Starlady Posted July 24, 2013 Report Posted July 24, 2013 Has anyone (gringos) who have paid into IMSS, had treatments and then been denied at their renewal time? I have very expensive NOB insurance that i would like to drop (i have had claims this year). Is this a wise move?
camillenparadise Posted July 24, 2013 Report Posted July 24, 2013 IMSS dropped a bunch of long-time clients this last spring at the beach in Nayarit. I'd had mine for years but never used it, considering it was emergency back-up, So now I will be looking into Seguro Popular.....
Carolina Posted July 24, 2013 Report Posted July 24, 2013 About a year and a half ago, when I was ready to gather info and look into getting health insurance of some kind in Mexico, one of my sources of information was this web board. I discovered many posts on here from people who had been suddenly dropped from IMSS, many after having paid into it for quite a number of years. To me, this was a Big No Brainer. I wasn't going to take any chances with IMSS. I went with Seguro Popular and have not regretted it.
sm1mex Posted July 24, 2013 Report Posted July 24, 2013 I had IMSS but they quite giving gringos medication for chronic conditions so I got private insurance and have not regretted it either.
HarryB Posted July 24, 2013 Report Posted July 24, 2013 Aren't these programs for POOR MEXICANS? Yes you can get in but what is the intent of the programs.
mod-3 Posted July 24, 2013 Report Posted July 24, 2013 This is going off topic and if this turns into another debate about the morality of ex pats participating in Mexican social programs I am going to lock this thread.
El Saltos Posted July 24, 2013 Report Posted July 24, 2013 IMSS is THE national Health Care and Retirement system, sort of like Social Security and Medicare/Medicaid in the US. This is the system that employers such as Walmart pay into for their employess.
twelveoaks Posted July 24, 2013 Report Posted July 24, 2013 I cannot speak personally on this. However, about a year and a half ago there were many stories about people being dropped after many years paying into the program This was suppossedly caused by a new director taking over who has since departed.
lcscats Posted July 24, 2013 Report Posted July 24, 2013 If you have FM2/3 or Permanent/Temporary visa you are a legal resident and can apply to the appropriate programs. If you are on a FMM/FMT tourist visa you are not a resident and cannot apply. IMSS has two programs one for employees and one voluntary program. We gringoes were on the voluntary program for the most part. This means we were not to suppose to get drugs. It was a mistake that the gringoes on the voluntary IMSS ever got drugs. Hope this helps understand the bad communications over the volunteer IMSS program.
lcscats Posted July 24, 2013 Report Posted July 24, 2013 IMSS is THE national Health Care and Retirement system, sort of like Social Security and Medicare/Medicaid in the US. This is the system that employers such as Walmart pay into for their employess. Two programs one for employees and one for voluntary enrollment. The two programs have different benefits which is where the confusion over getting drugs came from.
RVGRINGO Posted July 24, 2013 Report Posted July 24, 2013 What is this discussion doing on the Immigration and Customs thread?
FHBOY Posted July 24, 2013 Report Posted July 24, 2013 The website must be informative in Spanish, but I can't read Spanish that well, and the English version is a summary. So I have questions for someone who knows the Seguro Popular system: How does one qualify? What are the benefits? Where does one go for care? What is the cost? Are the care centers in or near Lakeside? Now an opinion question: What is your (or your friends) opinion of the Seguros Popular program? Thank You
FHBOY Posted July 24, 2013 Report Posted July 24, 2013 Seguro Popular is free or almost free to all residents of Mexico. Retirees are not charged. You cannot have other coverageand join SP. The hospital is in Guadalajara and from what I've heard not what we would like. You have to have someone stay with you 24/7, bring your own towels, soap, and you are in a ward with maybe 10 other people. If you have some money you can pay a discounted price to stay at San Javier and other private hospitals and private clinics that have an agreement with SP. Medical care at the local clinics is free. SP does not have all medications and does not treat all conditions but you will not be cancelled and it accepts preexisting conditions. The gossip is that IMSS will be rolled into SP in the near future. Since moving here (January) I have heard about SP. I heard about the DIY hospital visits, that sounds awful. As the medical visits to doctors here are so relatively inexpensive it doesn't sound like a clinic I'd go to for routine stuff and just pay cash as I go. I am carrying group catastrophic world wide coverage only, so I am not too worried about longer term hospital stays here or abroad. As to IMSS - again, I've read a lot and like all Residente Permanente Anglos will make the attempt to join and not be too disappointed if I am turned down - which living here at Lakeside, I expect to happen. Over all, being relatively healthy (Thank God) the issue of medical care is not high (yet) on the "Worry List". I still wish to hear from more people about SP - and thank y'all
lakeside7 Posted July 24, 2013 Report Posted July 24, 2013 Since moving here (January) I have heard about SP. I heard about the DIY hospital visits, that sounds awful. As the medical visits to doctors here are so relatively inexpensive it doesn't sound like a clinic I'd go to for routine stuff and just pay cash as I go. I am carrying group catastrophic world wide coverage only, so I am not too worried about longer term hospital stays here or abroad. As to IMSS - again, I've read a lot and like all Residente Permanente Anglos will make the attempt to join and not be too disappointed if I am turned down - which living here at Lakeside, I expect to happen. Over all, being relatively healthy (Thank God) the issue of medical care is not high (yet) on the "Worry List". I still wish to hear from more people about SP - and thank y'all Would you like to share your age group and premuims for you insurance.....age can prove to be a significant point for obtaining any private insurance...there are many of "us" at Lakeside who are uninsurable because of age and pre exiciting conditions...so one statement does not fit all situtions
FHBOY Posted July 25, 2013 Report Posted July 25, 2013 Would you like to share your age group and premuims for you insurance.....age can prove to be a significant point for obtaining any private insurance...there are many of "us" at Lakeside who are uninsurable because of age and pre exiciting conditions...so one statement does not fit all situtions 63 - Best Doctors Group Catastrophic Insurance - through Focus on Mexico or Booomers-in-Paradise members (both under $1,000 USD/year) and sold/serviced by Blue Angel Insurance (Valerie Freisen).
