BajaNomad

Temp Residency & Mexican Health Insurance?

Beagle - 7-31-2018 at 08:23 AM

Moved this over here because the Health and Wellness forum looks pretty dusty.

Combing through all of the old threads I can find about Nomad's different experiences in Baja with IMSS/ Seguro Poular/ and Private. We are Temp Residents and don't see how we can afford US insurance if we pull the plug to go mostly full time in Baja. It would suck up a lot of our monthly funds. We are in our mid-late 40's and one of us is really healthy while the other is sort of a slob that tends to get banged and bruised a lot.

Does anyone have recent experience with AXA or another Private insurer? Any ideas about their rates? I think we qualify for IMSS as Temp Residents so there's that too.

Would it be prudent to do with IMSS AND AXA? I've read the IMSS doesn't cover some stuff the first year or something.

At this point the only thing really holding us back from trying to go more full time in Baja is having are behind's covered for medical stuff. Don't want to go through a year's budget with a trip to the wrong hospital. The largest town near our place is Constitucion. Next would be Loreto or La Paz.

We also have DAN for emergency Evac sort of stuff but eventually will just want to be getting treated in MX if possible.

Thanks for any input and experience.

SFandH - 7-31-2018 at 08:35 AM

Perhaps find an insurance agent in Constitucion that can answer your questions, especially about private insurance.

Udo - 7-31-2018 at 08:39 AM

I live in the Ensenada area, and for most of my serious events, I went to the USA.
My IMSS has covered me in this area every time I went to a doctor.
But there are only four places with a decent hospital and trusted doctors: Tijuana, Ensenada, Mexicali, La Paz and Cabo.

I chose living closer to the border because of ease of driving to the USA.

Hook - 7-31-2018 at 09:22 AM

I cant speak for Baja, only the mainland. And, keep in mind, my wife and I are pretty solidly middle class, with an income stream and money in the bank.

We basically bought an international policy through a company called VUMI. The reviews I read on them were good. And I also like the husband/wife agent team in the Phoenix, AZ., area.

The idea is that you get a policy with a giant deductible. In our case, it was 10k. Dollars, of course, not pesos. This is meant to cover the real catastrophic things like cancer and heart related things. We made sure that the really good hospital near us in Mexico (seriously, it's as good as a US hospital) would accept that insurance. It is about 1.5 hours by ambulance from our home in Mexico.

The idea is that relatively minor stuff we pay for out of pocket. If we have broken bones or lacerations or even prudent preventative medical procedures (like mammograms, colonoscopies, etc.), we pay for that. We found that even going to the best hospitals/docs in our nearest large city, the cost was about 30% of US costs (that's 70% less!).

This policy WILL cover emergency procedures if you happen to be in the US, but it will not cover on-going medical treatment in the US, of course. Most all other countries, you can have on-going treatments. We travel to Europe, so this was a consideration.

Now, we did look into the hospitals that were covered by IMSSST insurance and Seguro Popular but, in our area, we werent happy with those hospitals. This was based on taking tours and word of mouth from other Americans and Canadians. Just sub-par, in our opinion. That may not be the case in other areas. But since we have the means to pay for the best medical care in our area (at 30% of US costs), we go that route.

So, we had a policy like this for the past 7 years...........and never used it. Nothing major happened to us. We are relatively healthy and active, though I do drink an average of 1-3 drinks per day (rarely hard alcohol; I like wine and beer), have slightly high blood pressure (that is easily controlled with meds) and am about 20 lbs overweight.

There was no coverage for meds on this policy. Generic Enalapril is really cheap in Mexico and no doc prescription is needed. I buy a half year's supply at a time. I think a month is less than 10.00US.

We have now terminated this type of policy because we are living half the year in the US again (for the first time in 10 years) and I become Medicare eligible TOMORROW. I turn 65 in August. I bought an inexpensive Medicare advantage policy through AARP that will limit our exposure beyond what Medicare covers. My wife works part time for the Feds up here and qualifies for a policy for a few months. Then, she goes COBRA on that for the rest of the year.

