Simple plans and strategies exist to help get basic health coverage to foreigners living full-time in Mexico.
BY KELLY ARTHUR GARRETT/The Herald Mexico
December 13, 2004
Are you going bare or fully covered? Those aren't clothing options. They're two opposing strategies that foreigners rooted in Mexico can use to deal
with the unavoidable challenge of finding and paying for medical attention.
Though some get away with going bare, getting yourself insured for potentially devastating medical costs is a must in Mexico, as it is anywhere else.
And it's easier to do than you might think.
Newcomers quickly learn that with the transition from tourist to full-timer, the old familiar health care options stop working. Travel insurance is
for tourists only. Your home-country policy no longer applies. Medicare and Medicaid don't cross the U.S.-Mexico border. And there's no such thing as
an HMO.
But with a minimum of adjustment, expatriates can take advantage of first-rate medical attention at a fraction of U.S. prices. "There are very
well-trained physicians in every major Mexican city and tourist area," says Robert Page, M.D., who has a family practice in Tempe, Arizona. "And the
better hospitals are as good as the ones in any big U.S. city."
Page speaks with some authority, having literally written the book on the subject. In "Mexico: Health and Safety Travel Guide," Page (along with his
son Curtis, also an M.D.) recommends some 200 English-speaking doctors across the country, as well as more than 50 good hospitals. The Herald Mexico
reviewer Barbara Kastelein lauded the book's "hands-on practical information that is easy to access and understand."
As useful as the Pages' guide is for finding docs and choosing hospitals, it's geared mainly toward tourists who can use vacation insurance or
temporary travel coverage in their home-country policy, not to mention the return half of their round-trip airline ticket. If you're here for the
long-haul, you need to look at three other options to pay for whatever medical help you'll need.
PRIVATE, PUBLIC AND GOING BARE
One is private health insurance, which can be surprisingly inexpensive. If you work for a company that provides a group medical plan, you're already
covered. If not, you can buy your own.
Another is IMSS, the Mexican social security system that provides medical care to all private employees (with government work covered by another
system called ISSSTE). If you work for a Mexican company, you're probably covered. If not, you can enroll on your own.
A third approach is known as self-insurance, a euphemism for no insurance at all. Known colloguially as "going bare," it simply means you're going to
pay right out of your own pocket for whatever medical care you may need, from a vitamin shot to heart surgery.
"Going bare is much less of a problem in Mexico than in the United States because medical costs are less all across the board," Page says.
Still, you're playing with fire. "If theres a calamity it's going to cost you a lot of money," he says. "Even in Mexico, where surgery may cost a
fifth or even a tenth as much as in the United States, it's still expensive."
Jos? Antonio Mart?nez, a Mexico City insurance agent, agrees. "One mistake a lot of new residents in Mexico make is thinking that this is a third
world country so health care is way below par and always cheap," he says. "But it can be the opposite. Private care can be excellent and in certain
cases it can be more expensive than people can afford on their own."
That's where medical insurance comes in. Private Mexican plans covers "gastos mayores," that is, your major hospitalization costs, and any follow-up
care related to that hospitalization. Policy prices vary according to how comprehensive you want your coverage. But the premiums will be less than
what you knew back home, even down to U.S.1,000 a year.
In the Mexican system, you're not buying into an HMO, so you're not limited in your choice of hospitals or doctors. But that also means your
non-hospital care doctor's visits, check-ups, tests aren't covered. For those "gastos menores," plans such as "VRIM" (www.vrim.com.mx) offer memberships for less than US30 a year that get you generous discounts with a network of doctors, labs and clinics.
While less expensive and just as thorough, Mexican private health insurance plans are more restrictive. You'll be examined and the companies are firm
about not paying for treatment of any pre-existing condition. Pregnancy and delivery normally aren't covered. And breast augmentation? Forget it.
ALTERNATIVE COVERAGE
If you travel a lot on business, consider an international health insurance plan. "That's a must for many executives because it covers everything
everywhere," Martinez says. "It's very expensive, but you have the tranquility of knowing you're covered in Mexico, the United States, Thailand,
wherever."
