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Alm
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| Quote: | Originally posted by EnsenadaDr
...as far as admitting you for a serious illness they {public hospital} do their best to put you in another facility or if you are American, they
encourage you to go to the States. |
... and they are right 
They know their limitations. I would rather be charged $$$ deposit in private hospital (which will be reimbursed less deductible) and get a proper
treatment without delay, than be transferred to another facility in Mx or US after several hours delay.
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EnsenadaDr
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Mood: Move on. It is just a chapter in the past, but don't close the book- just turn the page
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Getting reimbursed...a sure guarantee???
And so do you know for a fact that you will get your money reimbursed and from whom...and how long do you have to wait, or is this not an
issue?? | Quote: | Originally posted by Alm
| Quote: | Originally posted by EnsenadaDr
...as far as admitting you for a serious illness they {public hospital} do their best to put you in another facility or if you are American, they
encourage you to go to the States. |
... and they are right
They know their limitations. I would rather be charged $$$ deposit in private hospital (which will be reimbursed less deductible) and get a proper
treatment without delay, than be transferred to another facility in Mx or US after several hours delay. |
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DavidE
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Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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Personal Experience Spring 2011
Taken by ambulance from Tijuana to the border crossing. Customs took less than 10 seconds to ask me if I was a citizen, then I was transported by
another (US) ambulance from the border to Scripps, Chula Vista. There was absolutely no wait at the border. CBP had the gate open and I was on my way
north, fast.
Thought I'd post this as I haven't seen an account of what actually happens.
Had an afib episode and Cruz Roja ambulance team had me on a cardiac monitor, and then I started to feel worse, something showed on their monitor, and
off we went. Absolute 5-star professionalism and expertise by Tijuana Cruz Roja!
A Lot To See And A Lot To Do
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prorader
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Why Seguro Popular is better than IMSS for a expat
Mexican private hospitals are like big vacumn cleaners, they are like flies on peanut butter and they want there money up front and now. In my
experence the same doctor with his hand out in the private hospital is the same doctor at the public hospital the difference in the public hospital he
doesn't have his hand out and more concerned about medicine then profits. Now a lot of doctors use expensive private labs that have very expensive
operating rooms instead of hospitals to operate on people. The tactic with SP is the public hospital has most of the equipment that you need but
hidden and they want to selective use them. They want you to go outside the public hospital to a private lab to have your tests done and of course you
pay, so SP in not always free. The big public hospital in Guadalajara has, labs, mri, catscan, ultrasound all on a part of the hospital where patients
can't go, the 6th floor Internal Medicine department, I got to go there and it is as professional as any private hospital, BUT it is a secret to be
used?
I have had at least 4 high priced Mexican Doctors in the public SP system and they do there job as they should for free, and they do it very well, the
problem with the new system is saturation, lack of medication, and I mean the real medication like codine, or any Psyco drugs. I was in so much pain I
told my wife to go down to the corner from the hospital and buy the chit on the street. I kept everyone awake all night long, 10 shots of what ever
they had, getting shot with an AK 47 was a cake walk comparied to the pain I had from the operation, but it was free
What is going to happen to the sergeo popular program when Calderon is gone? I still say IMSS is done
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Alm
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Cruz Roja will work when it comes to it. But how long will it take to process you only to realize that they don't have resources? What if this is late
evening or a holiday? Wouldn't you think that private hospital, even if they won't be able to help, at least will go through all the steps faster than
under-stuffed and under-paid public hospital.
Would the insurer reimburse? Who knows... If this is something serious, then they will (using to their advantage all the deductions and limits and
"reasonable cost" clauses, naturally). If it's not, then I'll go home next morning after paying for one day of services, can't be too much by Mexican
prices.
Sorry for deviation - the subject was SG vs IMSS. Either one sucks, IMO. Private insurance sucks too.
