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Alm
Ultra Nomad
Posts: 2745
Registered: 5-10-2011
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There are no pre-existing conditions in SP, yes, but there are exceptions, kind of. There is a list of covered procedures, pretty long list.
OTH, IMSS does not cover - not supposed to cover - pre-existing conditions. How IMSS could accept somebody with a recently diagnosed condition, is
beyond understanding. Oh, land of wonders...
Btw, did anybody notice that the OP never specified whether he/she was interested in a Mex social healthcare at all. Or whether he/she was a resident
or somebody with a visitor status. The question was "Plans, costs, deductibles", and where to buy in La Paz/Cabo area.
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Mulegena
Super Nomad
Posts: 2412
Registered: 11-7-2006
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Again, to point out the inequalities of Seguro Popular/SP vs. Seguro Social/IMSS coverages:
Another relative has a condition that has become potentially life-threatening, an aortic hernia that's been present from birth; the lady is now in her
30s.
She has Seguro Popular (and cannot change to IMSS, btw, for whatever reason). She was sent to La Paz for a current exam which included x-rays and an
endoscopy. SP did not cover the endoscopy, nor of course will it pay for any medications or the necessary surgery to save her life. She was sent home
and told to come back when she had the money. Kinda cold. The family is raising payment at the moment by selling tamales door to door.
This brings up another point: Fundraisers.
Each little village helps to look after their own. When someone is sick they have fundraisers, usually a planned collective lunch sale with tickets
available by advance sale or "at the door". All proceeds are put into a bank account for that beneficiary's health care. Fundraisers are an essential
part of community life down here and are an excellent way tourists can help. When someone approaches you, buy a ticket. Ask who in town is in charge
of the Association (for example, in Mulege see Saul Davis). Go to that person and ask how you can help. Make a donation. Save a life.
"Raise your words, not your voice. It's rain that grows flowers, not thunder." ~Rumi
"It's the mark of an educated mind to be able to entertain a thought without accepting it." ~ Aristotle
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Pescador
Ultra Nomad
Posts: 3587
Registered: 10-17-2002
Location: Baja California Sur
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| Quote: | Originally posted by Mulegena
Again, to point out the inequalities of Seguro Popular/SP vs. Seguro Social/IMSS coverages:
Another relative has a condition that has become potentially life-threatening, an aortic hernia that's been present from birth; the lady is now in her
30s.
She has Seguro Popular (and cannot change to IMSS, btw, for whatever reason). She was sent to La Paz for a current exam which included x-rays and an
endoscopy. SP did not cover the endoscopy, nor of course will it pay for any medications or the necessary surgery to save her life. She was sent home
and told to come back when she had the money. Kinda cold. The family is raising payment at the moment by selling tamales door to door.
This brings up another point: Fundraisers.
Each little village helps to look after their own. When someone is sick they have fundraisers, usually a planned collective lunch sale with tickets
available by advance sale or "at the door". All proceeds are put into a bank account for that beneficiary's health care. Fundraisers are an essential
part of community life down here and are an excellent way tourists can help. When someone approaches you, buy a ticket. Ask who in town is in charge
of the Association (for example, in Mulege see Saul Davis). Go to that person and ask how you can help. Make a donation. Save a life.
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Mulegena, that is excellent advice. The problem with the fundraisers is that a lot of tourists never know who the sick person is because they have
very little interaction with the people who live in the village. We had a guy who was working over San Lucas Trailer Park, Dos Amigos, Punta Chivato,
and as far as the campgrounds at Concepcion. He had a Fonatur shirt and a typed up and signed sheet of paper. On closer examination the guy who was
supposed to be needing surgery had died 4 years prior and this guy was using this fundraising as an excuse to obtain money. Checking with Saul would
have brought that to a stop for sure. I knew the person who had died so I was not vulnerable. He also changed the amounts donated to reflect a
higher amount. So if you gave 20 pesos, by the time your neighbors read the sheet, it looked like you gave 200 or 2,000 so you upped your amount to
reflect what he showed the others as having given.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Wow I am sending this to the boss at Maneadero in Ensenada for his comment, this is crazy. He speaks good English. I will ask him what he thinks.
