IMSS is supposed to cover all family members, including young children when the parents are signed up. At least thats the way I have always understood it. As for an upper limit, that would seem pointless as it would again violate their "family" coverage policy. As for Hospiten, I've never heard anything negative about their quality of service (once they admit you), but their prices make them prohibitive for most. I was looking into an insurance plan once that claimed Hospiten as being included in the Cancun area for their coverage, but I was never able to confirm that with Hospiten, and I would hate to go in assuming I was covered then wake up with a hundred thousand dollar bill! As with many insurance plans here, they expect you to come up with the full cash amount and then file to be reimbursed, which needless to say is impossible for most if the amount is high.
I know this doesn't address the issue of healthcare coverage in Mexico. A number of posters have provided costs for healthcare or procedures in the States. I fully understand that healthcare costs are high in the US. What a hospital bills as revenue versus what they expect to be reimbursed is significantly different. Nationwide average for billed revenue to reimbursement is approximately 45%. Hospitals or ISN's frequently negotiate rates with the payers (Insurance) of approximately 60%. Both my wife and I have had to have treatment in Mexico at Hospiten. Each of us received excellent care and yes we were asked for a credit card after admittance and did have to pay the full amount upon discharge. We were fortunate in that we were reimbursed for the bills by our insurance company. Time from submittance to reimbursement was 45 to 90 days.
Letter requesting imss inscription Several posters asked me to share the letter, requesting inscription into the IMSS system. I've been told this letter is sufficient in particulars, as far as they're concerned, for an unmarried person, with no children, as the plan is a family plan. If you have a spouse/children, the request for enrollment should name them all, and you will be charged accordingly. [I can't, at this time, offer any information on questions like, if I have adult children living with me in Mexico, must I/can I include them in the plan, as well; or, if I have minor children but they don't live in Mexico, must I/can I include them, etc.? But, I can say there seems to be a public policy in favor of extending coverage as widely as possible. I, for example, will need special permission to enroll without including my wife in the coverage- one of the two issues that came up when I tried to enroll, the other being whether an official translation of my apostilled birth certificate would be required.] Here's what I wrote- Al Instituto Mexicano del Seguro Social Delegacion para Afiliacion y Cobranza [date} Estimados senores, Soy [full name]. Naci en [country of birth], [date of birth], [city and state]. Soy [nationality], numero del pasaporte, [passport number]. Tengo el permiso del INM para vivir en Mexico, documento migratorio numero [FM2/3 number]. Quiero inscribirme en IMSS. Con esta carta pido contratacion del Seguro Familiar. Atentamente, [Signature] [Name] This is probably "pigeon" Spanish, some of you may be able to improve on it, language wise and style wise. The content seems to be adequate. V.
Your health insurance It's annual renewal time on my personal health insurance plan. Living abroad, where health care costs are often many times less than they are in the states, I've always thought it made sense to opt for a form of "self-insurance" in which I sought to be protected by insurance only for those things which could threaten a "nest-egg". Practically speaking, that meant buying insurance which covered only hospitalizations, outpatient surgeries, dialysis, radiation and chemo, as examples. Nevertheless, even this limited insurance has crept up in cost over the years, having risen by about 80% in the last nine years, from about $2,600 to $4,600, annually. I'm now 62, and even if I have no medical problems at all, if the coverage continues to increase in price at this rate, I'll be paying out something like $75,000 in premiums over the next decade. [This insurance is said to be permanent, so long as the premiums are paid, and to afford coverage for treatments anywhere in the world; but, like many others, excludes all pre-existing conditions, and raises some barriers to enrollment after age 59, as well.] I know others have faced struggles at times, trying to get insurance, trying to stay insured, or having to pay more for health insurance than they'd like to, which largely explains my motive in starting this thread, discussing options, in Mexico. ______________________ Anyone have anything they'd like to share of their experiences with health insurance- getting it, keeping it, and paying for it, as they age?
Cost of health insurance It was reported, today, that Blue Cross of California has announced rate increases of 39% per annum in premiums for health insurance for 2010. Most people have become aware of significantly rising costs of health insurance if they have health insurance- but many do not.... __________________ This thread began with a search for affordable alternatives for health care/health insurance for aging expats living in Mexico. I now personally know two expats, both of whom have lived here for more than a decade and been eligible to apply for IMSS coverage but did not: each of them was subsequently hit with expenses for medical care that were either unaffordable, and left them in debt; or, while not "wiping them out," put a real hit on their savings. Enrolling in IMSS was an option for them, at any time, and would have resulted in their incurring little or no expense for the treatments and medical procedures they underwent. There are many reasons why a person might not enroll in IMSS, but among them may be that enrolling requires a good deal of foresight- some people have not enrolled because they couldn't imagine being in Mexico long enough to benefit from enrolling; or, felt fine and confident of their health and didn't see a need to have a foundational level of protection from medical care costs; or, having significant financial resources, couldn't imagine needing anything more; or, having insurance that seems adequate and affordable, haven't considered that either of these two conditions could change, at some point in the future. Recently, I met a long-term expat who had the foresight to enroll in IMSS, a thing which came in very handy when he developed colon cancer- requiring surgery and chemotherapy- five years ago. Sometime soon, I'll tell you more of his story.
