A family member of mine recently had surgery in the US. The bill was around $80,000 USD. After the insurance negotiated with the hospital the hospital accepted a reduced fee of $16,000 USD. The moral of that story is that even if you don't have insurance in the US there is room to negotiate prices and you should always do so. I have read that the primary precipitating causes of bankruptcy in the US are: sudden high medical bills, job loss and the birth of a child.
FREE TREATMENT FOR FLU VICTIMS Rivergirl, insurance companies have never been shy when it comes to protecting their own interests! Here's something everyone should be aware of, because having a case of the flu, with serious respiratory complications, here in Cancun, could leave a person in a financial position similar to that of the long-term expat I mentioned in my last post, above. ____________________ As a part of a bold program to control the spread of H1N1 influenza, all units of IMSS, nationwide, will treat any person presenting symptoms of flu, for free. The sign reads, "Be informed, that persons who present with symptoms of flu have the right to medical attention in all units of IMSS, whether or not they are residents with privileges at IMSS. The symptoms include fever, runny nose, headache, and cough." These signs appear on all IMSS facilities, near the entrances. The photo on the right shows you the entrance to the unit of Family Medicine of General Hospital, Zone 3 (the one between Coba and Ixcaret), where you could go if you had flu-like symptoms and wanted to be seen by a physician. To confirm that it means what it says, I spoke with an attending physician from the intensive care unit, and he confirmed that it meant everybody, regardless of status in the country, who was present on the territory of Mexico. In the photo on the left is an intensive care bed in IMSS General Hospital, Zone 3, where you might be cared for if the need arose (at the left is a monitor of heart function and, at the right, a respirator, should you need one). In the photo on the right, an intensive care physician attends a patient in the Intensive Care Unit. ____________________ From the Ministry of Public Health, here is an update on the situation regarding N1H1 Influenza (swine flu) in the state of Quintana Roo, thanks in part to Rivergirl's diligent research. http://portal.salud.gob.mx/sites/salud/descargas/pdf/influenza/situacion_actual_epidemia_211009.pdf The two tables, p.2 and p.7, appear to cover the period from March through October, this year, and show how many cases occurred, week to week. Quintana Roo, with 630 confirmed cases, total, for that period, p.8, was among the least affected of all the states of Mexico. Yucatan, on the other hand, with 3,088 cases, was among the hardest hit, with only the D.F., and Chiapas, having more cases. The pattern of older people being largely immune to this new flu held up in this data. Of 47,788 cases in Mexico, only 783 cases were of people 60, and older, nationwide, p.3., with those representing, perhaps, persons who managed to make it through both the Asian Flu epidemic, 1957, and the Hong Kong Flu epidemic, 1968, without having been exposed to those diseases, or immunized, at the time. There were 278 deaths attributed to the swine flu, nationwide, during the approximately six month period covered by this data.
FREE EMERGENCY PRENATAL CARE Although "retirees" are not likely to need this service, IMSS has a program aimed at reducing premature births, life-threatening complications of pregnancy, and injury or death of mother/child. The sign, posted at the entrance to the Emergency Department of General Hospital, Zone 3, which lies between Coba and Ixcaret, reads, "General Convention of Inter-Institutional Collaboration for the Reduction of Maternal Deaths, Notice to Patients who do not have the rights of those enrolled in IMSS, this hospital treats emergencies relating to pregnacies that present the following symptoms- preclampsia, high blood pressure, constant headache, swelling of the face and hands, blurred vision, ringing in the ears, excessive vaginal bleeding, purile fever, malodorous vaginal secretions, intense colic following delivery or caesarean, difficulties breathing. These signs appear on every IMSS hospital, of which there are a total of ten in Cancun. Should you need an emergency C-section, you might be treated in this surgical suite, one of three, in General Hospital, Zone 3, photo on right.
A LOOK INSIDE IMSS These views are from IMSS General Hospital Zone 3, on Avenida Coba. This hospital is an important part of the system, with ER, ICU, surgical suites, both medical and surgical hospital beds, a Family Medicine unit, and a large Polyclinic of medical specialties, and specialists. To the left, the information desk; to the right, the Family Medicine Clinic waiting room. On the left, three doctors consult regarding a new patient in the ER; on the right, one of the x-ray machines in General Hospital Zone 3. On the left, a CAT Scan machine; on the right, an intensive care bed awaits a patient, General Hospital Zone 3. The main administrative offices of IMSS are located in this facility. You will often see a long line waiting outside the administrative offices, early of a day. These are the people who wish to sign up for IMSS benefits. They come early, hoping to get through the process, and back, without missing too much work. Come a few hours later, and you will find no line, and an administrative office that looks like this: overhead displays show who's next! If you're not working, why not come just a little later in the day, and be served without having to wait. As soon as I have my FM3 in hand, it's my plan to go to these offices to enroll in IMSS. I have a fine policy of international health insurance, but I plan to have this as a supplement. I will pay 3,000 pesos per year for the privilege of being seen at any IMSS hospital, anywhere in Mexico. In the next installment, I plan to show you scenes from the cadillac of hospitals in the IMSS system, occupying an entire, large city block, Regional General Hospital, Region 17.
