Clinic/Physician/Hospital recommendation

by Axixic Sat Feb 09, 2013 3:21 pm

Well, I decided I've put this off long enough and I need to seriously investigate my options regarding health care. No big issues or anything; it's just that I have now passed the magic six months mark and that means I don't have the option to fly back to Canada and seek treatment there if anything should crop up.

At first glance I think the public health insurance plans are probably inappropriate for me. Does anyone have any recommendations regarding joining a private Clinic/Physician/Hospital? What do they offer as included services and what are the costs?

by Jim W Sat Feb 09, 2013 3:44 pm

Axixic, Wife and I have gone self insured. Cancelled Allianz of Mexico, as annual fees plus deductible, are prohibitive. Please check out the medical topics on this and other boards. Set up your own medical savings plan.

Should you have planned medical proceedure, contact Simpsca on this board, as she is well versed in negotiating surgical fees in Mexico.

by Axixic Sat Feb 09, 2013 3:50 pm

Thanks Jim.

That was actually what I had in mind since there are no underlying issues but it occurs to me that there are clinics you can "join" for some reasonable amount that will give you access to GPs, etc. for routine physicals and referrals and I think that is likely a good idea.

Being a Canuck, it feels a little odd to me to NOT have some type of coverage.

by E-raq Sat Feb 09, 2013 3:56 pm

Axixic wrote:Well, I decided I've put this off long enough and I need to seriously investigate my options regarding health care. No big issues or anything; it's just that I have now passed the magic six months mark and that means I don't have the option to fly back to Canada and seek treatment there if anything should crop up.

At first glance I think the public health insurance plans are probably inappropriate for me. Does anyone have any recommendations regarding joining a private Clinic/Physician/Hospital? What do they offer as included services and what are the costs?

No health problems, join IMSS. Cheapest option, then if you need to have something done fast, pay out of pocket. Way cheaper than insurance, we haven't had any for years, other than one year when the agent misrepresented the facts. Really serious health problem you use IMSS, something less serious, if you can afford 20,000 or less, have it done privately. Negotiating is pretty much the norm here. IMSS is a must in case of a serious road accident. Their trauma surgeons are the best, due to experience. Smaller, surgery only hospitals are your best option. My husband had an angioplasty, 3 balloons done by one of the top cardivascular surgeons in Guadalajara, total cost including the hospital was 7,500 U.S.

by Axixic Sat Feb 09, 2013 4:01 pm

I thought there was a recent decision that expats couldn't join IMSS.

What do they cover?

by Jim W Sat Feb 09, 2013 4:17 pm

Axixic, one thing for sure....rules change in Mx. I know you remember our discussions regarding blood donations etc. Please go back to those and many other threads on this board, and others!

Before you sign up for any IMSS or other public assistance type program, understand you must have a representative assist you, to provide sheets, TP, pick up your prescriptions, and translate on your behalf if you can't.

Sent PM

by E-raq Sat Feb 09, 2013 6:13 pm

Axixic wrote:I thought there was a recent decision that expats couldn't join IMSS.

What do they cover?

Au contraire, the recent decision was that residents here are entitled to the same care as nationals. Now if you're still on that old FM3, you'll have to go for FM2 permanente, asap. Then nothing to it. You do have to be checked over at the hospital in Tlajomulco, then that's it, you're in.

If you do have health problems you're not aware of they won't let you join.

We have no restrictions stamped on our cards, and never even used their services until I had a thrombosis. The whole thing was covered, didn't have to pay a cent to have a 4 inch long thrombosis removed from an artery in my leg. The surgeon was a genius.

Wonder what that would have cost in the U.S. a Four hour operation? Hmmm, I'm thinking about 30k or more.

by Axixic Sat Feb 09, 2013 6:23 pm

My status is non-imagrante. Do I qualify?

by Trailrunner Sat Feb 09, 2013 8:06 pm

Hi Axixic, yes you qualify in terms of INM.

I believe the best strategy here is to buy the best health insurance you can qualify for and afford. The private plans are pretty costly and go up every year and will drop you when you reach their age limits. But if you can afford them, get one.

Otherwise, that leaves Seguro Popular and IMSS. Seguro Popular is not really health insurance and in the event of an emergency you will be pretty much sol to get a bed. (see other posts on this subject) SP is completely over loaded and they only have 2 hospitals in Guadalajara - Hospital Civil Viejo y Nuevo. My experience in the medical system in this area is that you can be at death's door and still not get a bed or authorization for an ambulance transport to Civil even with Seguro Popular.

That leaves IMSS. The best strategy with IMSS is to just pay out-of-pocket for your doc appts and any other procedures or treatments that you can afford to pay out-of-pocket for and use IMSS for the big stuff - cancer, surgeries, cardiac/circulatory problems etc.

The best part about IMSS is you WILL get a bed. They are overloaded as well but they have several facilities that receive patients and ambulances. You WILL get an emergent bed if you need it whether it's trauma or medical. Dealing with them for minor problems or appts can be grueling in terms of waiting and bureaucracy but in the end, if you persevere, you will be seen and treated by competent doctors and it will not cost you a cent. For the most part.

