Health Insurance in Paradise

Dec 2, 2015 by Gretchen Ellinger

Sonoran Resorts Food Drive Poster 2015Many people ask about health insurance in Mexico. Their concern is who will pay for their care if they get sick or have an accident that requires medical care in Mexico. They wonder if Medicare works here, if VA benefits apply here, if their “regular” health insurance, either primary or supplemental, works here. The quick answers are no, no, and maybe…

Under no circumstances that I can find will either Medicare or Department of Veterans Affairs pay for health care, emergency or otherwise, delivered in Mexico. They will neither pay the provider nor reimburse the patient if he pays the provider. Many insurance companies will reimburse patients who pay the providers, if receipts are provided with medical records, or if bills with proper medical coding are presented. Always ask – there is at least one medical clinic in Puerto Peñasco that is in tune with coding for medical billing that will enable patients to recover from their insurance companies the cost, or at least part of the cost, of their care.

An option that many people choose is IMSS health insurance through the Mexican government. It is available to foreigners in Mexico who have permanent resident cards, and is quite affordable. The cost is in the hundreds of dollars per year per person, depending upon one’s age. The coverage is quite extensive after the first year, in which all pre-existing conditions are excluded for coverage. After the first year, coverage is head-to-toe. The doctors are talented, the facilities are modern and in some cases ultra-modern state-of-the-art, and the wait times are very short, especially when compared to wait times in the USA. The downside? IMSS health insurance does not cover any medications, but medications are generally quite reasonably priced in Mexico. The real downside is that IMSS health insurance pays for no care provided outside Mexico. Period. IMSS health insurance is one of the reasons some people decide to retire in Mexico – it is affordable and the care is excellent. Many of those people spend very little time outside Mexico, and many of them have Medicare and/or VA benefits, which they depend upon for medical coverage when in the USA. You can get information about IMSS health insurance at the Social Security office located at 255 Calle Guillermo Prieto (the street that turns off Blvd Benito Juarez behind Burger King) very close to Ave. No-Reelección. The office is open from 8 a.m. – 4 p.m., and there is usually someone there who can help in English.

What about the people in Mexico who qualify for neither Medicare nor VA benefits? What about the people in Mexico who have retired and need coverage outside of the US? What about people in Mexico who are working and may even have employees who need health coverage? How about people in Mexico who want to travel to places outside Mexico and the USA? An international health insurance policy may be the answer. Available to anyone who has an address outside the US, an international policy could be one’s primary or supplemental insurance because it will pay for medical costs, within the parameters of the policy chosen, in Mexico, in the USA, or anywhere else the policy holder chooses to go! A group of people may qualify for coverage under certain circumstances. Maybe the answer to the health insurance dilemma for people outside of the US, whether they are self-employed and small business owners or simply need coverage no matter where they decide to live, work or retire, is an international health insurance plan. Your Rocky Point vacation home serves perfectly! For more information on international health insurance policies, contact Robin Chase rmwchase@gmail.com, phone (US) 843-422-035 or Bill Norgaard bknorgaard@qwest.net, phone (US) 623-551-8501 or visit their website at www.worldhealthinsurance.net and www.facebook.com/worldhealthinsurance. Both Robin and Bill speak English!

I am far from expert in this subject, and the information for this article was acquired from a number of sources. I have learned that the one constant is the fact that things change, and we have learned that in Mexico things can change overnight! Please do your own investigating before deciding which health insurance course is best for you and your family, and then enjoy Paradise!

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