Reality check on current health Insurance and care costs at Lakeside

My wife and I lived at Lakeside for 3+ years in total but have been back N.O.B. for the past 2.5 years. Our plan was to keep spending summers at Lakeside and the rest of our time here in Tucson but this presidential election has thrown a big ol' monkey wrench into things.

The existence of ACA/Obamacare, flawed as it is, is the only thing that's made it possible for us to be back in the U.S., where we've either been on Medicaid or high-subsidy ACA plans depending on our yearly income from savings/investments. It seems pretty clear that both the Medicaid expansion to cover childless adults like ourselves as well as the ACA subsidies will be among the first things to go once Trump is in office. As a result of these changes and the overall truly scary atmosphere up here we are seriously considering returning to Mexico for good.

We had high-deductible coverage through Best Doctors when we lived at Lakeside but my understanding is that premiums for this and other private insurance have skyrocketed recently. We're lucky (thanks to Trailrunner and a few other posters on this board) to have a couple of doctors we know and trust at Lakeside who would be our go-to folks for routine and emergency care, and we MUCH prefer the care we received from them (not to mention access in time of need!) to what we have up here, which is essentially hospital-only coverage with multi-month waits to get 10-15 minutes of a doctor's (or more likely a PA's) time. We are both still 5 (in my case) to 12 (for my wife) years away from Medicare eligibility, and of course who knows what will be left of that program by then.

Our thought was/is to go ahead and get permanente visas up here, plan to pay out-of-pocket for routine care and then apply for Seguro Popular once we are eligible. I'm under the impression that IMSS (at least the Chapala office) still looks for every opportunity to deny coverage to gringos (as they certainly did to us three years ago when the particurlarly awful woman was in charge). We can afford to self-insure up to a certain point but realize we really need to have a plan in place in the event of a major cardiac event, cancer, getting hit by a bus, etc. I read a post on TOB today where a couple in their late 70's is paying $22,000 a year just for health insurance premiums there, and those are the kind of numbers that make me think Thailand might need to be in our plans!

Any feedback appreciated.

Happy Birthday Mr. Coffee!

How's that for feed back?

I just got a quote from Novamar Seguros Mexico. $1400 USD per year for both me and my wife. $1000 USD deductible. This is for coverage anywhere in the world EXCEPT the USA. The coverage looks really good although it doesn't cover cancer and a whole list of other diseases. I am going to get my doctor to take a look at it and review the list of illnesses they do not cover to see if it is worthwhile. I really just want coverage for accidents, heart attacks, strokes, etc. Long term disease I would head back to Canada.

Novamar specializes in expat medical coverage. They have offices in PV, SMA & Cancun/PdC

Thailand is hot, humid and a long ways away in a completely different time zone. No thanks.

We lived in Thailand for 7 years before moving here. CBob is right....hot and humid. You must have been there as a tourist.....believe me, living there full time is completely different. Be prepared to HAVE to deposit $25,000 US in a Thai bank evey year for a retirement visa and then HAVE to appear before immigration every 90 days....you are fined if you are late. Be prepared for rampant zenophobia. As for medical, be prepared for terribly inflated "farang" pricing. Medical insurance is not cheap. I have lived and worked in 8 countries on 3 continents and I would never return to Thailand. We are so grateful to be in Mexico. We have lived here for 8 years and have never had the feeling that we wanted to leave. I can tell you from personal experience that the medical care here is superior, the people show far more grace and manners than we experienced in Thailand and needless to say, the weather here is perfect.
Thailand is a great place to visit and there are some wonderful Thai people but to live there full time will eventually grind you down. I am normally a positive person and have lived in some third world, hardship post countries but Thailand is a special place. I guess it would be OK if you are a single guy......but even then, there are pitfalls. There should be a sign at the airport that says "leave your money here, F off and get back on the plane".
You would be far better off here in Mexico. We are very, very happy here.

Thanks oncesubtle for the kind birthday wishes, and CanuckBob and Meerkat for your thoughtful sharing.

I hadn't heard of Novamar but that sounds like a really good value-for-money policy to have. Interesting that you still have Canadian coverage as well - for some reason I thought one couldn't be out of the country for more than 6 months and still be covered. Glad I was wrong!

My mention of Thailand was more out of a "jeez maybe we need to have a plan C" (with suriviing the U.S. health care insanity a Plan A that's not working, Mexico as Plan B) rather than anything I'd really want to do. I'm very familiar with the xenophobia and other issues Meerkat summarizes so well, and yeah - great place to visit but the only expats I know of who are truly happy lliving there are rare birds who not only married Thais but have become fluent in the language. Mexico really does spoil you and that's why other Latin American options (e.g. Costa Rica, Ecuador, Panama) aren't on our radar screens.

Any thoughts on IMSS vs. Seguro Popular as part of one's contingency plans? We would be living somewhere between Chapala and West Ajijic so I gather we wouldn't be eligible to access the SP facilities in Joco folks seem to like.