Since you are relatively young, and if your health is still good enough to pass the IMSS physical, I urge you to buy some kind of insurance and keep it until the day you die or leave this country - no matter what. If you buy private insurance, and they bump you at 70, there is a good chance you will have incurred some kind of medical issue that will disqualify you for IMSS by then and you will again be s o l. SO, get IMSS now while you can and keep it.

We see way too many foreigner patients here who have no money, no health insurance, and no Spanish! That scenario, coupled with facing a major medical emergency, is entirely too overwhelming for anyone to deal with. Not having any plan for emergencies or any insurance or cash or credit cards to pay with or even rudiment Spanish to communicate with is just plain stoooooopid, reckless, and irresponsible.

IMSS is only about $250US/year, if that is hard on your budget . . . give up your TV plan, or your cell phone, or eating out twice a week, or cigarettes, or whatever it takes to put away a pinche $250 a YEAR for your medical health. That is a lousy 21 bux a month! It's about priorities.

It's difficult for us too, you know! Holding patient's hands while they die or get worse and worse or bleed out or writhe in pain because they can't get a bed. The reality is THEY didn't plan ahead.

Ok, soapbox shut down for the night. :)

by CheenaGringo Sat Feb 09, 2013 8:18 pm

Quoting Trailrunner:
"We see way too many foreigner patients here who have no money, no health insurance, and no Spanish! That scenario, coupled with facing a major medical emergency, is entirely too overwhelming to deal with. Not having any plan for emergencies or any insurance or cash or credit card to pay with or even rudiment Spanish to communicate with is just plain stoooooopid, reckless, and irresponsible."

Just what the hell are these foreigners doing in Mexico? Maybe life NOB might have been a bit of a test because of income levels but at the very least they wouldn's have been a burden on a system that they haven't paid into and is ill designed to absorb them!

by Trailrunner Sat Feb 09, 2013 8:27 pm

I'm not so convinced, CG, that we foreigners are such a huge drain on the gov medical systems. Remember, nowhere else in MX are there foreigners likethe numbers here at Lake Chapala. Many foreigners wouldn't touch IMSS with a 10 ft pole and don't need to. The rest of us pay every year for it. I've been paying into it for 9 years and have never used it yet, doing the math I believe that would pay for a stent or a knee by now. Remember, the pacemaker that costs $30,000 in the US only costs $3000US here. Same pacemaker.

In terms of SP, I agree with your statement.

by joec Sat Feb 09, 2013 10:09 pm

CheenaGringo wrote:Quoting Trailrunner:
"We see way too many foreigner patients here who have no money, no health insurance, and no Spanish! That scenario, coupled with facing a major medical emergency, is entirely too overwhelming to deal with. Not having any plan for emergencies or any insurance or cash or credit card to pay with or even rudiment Spanish to communicate with is just plain stoooooopid, reckless, and irresponsible."

Just what the hell are these foreigners doing in Mexico? Maybe life NOB might have been a bit of a test because of income levels but at the very least they wouldn's have been a burden on a system that they haven't paid into and is ill designed to absorb them!

I agree, the system is so overburdened now. If you like going back over and over to get one simple test each day and don't mind waiting and inconvenience, join IMSS. My PT including myself and our friends wouldn't touch it with a 10 foot pole. Many of our friends self insure.

by Trailrunner Sat Feb 09, 2013 10:21 pm

John, which medical insurance plan to you guys have? And, if you don't mind, what does it cost per year?

by joec Sat Feb 09, 2013 10:43 pm

Trailrunner wrote:John, which medical insurance plan to you guys have? And, if you don't mind, what does it cost per year?

All medical plans are different and you cannot compare them UNLESS you compare them using the same age and same deductibles. We are with Seguros Monterrey, a division of NY Life. I am 68 y/o and my premium with a $ 22,500. peso Deductible is $ 42,550 pesos or approx. $ 3,335 USD. He is 67 y/o and his premium with a $ 30,000 peso Deductible is $ 41,740. pesos or approx $ 3,275. USD.

Also with Seguros Monterrey there are NO LIMITS. MetLife has limits. Age limits to join a plan vary, Seguros Monterrey used to be 69 y/o, now it's 64 y/o. MetLife is 69 y/o.

by Parker Sat Feb 09, 2013 11:01 pm

Well if you can afford a bit over 3K per year and you’re under 64 the best deal in my personal experience, and I have plenty of personal experience, is Jesus Tejeda of AXA insurance. Over 1Million USD and still they’re there for me, excellent care and really concerned individuals.

We dropped IMSS because of the “rumored” problems and friends that we’re dropped when they needed them most plus we’ve decided to pick-up Medicaid. Also we had Jesus give us a cost estimate of what our cost might be at the age of 70. We felt comfortable with those numbers so this was our decision.

P.S. Keep in mind the best decision one can make is getting the right agent.

