Kgryfon
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Location: East Bay, CA
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IMSS Excludes Heart conditions?
Over on Rolly's page he has a link about IMSS. In part, it reads:
"Exclusions and Limitations
A foreigner will not be covered for these pre-existing conditions.
Chronic degenerative diseases such as: complications from long-standing diabetes, and diseases of the liver, kidney, heart, lung, neurologic,
cerebrovascular, peripheral vascular, and many others."
Does this mean that if you develop heart disease while you are in Mexico, have a heart attack, etc., IMSS will not cover it? After the initial waiting
period (2 years, I guess?) Or is this not considered a chronic degenerative disease? Thought someone here might have first-hand experience to
relate. Thanks in advance.
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BajaBlanca
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What I was told is that you can not even join if you have those conditions mentioned.
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EnsenadaDr
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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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Here you go translated from Google Translation and from the IMSS page:
Everything you wanted to know about IMSS:
http://www.imss.gob.mx/tramites/imss02014
Under the section ten presente estos puntos:
validity
IMSS medical services start from the first day of the month following the incorporation
And take into account ...
Age Range Annual Fee *
0-19 years $ 1,600.00
20-29 years $ 1,900.00
30-39 years $ 2,000.00
40-49 years $ 2,850.00
50-59 years $ 3,050.00
60-69 years $ 4,400.00
70-79 years $ 4,600.00
80 and over $ 4,650.00
* Prices valid from February 1, 2014 to January 31, 2015
The annual fee is anticipated and is determined according to the age range that belongs to every member of the insured group and updated in February
each year .
The services provided are medical- surgical care , pharmaceutical and hospital
No insurance will be subject to people who have:
Any pre-existing condition , such as malignant tumors ; chronic degenerative diseases ( late complications of diabetes mellitus) ; hoarding diseases (
Gaucher disease ); chronic liver disease ; chronic renal failure; cardiac valve ; heart failure; sequelae of ischemic heart disease (arrhythmia ,
angina or myocardial infarction ); Chronic obstructive pulmonary disease with respiratory failure, among others, and
Chronic systemic connective tissue diseases; addictions such as alcoholism and other addictions ; mental disorders such as psychosis and dementia ;
disease and congenital or acquired immune deficiency Virus Acquired Immunodeficiency Syndrome Humana positive ( HIV)
You can renew the Health Insurance for the Family, 30 days before the due date
In any case, the IMSS will reimburse all or part of the payments made , so it is very important that all information provided is correct and complete,
in particular with regard to the pre-existing diseases
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Kgryfon
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Location: East Bay, CA
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Thanks, but that didn't answer my question so I guess I was not very clear. Has any one obtained IMSS while healthy, then later on (after the intro
period) developed heart disease/had a heart attack, and if so, was it covered? (Note that the above says no coverage will be provided for the
"pre-existing" conditions listed - I am asking about such conditions, but developed after you already have IMSS).
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EnsenadaDr
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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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Let's put it this way. If you have a heart attack and they check out your coronary arteries, chances are you have blockage somewhere. Almost no one
over the age of 40 has completely clear arteries. Any Doctor can claim your condition was preexisting unbeknowst to you. I wouldn't chance it. Go
for Seguro Popular or Private insurance. Besides looks like anyone over 50 pays quite a bit per month for insurance. And add in the waiting period.
I have seen Insurance companies in the states claim preexisting on a nasal polyp because even though the person didn't know about it, it was already
growing before they signed up for insurance, so they denied them coverage. IMSS was designed for young healthy workers in Mexico and is not the best
option for retired or middle aged adults.
[Edited on 5-18-2014 by EnsenadaDr]
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Kgryfon
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Thanks, EnsenadaDr.
Does anyone have any actual experience with a situation like this?
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Brinloor
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I signed up my 89 year old mother with IMSS several years ago after a perfunctory physical exam. In the year we were covered she was diagnosed with
an enlarged heart and hospitalized for a week. Unfortunately I did not realize that you will not receive an invoice for insurance, it is up to you to
go in before the expiration date and pay. Our IMSS coverage lapsed during the week my mother was in the hospital. When we went to reapply they would
not enroll her because she now had a pre-existing heart condition. And for some reason they told me that it was only for families and I could not be
enrolled as a single individual, although originally I was.
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Kgryfon
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Location: East Bay, CA
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Thanks, Brinloor. That sounds like she would have been covered if the policy had been in force. It's really unfortunate that she had her issues at
just the wrong time! Never heard the "families only" issue before.
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