One of the things I’m asked about the most is health care and health insurance in Mexico. Of course, that makes sense; as we age or look to the future, health concerns become more relevant.
Since I’m not an expert, I thought to share information from someone who is; in this case, Juan and Alejandro Chong, father-and-son insurance agents here in Mazatlán. I’ve known Juan and used his services for car and health insurance for more than a decade; he’s honest, genuine, helpful and professional (and perfectly bi-lingual!). The Chong insurance office has been serving Mazatlán locals and foreigners for three decades, beginning with Juan’s father. Whether visiting or staying, they can help with your insurance needs (medical, home, renter’s, vehicle).
We compiled this list of FAQs about health insurance in Mexico to share some basic information. Should you have other questions or wish to speak to them directly, you’ll find the Chong insurance office contact information at the end of this post.
Q. Does Medicare work in Mexico? A: Medicare only works in the United States, within its own network and conditions.
Q. What about IMSS or Seguro Social for foreigners? I have expat friends who use this. A: Please note this is not our area of expertise; here is some basic information and the official Mexican government website where you can find more details.
Some expats with Permanent Residency use these options for their health care in Mexico. These types of insurance are usually for Mexican citizens and/or residents who comply with the enrollment requirements. Coverage is subject to availability of the local public hospital and doctors and is not free; cost depends on your age and medical condition. IMSS public healthcare is for general medical needs; complicated surgeries and special needs (for example, heart surgeries) can only be performed at specific larger hospitals in bigger cities, such as Mexico City.
Public healthcare in Mexico is generally provided to employees and covered by their employers, or by voluntary affiliation. Attention and quality of the service can vary and wait times are common, as it is a public service for the general population. There’s a general checklist of requirements necessary to apply for public healthcare (IMSS, Seguro Social) such as having residency in Mexico and not having certain listed pre-existing conditions. There are also a variety of mandatory waiting periods for enrollment and certain procedures. Further details available at: http://www.imss.gob.mx/derechoH/segurosalud-familia (Spanish).
Q. What are the biggest differences between international health insurance and a U.S. plan? A: Most international health insurance plans cover the holder in all countries of the world except for that person’s home country (where their passport is from) although there may be exceptions. Private U.S. plans provide domestic coverage and might include international coverage as well. Always carefully review your policy conditions and coverage limits.
Q. Is there an age limit for coverage? A. Yes, for most health insurance plans there is an age limit to enroll. Most domestic Mexican insurance carriers insure people up to age 64. Some international plans will accept people up to age 74, and some may accept older people with limited and listed coverage.
Q. What about pre-existing conditions? A. Pre-existing conditions are usually excluded in Mexican domestic insurance plans, and depending on the condition, it may result in full application denial. Some can be submitted for review by the insurance company, but the coverage and terms are subject to their approval. International carriers are often more flexible with certain conditions and will offer limited coverage depending on each individual case.
Q: Do Mexican hospitals accept international medical insurance? A: Most major hospitals in Mexico will accept these types of insurance; however, it’s very important to note that hospitals are not required to accept the insurance company settlement and can reject it. In that case, the insured person must pay their bills upfront and submit them to their insurance company later for reimbursement.
Q: How is Mexican health insurance different from in the U.S. or Canada? A. The most notable differences with Mexican insurance carriers are that deductibles are applied per illness, per patient, only once in the period of the ailment or incident; ie, there’s not a yearly deductible—the deductible is paid once for each condition. And of course that premiums are in Mexican pesos.
Q: Is Mexican health insurance expensive? A: Compared to costs in the U.S., for example, it is less expensive, however, premiums are linked to the age and medical condition of the person and priced accordingly.
More questions? Here’s how to contact Juan, Alejandro and Chong Seguros. (“Seguros” means “insurance” in Spanish.)
By phone: (+52) 669-982-0260 (To call from the U.S., dial +52 and then the 10-digit number)
In Mazatlan? Visit the office: 5 de Mayo #2214, Centro Historico, Mazatlán, Mexico (Open Monday-Friday, 9am-6:30pm. Saturday, 9am-1:30pm. Closed Sunday.)
This content was originally published here.