The Joco hospital welcomes all residents of Lakeside. You would be eligible for Seguro Popular as soon as you cease being a tourist. Unless you really have no idea what you are doing...there is no charge for Seguro Popular. There is always a charge for IMSS

coffeeguy wrote:Thanks oncesubtle for the kind birthday wishes, and CanuckBob and Meerkat for your thoughtful sharing.

I hadn't heard of Novamar but that sounds like a really good value-for-money policy to have. Interesting that you still have Canadian coverage as well - for some reason I thought one couldn't be out of the country for more than 6 months and still be covered. Glad I was wrong!

My mention of Thailand was more out of a "jeez maybe we need to have a plan C" (with suriviing the U.S. health care insanity a Plan A that's not working, Mexico as Plan B) rather than anything I'd really want to do. I'm very familiar with the xenophobia and other issues Meerkat summarizes so well, and yeah - great place to visit but the only expats I know of who are truly happy lliving there are rare birds who not only married Thais but have become fluent in the language. Mexico really does spoil you and that's why other Latin American options (e.g. Costa Rica, Ecuador, Panama) aren't on our radar screens.

Any thoughts on IMSS vs. Seguro Popular as part of one's contingency plans? We would be living somewhere between Chapala and West Ajijic so I gather we wouldn't be eligible to access the SP facilities in Joco folks seem to like.

The provincial medical coverage kicks back in after 90 days (in BC) upon return. Other provinces may have a different waiting time. Some shorter, some longer. I believe Nova Scotia allows their residents to be out of country for 9 months of the year. Every province is different.

benjji wrote:The Joco hospital welcomes all residents of Lakeside. You would be eligible for Seguro Popular as soon as you cease being a tourist. Unless you really have no idea what you are doing...there is no charge for Seguro Popular. There is always a charge for IMSS

There is no charge to sign up with SP but you are charged for some procedures and medicines that you may need.

Thank you all very much for the helpful info!

CanuckBob wrote:I just got a quote from Novamar Seguros Mexico. $1400 USD per year for both me and my wife. $1000 USD deductible. This is for coverage anywhere in the world EXCEPT the USA. The coverage looks really good although it doesn't cover cancer and a whole list of other diseases. I am going to get my doctor to take a look at it and review the list of illnesses they do not cover to see if it is worthwhile. I really just want coverage for accidents, heart attacks, strokes, etc. Long term disease I would head back to Canada.

Novamar specializes in expat medical coverage. They have offices in PV, SMA & Cancun/PdC

Thailand is hot, humid and a long ways away in a completely different time zone. No thanks.

Is Novamar Seguro sold through any of the insurance brokers here in Lakeside?  I'd like to find out more about it, but the website seemed to only focus on gastro-surgery (at least in the FAQ)

I'm not sure. I found them online after a recommendation.

CanuckBob wrote:I'm not sure. I found them online after a recommendation.

Thanks for the find, Bob. Let us know if your doctor has any concerns with this plan, or if he thinks that it's got good coverage. I'll see if I can find out more about it as well.

Here is the website:

https://www.novamarinsurance.com.mx/

The insurance carrier is WEA

I have Seguro Popular and have been THRILLED with recent care for pneumonia lakeside, at their new facility in Jocotepec. From reading others' reviews of SP, it seems that quality of coverage really depends on where you live in this beautiful country. In some areas, coverage and care are...well..."questionable." But lakeside, we are BLESSED to have a beautiful, clean, well staffed, excellent clinic near Joco. Once you have temporal or permanent residency, you're eligible to apply, and coverage is free unless you own property here. In that case, you will pay premiums on a sliding scale...a pittance compared to coverage in the US and elsewhere...AMAZING! I am also investigating private coverage through Launa Brockman. You can e-mail her at brockmanlauna@yahoo.com. She has been a medical insurance broker in the US for many years, now living here in Mexico. She'll send you information on a cost/coverage analysis from several different carriers, depending on age and pre-existing conditions. SUERTE!

Hi DeborahM, thank you for your report on SP. I'm assuming you mean the hospital in El Chante, right??? I've had other friends report good news using that facility too. I'm happy I switched to SP.

Please tell me how you accessed your care for pneumonia. Did you present in the emergency/urgencias department, or did you start with an MD appt there or somewhere else? Thanks!

Yes, Trailrunner, in El Chante. I just presented at emerg, and despite a full waiting room, I was given a mask and seen within five minutes...I think because of the possibility of infecting some of the other patients. The doctor who examined me was very thorough, and we even managed communication with my Spanglish. (lol) SO pleased with SP!

Excellent! Thanks again.

I was at the Chapala firehouse talking to the Chief the other day and he said we can use their ambulance if we need one and the hospital in El Chante will receive it. This was news to me, hope it works that way as I would much prefer to use them if needed. Their numbers are: 766 3515 and/or 766 5252 per his card.

My wife is here and just received a one-year visa since I have a permente.

She is a citizen of Panama.

Would she qualify for S.P?

I'm on Medicare but it's nice to have something "local" if/when needed.

Thanks.