What did this type of policy cost, in the last year we held it? For a 10k deductible, covering most all catastrophic situations, for a couple ages 64 and 52, it was around 400-500 US per month. It was half of that, up until I hit age 61-62.

My age accounted for about 65% of that cost. I think a policy like this would be "reasonable" (everyone's definition of reasonable will differ), for a couple your ages.

So, that was our scenario. And I must say, it is commonly done by couples I met who are retired, but below Medicare age. Pay for the small stuff, have coverage for the big stuff. And make sure you have researched and are comfortable with the hospitals you will be treated at.

[Edited on 7-31-2018 by Hook]

shari - 7-31-2018 at 09:44 AM

The best choice is location dependent as some areas only have one ption and some have a better IMSS hospital and others have a better Seguro Popular facility so check out where you would most likely be treated to decide which insurance to buy.

Alm - 7-31-2018 at 10:56 AM

Another catastrophic plan, 4K deductible: https://www.focusonmexico.com/wp-content/uploads/2017/06/Ove...

Relatively cheap because it's a group plan. The "group" is the expats association, with (pretty low) membership fees. 2 groups are selling it - Chapala-based Focus on Mexico and Boomers in Paradise (don't remember where they are). It will only cover emergencies. There is a description of services somewhere on the Boomers portal. Focus portal is poorly written.

Not everything is considered an emergency, ex. appendectomy or bladder stones are not because there are advanced symptoms few days before, hence you "should have listened to your body". So, 12-15K you'll have to pay out of pocket. I wouldn't be surprised if some Cabo private hospital charged you 40K for that.

Emergency-wise, IMSS can't be compared to any private plan, you can only use their hospitals and very few are good.

[Edited on 7-31-2018 by Alm]

bajatrailrider - 7-31-2018 at 11:49 AM

I was told by Mex Ins Agent that policy in Mexico existing cond not covered. Anybody have answer to this. In my case have Medicare in states only 120.00 a month covers everything. Problem I live here so was told great policy only 132.00 a month but no coverage existing cond.

Alm - 7-31-2018 at 02:02 PM

... btw, it looks like something is brewing in IMSS and Seguro Popular.

April 2018, the article is from Yucatan, but public health system is federal, as I understand.

If a foreigner holds a Permanente status, they automatically qualify for Seguro Popular for a three-year time period, even with a pre-existing condition. But that’s only if they cannot afford a different health plan or cannot apply for coverage with the Mexican Social Security Institute

Temporary residents will have to jump through more hoops yet, getting a 3-months Seguro first, then - Mexican Drivers License (solely as an additional piece of ID), and then - Seguro Popular.

Bajatrailrider: it's better to ask your insurance agent about your insurance policy, because nobody here probably knows what policy you have bought.

Stay healthy.

Beagle - 7-31-2018 at 04:47 PM

Hey thanks everyone for the all of the info. It's a big puzzle. Always appreciate the input from Nomads. Still trying to find out more about AXA and premiums with them. Their website is a little tricky. Apparently they have an office in the US as well.

Again thanks and I will continue to monitor this thread!

bajatrailrider - 7-31-2018 at 08:16 PM

Quote: Originally posted by Alm  
... btw, it looks like something is brewing in IMSS and Seguro Popular.

April 2018, the article is from Yucatan, but public health system is federal, as I understand.

If a foreigner holds a Permanente status, they automatically qualify for Seguro Popular for a three-year time period, even with a pre-existing condition. But that’s only if they cannot afford a different health plan or cannot apply for coverage with the Mexican Social Security Institute

Temporary residents will have to jump through more hoops yet, getting a 3-months Seguro first, then - Mexican Drivers License (solely as an additional piece of ID), and then - Seguro Popular.

Bajatrailrider: it's better to ask your insurance agent about your insurance policy, because nobody here probably knows what policy you have bought.

