54 replies to this topic

[barbara habacht]

This circus situation with IMSS has made it necessary for us to consider starting the hunt for a Mexican based health insurance plan. We feel we only want to get coverage for the "biggies", Heart attack; Cancer, etc. We will depend on our local doctor for the basic stuff. Suggestions are appreciated.

[simpsca]

I've had Seguros Monterrey New York Life through Edgar who comes to LCS Tues. and Thurs. from 11 to 2pm. I've been with them for 11 years. They have paid for three surgeries plus one week in the hospital with pneumonia. For surgeries I had pre-approval. For the pneumonia went in right away without approval. Edgar said to go to San Javier where an agent for my company has an office - she brought the forms up and had approval and claim paid when I left the hospital. Only paid the deductible in all cases plus got reimbursed for meds, etc. Definitely recommend them.

[golden bead]

We had New York life and there were too many exclusions for us ( i.e. husband had slightly elevated blood glucose and told not covered for anything related to Diabetes. I have osteopenia ...no bone related injuries covered) Make sure Edgar explains implications of all exclusions. He is very helpful and am not saying don't contact him but maybe a second opinion would be helpful.

Across from Superlake is an agent Andre Paul Bellon Topete

He sells several insurance plans. We have Met Life Mexico for catastrophic .He speaks excellent English This will be our third year with them. Our previous agent moved to Colima

cell 044 33 3662 6915 andre@bellon.mx

[simpsca]

I should have added that I'v had Seguros Monterrey New York Life for 12 years since I was 51 - so I have no exclusions.

[Malaya]

We have Met Life Mexico for catastrophic .

Could you explain what you mean by "catastrophic". We simply want coverage if something bad happens or we are in an accident. The day to day stuff we pay for ourselves. MRI's, meds, diagnostic tests etc.

[David J.]

I can give you some info on Plan Seguro, a Mexican-based health insurance plan, and how you can get very good rates. Give me a call--766 1718

[EnglishRose]

What is the difference in actual health care between private insurance (Met Life & New York Life etc) and Seguro Popular? Forget the fluffed pillows and a private nurse, but include regular care and catostrophic care all done here in Mexico.

[tobyjug]

What is the difference in actual health care between private insurance (Met Life & New York Life etc) and Seguro Popular? Forget the fluffed pillows and a private nurse, but include regular care and catostrophic care all done here in Mexico.

Money

[cracker]

Health insurance here is a dodgy proposition. Many have discovered that the fine print excludes more than you might imagine. Example, blood pressure a little high? Almost anything can be pinned on that. Do you smoke? There's an exclusion for tabaquismo. What's that you say? That's another way of denying coverage since the medical community has decided that smoking is the cause of every disease known to man.

Rising premiums every year. Imagine a 10% increase on average every year, even if you have no claims. It's the total number of annual claims to that insurance company that count. You do the math. Yes, coverage can also be cancelled in many ways. One, the company is sold, and the new one wont pick you up as a client. Let's say you have had a lot of claims, they may try to say you had a pre existing condition. Now I don't know about you, but taking an insurance company to court would not be a solution in my book. Winning that? The chances would be slim to none.

If you are over 65, forget it. Not eligible in most cases.

[tomgates]

You might talk to the people at Parker Insurance. In general there are two main categories of plans, National or International. The National plan allows some emergency coverage if you visit the US or Canada, like $50,000. The rates are reasonable. The International coverage, however, is quite expensive as it covers someone all over the globe including the US, were medical care is very expensive and it isn't like the companies don't know that.

[Intercasa]

Anybody know what is a good deal for younger people (under 50) who want health coverage as well as temporary for trips to the US not totaling too much?

[barbara habacht]

Thanks for all the advice....Here is what we found.....plenty of great affordable coverage up to 69 years old, coverage up to 75 years old with more deductibles and much higher costs....if you delete the USA and Canada, except for two to three week trips a year and if you can pay up to $6000.00us a year.

Best plan....Barbara 68...no illness, no disease. 20,000 pesos deductible. Includes nearly all hospitals in Mexico and even dental coverage. About 150.00 us a month. 3 large companies with international reputations. Some waiting time for some coverage. All have been in business for over 20 years. The one we chose has great english speaking agents who will be with you throughout any claims.

Available plan.............Fred 72....no illness, no disease....plenty of turn downs....but five companies willing to play. Most bring the prices down to about 200.00 us a month, BUT with large deductibles, 5000 to 10,000 us dollars. and a two year wait for full coverage and greatly reduced benefits. Most require a physical...some will pay for that but some won't. Most companies out of the 5 will guarantee your annual cost for between 2-5 years before the next increase. Many others will not offer more than one year rate guarantees and several want you to pay out of pocket then wait for reimbursement. The important fact...is you can get coverage up to 75 years old...at this time.

