BajaNomad

IMSS *and* Seguro Popular?

Mula - 9-19-2013 at 05:29 AM

I don't think so. IMSS would be enough.

Pescador - 9-19-2013 at 07:04 AM

If you pick up the Gringo Gazette, they had an interesting article where they talked to a lot of Mexican citizens about their coverage with Seguro and IMSS. When the government decided to make sure all citizens were covered they did very little or anything to make sure that would come to pass. Before Seguros a lot of people had no coverage at all and relied on donations or fundraisers in the community when someone needed to go to the hospital or have something done. Those that were employed had coverage provided by their work.

That meant there were a certain number of facilities, doctors, and other professionals who delivered the health care to the population. When Seguros came along, it was a great political move from the standpoint of the government who could now brag on the world scene that they provided coverage and healthcare for all of their citizens. The only problem is that they did nothing to ramp up the number of providers. So now it is pretty common that doctors are trying to see more patients than ever before, the waiting rooms are packed and overloaded, and the medicines are almost never available. I have several friends who are doctors and their feeling is that the system is so poor at covering their expenses that they end up doing most of it for free.
I have been signed on with Seguros for three years now. I have never used it and mostly I carry it for a backup because I live here. I have gone to the doctor, but normally I just pay for the service, choose the best doctor I can get and leave it at that. I do pay around $100 a year for the coverage and I have some friends who get it for free.

Mula - 9-19-2013 at 07:15 AM

We have Seguros but go to Dr.'s of our choosing and pay. Use it mainly for back up, also.

tripledigitken - 9-19-2013 at 07:16 AM

Quote:
Originally posted by Pescador
If you pick up the Gringo Gazette, they had an interesting article where they talked to a lot of Mexican citizens about their coverage with Seguro and IMSS. When the government decided to make sure all citizens were covered they did very little or anything to make sure that would come to pass. Before Seguros a lot of people had no coverage at all and relied on donations or fundraisers in the community when someone needed to go to the hospital or have something done. Those that were employed had coverage provided by their work.

That meant there were a certain number of facilities, doctors, and other professionals who delivered the health care to the population. When Seguros came along, it was a great political move from the standpoint of the government who could now brag on the world scene that they provided coverage and healthcare for all of their citizens. The only problem is that they did nothing to ramp up the number of providers. So now it is pretty common that doctors are trying to see more patients than ever before, the waiting rooms are packed and overloaded, and the medicines are almost never available. I have several friends who are doctors and their feeling is that the system is so poor at covering their expenses that they end up doing most of it for free.
I have been signed on with Seguros for three years now. I have never used it and mostly I carry it for a backup because I live here. I have gone to the doctor, but normally I just pay for the service, choose the best doctor I can get and leave it at that. I do pay around $100 a year for the coverage and I have some friends who get it for free.


Pescador,

I notice that your signature indicates that you sell medvac insurance. Do you have backup insurance for major issues NOB?

Ken

EnsenadaDr - 9-19-2013 at 07:47 AM

We have several long threads concerning this topic. IMSS are for workers in Mexico that by law their companies need to provide insurance for. You can join this as an expatriate, but you do need to have a physical and from what some were mentioning on this board you would be restricted to emergency treatment for about a year, and the cost is a few hundred dollars.

When I did my last year as a clinic doctor in Ensenada, many patients were coming over to me from IMSS because they or their spouses lost their jobs. As Pescador mentioned, and I am glad we ironed this point out, some people pay for Seguro Popular which is a completely different program from IMSS, (Instituto Mexicana Seguro Social) or as some call it, Seguro Social. So you see the confusion, Seguro Social, IMSS sounds very similar to Seguro Popular, but the are both very different programs. Seguro Popular is for the general public and anyone can qualify for it, IMSS is for workers and others that can pay and for expats it runs about $250 a year.

IMSS, especially the one on Reforma in Ensenada, is completely inundated with patients. Seguro Popular has many satellite locations that you can show up for in an emergency and be seen a lot faster. Seguro Popular uses the General Hospital in Ensenada as its base, IMSS uses the one on Reforma near McDonald's. The General Hospital just got a new mammogram machine which cost a few hundred thousand dollars and it appears Seguro Popular has much more funding.

Osprey - 9-19-2013 at 08:49 AM

That's very good news Dra. Some of my Mexican friends have serious conditions. They apply to Seguro Popular then are shuttled to facilities with the special equipment not found at Seguro and then they can ill afford the price of service. Nobody is at fault -- Seguro is simply not funded to buy the equipment or to pay for out of facility services.

EnsenadaDr - 9-19-2013 at 10:25 AM

Are your friends members of Seguro Popular or Seguro Social (IMSS)?
Quote:
Originally posted by Osprey
That's very good news Dra. Some of my Mexican friends have serious conditions. They apply to Seguro Popular then are shuttled to facilities with the special equipment not found at Seguro and then they can ill afford the price of service. Nobody is at fault -- Seguro is simply not funded to buy the equipment or to pay for out of facility services.