But between us, the Internal medicine guy probably decided he didn't want to take any further action on this because of the risks involved. But he
should say that not deny funding. | Quote: | Originally posted by Mulegena
Again, to point out the inequalities of Seguro Popular/SP vs. Seguro Social/IMSS coverages:
Another relative has a condition that has become potentially life-threatening, an aortic hernia that's been present from birth; the lady is now in her
30s.
She has Seguro Popular (and cannot change to IMSS, btw, for whatever reason). She was sent to La Paz for a current exam which included x-rays and an
endoscopy. SP did not cover the endoscopy, nor of course will it pay for any medications or the necessary surgery to save her life. She was sent home
and told to come back when she had the money. Kinda cold. The family is raising payment at the moment by selling tamales door to door.
This brings up another point: Fundraisers.
Each little village helps to look after their own. When someone is sick they have fundraisers, usually a planned collective lunch sale with tickets
available by advance sale or "at the door". All proceeds are put into a bank account for that beneficiary's health care. Fundraisers are an essential
part of community life down here and are an excellent way tourists can help. When someone approaches you, buy a ticket. Ask who in town is in charge
of the Association (for example, in Mulege see Saul Davis). Go to that person and ask how you can help. Make a donation. Save a life.
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EnsenadaDr
Banned
Posts: 5027
Registered: 9-12-2011
Location: Baja California
Member Is Offline
Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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I just got a response from the head boss over at Maneadero and wants to know more information. Name, and address. He said he could help her with
Seguro Popular in La Paz. If you don't want to make it public please U2U me. | Quote: | Originally posted by Mulegena
Now what I came on to share before I read Alm's last paragraph.
This is about how Mexico's public insurance plans can be flexed at the discretion of the people in charge, which corroborates statements made by
DrEnsenada:
My mother-in-law is in-hospital at this moment. She had an inactive Seguro Popular which was easily verified and updated when she became an
in-patient in Sta. Rosalia Seguro Popular Hospital two weeks ago. No worries.
Last week she was transferred to the Seguro Popular hospital Salvatierra in La Paz for specialist(s) care. She was again evaluated as to her
qualifications, a simple matter of a short verbal chat with a social worker.
When a diagnosis was determined it was found that the treatment coverage (read, "paid for by") Seguro Popular was not available for her illness. Not
at all. 0% coverage. Zip.
She has a son in La Paz who has Seguro Social coverage, IMSS. He signed her up on his policy as a dependent living with him. She was transferred out
of the Seguro Popular hospital and directly into the Seguro Social/IMSS hospital. Her medical treatment is covered by the insurance, 100%.
I think it's great that the two public insurance providers will coordinate and work together, and that one of her sons is employed by a Mexican
company. |
[Edited on 9-23-2013 by EnsenadaDr]
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Alm
Ultra Nomad
Posts: 2745
Registered: 5-10-2011
Member Is Offline
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Have forgotten about Rolly Brook site, in case if the OP is still reading: http://rollybrook.com/health.htm
Kind of 101 on the subject. With links to private insurers as well, that Pescador and Mula mentioned.
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pauldavidmena
Super Nomad
Posts: 1734
Registered: 5-23-2013
Location: Centerville, MA, USA
Member Is Offline
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| Quote: | Originally posted by Alm
Have forgotten about Rolly Brook site, in case if the OP is still reading: http://rollybrook.com/health.htm
Kind of 101 on the subject. With links to private insurers as well, that Pescador and Mula mentioned. |
the Rolly Brook site, as well as the book he co-authored is definitely a good primer on not just Mexican Health Insurance, but on the ex-pat life in general. Of course the
continued experiences of people on this forum is even more informative.
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