health insurance and issues

lpg wrote:Get Mexican Health insurance today.
Sat Mar 10, 2018 10:21 am (PST) . Posted by:
bret.band
I thought I did not need Mexican insurance, Seguro Popular, because I could afford to pay private. Then I had a heart thing which was costly. Something else popped up. But I was nervous to try to sign up. Then I heard of Andi Maynes, 612 348 1498, who will for a few pesos sign you up in a few hours, No previous conditions, no age.
The cost for one year for me and my wife is 2000 pesos. Whatever you have in the US get this. You may not make to the us

2015 Open Enrollment Period Has Started for 2016 Obamacare

Basic Information on Americans Living Abroad and ACA Obamacare

this is a copy of some information provided by THE PAPER CHASE Tel. (612) 1656503 Cell. 6121577285 www.thepaperchase.com.mx

I. MEXICAN HEALTH INSURANCE
If your health insurance is not valid for Mexico, you can get Good health care insurance in Mexico.
Health Insurance in Mexico: a) Private b) Social Security (government-backed health care program).
SOCIAL SECURITY Mexico is one of the few countries in the world you can move to and take advantage of the government health care program.
IMSS INSTITUTO MEXICANO DEL SEGURO SOCIAL (MEXICAN INSTITUTE OF SOCIAL SECURITY)
IMSS is Mexico’s national health care system. It has a legal mandate derived from Article 123 of the Mexican Constitution. IMSS is a public service provider for all workers and their families. It is also responsible for the provision of pensions guaranteed by the State. There are IMSS-related hospitals, clinics, and pharmacies all over Mexico.
IMSS is the largest social security institution in Latin America.
Foreigners with a valid residence visa for Mexico qualify to get health coverage through IMSS.
There is no age limit for signing up with IMSS.
Insurance is offered under the Mandatory or Voluntary Regimes. The benefits, requirements and contributions vary in each regime and are clearly stated in the Social Security Law.

VOLUNTARY REGIME
1) AS AN INDEPENDENT WORKER. This type of insurance can be obtained by any person who works independently and is registered with Hacienda.
COVERAGE:
The applicant and his/her beneficiaries receive medical assistance, surgery, pharmaceutical assistance, hospital, maternity, disability, retirement and old age.
NOT COVERED: Plastic Surgery, glasses, treatment of damages produced by attempts of suicide, dental procedures except for extractions and cleaning, treatment of chronic diseases that require permanent therapeutic control, etc.
COST
IMSS cost is per person rather than a set family rate and it includes medications. Approximately $4,000.00 per year for a person that is over 60 years old. Beneficiaries: Spouse, children, parents (if they live with the applicant).

REQUIREMENTS
1. Copy of registry with Hacienda, RFC number. 2. Proof of address and copy. 3. ID 4. Medical examination 5. Three pictures 2.5X3.0 cms.
NOTE: If pre- existing condition such as cancer, diabetes, stroke, arthritis amongst others, the application will be rejected.

2) SALUD PARA LA FAMILIA (HEALTH FOR THE FAMILY). This type of medical insurance is provided for people that work independently (or not), are not registered with Hacienda and have never been in the IMSS system. It protects the applicant (who lives abroad) and his/her family in Mexico, when you are in Mexican Territory.

COVERAGE:
Medical, pharmaceutical and hospital assistance. Surgery after a year.
NOT COVERED: Plastic Surgery, glasses, treatment of damages produced by attempts of suicide, dental procedures except for extractions and cleaning, treatment of chronic diseases that require permanent therapeutic control, etc.
COST:
Per person and varies according to age, paid yearly. The fee is adjusted every February.
Example: 60 years or more, fee is $3730.00
REQUIREMENTS:
1. 3 photos 2.5X 3.0 cm 2. Passport, original and copy. 3. Immigration document. 4. Proof of address and copy 5. CURP 6. Medical examination.
AFFILIATION AND ORIENTATION CENTER IN LA PAZ:
Coordinación del IMMSS on 5 de Febrero and Altamirano.
NOTE: If pre-existing condition such as cancer, diabetes, stroke, arthritis amongst others, the application will be rejected.