EnsenadaDr - 9-19-2013 at 10:33 AM

I don't think there are too many ex pats that have Seguro Social since they usually don't work as an employee in Mexico. You can correct me if I am wrong.
Quote:
Originally posted by lencho
There have been a number of comments here about the pros and cons of Seguro Popula for expats.

Those of you with firsthand knowledge about this and IMSS medical; if you already had IMSS from work, would there be any benefit to also getting Seguro Popular?

DavidE - 9-19-2013 at 10:38 AM

The Seguro in Ensenada is a disgrace. A really good seguro like the primero in Hermosillo is like walking into a different world. Talented specialists make monthly "rounds" to these perifericos and they are avalanched with referrals.

I try to keep in mind if I have a serious problem outside a big city I am screwed. I can have the "Plutonium Plan" evac insurance, all the policies in the world and still die just as painfully as if I hadn't spent a dime on Seguro. This is a fact of life down here. Luckily B.A. has an IMSS sub periferico and hopefully if I ever have a serious problem they can stabilize me enough for me to reach the border.

If not, the film rolls until "FIN" appears, and well, that's that...

comitan - 9-19-2013 at 10:38 AM

lencho

Is or was Gov. employee.

EnsenadaDr - 9-19-2013 at 10:43 AM

Ah ok Comitan. I see. And to add to this, certainly a non-Mexican worker can pay for insurance but I believe Seguro Social (IMSS) is much more expensive than Seguro Popular and has limitations. Comitan, we need to probably include the IMSS when talking about Seguro Social. Many people including myself were confused initially about which were which because they sound so similar. Glad to hear IMSS has a nice hospital somewhere. I have a good friend that graduated with me and started to do her residency at the one in Hermosillo.

DavidE - 9-19-2013 at 10:45 AM

Ensenada Dr. IMSS, the three-thirds insurance plan

Employer

Employee

Gobernacion

A residente permanente or citizen can pay 3/3rds of the premium and get insurance. But oh boy the exclusions for prior medical conditions is daunting.

The medication formulary in IMSS, ISSSTE (for government employees), and Seguro Popular, is pathetic. The Wal-Mart USA three dollar and ten dollar medicine formulary has TWENTY TWO TIMES the number of medicines. Discount pharmacies like COSTCO and regular pharmacies in the USA have perhaps A THOUSAND times greater selection of medications, than the Mexican insurance allows.

EnsenadaDr - 9-19-2013 at 10:47 AM

David a previous American ex pat resident in Ensenada sung the praises of his abdominal surgery done in Guadalajara. Is the seguro you are talking about IMSS? For those who don't know, seguro is referring to a type of insurance, and in Spanish means secure or sure, but like many words in Spanish can have many meanings.
Quote:
Originally posted by DavidE
The Seguro in Ensenada is a disgrace. A really good seguro like the primero in Hermosillo is like walking into a different world. Talented specialists make monthly "rounds" to these perifericos and they are avalanched with referrals.

I try to keep in mind if I have a serious problem outside a big city I am screwed. I can have the "Plutonium Plan" evac insurance, all the policies in the world and still die just as painfully as if I hadn't spent a dime on Seguro. This is a fact of life down here. Luckily B.A. has an IMSS sub periferico and hopefully if I ever have a serious problem they can stabilize me enough for me to reach the border.

If not, the film rolls until "FIN" appears, and well, that's that...

EnsenadaDr - 9-19-2013 at 10:56 AM

Expatriate, officially translated it means someone who isn't a patriot of their native country anymore.
Quote:
Originally posted by lencho
Quote:
Originally posted by EnsenadaDr
I don't think there are too many ex pats that have Seguro Social since they usually don't work as an employee in Mexico. You can correct me if I am wrong.

Your statement is probably correct, though I personally have been enrolled in IMSS for around 20 years... though never used the services.

What the heck is an "ex pat," anyway. :?: Yeah, I used the phrase, but upon second thought I don't really know what it means...

EnsenadaDr - 9-19-2013 at 10:59 AM

David I am wondering about the medication quality control as well for the generics supplied to Seguro Social. A patient was taking Lisinopril for high blood pressure, and said it wasn't working. He then went to Long's drugs to get the same one in the US and said he felt dizzy. When he came back for a check up his blood pressure was normal. Was it the quality control standards in the US? I am beginning to wonder.
Quote:
Originally posted by DavidE
Ensenada Dr. IMSS, the three-thirds insurance plan

Employer

Employee

Gobernacion

A residente permanente or citizen can pay 3/3rds of the premium and get insurance. But oh boy the exclusions for prior medical conditions is daunting.

The medication formulary in IMSS, ISSSTE (for government employees), and Seguro Popular, is pathetic. The Wal-Mart USA three dollar and ten dollar medicine formulary has TWENTY TWO TIMES the number of medicines. Discount pharmacies like COSTCO and regular pharmacies in the USA have perhaps A THOUSAND times greater selection of medications, than the Mexican insurance allows.

Pescador - 9-19-2013 at 11:19 AM

Quote:
Originally posted by tripledigitken


Pescador,

I notice that your signature indicates that you sell medvac insurance. Do you have backup insurance for major issues NOB?

