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How much do you need to be self Insured for Health problems?


valbogyo

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We know of a local family who's 9 year old son had acute appendicitis. The doctor here at lakeside sent them to a private hospital in Guadalajara - after misdiagnosing it for more than 24 hours. Not sure why the doctor chose that hospital but that is where they were told to go - at three in the morning. The hospital admitted the young man but would not do the surgery until the family put 20,000 pesos in cash in the hospital's hand. I guess they would have taken a credit card but of course the local family didn't have that option. His fever had spiked and he was pretty unresponsive.

The young man did get the surgery but went through a lot more than he should have - and his poor mother almost needed to be hospitalized from the fear and stress. (That last part is an exaggeration but she was understandably terrified.)

Don't mess around with this - here are anywhere else. We could be talking about life and death! Not a place it makes sense to cut corners to save a few bucks. At least that is what makes sense to me. YMMV.

You do not need to be a member of SP to receive treatment for a life threatening problem. If they didn't have the money, why didn't they go to the SP Civil Hospital? I do realize that during a stressful event like this people cannot think of all the alternatives.

If a medical issue is not life threatening then the person needs to join SP. Anyone here who doesn't have insurance should sign up for SP in case of an emergency.

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Regarding Canadian Hospitals and UnInsured. There is a different price for Canadian Citizens who are uninsured and Non Citizens who are uninsured. It is almost half for UnInsured Canadians. At least in BC. Also, the finance departments will work with you on a payment plan *for citizens who return to Canada but are temporarily uninsured. I write this because it is important for Canadians to realize that, should they become ill with a chronic expensive illness, they can return to Canada and pay cash for three months. Example: Dyalysis. That would be a better choice for the uninsured, than staying in Mexico. There would be an end to your payments.

That said, you really have to look at the Insurance plans you have and make sure that they cover Cancer beyond stage 1, Dialysis, transplants etc. The really expensive stuff, over time. You would get Dialysis via IMSS or SP, but you will have to wait for a while to get on a regular schedule and you would have to travel to Guadalajara. Stuff to think about.

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Not being able to find a Doctor if you are on Medi-care ..is a myth. There are thousands of Doctors in the US that still accept Medi-care. If you live is a small town in Montana with a population of 13 maybe not

You are correct. There was some truth to this many years ago, but it is not true now. Doctors had been underpaid by Medicare back in the 70s, payments were slow, tedious and often unknown at the time of treatment, too much bureaucracy to deal with. But that changed quite awhile ago. Currently, US doctors like Medicare patients as the reimbursements are known, fair and quick. I speak as someone with practicing doctors in my family in the US in various size communities.

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This information is not from personal expereince - but might be useful for those paying out of pocket for medical emergencies. Apparently the Mexican military hospitals have very good doctors, and their prices are much lower than most private hospitals. Also Seguor Populares has a menu of paid procedures, much less than the private hospitals.

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You are correct. There was some truth to this many years ago, but it is not true now. Doctors had been underpaid by Medicare back in the 70s, payments were slow, tedious and often unknown at the time of treatment, too much bureaucracy to deal with. But that changed quite awhile ago. Currently, US doctors like Medicare patients as the reimbursements are known, fair and quick. I speak as someone with practicing doctors in my family in the US in various size communities.

I am not talking about forty years ago in the 70's, when that may have been true. My reference is to the Silicon Valley area in CA, in the 2000's. There was still a short list to choose from, especially for those using HMO's. I know this from experience.

Picture going to the U.S. if you have no relatives to take you in, being sick enough to not really being up to travel from your Mexican home and trying to find a doctor who will treat your condition when he's never seen you before, finding lodging and so on......and remember, you're already sick while all this is going on. If you happen to have a support system (like a spouse) or a relative to take you in during your treatment and recovery, then this could work.

Otherwise, it sounds like a nightmare that would probably make you sicker. Try to figure out what this would cost in $$$, in the case of the single, no support system person. No gracias.

Don't ask me what I think of the HMO's, in general. :angry:

'

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This information is not from personal expereince - but might be useful for those paying out of pocket for medical emergencies. Apparently the Mexican military hospitals have very good doctors, and their prices are much lower than most private hospitals.

I've heard that as well,from Mexican friends in Guadalajara,they didn't mention the prices but said the doctors were very good.

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I think a lot of good points are coming up here. The return to the homeland works if you keep up a relationship with a Dr. back in your home Country. It won't work for everyone.

A good friend has lived here for 10 years, but she expects to move back to the States, near her kids when she can no longer take care of herself. She has IMSS and she lives on her Social Security. She saves enough to return to the US, every year, and goes in for an annual check up with her Dr. She also renews registration of her US car. I think that there are many Americans and Canadians here who do have a similar plan in the back of their minds.

I think I will sign up for SP while I can, just in case. It is not a Charity hospital, by the way. We have been over that here, on this board, many times.