POPULAR INSURANCE SCHEME (SEGURO POPULAR DE SALUD)
It is a social health protection system implemented by the Federal Government which seeks to provide health service coverage, through voluntary, public insurance for persons that are not affiliated to any social security institution.
BENEFICIARIES Seguro Popular protects the family, which may comprise: 1. Spouses; or 2. Concubine and the man having a concubine; or 3. Mother and/or father not married or living together without being married 4. Underage children 5. Underage children who are part of the family and have blood links with those mentioned in numbers 1 to 3 6. Unmarried children up to 25 years old proving to be students
Persons over the age of 18 can voluntarily become affiliated on an individual basis. AFFILIATION REQUIREMENTS
1. Reside in the National Territory 2. Being without any rights in any social security institutions (IMSS, ISSSTE, etc.) 3. Submit application at the Affiliation and Orientation 4. Socioeconomic evaluation of the family 5. Submit original and copy of the following documents
DOCUMENTS
1. Proof of Address 2. CURP 3. Official ID of person who will act as head of the family 4. Receipt of payment for family quota. 5. Foreigners must present document of legal status in the country.

AFFILIATION PROCESS
The member of the family entitled to join the system should attend an Affiliation and Orientation Module to express his desire to join the Health Protection Social System through the popular Insurance Scheme.
Socioeconomic evaluation of the family to determine their ability to pay. This evaluation must be carried out every three years.
The Affiliation and Orientation Module will be responsible for:
a) Providing the head of the family with the Charter of Rights and Obligations (describes the medical actions covered by the Social Health Protection System).
b) Issue the Affiliation Policy indicating the householder, members of the family that are also beneficiaries, the duration of their rights, the annual family quota and the medical unit that corresponds to them.
The family will be able to receive the medical services covered by the Popular Insurance Scheme on the first day of the month after their affiliation according to the capacity for treatment of the Health Secretariat in the state where the family has established its residence.
Note: Beneficiaries should show The Policy and ID when using the medical services affiliation to the Social Health Protection System (Popular Insurance Scheme) will be formalized as soon as the head of the family is given the Affiliation Policy.
COVERAGE
Members have access to the medical, surgical, pharmaceutical and hospital services. The Popular Insurance Scheme currently provides coverage for 275 medical operations, described in the Universal Health Service Catalogue.
Seguro Popular covers 284 medical interventions included in the Universal Catalog of Health Services
58 high specialty medical interventions (third level of medical attention) corresponding to the Fund of Protection Against Catastrophic Expenses which provides the economic resources for the attention for 17 diseases or conditions such as kidney transplant, some types of cancer, VHI, stroke, etc.

100 % of conditions included in the first level of medical attention and over 90% of conditions of the second level of medical attention (hospitalization).
Over 500 diseases are financed by Seguro Popular which are related to special medical attention such as urgencies, oral health, orthopedics, gynecology, rehabilitation, rheumatology, mental health and addictions, dermatology, etc. Besides prevention and promoting of health, attention of transmissible conditions, chronic-degenerative and general surgery.
Unlike the IMSS, people can affiliate themselves with Seguro Popular, whether they have a pre-existing condition or not.
COST
Fees are paid yearly, depending of the family income the quota goes from 0.00 pesos to 11,378.86 pesos (for 2012).
Medical attention can be received at Health Centers (centros de salud) and hospitals of the State Health Services.
AFFILIATION AND ORIENTATION MODULE IN LA PAZ:
Jurisdicción Sanitaria La Paz "Velodromo".
Av. los Deportistas y Carabineros la Paz B.C.S. 23000
Baja California Sur
Teléfono: (612) 1254376
Monday to Friday from 8:00 to 1:00

Gabriel O'Shea Cuevas, National Commission on Social Health Protection, said the government of President Enrique Peña Nieto has given priority to health in the state of Michoacan, and proof of this, he said, is the opening of the Control Center Emergencies with 30 ambulances.