While IMSS clearly has better equipment and facilities than many small clinics or the public (general) hospitals... I can think of several instances involving people I know where the service they received was a joke... like not being able to see a heart specialist for 4 months.. meanwhile you're risking a heart attack.. or not being able to get a corrective stomach surgery for A YEAR! meanwhile you suffer in pain.... and so on. For ER care, its a good thing to have the IMSS access.. but for medical issues that are not deemed "critically urgent" you'll run into long waits to get appointments or have procedures done.. which leads many people who have IMSS to seek treatment at private practices. So unless this has changed in the last few months.. the IMSS system isnt a replacement for general medical care for most people....
Where are the bottlenecks? Thanks, Life, I've been told something like that by physicians in the system. It doesn't apply to all services, but does to some. They told me they don't have enough orthopaedic surgeons to accommodate the demand, resulting in delays for surgery, and longer waits for consultations, for one example. Over time, we'll learn more- the good with the bad, as usual, right? It will take time to learn where it is most useful, and where it is not, as a practical matter. My problem is that no expats seem to have used the system enough to really know how well it works. For example, not a single poster has come on here to tell us about their use of/experience with, the IMSS system. That's why I think it's important for me to move forward on this. We're still trying to get info. Is it viable, as a resource worth having, for an expat? We already know it is affordable, and permanent; but, will it really work for those who are not forced to rely on it, exclusively, by financial necessity. If other options are simply too expensive for a given expat, then it represents a fallback position they could end up being thankful for. Based on what I've seen, so far, I think it could prove to be much more than that. Over time, I'll share what I've seen, and experienced, personally.
Re: Where are the bottlenecks? That's probably because most of us have heard the stories of how long the waits are for service, and therefor don't bother with it.... since we tend to be an impatient bunch If you are someone who is expecting to need expensive emergency treatment due to health issues or a family history, then by all means get signed up with it and have it as a plan B, but from what I've seen/heard you'll need a plan A for most other things. BTW If you're working here... your employer is supposed to be paying IMSS for you as thats the law. So if that's the case there isn't any reason not to go ahead and get the membership card thing....
WAITING LISTS As Life has pointed out, IMSS covers those employed in Mexico. It is also available on an elective, self-sponsored basis- in which you enroll yourself and pay an annual assessment- to those with permission to live in Mexico, holders of FM2/3. No one likes to wait, and I'm no exception. But, waiting is one thing for a person who has a job, and quite another for a retiree, if we're talking about sitting in a doctor's office, or clinic, for example, waiting to be called. Then, there is waiting for a procedure, like a hip replacement that, while needed, is not critical; versus, waiting for an angiogram when you have crushing chest pain; again, two different types of waiting, to be sure. In Cancun, I've repeatedly been told Hospital Hospiten is the only place, in Cancun or anywhere nearby, that has the capacity to do an angiogram (to look at the arteries of the heart), or to implant a stent. So, for as long as I could maintain insurance that would cover the cost of the procedure, I'd ask the ambulance to take me there, if I had severe chest pain, and suspected a heart attack. The nearest IMSS hospital with this capacity is IMSS Regional Hospital No 1, in Merida. I've not talked with them, there, but they probably have a backlog of non-urgent procedures, while keeping the equipment available for true emergencies. (For example, a patient with bouts of angina that he's had for several years, and might benefit from a stent, would be put on a waiting list.) Procedures to implant stents in blocked coronary arteries are not cheap, if performed in a private hospital. I've not asked Hospital Hospiten what the total cost is for a routine case, there; but, in the U.S., the range is $40,000 to $100,000 for a single vessel procedure, with the low end being a city in the midwest, the high end a city such as San Francisco. (These figures are from a website which allows you to compare the average cost of medical procedures in the U.S., in different parts of the country.) What I feel we're looking at, among other things, is how to be sure that if, as we age, we will have affordable, comprehensive health care available to us. IMSS can represent that, as a fall back position, but only for those who've prepared themselves for that eventuality. I'll explain why. As I currently understand it, if you applied today, your benefits would be phased in, so that you would have full coverage only after the first two years. As generous as the system is, to allow aging foreigners to enroll, they are not prepared to accept seriously health impaired refugees from the U.S. health care system without limitation. Not only is the coverage phased in, you will never receive coverage for serious health problems that existed at the time of enrollment. So, there is a big incentive to enroll now, while you're still in relative good health, if you have any thoughts of living, permanently, in Mexico. We still don't have good information about the true accessibility and quality of the services at IMSS, that is what this thread is principally about. But waiting too long to decide to enroll could leave a person, financially, where the individual I spoke of earlier on this thread was left, after they'd had surgery at a private hospital while having, for a number of years, though eligible to enroll as a holder of an FM2/3, chosen not to.
I know that the application process for retirees in the IMSS system requires a letter written in Spanish requesting the enrollment. I understand it has specific language that need to be in it. Does anyone on here have a ample of the letter?
