing clause. It is not really an "insurance", it's more like a Medicare. You pay nothing (or very little) and get something. Don't expect getting a lot, though. It has no provisions like "evacuation" feature included in a typical private treatment plan, and has nothing in common with services like Med Jet (which, in turn, are not treatment plans). I hope this is not too confusing.

[Edited on 11-21-2012 by Alm]