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Insurance- What to get????


Denise
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I have had two very recent experiences with Segoro Popular. Both of them very good. The first thing to realiize that SP is now officially Mexico's universal healthcare, by international standards. the y have over 50, milion registrants/customers. My first experience was to be a hernia operation at Jocotepec. But that had to cancel half way through because the aneasthotologist felt a spinal was not safe with low blood platelets. The surgeon was 100% confident it would be O.K. The total cost would have been appr $200US, for the mesh, which I had prepurchased.Second opinion time.

I had heard good things about Occidental Hospital, in Guadalajara, and have a friend who works there. This a tier 2 hospital, meaning they have a full gas operating theatre. This is a pubic hospital, which accepts Seguro Popular insurance. In the meantime, I had a heart problem which caused 25-30 kilos of fluid retetention.They want it gone - quickly. First two weeks at home, lost 15 kilos.Last 8 days in hospital (released last night). lost another 10 kilos. This is very different experience from what we are used to in the North. First of all, you have to deal with a social worker who will insist you bring family members to help and support you. That might be a deal breaker right there, but there are people you can hire to help. This should be considered inexpensive when I mention that I stayed there 8 days and and 0 pesos, for drugs, numerous tests, prescriptions, food and all round excellent care. lots of staff there - i think it is a teaching hospital.

Now-we have never been asked if we own an auto or a house. EPN has announced for the next three years,anyone over 60 in Jalisco will get free enrollment in SP, even foreign nationals who are in the country legally. If the full blown scheme, comes into effect might require an annual fee but even if you are considered very wealthy, these fees are very low. I believe they are trying  to keep the enrollment rates low, so when the time comes they can easily switch employers from IMMS to SP.

For those expecting a Marcus Welby/General Hospital experience will be in for a surprise. No one would ever say they 'enjoyed' being in hospital`, but i did learn a lot of Spanish, saw some sights of misery,also great beauty and true compassion (haven't seen a tiny new born baby for years, perhaps never!)

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Oh yes, Barcelonaman. There are levels of constant paperwork i have never seen before. Once a hospital unit clerk woke me up at 11pm to ask my birthdate! Very few computers, lots of clackety clacks. A bit like that Michael Palin film Brazil.

Once you are signed up and registered, go to the Chapala Seguros Popular clinic by 7:30 am.everyone will enter just before 8 - don't worry about the volume, many already have appointments and/or or travelllng as a family 'pack'. At about 8 pm a door, and small lineup will start in the far upper left of the waiting room. The are waiting the see Dra Anna -she is a very good doctor, who also speaks good Engish. The lineup will move quickly, she is giving out appointments for later. I think she is there everyday, but definitely Tuesdays. Mondays are always the worst days for public health facilities.

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12 minutes ago, HoneyBee said:

Thanks for the detailed reply Chillin. 

Would Spencer be the right contact to walk me thru the enrollment process. I just turned 60 a couple of weeks ago and have permanent resident status.

 

 

I have to be honest with you and say even the signups have quirks and twists that even Spencer's crew cannot keep up with.Ms Chillin has had good success in signing up some elderly neighbors, but she has been in health administration 45 plus years, the last 5 pretty senior. She does not speak Spanish, but she has an Alpha Dog way about here, knows what papers are needed, and everybody ends up smiling. does she offer this as a service -abosolutely not.

There needs to be a real world group to discuss signup and actual using Seguro Popular services.Perhaps including the"medical' Spanish which is not only useful, but may save your life. This group could also recommend - or not recommend helpers, drivers, doctors.

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5 hours ago, HoneyBee said:

I was told that if you own your home and your car you are not eligible for SP. Is this a new rule (currently I have private coverage with GNP thru Bellon but am just curious to know about this possible new rule).

No.

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2 hours ago, barcelonaman said:

Good news all round chillin.

I presume you had to go to see sp doctor at your local so centre first?