AlanMexicali Posted July 25, 2013 Report Posted July 25, 2013 Seguro Popular is free or almost free to all residents of Mexico. Retirees are not charged. You cannot have other coverageand join SP. The gossip is that IMSS will be rolled into SP in the near future. I asked my wife who is a Licenciada and an administrator bureaucrat here for the Federal Government Secretaria de Salud and in the Seguro Popular administration and she say they will not be merging SP and IMSS. They "might" be allowing IMSS patients to use Seguro Popular facilities for medical care and services in zones where IMSS concentration is limited to help people on the IMSS medical plan have closer medical care and then will be billing the IMSS if all parties agree in the future. Secretaria de Salud clinics are in all small towns in most rural areas and the IMSS is not.
lcscats Posted July 25, 2013 Report Posted July 25, 2013 63 - Best Doctors Group Catastrophic Insurance - through Focus on Mexico or Booomers-in-Paradise members (both under $1,000 USD/year) and sold/serviced by Blue Angel Insurance (Valerie Freisen). This is what my wife has. No exam if under 64. Remember this is Catastrophic insurance. They are not going to rebuild your bad worn out tennis knee but they will fix your broken leg. You need to have a small pile of cash to augment this insurance which is understandable when you look at the cost.
luisa Posted July 25, 2013 Report Posted July 25, 2013 This is what my wife has. No exam if under 64. Remember this is Catastrophic insurance. They are not going to rebuild your bad worn out tennis knee but they will fix your broken leg. You need to have a small pile of cash to augment this insurance which is understandable when you look at the cost. How about treatment for cancer?
AlanMexicali Posted July 25, 2013 Report Posted July 25, 2013 If you have FM2/3 or Permanent/Temporary visa you are a legal resident and can apply to the appropriate programs. If you are on a FMM/FMT tourist visa you are not a resident and cannot apply. Actually the Seguro Popular has a policy of non discrimination and turning no one away who needs emergency medical care. The only prerequisite is you do not belong to any other Mexican Medical Insurance Plan. If you belong to another Mexican Medical Plan but that plan´s facility is not in the region close by they will treat you also for the same fee as they will treat a tourist. They accept tourists on FMM tourist cards and even though they cannot enroll they will treat them. The fee is $65.00 peso for diagnosis and prescriptions are filled outside the clinic. They will give you a medicine but only what you need before a prescription can be filled and charge you a reasonable price for it. They will put on a cast, for example, for a reasonable fee and follow up visits are still $65.00 pesos.
FHBOY Posted July 25, 2013 Report Posted July 25, 2013 Actually the Seguro Popular has a policy of non discrimination and turning no one away who needs emergency medical care. The only prerequisite is you do not belong to any other Mexican Medical Insurance Plan. If you belong to another Mexican Medical Plan but that plan´s facility is not in the region close by they will treat you also for the same fee as they will treat a tourist. They accept tourists on FMM tourist cards and even though they cannot enroll they will treat them. The fee is $65.00 peso for diagnosis and prescriptions are filled outside the clinic. They will give you a medicine but only what you need before a prescription can be filled and charge you a reasonable price for it. They will put on a cast, for example, for a reasonable fee and follow up visits are still $65.00 pesos. Alan - is it really that simple? I still need someone from here to tell me where to got o sign up. I am waiting for my CURP, which I assume I will need. I think I only have two more "official" buracracies to go through: INAPAM, IMSS (to get rejected) and then SP. Help needed...thanks
FHBOY Posted July 25, 2013 Report Posted July 25, 2013 How about treatment for cancer? There are pre-existing exclusions, you need to check with Blue Angel insurance. BUt once you are accepted, under the FOM group policy, cancer care is included (up to policy limits). BTW, the overall policy limit, for all the parts, is $500K USD yearly, each and every year. Yes, you need to keep private funds to cover the first $5K USD, but other than that...my kids are now very happy we have some kind of medical coverage.