(3K deductible per each seperate medical issue.)

by joec Sat Feb 09, 2013 11:27 pm

Parker wrote:Well if you can afford a bit over 3K per year and you’re under 64 the best deal in my personal experience, and I have plenty of personal experience, is Jesus Tejeda of AXA insurance. Over 1Million USD and still they’re there for me, excellent care and really concerned individuals.

We dropped IMSS because of the “rumored” problems and friends that we’re dropped when they needed them most plus we’ve decided to pick-up Medicaid. Also we had Jesus give us a cost estimate of what our cost might be at the age of 70. We felt comfortable with those numbers so this was our decision.

P.S. Keep in mind the best decision one can make is getting the right agent.

(3K deductible per each seperate medical issue.)

Parker, what was his cost increase in % per year that he figured until 70?

Hi all - If I were getting Private Insurance from my experience now, I would start with the highest USD deductible that you can afford. We started low and gradually increased it as premiums went higher. Always ask what a 30 K, 35 K, 40 K, 45 K and 50 K Mexican pesos deductible will cost you so you can see the premium differences

by Parker Sun Feb 10, 2013 12:33 am

joec wrote:
Parker wrote:Well if you can afford a bit over 3K per year and you’re under 64 the best deal in my personal experience, and I have plenty of personal experience, is Jesus Tejeda of AXA insurance. Over 1Million USD and still they’re there for me, excellent care and really concerned individuals.

We dropped IMSS because of the “rumored” problems and friends that we’re dropped when they needed them most plus we’ve decided to pick-up Medicaid. Also we had Jesus give us a cost estimate of what our cost might be at the age of 70. We felt comfortable with those numbers so this was our decision.

P.S. Keep in mind the best decision one can make is getting the right agent.

(3K deductible per each seperate medical issue.)

Parker, what was his cost increase in % per year that he figured until 70?

Hi all - If I were getting Private Insurance from my experience now, I would start with the highest USD deductible that you can afford. We started low and gradually increased it as premiums went higher. Always ask what a 30 K, 35 K, 40 K, 45 K and 50 K Mexican pesos deductible will cost you so you can see the premium differences

We started out with the highest deductible allowed so I agree that is probably good advice.

AXA is allowed by law to raise their premium by as much as 30% per year however they must raise everyone’s premiums by the same amount which is a controlling factor. If they rise too much, too often people would, if they can, very quickly drop out or worse yet never buy in. If you’ve have no customers, no matter how much you charge isn’t going to change the bottom line. I would imagine his figures were an average over the last ten years. His numbers were close enough to mine so I felt fine (if not I have all this extra housekeepers’ retirement fund stashed away Hahaha!!!) 15 to 20% ?

by Axixic Sun Feb 10, 2013 6:10 am

So, no one has bought any kind of plan with a local doctor or clinic? I am thinking mostly of the routine, maintenance kind of things.

by Jim W Sun Feb 10, 2013 7:12 am

Dr. Garcia @ Maskeras offers a plan, I signed on in 2006, dropped it the next year, as I didn't see the value in continuing.

by Trailrunner Sun Feb 10, 2013 7:56 am

Axixic wrote:So, no one has bought any kind of plan with a local doctor or clinic? I am thinking mostly of the routine, maintenance kind of things.

No

by joec Sun Feb 10, 2013 9:01 am

Jim W wrote:Dr. Garcia @ Maskeras offers a plan, I signed on in 2006, dropped it the next year, as I didn't see the value in continuing.

As have others that I know. I wouldn't want a plan with him anyways and I dislike Mascaras Clinic except for the Ortho guy, Dr. Gonzalez who is very competent. Ajijic Clinic is so superior.

by little italy Sun Feb 10, 2013 12:41 pm

My Husband and I had a plan with Dr. Garcia when we first arrived. I can honestly say I really liked him especially when my Husband became ill. I now use the Ajijic Clinic as it is closer to where I live. Forgot the price using Maskeras, however, was worth every penny at one time.

by Axixic Sun Feb 10, 2013 12:58 pm

little italy wrote:My Husband and I had a plan with Dr. Garcia when we first arrived. I can honestly say I really liked him especially when my Husband became ill. I now use the Ajijic Clinic as it is closer to where I live. Forgot the price using Maskeras, however, was worth every penny at one time.

Does Ajijic Clinic offer a plan?

by David Sun Feb 10, 2013 2:03 pm

Routine medical care is so inexpensive here that there's no benefit to a "plan." Just pay as you go.

by little italy Sun Feb 10, 2013 2:11 pm

Axixic wrote:
little italy wrote:My Husband and I had a plan with Dr. Garcia when we first arrived. I can honestly say I really liked him especially when my Husband became ill. I now use the Ajijic Clinic as it is closer to where I live. Forgot the price using Maskeras, however, was worth every penny at one time.

Does Ajijic Clinic offer a plan?

I don't believe they do.

The plan worked for us as my Husband was in the clinic at least once a week with problems.

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