Stay healthy.
I have a Mex DL have not got Mex ins yet because it does not cover all. I will do more checking If I'm going to pay for med Ins I want to be fully covered.

Beagle - 8-1-2018 at 06:29 AM

Quote: Originally posted by Alm  
... btw, it looks like something is brewing in IMSS and Seguro Popular.

April 2018, the article is from Yucatan, but public health system is federal, as I understand.

If a foreigner holds a Permanente status, they automatically qualify for Seguro Popular for a three-year time period, even with a pre-existing condition. But that’s only if they cannot afford a different health plan or cannot apply for coverage with the Mexican Social Security Institute

Temporary residents will have to jump through more hoops yet, getting a 3-months Seguro first, then - Mexican Drivers License (solely as an additional piece of ID), and then - Seguro Popular.

Bajatrailrider: it's better to ask your insurance agent about your insurance policy, because nobody here probably knows what policy you have bought.

Stay healthy.


Alm-Do you know if the Driver's License thing goes for Temp Residents and IMSS? Or just Poular?

Alm - 8-1-2018 at 10:07 AM

Beagle - no, Mex DL is for 3-year Popular only. They will give 3-months Popular without DL. Something new, never heard about this before - or about requirement (in Popular) that a foreigner has to be poor enough not to be able to afford IMSS premiums 800 pesos/month.

Here is the article, very short, no reference to sources, more like a tweet: https://yucatanexpatlife.com/rules-tightened-for-foreigners-...

Hook - 8-1-2018 at 02:19 PM

One thing I have learned over the years is that qualifying for many things in Mexico can vary from location to location. It holds true for even Federal functions like IMSS and Seguro Popular, for qualifying for the senior discount card and even INM stuff.

Remember when they did away with the FM-3s and 2s and Inmigrado cards? What followed was completely different interpretations from one region to the next. I was all set to jump directly to Permanente status on the basis of financially qualifying for it. The qualifications were right there in their equivalent of the Federal Registry and others were doing it in other parts of Mexico. But the Guaymas office knew nothing about it, and wouldnt allow it. I was forced along the laborious Temporal route to eventually qualify. As it turned out, the delay worked in my favor as I would have had to import my cars. I eventually chose not to go permanente. This is a mainland thing.

Mexico is very poor at rolling out changes and getting the word out to those who administer these changes. Sometimes it can take months to years to get all the regional departments on the same page.

Beagle - 8-1-2018 at 02:56 PM

Quote: Originally posted by Alm  
Beagle - no, Mex DL is for 3-year Popular only. They will give 3-months Popular without DL. Something new, never heard about this before - or about requirement (in Popular) that a foreigner has to be poor enough not to be able to afford IMSS premiums 800 pesos/month.

Here is the article, very short, no reference to sources, more like a tweet: https://yucatanexpatlife.com/rules-tightened-for-foreigners-...



OK, Thanks Alm! That makes sense to some degree. I think we will probably try to go for IMSS and then maybe some AXA or other private to over lap. Looks like I need to find out what services we would even have at or near us. Closest town would be Constitucion which is not a Mega-tropolis by any means.

Beagle - 8-1-2018 at 03:01 PM

Quote: Originally posted by Hook  
One thing I have learned over the years is that qualifying for many things in Mexico can vary from location to location. It holds true for even Federal functions like IMSS and Seguro Popular, for qualifying for the senior discount card and even INM stuff.

Remember when they did away with the FM-3s and 2s and Inmigrado cards? What followed was completely different interpretations from one region to the next. I was all set to jump directly to Permanente status on the basis of financially qualifying for it. The qualifications were right there in their equivalent of the Federal Registry and others were doing it in other parts of Mexico. But the Guaymas office knew nothing about it, and wouldnt allow it. I was forced along the laborious Temporal route to eventually qualify. As it turned out, the delay worked in my favor as I would have had to import my cars. I eventually chose not to go permanente. This is a mainland thing.