I did not when I enrolled last month.

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My insurance costs me roughly $4000-4500 USD per year, a bit more each year. This is for myself and my 27 year old son.  It is private insurance with top hospitals, private room.  Can never be drooped against the law in Mexico unless you do not pay of course. 

I have gotten well over my costs of insurance as I had cancer and follow up for 8 years.  My son also had a major accident requiring surgery and follow up.

I get a bone injection 2 times a year it costs over $500. an injection..  just as an example. 

Manana here also means anytime after today! 

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By all means if you move here and think you might return to the USA then you should pay for Medicare Part B.  We made the decision years ago that this is our forever home.  We have private medical insurance here that pays for all but routine things, e.g. annual checkup.  It's non-cancelable and has no upper or lifetime limits.

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IMO, the whole Part B Medicare insurance thingy is a tough one to call. I have had two sets of friends who also said that they would be buried in Mexico... that's how sure they were that they would stay and I believed them. Both sets LOVED Mexico and especially Lake Chapala.

But for each set the time came when, due to unforeseen medical situations, they HAD to retreat to the US to obtain healthcare/drugs that were not available in Mexico at the time (or extremely expensive per dose but covered by Medicare). Since it was crucial to their staying alive they left....crying, but they left.

 

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32 minutes ago, RickS said:

IMO, the whole Part B Medicare insurance thingy is a tough one to call. I have had two sets of friends who also said that they would be buried in Mexico... that's how sure they were that they would stay and I believed them. Both sets LOVED Mexico and especially Lake Chapala.

But for each set the time came when, due to unforeseen medical situations, they HAD to retreat to the US to obtain healthcare/drugs that were not available in Mexico at the time (or extremely expensive per dose but covered by Medicare). Since it was crucial to their staying alive they left....crying, but they left.

 

Rick is right on. That seems to happen frequently. "when my time comes I'm not going to waste a bunch of money to stay alive for an extra year or so". The speaker always means it but when the diagnosis comes, some do not want to just give up. We pay for Part B and never expect to use it but would feel horrible if our spouse changed their mind and wanted to use Medicare but it wasn't there. To each their own.

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On 11/11/2017 at 11:44 AM, pappysmarket said:

Rick is right on. That seems to happen frequently. "when my time comes I'm not going to waste a bunch of money to stay alive for an extra year or so". The speaker always means it but when the diagnosis comes, some do not want to just give up. We pay for Part B and never expect to use it but would feel horrible if our spouse changed their mind and wanted to use Medicare but it wasn't there. To each their own.

My parents were nearly 40 when I was born. Which for the mid 1950s was highly unusual. I went through reverse parenting my parents in my late 30s. You just do not know where you will be in 20 years and how this will effect your spouse or your children. My parents made some unusual choices that were made to reduce the burden on others when they got unable to manage their affairs.

When my wife becomes medicare eligible in less than 2 years, we will likely sign her up.

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On 11/11/2017 at 10:11 AM, El Saltos said:

By all means if you move here and think you might return to the USA then you should pay for Medicare Part B.

For what? Part B is for non hospital costs and Part A is hospital coverage. Part A is free and available to all that apply. Should a high cost procedure be needed, you return to the US if you can with hospitalization.

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2 minutes ago, El Saltos said:

Part A is automatic,you don't apply.  It's there for you at age 65.  If you return w/o Part B you pay all the surgery etc. costs.  Get good insurance here and get your medical care here.  Otherwise self-insure.

Yes its there is you apply, they don't just send you a card. Part B has nothing to do with surgical costs.

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Just now, El Saltos said:

Wrong, they sent me a card when I turned 65, my wife got hers when she turned 65.  No application required.  Automatic.

Medicare Part B (medical insurance) helps cover medically necessary services and supplies needed for the diagnosis or treatment of your health condition. This includes outpatient services received at a hospital, doctor’s office, clinic, or other health facility.

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