This in the town of Tepalcatepec, where President Enrique Peña Nieto led the installation Basin Commission Tierra Caliente-CNA and the Caravan for Women's Health

He said that since it was launched actions instructed the President Enrique Peña Nieto to Michoacán, has made progress in the supply of drugs in 110 medical units of first level that exist in the 30 municipalities of the region of Tierra Caliente, the spend 60 to 85 and 90 percent, and will continue up to 100 percent.

It also announced that it has a budget of 100 million pesos to rehabilitate, equip and increase medical staff of these 110 medical units, "which was one of the biggest demands of the people of this land: the supply of drugs; and secondly, the lack of doctors. "

>My name is Katya Berci and I represent Best Doctors International Health Insurance in La Baja.
>Thank you for giving me the opportunity of telling you a bit about Best Doctors.
>>
>>
>>Many of you are already insured thru me and I thank you for your trust!
>>
>>
>>Best Doctors is an american company based in Boston, Mass formed 1n the late 1980s ... it offers:
>>
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>>World wide coverage, wherever you want with whom ever you want.
>>One administered deductible per person per year in case you need it, two deductibles maximum per policy. 
>>(all the medical expenses during the year are subtracted from deductible)
>>
>>You can be insured for the first time up to the age of 74. Once you are insured your renewal is guaranteed for lifetime.The children stay in the same policy until they are 18 years and if they continue studying...until they are 24 with the preferencial rate of dependents.
>>Aereal ambulance (air evacuation)
>>Terrestrial ambulance
>>Free choice of hospitals and doctors
>>Prescribed medication included 
>>Interconsultation services
>In Cabo direct payment to Blue Medical Net and Amerimed Hospitals....
>
>All the benefits are per person/ per year.www.bestdoctors-ins.com Please let me know any questions you might have and I would love to meet you and talk a bit more about all the plans and options.
>>All the best, 
> 
>Katya Berci
>
>
>624 19

Alba Walker of the Paper Chase gave a seminar on this on Monday at Marina La Paz, and has promised to email registrants with a summary of the various health insurance options (and other relevant expat topics) -- which hopefully will be posted to LPG when available.In the meantime, here's a really basic synopsis of the options and some links for further info. In essence, you have 4 choices:1. Pay as you go (cash payment for medical services, RX, Fidepaz Hospital stays)2. Private insurance (thru' various 'worldwide' insurance carriers) - generally very expensive, even if just for 'catastrophic' insurance3. Seguro Popular - low cost gov't health insurance available to anyone who resides in Mexico. Some conditions & restrictions apply:http://www.seguro-popular.gob.mx/index.php?option=com_content&view=article&id=100&Itemid=1374. IMSS Insurance - originally designed for working people now available to others as well. More expensive than SP but still very
affordable. Must be under 65 years of age and no (serious) pre-existing conditions. Medical examination req'd.http://www.mazinfo.com/infofiles/IMSS.htm

I'd like to share with you I have a policy from Best Doctors, who have an excellent reputation, and pay claims in both Mexico, and in the USA, Canada - your option. I'd recommend this international coverage to anyone, who lives here, and still want the peace of mind knowing they also have health coverage in the USA . Before I bought, I did my research by visiting Blue Medical net, and Ameri-Med. Best Doctors Regional Rep is Ms. Katya Berci, who also appeared and spoke at Alba Walker's presentation at Marina La Paz, last Monday. Katya can be reached atkatyaberci@yahoo.com Katya is 100% English fluent, and is a true professional.

If you are coming from downtown on Abasolo, find Colosio, turn left, and find "Calle de los Deportistas". You find "RED CROSS" and next to that is the office where they will give you all the requirements you need for the SEGURO POPULAR.

dean
Posts: 2453
Join date: 2008-01-01

 

IMSS is the Mexican Institute of Social Security. If you plan to obtain medical insurance from IMSS, read the following instructions.

First, you have to gather all necessary documentation:

1. Photo ID – original and copy;

2. Three recent pictures, small size

3. Mexican: Either birth certificate or “Carta de Naturalization” – original and copy;

Foreigner: Immigration document

4. Unique Population Registry Code (Personal ID Number)

5. Proof of domicile: electricity or water bill with your name on it. If you do not have a utility bill, you may use a copy of FTD contract or Escritura

The insured must be checked by a Medical doctor at the IMSS hospital before he/she is insured. During the first year, the insured will benefit from basic coverage (family doctor, medicine, tests). Starting with the second year, the insured receives extensive coverage (specialists).