Mexico is very poor at rolling out changes and getting the word out to those who administer these changes. Sometimes it can take months to years to get all the regional departments on the same page.


Yeah Hook, We just got finished with getting our Temp Residencies so have some first hand experience with the random bureaucratic inconsistencies when dealing with different govt parties. Our consulate here was really pushing us to go Perm Resident but we ended up going Temp for the same Car reasons...still wonder if that was the right choice but that's what we did.

BajaBlanca - 8-2-2018 at 08:47 AM

Beagle -IMSS is everywhere. Even the small villages have a mini clinic and give meds plus have a doctor on board 24/7.

In our village, even if NOT part of IMSS, anyone can see the doc for a "fee" according to a new sign I saw a couple months ago.

In my case, we got seguro popular for less than $100 a year. It covers a monthly doctor visit with all medications, flu vaccinations, yearly mammograms on a machine that looks like something from NASA, and my insulin included at no extra cost to us.

I can get xrays and see specialists if I go to La Paz. The hospitals, as far as I can tell, are substandard, so we head to the States for anything more serious.





Hook - 8-2-2018 at 09:04 AM

Quote: Originally posted by BajaBlanca  
Beagle -IMSS is everywhere. Even the small villages have a mini clinic and give meds plus have a doctor on board 24/7.

In our village, even if NOT part of IMSS, anyone can see the doc for a "fee" according to a new sign I saw a couple months ago.

In my case, we got seguro popular for less than $100 a year. It covers a monthly doctor visit with all medications, flu vaccinations, yearly mammograms on a machine that looks like something from NASA, and my insulin included at no extra cost to us.

I can get xrays and see specialists if I go to La Paz. The hospitals, as far as I can tell, are substandard, so we head to the States for anything more serious.




Man, that's too good a deal to pass up, really. I simply dismissed SP, on the basis of the hospitals in our area. But it would be worth it to have for those expenses you mentioned, alone.

Alm - 8-2-2018 at 10:02 AM

Quote: Originally posted by BajaBlanca  

I can get xrays and see specialists if I go to La Paz. The hospitals, as far as I can tell, are substandard...

I've heard that new La Paz public hospital is quite decent. A bit too far from me, though. The nearest one is a small IMSS, and it is really basic.

John Harper - 8-2-2018 at 11:37 AM

Quote: Originally posted by BajaBlanca  

In my case, we got seguro popular for less than $100 a year. It covers a monthly doctor visit with all medications, flu vaccinations, yearly mammograms on a machine that looks like something from NASA, and my insulin included at no extra cost to us.

I can get xrays and see specialists if I go to La Paz.


Yet our politicians whine we can't afford some type of universal care here in the US.

John

Alm - 8-3-2018 at 03:35 PM

"Some" type of universal, i.e. govt funded, health care in the US already exists and is called Medicare ;)

It is better than Canadian Medicare, where they stop the coverage after 7 months of annual absence, and if you suddenly return, they make you wait for 3 months to renew the plan again.

Mexican "Seguro Popular" is similar to Canadian in that it covers all citizens and permanent residents, only much worse because there is less money. Fewer good hospitals, fewer free medications, and same several months wait times to see a specialist or non-urgent surgery.

Alm - 8-4-2018 at 09:44 PM

...and, what Seguro Popular is good for - list of 266 covered conditions. Scroll to the bottom of the screen: http://www.seguropopular.org/. Surprisingly short list. I don't even see appendectomy or bladder stones, which is odd. Maybe there is another list for "urgencias"?

When it's not on the list, chances are that SP won't treat it or won't treat for free. Happened to some people already.

In Requisitos it also explains somewhat muddled testimonies that I hear from time to time, that SP would treat you even without proper documentation like CURP. Yeah, kind of. Temporary for 90 days, and only to give you time to submit rest of the documents. Likely involves an authorization or two from regional SP administration.

[Edited on 8-5-2018 by Alm]