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Insurance- What to get????

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We are 50 and 52 and moving to Ajijic in May. I have read a lot about insurance and it seems that the IMSS is not the way to go. I have started to read about Seguro Popular and I think that will be alright as back up , but I would like something more. We have no preexisting medical conditions and both of us are healthy.

Any suggestions?

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Seguro Popular is akin to US Medicaid or worse. If you are from the US, like we are, and under Medicare age, like we are, we have been covered here (or anywhere in the world) for emergencies with our existing ObamaCare coverage. If that is too expensive then any of the insurance agents in town offer health insurance. We are fine with our ObamaCare coverage as we get the meds we take in the US and either go up there or someone comes down here and brings them to us. The meds are very expensive here and not always available. 

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If you are healthy then private insurance could work at least for now along with a private doctor and annual premiums will be in the range of $25,000 pesos ($100US per month) per person (assuming top rated company and coverage such as New York / Monterey Seguros), probably much less than in the US and you would have access to the best private hospitals.  IMSS and Seguro Popular are cheap options for those with little money or who would have no coverage due to preexisting conditions.  I have both IMSS and private, IMSS in case I get some rare random disease and insurance would only pay a small part as IMSS raises fees each year its advantage declines. 

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I know of 2 cases that went to Seguro Popular that didn't work out.  One was a child that needed a procedure done.  They took her to SP and they said they could do it but they did not have the equipment available but they could rent it for 4000 pesos, so the child did not get the procedure done.  Another case a a man took his sick wife to SP and they said they would do tests but results would take a week.  the wife was too sick to wait, so the man sought other help.  Turns out his wife had a pulmonary embolism which is very dangerous.

But another man went in for a large cut and was sutured on the spot, so it just depends on what type of medical care you need at SP.

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I realize this post is old, but I have been doing the same research and thought my findings might help someone. From the Novamar insurance link above, be aware that Pam American gets terrible reviews, while Bupa is considered to be a premier insurer. Aetna and Cigna also have global insurance plans.

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we also got Seguro Popular and still have it but a friend lost her husband.  The had IMSS and i saw all the problems, wait times and conditions so we purchased private from Andre Bellon GNP insurance came highly recommended.  Suppose to be excellent in the finest hospitals.  We are 63 and 60 with no health problems and pay $220 US a month.  There is one deductble but only per illness for life. So, if we constantly have heart issues we only pay one deductable.   Havent used it yet so hoping it is all it claims to be.  Covers emergency while in the states, any doctor, doctor home visits, medical transfer, 2nd medical opinion free. In suite rooms....so...we will see

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40 minutes ago, MrMiller said:

If we become a full-time expat in Ajijic, how does the ACA mandate that we have health insurance in the U.S. affect us?

I am 61 and my wife is 63 and our health insurance costs are exploding.  Read this article http://money.cnn.com/2017/11/09/news/economy/obamacare-early-retirees/index.html

Our plan is to become expats in 2018.

Any advice is most welcome.

Much will depend on what the government does as far as ACA coverage goes, stay tuned as things may or may not change in the coming months/years. As far as obtaining insurance for yourselves in Mexico much will depend on your own health histories. There aren't many group plans here where people who are much more likely to have claims can "hide", so to speak. Acquaint yourself with SP (Seguro Popular) and if that fits your lifestyle you should be able to get that type of coverage easily. If you want your own policy and to use your own doctors you will have to talk to different agents and actually apply for a policy to see if you are accepted. You will get many good suggestions as to which agents are good but that agent does not make any final decisions. That is up to the companies they represent. My own free advice, obviously just one man's opinion, is that anyone with serious health problems is crazy to consider moving to Mexico from either the US or Canada where they are assured of coverage, even if that coverage is expensive. I know several people who were sure that using SP or IMSS coverage would be fine with them, until they actually had to use it and then they were very bitter about the lack of advanced care facilities, procedures and especially the lack of meds they needed.

YMMV

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43 minutes ago, pappysmarket said:

Much will depend on what the government does as far as ACA coverage goes, stay tuned as things may or may not change in the coming months/years. As far as obtaining insurance for yourselves in Mexico much will depend on your own health histories. There aren't many group plans here where people who are much more likely to have claims can "hide", so to speak. Acquaint yourself with SP (Seguro Popular) and if that fits your lifestyle you should be able to get that type of coverage easily. If you want your own policy and to use your own doctors you will have to talk to different agents and actually apply for a policy to see if you are accepted. You will get many good suggestions as to which agents are good but that agent does not make any final decisions. That is up to the companies they represent. My own free advice, obviously just one man's opinion, is that anyone with serious health problems is crazy to consider moving to Mexico from either the US or Canada where they are assured of coverage, even if that coverage is expensive. I know several people who were sure that using SP or IMSS coverage would be fine with them, until they actually had to use it and then they were very bitter about the lack of advanced care facilities, procedures and especially the lack of meds they needed.

YMMV

2

I am quite healthy. My wife has a number of conditions that are very inexpensive to treat. Thanks for your advice I really do appreciate everyone who has been helping us.

One option is to self-insure for a while. We are doing that for long-term care. We are setting aside money every year in a segregated account for long-term care planning.

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  US citizens living in a foreign country are not currently required to get health insurance coverage under the Affordable Care Act. If you're uninsured and living abroad you don't have to pay the fee that other uninsured US citizens may have to pay.

You may or may not want to pay for Part B insurance when you reach Medicare age of 65. Some expats think it is a waste but others, not knowing if they may want/need to go back to the US for health reasons,  continue to pay that fee which is currently $134/mo each. If one doesn't get/drops it they can 'buy back in' later but the penalty for doing so is 10% per each year that one did not pay the premium. 