All seemed aware of the IMSS financial collapse that is spreading. Some knew that the state of Jalisco IMSS has to pay for the upcoming retirement costs for 200 doctors....all suggested that costs to enroll in most health plans will go up in January 2012.

Best places to get info....I hit up friends for who they were using and whether they liked or disliked their coverage, the company and the agents. Had good luck at LCS as many agents visit on different days and occupy tables and at Tio Corp. Some agents knew far less than I did and some were very, very knowledgeable about this area and our needs. Some agents went out their way to explain the possible problems and were willing to compare their companies to the competition. I also went on line and read consumer comments about the companies that I was most interested in.

Now as to who I picked and who I didn't pick and as to which agents were most knowledgeable...I will share with most anyone by e-mail. I will not tell you which agents were not chosen nor why.....mostly since it is only my opinion. Barbara and I have spent numerous hours on this and realized that waiting to do this can only cost more in the long run. Once you hit above 70 years old....you are in a very small market for decent affordable coverage.

I also have more info on which IMSS offices will be most affected by the up coming service cutbacks.

Fred

[barbara habacht]

Because of numerous e mails...there may be a delay in responses but we will get back to everyone as the system allows or you can reach us at habachtf@prodigy.net.mx as we can reply to anyone without limit.

This is bigger than we could have imagined. Many international companies are offering coverage but if price matters...shop and then shop some more. Thanks.
Fred

Edited by barbara habacht, 05 November 2011 - 07:53 AM.

[cracker]

One other way of looking at this is self insurance, plus either IMSS or Seguro Popular as a back up.
Let's say you were considering paying 400 a month for insurance. If you were to put that in a separate account, and receive interest, chances are pretty good that lets say in 10 years you would have $48.000, plus interest, maybe 5% on average, you would have your very own insurance fund of roughly $55,000. You can not be cancelled, or turned down for any reason and there's no massive deductible or co-pay.
I can assure you that medical treatment here, if done sensibly, is way way less than in the U.S. or Canada. Don't go to the high priced hospitals which cater to insurance patients, make a deal with the Doctors, and relax. Medication, use generics which are readily available here. There's absolutely no reason to pay for brand name off patent medication.

[Trailrunner]

Totally agree, Cracker! The only thing I would add to that is to use CR for ambulance transport and clinic care as well.

Excellent hospitals in Guad other than the big bux ones and your doctor can negotiate and help you with those decisions. IF you have a good doc. . .

[barbara habacht]

As to self insurance....at 68 years old Barbara would be 78 before she had 48,000...a typical....cancer surgery and follow up care would cost in excess of 400,000 pesos...she would be okay if she schedules her cancer for 10 years out and also lays down for several years while waiting for the ten year period if she has a heart attack or organ failure...
Insurance is for major needs. We put away pesos, even with the IMSS plan we have BUT what about a transplant....my adding machine shows that Barbara will have to save through her nineties for that one.
An example of why a medical savings account should only be considered in the following situations.
You are young enough to build the fund. You have the $800 (suggested $400.00 per person) a month money to cover a couple....like us and or IMSS suddenly recovers future funding....and best of all....nothing unexpected happens for up to ten years.

We are no fans of insurance...we don't want everyday things covered...we need insurance for Heart, Cancer, organ failure, serious burns etc.
Fred

[barbara habacht]

Quotes for a 72 year old male, me.
One year with annual 5-7% increases. Serious medical needs only. In USA dollars. Most hospitals, most doctors. Drugs only as part of the illness and recovery. Up to one million us dollars a year, per patient.
2000us deductible $1326.00
3500us deductible $1080.00
5000us deductible $1021.00
10000us deductible $ 800.00
Subject to being accepted.
These were the best numbers I found. This company is one of the few that will insure up to a 74 year old. More details if you need them at our e mail address.

[gringal]

My spouse and I use Cracker's system. So far, we're way ahead of the game. Dropping Medicare Part B happened shortly after we decided Mexico is our permanent home, and that was a substantial chunk right there. With a little bit of luck, medical insurance won't be the biggest thing we need to worry about in the future.

Thanks for all the research you've done, Barbara and Fred. A real public service for so many.

[tobyjug]

What ,if any insurance to you(or any other poster) take if you travel toor through the US?

[lakeside101]

i use a short term policy when i go back to the states. http://www.worldnoma...et-a-quote.aspx