Yesterday, I ran into an expat at IMSS Regional Hospital No 17. He was there simply to accompany another expat whose 26 YOA daughter was having surgery that day. But, my story is about the first. Being from the UK he'd grown up in a system of national health and knew he wanted the comprehensive coverage and protection from medical expenses that could offer him. Being of a cautious nature, he went further than anything I've heard of to get it: although holding jobs through the years that resulted in IMSS coverage, he preferred that the matter be firmly in his hands and maintained the coverage as a self-pay. This guaranteed no lapses when changing jobs, or for any other reason. He got my first prize for foresight when, after nearly twenty years of living here, and after he'd retired from all full-time work, he suffered a catastrophic medical event which lead to several years of treatment, following the initial surgery. The existence of IMSS coverage guaranteed he'd have to pay nothing for it, beyond the annual premiums, modest as they are, preventing nonavailability or cost of medical care from stealing his best retirement years.
Cancer treatment, IMSS I recently had a chance to speak further with the gentleman I mentioned, above, and here's what he told me. Eight years ago, at about age 59, he was diagnosed with colon cancer: he underwent surgery, and a ten inch segment of his color was removed at a local, IMSS hospital. The IMSS path lab determined that his cancer had spread to nearby lymph glands, and that further treatment would be required. Following this, he received weekly chemotherapy treatments, and a course of radiation. Because chemotherapy is offered by IMSS only at Regional General Hospital Number One, in Merida, he made a weekly bus trip there to receive this treatment. Owing to his Desire to take advantage of a private clinic's new radiation center, and because he could afford to supplement what was available at IMSS, he opted to receive the radiation portion of his treatment at a private clinic, also in Merida. He has been cancer free since that time, and receives regular, followup tests at IMSS to detect any possible recurrence. All procedures, consultations and treatments available through IMSS are offered for free to their membership, including drugs. IMSS membership currently costs just under $300 USD/year, for those 60 YOA, and older. [In addition to oncology, there are limitations on what is available through IMSS, locally; for example, cardiac imaging is also available only at IMSS Regional General Hospital Number One, in Merida.]
Imss Wow again I am finding this site full of useful information. My husband is looking for affordable medical insurance. Here is what we are dealing with. He is 72 and has medicare/blue shield in the states. We live in Playa del Carmen. He has tried to get private mexican insurance but most companies will not cover him because of his age. We did find one that we are looking into now. He does have diabetes/meds only-no insulin, but otherwise in very good health. His major concern-if he would have an emergency like a bad fall or anything that would not allow him to get back to the states. However, if he can get any coverage for anything for the first two years-it would be pointless to even apply. As for me, I do have a private policy in Mexico and would not be interested in the IMSS. Would he still be obligated to list me? And off topic-does anyone know what insurance companies Hospiten will do a direct billing. I am talking about insurance companies that are not Mexican. Thank you
Imss Can't answer your question at the end of the post, Grandma, but everything I know about IMSS and the availability of it's services to foreigners, holders of FM2/3, is posted on this thread. Your question has been addressed, in part, by a couple of posters, earlier in this page, but I don't see an exact response to your question: the only way to get that may be by making a personal visit to the hospital, where there is a very charming and English speaking young lady, pictured earlier on this thread, who will be happy to assist you. I'll mention one thing about Hospiten that I think is worth knowing: the physicians who practice there are all employees of the hospital, and screened for apparent competence by the director of medical services, rather than independent contractors of medical services who rent space in the hospital, as it the case at Galenia, for example (though I hear nothing but good things about their doctors, and it may take more than just a medical license and a willingness to pay rent to get a space, there). This means, among other things, that it's possible to know exactly what procedures and medical attention will cost, before hand (with due allowances for the unforeseen, and variability that will exist between patient needs in any given procedure). Holders of FM2/3 get a discount on all services at Hospiten, whether medical or hospital, without exception (20% is the figure that comes to mind): be sure to tell them you are in that category, and offer your evidence, each time you request services.
I am pretty sure that Star Medica (closest for us would be Merida but they are all over Mexico) has a program where the entire famdamily is enrolled for $170 a year (MN) and then receives discounted (25%+) off consultations ($400-500 normally) and labs and PT. The last time I checked into this was in November of last year so I believe it is still running. Star Medica has amazingly highly rated docs - if I had something serious (and last year when the Hospiten docs were sure I had a brain tumor I went over there - no brain tumor, YAY!) for a neuro consult. I consulted with the neuro in Cancun Hospiten and was incredibly UNDER impressed. The neuro in Merida was amazing. For now, we use the amazing doc at the hyperbaric chamber (Dr. Eduardo) who has nailed each and every diagnosis (which was then proved with diagnostics and specialists). Their consult fee just raised to $300 but he is an amazing diagnostician and I'd go to him for anything but GYN issues. If I were you, Grandma, I'd get IMSS as "insurance" and then use the hyperbaric chamber. They're on 10th and pretty easy to get to and park.