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If you live long enough, you may develop chronic conditions, yet not be terminal. Those chronic conditions can get very expensive to treat, especially if surgeries are involved. It happened to me and forced me back to the USA, where I have VA medical care, as well as Medicare for my wife and myself. She recently developed two cancers and those surgeries and oncologists would have been a financial disaster in Mexico without insurance, but Medicare has made it economical in the USA.  Yes, we would prefer to be in Mexico, but our resources would no longer support our medical needs at our advanced ages; 69 and 80.  Keep your US coverage, including Part B as soon as it is available with Medicare at age 65.  Your current ages and a few pre-existing conditions may make it difficult to find affordable insurance in Mexico, beyond the Seguro Popular public plan for residents; which is useful but may not meet your needs.

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47 minutes ago, RickS said:

  US citizens living in a foreign country are not currently required to get health insurance coverage under the Affordable Care Act. If you're uninsured and living abroad you don't have to pay the fee that other uninsured US citizens may have to pay.

You may or may not want to pay for Part B insurance when you reach Medicare age of 65. Some expats think it is a waste but others, not knowing if they may want/need to go back to the US for health reasons,  continue to pay that fee which is currently $134/mo each. If one doesn't get/drops it they can 'buy back in' later but the penalty for doing so is 10% per each year that one did not pay the premium. 

My wife is 20 months from Medicare eligibility and you are correct the penalty for not signing up for Medicare at 65 is pretty severe. I am 61 and 3.5 years from Medicare eligibility.

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Get insurance here. It's non-cancelable.  Forget Medicare, don't waste $ on it.  The idea that going back to the USA where health care costs many times what it does here is ludicrous!

 

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10 hours ago, El Saltos said:

Get insurance here. It's non-cancelable.  Forget Medicare, don't waste $ on it.  The idea that going back to the USA where health care costs many times what it does here is ludicrous!

 

Although I don't live Lakeside, I think that the decision to forget Medicare Part B should be an individual's decision. I have been on Medicare for 11 years now NOB and although I am pretty healthy my costs have been minuscule. Also suggesting that one who has Medicare NOB is in bad shape compared to being in Mexico is not accurate in my opinion. Dental I agree with wholeheartedly but not medical.

I pay for PartB @ $130/mo and my premium for Medicare Advantage is $0. Health Club costs $0. Costs me $15 to see my wonderful PCP, $0 for a thorough annual physical or $50 for a specialist. Something like a colonoscopy as an outpatient cost $250. Hospital stay is $200/day for 5 days then $0. If something big happens my maximum out of pocket is $5,000 per year. 

 

 

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32 minutes ago, RickS said:

Although I don't live Lakeside, I think that the decision to forget Medicare should be a individual decision based on individual facts. I have been on Medicare for now 11 years NOB, and although I am pretty healthy our costs have been minuscule. If something big happens my maximum out of pocket is $5,000 per year.  Also suggesting that one who has Medicare NOB is in bad shape compared to being in Mexico is not accurate in my opinion. Dental I agree with wholeheartedly but not medical.

 

What is NOB? North of the Border?

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2 hours ago, MrMiller said:

What is NOB? North of the Border?

Yes.....

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Bottom up in Mexico..Seguro Popular, then IMMS then Private insurance. 

Unless you are fluent in spanish and are okay with less than half par nursing services the Seguro Popular or IMMS may work for you.  I have had one experience with IMMS, I am an RN, they were ore than kind but..not my idea of health care.  Seguro Popular had another experience with an elderly parent...no way Jose...7 hour wait for a life or death issue...

Think over your health insurance needs and costs thoroughly.  Some of the catastrophic illnesses can bust you.  Even with insurance.  Yes I know it will not happen to you...I said the same..now with private health insurance we are still in debt thousands from a cancer diagnosis....yes I am alive but in debt , thank goodness I had private insurance, 9 years later the costs still keep coming...take heed.

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You have private insurance in Mexico and you're in debt from a cancer diagnosis?  Please explain why the insurance didn't cover it.

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9 hours ago, bezerk said:

Bottom up in Mexico..Seguro Popular, then IMMS then Private insurance. 

Unless you are fluent in spanish and are okay with less than half par nursing services the Seguro Popular or IMMS may work for you.  I have had one experience with IMMS, I am an RN, they were ore than kind but..not my idea of health care.  Seguro Popular had another experience with an elderly parent...no way Jose...7 hour wait for a life or death issue...

Think over your health insurance needs and costs thoroughly.  Some of the catastrophic illnesses can bust you.  Even with insurance.  Yes I know it will not happen to you...I said the same..now with private health insurance we are still in debt thousands from a cancer diagnosis....yes I am alive but in debt , thank goodness I had private insurance, 9 years later the costs still keep coming...take heed.

Can you give me a rough idea of how much it cost? Are we talking thousands, tens of thousands, one hundred thousand, multiple hundreds of thousands ,.... I do not mean to pry but just trying to put this into perspective.

We were looking at moving to Cuenca Ecuador and when I would read on various websites about people's experiences with insurance and healthcare, there were those who chose to move there and those that had to move there to survive. There was one couple living on $1200 a month SSI check, were on the state health insurance and had moved to Ecuador out of necessity. This couples view of the world was very different than those who chose to move there and were not so stretched financially. The Ecuadorian health system was very slow, inconsistent with the level of care and bureaucratic. This created a lot of stress for the couple that you had to put in context to the rest of their situation. Manana in Ecuador does not mean tomorrow but not today.

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