NOTE: If you only have an FMM, you can not apply for insurance, but if you have a medical problem anywhere in Mexico, the local Centro de Salud must assist you, and it is free.

Cost in pesos: This can be paid in full or installments:

Per person / year: age: 0-19= $1371.25; 20-39= $1602.60; 40-59=$2395.40; 60 and on= $3604.70

For more information, contact:

Lic. JACQUES-EDOUARD BEAULNE,

can-am-mex-law-firm@hotmail.com

I have Poplar Insurance and would like to tell of my experience. What has already been said for getting on the program is true. This is when you go to get medical service.

I had a cancer on my arm that needed to be removed. First I went to the clinic downtown, waited in line for around 45 minutes to get to the window and a number. Then waited around 3 hours until they called me for a blood pressure check and weight check. While I was doing that they called my number to see a doctor. When I realized that I missed the doctor's call I told someone and they told me to just wait. The doctor I was to see didn't speak English but there was one doctor that did and I saw him. He was very helpful, examined my arm, filled out the paperwork and told me to go to the hospital and make an appointment for the doctor.

I went the next day and was given an appointment for 2 weeks away. On the appointment day I sat with a bunch of people outside the doctor's office and since I was reading a book I didn't notice that people were not going into the office but were drifting off. That was after 2 hours of waiting. I went to the lady who gave me the appointment and found out that the doctor didn't come in that day. She gave me another appointment for 3 days later.

When I saw the doctor I told him my Spanish wasn't very good. That didn't stop him from talking for around 5 minutes. I had no idea what he was talking about. He gave me a piece of paper with the name of another doctor and a phone number and indicated that I was to go to there for a biopsy. I called the number for several days and nobody ever answered. I went back to the hospital and told the lady that and she got all confused, saw the doctor in the hallway and approached him. He seemed to get irritated and told her to send me to the emergency room

After that things went pretty well. I didn't have to wait behind around 20 other people, they got a doctor who spoke English and they cut out the the cancer. He was very nice. He told me to go to the first doctor in 10 days to get an update on what was happening and get the stitches out. I went, with an appointment, waited for an hour or so before I realized that I would have no idea what the doctor would be saying. To get the stitches out I would have to go to emergency and wait for several hours behind around 20 people. I decided to go to one of the doctors available at Similares. He took the stitches out in just a couple of minutes and charged me 50 pesos. 

As I understand it, if you come in an ambulance and it is an emergency you are taken right in. Normally I would just pay for something this small but I wanted to see what the process would be like. I have the Popular insurance for emergencies only and for other smaller and treatable things I'll just pay out of my pocket.

My advice: If you want to check out the process yourself take a book. A very large book.

1a. Seguro Popular
   Posted by: "Cindy Crane"
   Date: Thu Feb 28, 2013 12:17 pm ((PST))

For the first 3 years of living in La Paz I didn't do anything about health care because I didn't know how to get thru the system.

However, 2 years ago we paid someone $600 pesos (and well worth it for translations,etc).  Yes the process to get started is long and stressful because we aren't used to this process taking so long in our own countries.  I don't recall the name of the building but it is 1 street behind City Club by the red cross building.  This person went and stood in lineup @ 7am to get us a number with an appointment date and time to return the next day.

This person also went back with us the next day at 7am....because you still have to stand in line with a number.  Please be aware that even if you appear to to be the first (only) person in line, if there were others who arrived before you, they know their place in line and will butt right in when the doors open.  It is quite an experience.  Once you stand in this line, and the doors are open, when you get to the front they will move you to another line if you have a number....I know, why didn't they tell us that in the first place..LOL  So now you wait till your number is called.

Finally inside we were asked lots of questions in Spanish and this is where our translator was so helpful.  You will be asked if you own a house, how many bedrooms, bathrooms, if you have a washer/dryer, a car, how much money you make, your education, etc.  This all determines how much you will pay.
We paid approximately $230 USD/year for both me and my husband.