Ken


Ken, before retirement I was one of the largest health insurance agents in Colorado. So when I moved to Mexico full time I thought it would be a good idea to get some coverage here. I also was on an advisory board for the Santa Rosalia Hospital. So, I hooked up with Seguros Popular and figured it would be an acceptable base insurance and would provide me with some coverage.
When my late wife was still alive and fighting lung cancer, we managed to take several trips down to the house she loved so much and the only way we felt safe doing that was to have a policy with an evacuation insurance in case something came up rapidly. So I signed on as an agent for that particular company because the rates were good and they did not do medical underwriting for their policies.
So, since I am pretty much aware of medical coverage in the US as well as Mexico, I am enrolled in Medicare since I am over 65. I carry a $2,000 deductible supplement with Blue Cross Blue Shield for the 20% that Medicare does not cover. We shall see what shakes out when the disaster that is called Obamacare takes over and I may have to make some adjustements in coverage.
I think this issue is very important to all of from retirment on and it is good that the information keeps flowing in order to help people make good decisions for their own healthcare.

weebray - 9-19-2013 at 11:42 AM

I guess I'll wade in here since we have and have used S. popular for a number of years. Here in La Paz the clinic is normally very busy and we expect a 1 - 2 hr. wait to see a doctor. We have used the service a number of times and have found the doctors helpful. Most "basic" meds are available and blood tests, xrays etc. are available. For the (approx.) $200 a year it is an unbelievable bargin. Go sign up - do it today.

EnsenadaDr - 9-19-2013 at 11:55 AM

Interesting in that Baja Sur charges for Seguro Popular and Ensenada does not even though officially there is a charge in the bylaws.
Quote:
Originally posted by weebray
I guess I'll wade in here since we have and have used S. popular for a number of years. Here in La Paz the clinic is normally very busy and we expect a 1 - 2 hr. wait to see a doctor. We have used the service a number of times and have found the doctors helpful. Most "basic" meds are available and blood tests, xrays etc. are available. For the (approx.) $200 a year it is an unbelievable bargin. Go sign up - do it today.

Mula - 9-19-2013 at 12:05 PM

5 of us got Seguro Popular in Ciudad Constitucion a year and a half ago and did not pay a cent.

Have used it and are happy with it.

We understand the limitations.

weebray - 9-19-2013 at 12:23 PM

When we first applied they asked us a number of questions intended to position us on Mexico's financial and social ladder. The questions were along the line of: Do you live in a house? How many people live in your house? Do you have your own room? Do you have running water? Do you have access to a toilet? Do you have electricity? We obviously qualified in the upper category. We are happy to pay a couple hunnert bucks for our coverage. We understand the limitations of our coverage. Thank you Mexico.

EnsenadaDr - 9-19-2013 at 01:21 PM

Yes I guess it just depends on who the interviewer is and how closely they want to follow the guidelines. All in all, it's a pretty good program. Did you say you had seguro popular or seguro social IMSS?

tripledigitken - 9-19-2013 at 01:46 PM

Pescador,

Appreciate your clarification. No surprise with the route you have chosen.

Ken

weebray - 9-19-2013 at 03:47 PM

Quote:
Originally posted by EnsenadaDr
Yes I guess it just depends on who the interviewer is and how closely they want to follow the guidelines. All in all, it's a pretty good program. Did you say you had seguro popular or seguro social IMSS?

We are signed up with Seguro Popular. In La Paz you apply on the 2nd. floor of the multistory hospital at the corner of Bravo y Heros de la Independensia.

ccorbridge - 9-19-2013 at 07:09 PM

I'm confused. can a retired person with a temporary resident VISA apply for either IMSS or Seguro Popular? or does one the other or both require a permanent resident VISA?

Mulegena - 9-19-2013 at 08:14 PM

Quote:
Originally posted by ccorbridge
I'm confused. can a retired person with a temporary resident VISA apply for either IMSS or Seguro Popular? or does one the other or both require a permanent resident VISA?

Any foreigner legally residing in Mexico with a Temporary Resident Visa can apply for either Seguro Popular or IMSS, I believe.

EnsenadaDr - 9-19-2013 at 10:15 PM

I had a very nice patient come into my office about a year and a half ago. He was a German guy and I had never seen him before. He had no seguro papers and asked to be treated with about 13 different medications. My boss in Maneadero said for me to continue to give him his meds each month even though he had no papers and could not pay. He had a very erratic heartbeat and I referred him to a cardiologist in town. I told him he needed a pacemaker immediately. No one would put a pacemaker in him for free, even the internal medicine doctor did not suggest a pacemaker with the seguro referral system. The patient wanted to go back to Germany and get the free pacemaker the cardiologist in Ensenada recommended but he told me the cardiologist told him he was too sick to fly. Sadly I heard he passed away. Point in case, many times undocumented patients get treated without paying.
Quote:
Originally posted by Mulegena
Quote:
Originally posted by ccorbridge
I'm confused. can a retired person with a temporary resident VISA apply for either IMSS or Seguro Popular? or does one the other or both require a permanent resident VISA?

Any foreigner legally residing in Mexico with a Temporary Resident Visa can apply for either Seguro Popular or IMSS, I believe.