AlanMexicali Posted July 25, 2013 Report Posted July 25, 2013 Alan - is it really that simple? I still need someone from here to tell me where to got o sign up. I am waiting for my CURP, which I assume I will need. I think I only have two more "official" buracracies to go through: INAPAM, IMSS (to get rejected) and then SP. Help needed...thanks But, the coverage from FOM does include cancer care. God forbid, we develop cancer now that we have the policy, after the $5,000 USD deductible, we will be covered up to the policy limits for the cancer care. BTW, the overall yearly coverage limit is $500,000 USD - that's each and every year. You need an INM visa card, a CURP, a CFE bill for a few months or more, maybe 6 in your name. plus: "What do I need to join? 1. A resident of the country. 2. Not be entitled to Social Security (IMSS, ISSSTE, Pemex, military's, Semar etc.). 3. Enlist the Unique Key Population Register (CURP) or birth certificate. Get your CURP here.http://consultas.curp.gob.mx/CurpSP/ 4. If so, meet the family fee accordingly. See quotas. 5. Locate the Membership and Orientation Module (MAO) closest to your address, toll-free at 7172 583 01800 or here.http://www.seguro-popular.salud.gob.mx/www/index.php What documents should I bring? Original and certified copy of the following documents: a. - recent Proof of address. b. - CURP or birth certificate of all family members. Get your CURP here.http://consultas.curp.gob.mx/CurpSP/ c. - In the case of infants, birth certificate. d. - Official photo ID. e. - If applicable, proof that you are the beneficiary of a support program or Federal Government subsidy or voucher certifying you as part of any collective [Workers Collective, I assume]. f. - Proof of studies of children or dependents of the holder represented up to 25 years of age, if applicable g. - Diagnosis of pregnancy, in case any family member is in that state. NOTE: Failure to have any of the above documents, MAY BE enroll temporarily for a period of up to 90 days, which shall submit such documents. If not delivered the missing documents will be deemed not filed the application for incorporation.¨" http://www.seguro-popular.salud.gob.mx/index.php?option=com_content&view=article&id=269&Itemid=288 "Qué necesito para afiliarme? 1. Ser residente del territorio nacional. 2. No ser derechohabiente de la seguridad social (IMSS, ISSSTE, Pemex, Sedena,Semar etc.). 3. Contar con la Clave Única de Registro de Población (CURP) o acta de nacimiento. Obtén tu CURP aquí. 4. De ser el caso, cubrir la cuota familiar que corresponda. Ver las cuotas. 5. Localizar el Módulo de Afiliación y Orientación (MAO) más cercano a tu domicilio, llamando sin costo al 01800 7172 583 ó aquí. ¿Qué documentos debo llevar? Presentar original y copia simple de los siguientes documentos: a.- Comprobante reciente de domicilio. b.- CURP o acta de nacimiento de todos los integrantes de la familia. Obtén tu CURP aquí. c.- En el caso de recién nacidos, certificado de nacimiento. d.- Identificación oficial con fotografía del titular. e.- De ser el caso, comprobante de que eres beneficiario de algún programa de apoyo o subsidio del Gobierno Federal o comprobante que te acredite como parte de alguna colectividad. f.- Comprobante de estudios de los hijos o representados dependientes del titular de hasta 25 años de edad, de ser el caso g.- Diagnóstico de embarazo, en caso de que alguna integrante de la familia se encuentre en dicho estado. NOTA: De no contar con alguno de los documentos antes mencionados, SE PODRÁ afiliar temporalmente por un periodo de hasta 90 días, en el cual deberá presentar dichos documentos. De no ser entregado la documentación faltante se tendrá por no presentada la solicitud de incorporación."
AlanMexicali Posted July 25, 2013 Report Posted July 25, 2013 I am waiting for my CURP, which I assume I will need On the front of your Residente Permanente or Residente Temporal card should be printed your CURP and go to this website , fill in the Info. and print out a color copy of it, cut along the dotted line, fold it in 1/2 and go to a papelaria and have it laminated. http://consultas.curp.gob.mx/CurpSP/
AlanMexicali Posted July 25, 2013 Report Posted July 25, 2013 Centro de Salud Chapala "F. Romero De Velasco # 406, Col. Centro, Jal." 45900 Jalisco Teléfono: (376) 7656306 crissnett28@hotmail.com Lunes a Viernes de 8:00 a 16:00 hrs. VER MAPA APROXIMADO Centro de Salud Tapalpa "Juan Gil Preciado # 15, Col. Centro, Jal." 49340 Jalisco Teléfono: (343) 432-15-71 angelicaspj_@hotmail.com Lunes a Viernes de 8:00 a 16:00 hrs.
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