Documents we took if I remember correctly:  passport, FM2 or 3, electric bill with our address on them.  I can't remember if there is anything else you need but you would want to check before you go....you must also have copies of all the documents or you could be sent out and have to start the process all over again.

Then we were given a paper to go to the bank and pay....when we returned we once again returned to a line in order to give them our receipt from the bank but it didn't take long.  We gave them the paper and was told to return around 1pm to get our photos done....then I believe we went back the next day to pick up our cards.  If I remember correctly the entire process on this day took from 7am to about 10am....

I would definitely recommend you take someone who knows this system and speaks Spanish to help you thru this....it makes it a whole lot easier.

Now in saying all this...you must remember to renew on your own each year...you will not be sent reminders on when it is due.  If it expires you must start the entire process over again.  You can renew at the same place, however, we have gone to the old Salvitierra Hospital upstairs office for renewal....it is much easier and faster if you are there before they open at 8am.

Yes I am aware that this insurance will not cover everything, however, it is the only insurance here that I qualify for with having per-existing
conditions:  so  I have it for emergency situations.

Have I used it yet??
I had to go to emergency a year ago for a bad pain in my side....they kept me there from 2am till 8am...took x-rays and had multiple doctors tending to me....never did figure out what the problem was because the pain just stopped and has not returned....however I had to pay nothing!

I was also in the hospital a week ago for my asthma.  Was admitted into emergency from 10am to 4pm...IV, nebulizers, everything I needed including all my medications to take take home, and again I paid nothing.

I have an older booklet on what it covers that I had translated by google if someone would like to take a look.  It is somewhat confusing with translation but it's better than nothing and might give you some idea of what it covers....but if you would like to take a look at it, knowing it's not 100% perfect and a bit confusing I would be happy to pass it along.

Hope you find this helpful...Please contact me personally if you need more info

Gringos in Paradise Website - Whether you're new to Baja and Mexico or just want to keep up with new happenings that effect all of us living or visiting here, please check out Gringos in Paradise website. It's FREE and we publish daily with our newsletter every Saturday morning so you can catch up on what you might have missed during the week. We post new articles daily about life here in Mexico with loads of tips on how to preserve your retirement dollars and even earn an income while living or visiting Mexico. If it's news worthy, we will have it.

We alos post articles written by local folks just like you, people love to read what real expats have to say whether its fiction or real stories like George Bergin of La Ribera on East Cape a wonderful local writer.

We also have the finest Insurance products available with all A credit rated companies offering auto, Home, RV, etc. Health Insurance that works just like your back in the states except you can save over 50% in many cases and the hospitals in Baja love our plans and you can keep your credit card in your wallet. These are American companies who understand Mexico and your needs here. www.expatinsuranceplans.com see how much you might save today. I have own property in Todos Santos since 2006 and you will always be able to reach me by email or phone. We live here in Mexico full time. - Larry Crowson, larry@gringosinparadise.com.mx, www.gringosinparadise.com.mx, 888-300-4368 Toll Free US Vonage, United States - Larry Crowson, larrycrowson2010@gmail.com, www.gringosinparadise.com.mx, (888)300-4386, Todos Santos

We learned a lot as we applied for IMSS and were accepted, so I thought i'd
pass this current info on. It only took 2 weeks and a bit of regular
hoopjumping. The cost of IMSS per person per year is 2307 pesos for age
40-59 and 3472 pesos for +60.

Contrary to the info that's in the archives and was published in the
paper....you do NOT have to be a worker to qualify for IMSS. You do,
however, have to pass a medical check. You will not be accepted with
preexisting medical conditions. They are also quite strict about blood
pressure, cholesterol, sugar levels and waist measurements. (If you do not
qualify for IMSS then you are entitled to Seguro Popular without a medical.
It's also much cheaper.)