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I ran into a health issue exactly 2 years ago. I emailed a pulmonologist in the Bay Area (Silcon Valley/high rent district) and set up an Appt. No Problem with having Medicare. Unfortunately, he sent me for a outpatient biopsy which didn't go well and, I ended up with a collapsed lung and 6 days in El Camino Hopital. I was seen by a top-notch Cardiologist during and after the fiasco with Medicare being no problem. Hospital, Medicare, no problem. All the pre-biopsy Xray, tests @ labs, Medicare, no problem.

Last year about this time, on a visit, I contacted another top rated Dr. in the same locale, an internist - Medicare, no problem.

All these doctors (et al) saw me promptly on contacting them and treated me with the utmost respect & caring. The total for the Dr's & hospital in March 2012 was about $110,000. I paid a pittance of that ($2000 or less, if I remember correctly). I even received a check for a $77. overpayment last month - who knew?).

Anyway, I just wanted to let everyone know that my experience with Medicare has been fabulous. I have no Supplement or Advantage Plan, this was stright up Medicare Part A&B.

This one unfortunate experience has more than repaid the ~$209/mo I had paid for Part B up to that date. ($209X31/mo=$6,479+$2000/copay=$8,479). I will gladly pay a Part B premium and co-pay with no complaint going forward.

So, in summation, I'm not sure why Gringal has this negative feeling about Medicare accessability. I have not found that to be the case.

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I think I will sign up for SP while I can, just in case. It is not a Charity hospital, by the way. We have been over that here, on this board, many times.

No, it is not a charity hospital because many people pay for SP but the hospital is not going to be like a private hospital, at least in Guadalajara. The patient is in a ward with many other patients and he must have someone with him at all times to take care of him. He must bring his own toiletries including towels. The person staying with the patient needs to speak Spanish and he cannot bring a blanket or pillow into the hospital. It is not a comfortable stay but it is better than nothing.

In SMA the SP hospital is new and state of the art according to those who have seen it. It is not like the Civil hospital in Guadalajara.

The best option is to pay for discounted care that can be provided through SP.

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It is a good backup plan,SP. It would not be to expensive to hire a Mexican care giver to accompany you and translate. Certainly better than paying tens of thousands of dollars. Guess I will keep my private and register for SP as a backup, should I not be able to afford private some day. Thanks for everyone input.

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It is a good backup plan,SP. It would not be to expensive to hire a Mexican care giver to accompany you and translate. Certainly better than paying tens of thousands of dollars. Guess I will keep my private and register for SP as a backup, should I not be able to afford private some day. Thanks for everyone input.

Every private hospital I have visited has a sign on the wall saying that a patient has to have each day for 24 hours a family member or friend there to monitor patients after surgery as the hospital is not responsible if something happens. This is a limited liability thing in Mexico and is the policy that you are there all the time, not to help attendants or nurses, but watch and report.

Where and in what hospitals is this not required in Mexico? Or do they let it slide when the patients have not had surgery?

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No, it is not a charity hospital because many people pay for SP but the hospital is not going to be like a private hospital, at least in Guadalajara. The patient is in a ward with many other patients and he must have someone with him at all times to take care of him. He must bring his own toiletries including towels. The person staying with the patient needs to speak Spanish and he cannot bring a blanket or pillow into the hospital. It is not a comfortable stay but it is better than nothing.

In SMA the SP hospital is new and state of the art according to those who have seen it. It is not like the Civil hospital in Guadalajara.

The best option is to pay for discounted care that can be provided through SP.

I have been in a Seguro Popular hospital for 4 days after surgery. Yes you need someone there 24 hours a day after surgery. Yes you need to bring toilet paper and hand soap. No you cannot bring blankets or pillows in for saftey reasons of possible contamination. They will give the person monitoring a surgery patient blankets and pillows. They have chairs you can sleep on. What you call wards is 4 beds per room. It is not that much to ask. IMO The old Seguro Popular hospitals do need remodeling and they seem to only patch them up but the new ones are very nice and a few have 3 beds per room now.

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Seguro Popular went from about 5 million 'clients' to 52 million clients in less than 10 years. I am sure the Doctors are compensated the same way as I.M.S.S. The wages paid are lower than private practise, but carrot on the stick is that you put in so many days/hours and then at the ripe old age of 53, you are eligible for a pension of about $1,500 (U.S.) per month and you can collect that pension while still working (double dipping). Other Mexicans, if they were lucky enough to have had a contributing employer, must wait until 65 years, and the pension is about $225 (U.S).

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Seguro Popular went from about 5 million 'clients' to 52 million clients in less than 10 years. I am sure the Doctors are compensated the same way as I.M.S.S. The wages paid are lower than private practise, but carrot on the stick is that you put in so many days/hours and then at the ripe old age of 53, you are eligible for a pension of about $1,500 (U.S.) per month and you can collect that pension while still working (double dipping). Other Mexicans, if they were lucky enough to have had a contributing employer, must wait until 65 years, and the pension is about $225 (U.S).

Isn't the pension what caused IMSS so many financial problems? I hope they are monitoring the SP doctors' hours better than they did with IMSS.