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Pescador
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It was a very honorable thing that the Mexican President and Congress tried to do in terms of providing some level of coverage for all residents, but
the reality is that it is impossible to provide good coverage for every resident unless they pay a large percentage of the costs. Europe and Canada
are going through the same problem with only slightly different results. The good news is that by talking about the coverage, perhaps more people
will understand that they are going to have some real gaps in coverage and treatment.
One thing that has been misunderstood is the coverage by a US policy while in Mexico. Almost all policies that I ever wrote all had an "Emergency
Care Provision" and it simply states that you are covered anywhere in the world on an emergency basis. This means that any life threatening situation
will be covered by your insurance and will be reimbursed to you at "Reasonable and Customary" basis. Since Medical costs are lower in Mexico, it has
been my experience that they are happy to reimburse you for any expenses that are covered by the emergency care provision but will not pay directly to
the hospital and medical people because they have no means to even make that happen. All you need is good receipts and a detailed description of what
was done.
I know it goes against everyone's grain, but you can find out all of these things by a simple reading of your policy.
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prorader
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Cruz Roja is the primo medical emergency system, they do what needs to be done and at little or no cost to you. I would say that they are equal to
any emergency system in the US. In fact most emergency systems in the US take you to the local emergency room. In most areas Cruz Rajo has there own
emergency room or if critical to the nearest hospital
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prorader
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It sounds like Pescador works for a medical Insurance company?
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Pescador
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| Quote: | Originally posted by prorader
It sounds like Pescador works for a medical Insurance company? |
No, actually I had an agency that focused on Health Insurance but never chose to ally with only one company because the needs of my clients came
first. So I was an independent agent with a large, satisfied clientele. If you had an experience that was different than that, I am sorry that you
were unable to find an agent that put your needs first.
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prorader
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Pescador, wasn't to come out negative, sorry. Think about a few things. The Doctors in the US Army, train on a regualr basis at public Hospital
emergency rooms. Why? That is where all the action is, guns, knives, beatings, traffic accidents and a lot of them, that being said a lot of private
Hospitals in Mexico arn't giant hospitals most are small and basic service is for the people that have money. The people that have money don't always
get in gun fights, knife attacks, beatings, they are more inclined to have a heart attack or kidney stones. The same goes with ER nurses and medics,
intense training real word stuff every day. As far as Cruz Roja, I consider them to be one of the best in the world, they saved my son's life when he
was run down by a Chapala bus and left in the middle of the highway to die. The took fantastic care of me in 2 different traffic accidents, and 3
other times with other medical issues. I have never been asked to pay 1 peso, but I do support them. There Paramedics and EMT's are professional and
well trained. When these folks get the call they go balls to the wall to get to you no matter what. Thanks Cruz Roja. So the public Hospital Emergence
Room may be the best place to go. They are saturated yes but poor people have no other place to go the same as in the US, if you have a cold and no
money you go to the Emergency Room. The public Hospital uses the Triage system and if you show up in bad shape you go to the front of the line as in
any other. Mexico is working towards a middle class country that will mean better medical care. I think La Paz just opened a brand new state of the
art Public Hospital.
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Pescador
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Okay, some posted here that they received Seguro Popular for no cost and the thread started with Ensenada Dra. indicating it was a free coverage. So
I spent the morning and met with the local director of Seguro Popular in Santa Rosalia. He is a delightful gentlemen and I raised the question about
the discrepancy with rates that I was told on this thread. Well, to say the least, that got him going at about 100 Kilometers Per Hora and he had a
great time telling me that there is a sliding scale, (which was what I understood from the year before) and he reiterated how the breakdown happens.
Those Norteamericanos who are getting it for free either gave the wrong information at application or found a lazy intake specialist who did not
bother to try to ask the questions. When you are signed up as a Contributiva it means you have a car,or a house, and/or lights. If you said you had
none of those things then conceivably you could qualify for free. He indicated that as soon as someone gives an address of El Rancho, they are
immediately non-contributiva. He had his facts together and knew what Medicare part A and B cost and knew a little about supplements, so he thought
it really Codo (means cheap in Spanish) and un Mentira that someone needed to come in under the wire and end up taking money from those it was
intended to help. This years fee for a Contributiva is $1037.40 MN. for the annual fee.