*How to Apply:*
(take a Spanish-speaking friend along with you if you don't speak Spanish.
It's a simple process but it's a no English situation, and it would be
difficult)
Go upstairs above the Farmacia Benidades on Cinco de Mayo with:
1. original and a copy of FM2 or FM3
2. original and a copy of your birth certificate --they have a slight
distrust of our birth certificates without our parents' names on them
3. original and a copy of your CURP card
4. original and a copy of proof of address
5. 3 small pictures (same as for your FM3)

When your documents are approved and duly stamped you'll take them to the
main hospital across the street. Depending on how busy things are, you
might have your medical check right then or you'll be given an appointment
time. You'll answer a few questions and have a brief examination. In one
week, return to the IMSS office and see if you have been approved. If yes,
they will give you the banking forms so you can pay the fees. Coverage
begins one month later. It's restricted to General Physicians only for Year
1 (no specialists) and no operations for 2 years but accident coverage has
no restrictions.

So if you've been putting it off..start now while you're still healthy. The
good news is that you only have to do it once, and the office and hospital
staff were patient and helpful.
Good luck,
Fern Corraini

Re: Seguros Popular Insurance
Posted by: "Luiza Lanoy" luizalanoy@yahoo.com luizalanoy
Sun Dec 19, 2010 6:52 pm (PST)


I'm no expert but here goes.

Need:

1) your CURP - I guess it is like a social insurance number. This is a
separate process

2) copy of the electrical bill

3) your FM-3

4) it covers everying - all tests, pap, prostate, mamogram, etc and everything
in between including drugs.

5) Yes it costs about $1300 pesos per person

6) Here is what I do. I go to see Dr. Tuckmann. He has a private practice
AND works out of the New Salvateria Hospital. I pay his fee and he has the
option of sending me to a private lab (if I am in a hurry for the results) or
to the New Salvateria Hospital. You might have to wait in line, get an
appointment for a test and then get the results a couple of weeks later.
BUT for $1,300 pesos per year I'm not complaining.

A friend was diagnosed with breast cancer. She opted to have the lump removed
by private surgery and it was done within 2 days of the diagnosis. Her monthly
medication, $500 usd per month, is free with her Seguro Popular insurance at
the New Salvateria Hospital.

7) I don't know if the booklet is available on line. It is my understanding
that it covers everything AND if they (New Salvateria Hospital ) can't do it
here in La Paz, I believe they send you to wherever you can get the treatment
you need.

Where to apply. You might want to have your friend contact Gina Ireton.
She is really the local expert and the "arranger" for the coverage. She may be
on holidays for Xmas. She has a fee for your CURP and another fee for "
arranging" for your Seguro Popular.

Please, please cut and paste her e-mail address which is on the c.c. line of
this e-mail. Do not respond to LPG

9) We just renewed our policy and gladly paid her fee to avoid any anxiety
associated with the process. We are good for another year.

Hope this helps.

Luiza



________________________________
From: greglothian
To: lapazgringos@yahoogroups.com
Sent: Sun, 19 December, 2010 19:31:14
Subject: [LPG] Seguros Popular Insurance


I have a question for a friend that wants to know what the New Salvateria
Hospital group insurance covers for the annual fee of 1,300 pesos.

Does any body have this insurance and know what is covered and what isn't? I
have tried to find a brochure but no luck so far.
Are they still taking new members?

What are the requirements to join?

thank you in advance for any information.

Greg and

In response to the recent requests for Health Insurance I would like to offer assistance. I have been an agent for BUPA and BEST DOCTORS INTERNATIONAL HEALTH INSURANCE for over 2 years. Each Health Insurance plan includes ground ambulance and air evac if necessary. I assisted in forming a direct association between BUPA and Amerimed Hospitals in San Jose and Cabo San Lucas for direct payment if hospitalized over 24 hours. I have brochures explaining the specifics of the various plans in the Amerimed Clinic and can provide a quote in just a few minutes or visit our web page at www.bupalatinamerica.com
In order to help with the application process I recommend coming in to talk with me directly rather than trying to submit through the web page. If you are interested, please contact me at Amerimed Clinic Los Barriles 141-0797 / cell 624-157-0081 or email cwenger@amerimed-hospitals.com or retyer@aol.com
Thank you
Char Wenger