Another variation: Some (not all) of the better private hospitals offer their own packages. The advantage is that the plans are less expensive, and
many Mexican residents wouldn't consider any hospital other than their favorite.
The disadvantage is that a private hospital plan is good only at the hospital you bought it from. If you suffer a heart attack across the street from
Medica Sur, your Hospital Espa?ol coverage isn't going to help. "Some people buy the private plan at their preferred hospital and supplement with a
less expensive, high-deductible broad-coverage plan just in case," Mart?nez says.
Now for the bad news: Almost no Mexican insurer will take on a new customer who's reached age 65. A few international companies (such as IHI and BMI)
will accept you up to age 74. And even if you're under 65, make sure whatever policy you buy is for-life ("vitalicio"). Otherwise you'll be dropped on
your 65th birthday.
Foreign residents of all ages with valid visas can join IMSS. The price is under US500 a year, and that covers all your family's medical costs,
including doctor visits, medications, therapy, and hospitalization. The coverage is only good at IMSS clinics and hospitals.
You'll hear wildly varying opinions of the quality of IMSS care. And for good reason the quality varies wildly from city to city, and from facility to
facility within the same city. But generally its well below the high standards of private Mexican hospitals and clinics.
"IMSS has had funding problems in recent years, so there are supply problems," says David Warner, Ph.D., a University of Texas economist who has
studied the Mexican public health system. "It can be a real problem getting in to see somebody. It's first-come, first-served so the wait can be long,
and you don't get to choose your own doctor."
Others, however, report reasonably prompt attention. The quality of IMSS service, like the quality of its care, can vary depending on where you are
and when you go.
Still, Warner says his surveys have shown that many foreign residents do choose IMSS for its low cost. Many expressed satisfaction. Others join IMSS
only as a stop-gap against major illnesses or surgery, while paying for their own doctor visits and lab tests.
COURSES OF ACTION
How do you sign up? Call the IMSS information number 5241-0245 if you like busy signals. Then check the Yellow Pages (Secci?n Amarilla) under Seguro
Social for the "IMSS delegacion" nearest you and go there but only during one of the sign-up months of January, February, July and August.
If you're registered with Hacienda, bring proof. Also bring a copy and the original of something verifying your address, of your resident visa, of
your passport, and of your marriage certificate. Don't forget a good book, a snack, and plenty of patience. Once you're accepted, coverage kicks in
six months later.
To explore your best option private insurance Mart?nez recommends contacting an insurance broker. A broker is independent, so he or she and can work
with you to find the company with a plan that best suits your budget and needs. Brokers are listed in the Secci?n Amarilla under Segures-Agentes de.
If you prefer to go straight to an insurance company, they're listed under Seguros-Compa??as de. ING, GNP, MetLife and Seguros Tepeyac are some of the
major ones.
If your Spanish isn't good enough even to ask for somebody who speaks English, try contacting a U.S. insurance broker first for guidance. Some, like
Marsh & McLennan, have Mexican offices or work in agreement with Mexican brokers. U.S. insurance companies, however, have no presence yet in Mexico,
though some have been making moves in this direction.
You can also punch up www.medtogo.com, the web page of Drs. Robert and Curtis Page. You'll find a generous supply of tips and information about medical care in Mexico,
including a referral service for health insurance agents.
Don't cover delivery of babies
flyfishinPam - 12-13-2004 at 02:52 PM
Loreto, BCS- In 2000 I had to pay the full price to deliver my daughter in the local hospital, natural and without pain meds. Cost was $50.00 US
and a cast of Tecate. I'm not making this up!
In 2002 I gave birth to my son very quickly by myself and in my own home. The midwife couldn't make it in time but she treated me after the delivery.
The cost was $60.00 US and no Tecate.
Two babies and enough extra money to go fishing once in awhile.
[Edited on 12-13-2004 by flyfishinPam]woody with a view - 12-13-2004 at 07:23 PM
Quote:
Two babies and enough extra money to go fishing once in awhile.