[Edited on 6-20-2012 by Pescador]
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prorader
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I must have forgot to tell you that my wife is Mexican and when we registered we lived on the Rancho, and I am 65 and do not own a house.
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prorader
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Please tell me that there isn't any Mexicans abusing the program. That is saying cops don't take bribes. Calderon says it is for anyone living in
Mexico, anyone. Codo (means cheap in Spanish) and un Mentira that someone needed to come in under the wire and end up taking money from those it was
intended to help. "This years fee for a Contributiva is $1037.40 MN. for the annual fee." What he isn't saying is the rules change from office to
office and state to state, you are making a blanket statement based on the guy that lives here not where I live, come on this is Mexico. They are
signing anyone and everone up for this program and they don't care. So you are now the poster child for a Mexican program, this is politics so, I
forgot to mention the law about messing in Mexican affairs. It isn't your business
Of course you took his word and didn't see it in writing? That makes your statments as rumor, quote the facts not your hearing what someone said. and
again this is a Federal Mexican program not your business.
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DavidE
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Location: Baja California México
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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First a question for EnsenadaDr, if I may...
The IMSS primer grado hospitals like the one in Mexicali, or Hermosillo are impressive as all get out. Cat Scans, MRI's, tropical disease specialists,
rheumatologists, neuro surgeons. The whole ball of wax. But there's a catch. The catch is to access a level of care like that, one has to be passed
through the systems and be upgraded to the "next level of care" which may start at a periferico, graduate to a 2nd class hospital, then on to services
from migrating primer specialist, and then finally to the top of the heap. Is the process as lengthy and complicated as I would think it to be?
Secondly, if you are hospitalized in Seguro Popular sans insurance coverage, and whatever treatment or operation is being delayed by reason of no
fault of your own, you should immediately contact the administrative billing department in the hospital and explain that your continued
hospitalization is costing a lot of money and the bill is rising through no fault of your own. Examples, waiting day after day to see a specialist, or
have an operation. The difference in the final bill may add up to be hundreds of dollars. However if you are being kept for observation, or
recuperation your stay is legitimate and must be honored with payment.
Seguro Popular does indeed bill by the merit system as noted so clearly above. Thank god for that.
A Lot To See And A Lot To Do
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EnsenadaDr
Banned
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Location: Baja California
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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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Seguro Popular is FREE...I will check again with the main government office in Ensenada tomorrow as I have a meeting there...and if they say it is I
will tell them something is rotten in Santa Rosalia.
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DavidE
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Mood: 'At home we demand facts and get them. In Mexico one subsists on rumor and never demands anything.' Charles Flandrau,
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Yo no tenía seguro el Seguro Popular, mientras estaba hospitalizado en La Paz. He pagado un total de quince mil pesos.
A Lot To See And A Lot To Do
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prorader
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You are talking about going to a public Hospital 2 or 3 years ago, which was run by the social workers, they came to your bed and ask all of these
questions then you and they negoitated what the fee was going to be. I did that. When segero popular came into effect they took over all of the free
clinics, and the public hospital system. I wish to say your care is free and covered, but what in fact happens if you need and mri, catscan, blood
tests they will try to get you to go outside of the hospital to a private lab, which you will pay. The rule that I am under is my wife is Mexican, I
have SS, do not work, do not own a house, do not own a car. The person made a statement about not having LIGHTS, come on you don't know squat. You are
passing hearsay information, not facts.
You met someone someplace so you say, you are discussing facts without quotes, without identifing who you are talking about and not naming this person
you are "Quoting", again you are involving yourself into Mexican policy and you are not giving facts under any rule. It is call Rumor, or Hearsay, or
BS
Your Quote "So I spent the morning and met with the local director of Seguro Popular in Santa Rosalia". Santa Rosalia is a small town with about 12000
people so you met with the Director, if you have ever been to any clinic under this program there is no such thing as a Director, I would say from my
experence in 3 different towns of that size, there is 1 Doctor and 2 Nurses, NO Director, so what you are quoting is probably a public service Doctor,
who has an opinion, your a big member of this board and you went to a little town in Mexico to get the true facts, shame on you.