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I have been in a Seguro Popular hospital for 4 days after surgery. Yes you need someone there 24 hours a day after surgery. Yes you need to bring toilet paper and hand soap. No you cannot bring blankets or pillows in for saftey reasons of possible contamination. They will give the person monitoring a surgery patient blankets and pillows. They have chairs you can sleep on. What you call wards is 4 beds per room. It is not that much to ask. IMO The old Seguro Popular hospital do need remodeling and they seem to only patch them up but the new ones are very nice and a few have 3 beds per room now.

I joined SP but I have never used its services. The information I have about the hospital is from the experiences of others. I don't have a problem with SP not providing as much comfort as an expensive private hospital because I want to get out of any hospital as quickly as possible.

If I have a choice of being evacuated to the U.S., or paying $10,000 plus for a local private hospital or almost free for SP, I'll take SP. There is always the discounted private care one can pay for through SP.

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Seguro Popular went from about 5 million 'clients' to 52 million clients in less than 10 years. I am sure the Doctors are compensated the same way as I.M.S.S. The wages paid are lower than private practise, but carrot on the stick is that you put in so many days/hours and then at the ripe old age of 53, you are eligible for a pension of about $1,500 (U.S.) per month and you can collect that pension while still working (double dipping). Other Mexicans, if they were lucky enough to have had a contributing employer, must wait until 65 years, and the pension is about $225 (U.S).

That is not the way it works in the IMSS, Seguro Popular, ISSSTE etc. The Drs. are there for 4 to 5 hours a day and at their private practice for another 4 to 5 hours a day or possibly at the Red Cross etc.. All the socailized medicine systems here take on/mandatory service to be licensed, interns that work for peanuts for 4 years or if specialized 5 years. They are there for 8 hours. The private practices the Dr.s have, supplement their income and many are top specailists who still prefer to stay in the socialized medicine for various reasons and as you mentioned a pension after so many years served, but also can reserve private hospitals for paying patients. The limited liability the socialized medicine system has keeps them trained and out of any potential lawsuit and connected to other specialists and technology for free.

Most large Seguro Popular hospitals are connected to the medical schools [example: Hospital Civil in Guadalajara] and have training from 2nd year inside the hospital and many interns observe procedures that at a private hospital they would not be able to do. The Secretaria de Salud [incorporated in 1954] introduced the Seguro Popular and Centro de Sauld system which is very complex and growing at a rate most do not know about. It was introduced and implemented in 1999. Pensioners cannot collect a pension and still work for the gov´t. They have to retire from their job to collect a pension here. No "double dipping". The Seguro Popular, IMSS and ISSSTE do have contracts with specialists and I presume you were refering to Dr.s under contract with a private practice "working" when retired from the Seguro Popular or IMSS and called in to do a procedure at times and getting a fee.

Some state and private company employees collecting an IMSS pension get a much larger pension that about $255.00 US per month. The employer puts in a percentage of their wage per month in the pension fund and pays the medical fees for them and their family who are dependants and they get back a pension amount calculated in a complex equation. It is not similar to the US or Canada. The employer does not have to pay the medical fees if the employee is covered in another socialized medical plan. You can only belong to 1 socialized medical insurance plan at a time here. You can have private medical and socialized medical at the same time.

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Isn't the pension what caused IMSS so many financial problems? I hope they are monitoring the SP doctors' hours better than they did with IMSS.

IMSS pensions are national and given to anyone working and their employer paying into it until age 65 or less, depends. It can be for all workers who are working {some others have pension plans like teacher´s unions etc.} but not in federal jobs, they have their own pension plan called ISSSTE and state gov´t. employees still have IMSS, depends, not under the table, so to speak. Similar to US social security pension. It would be hard to not pay these days with all the computerized gov´t. systems checking each other. The cash society can get away with it if they want, but for example, a construction worker injured on the job can go to SP but will be questioned by social workers where he works and for whom and this could lead to an investigation and the contractor being fined for not supplying workers with IMSS.

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  • 2 weeks later...

I think calling IMSS and SP "socialized medicine systems" is a complete misnomer.

Isn't it socialized medicine if it is run by the government, tax dollars help to fund it and all the employees-doctors-nurses-technicians all work for the government?

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I have a question that's a bit different than the focus of this thread...but still pertains to medical care. What happens if you end up in the hospital because a driver runs into you, as a pedestrian or in your own car, and it's the other driver's fault, and now you need some medical procedure...but.....this person does not have auto insurance. (or perhaps even a driver's license) and let's say you need to be in the hospital for 3 days and maybe, you have a broken arm or leg. What then? Do I have to pay the hospital bill? how does that work? This scenario gives me nightmares. It's the main reason I hate driving in Mexico. And yes, I have good auto insurance, and also have SP. Thanks for any input.

Wouldn't your "uninsured driver" coverage in your insurance plan cover an accident caused by an uninsured driver? I don't know about your own auto insurance covering you if you are a pedestrian and hit but that is a frightening thought. Uninsured drivers are going to flee the accident anyway and never be caught.

Join SP as a back up and of any expensive incident occurs you will be taken to SP or Cruz Verde.

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