[Edited on 6-20-2012 by prorader]
[Edited on 6-20-2012 by prorader]
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Pescador
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| Quote: |
You met someone someplace so you say, you are discussing facts without quotes, without identifing who you are talking about and not naming this person
you are "Quoting", again you are involving yourself into Mexican policy and you are not giving facts under any rule. It is call Rumor, or Hearsay, or
BS
Your Quote "So I spent the morning and met with the local director of Seguro Popular in Santa Rosalia". Santa Rosalia is a small town with about 12000
people so you met with the Director, if you have ever been to any clinic under this program there is no such thing as a Director, I would say from my
experence in 3 different towns of that size, there is 1 Doctor and 2 Nurses, NO Director, so what you are quoting is probably a public service Doctor,
who has an opinion, your a big member of this board and you went to a little town in Mexico to get the true facts, shame on you.
[Edited on 6-20-2012 by prorader]
[Edited on 6-20-2012 by prorader] |
First of all, we have an office which is recognized for the area of the municipality of Mulege, which is a much larger area than you are admitting and
I did meet with the local director of Seguro Popular. Now things may be different in other areas, but I doubt it since I am now going to quote the
website. Hope that works for you.
Cuotas familiares
Miércoles, 08 de Julio de 2009 16:33
El Sistema de Protección Social en Salud busca que las familias paguen una cuota de afiliación de acuerdo a su condición socio-económica. Los Módulos
de Afiliación y Orientación (MAO) realizan la evaluación de cada familia que solicita su registro y determinan la cuota familiar que debe cubrirse o
si por su condición socioeconómica ingresan al régimen no contributivo.
Las cuotas familiares del Sistema de Protección Social en Salud publicadas el 15 de febrero de 2011 en el Diario Oficial de la Federación (DOF), que
se mantienen vigentes para el ejercicio fiscal de 2011 son las siguientes:
CUOTAS VIGENTES
Decil de Ingreso
Cuota anual familiar (en pesos)
I
0.00
II
0.00
III
0.00
IV
0.00
V
2,074.97
VI
2,833.56
VII
3,647.93
VIII
5,650.38
IX
7,518.97
X
11,378.86
Dentro del régimen no contributivo se consideran las siguientes familias:
•Familias que se ubiquen en los niveles más bajos de ingresos, deciles I y II, y aquellas hasta los deciles III y IV de la distribución de ingresos
•Familias beneficiarias de algunos de los programas de combate a la pobreza extrema del Gobierno Federal (por ejemplo, Programa Oportunidades).
Las personas mayores de 18 años que se afilien de manera individual aportarán el equivalente al 50% del monto de la cuota familiar que corresponda al
decil de ingresos en que se ubique.
Now, if we look under section 5, which was my level of contribituva, the fee for a family is 2074.97 MN according to the official Government Website,
Being single, I get coverage for half price which is $1037.40 MN.
So this is not a political manuevering as you suggest, but I am a consumer and had a logical question about why the difference in rates. If you
happened to qualify for a section 4 or less, great, for you. I am happy to pay the $1037.40 MN and think it is a bargain.
[Edited on 6-21-2012 by Pescador]
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Pescador
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| Quote: | Originally posted by EnsenadaDr
Seguro Popular is FREE...I will check again with the main government office in Ensenada tomorrow as I have a meeting there...and if they say it is I
will tell them something is rotten in Santa Rosalia. |
I think if you check the website, you will see a different story.
http://www.seguro-popular.gob.mx/
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Alm
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| Quote: | Originally posted by Pescador
we have an office which is recognized for the area of the municipality of Mulege, which is a much larger area |
Pardon me deviating... Is there a real hospital at all in this joint area of St Rosa / Mulege?
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