OT: Mexican Health Insurance

User Forum Topic
Submitted by davelj on April 6, 2012 - 2:09pm

I finally did it... I'm now essentially completely divorced from the US health care system.

I've been going to Mexico for health care and dental for a few years now. (Fortunately there hasn't been much to attend to.) For the last three years I've had a catastrophic policy through a US carrier (Assurant) with a $10K deductible that was locked in at about $150/month. Which was fine until... I got the renewal notice a few months back and they now want $290/month. Since I was already completely comfortable going to Mexico for health care anyway, I had thought about getting Mexican health insurance but hadn't bothered to look into it. The bump in the cost of my US policy was the impetus to get more information.

Long story short, I've now got a policy through Grupo Nacional Provincial (GNP) Seguros that is essentially a catastrophic policy with an unlimited ceiling. The deductible is about US$6,000 and it costs US$65/month (converting from pesos). Now, I have to use Mexican providers (which I have no issue with), BUT in the case of a life or death emergency I have $100K worth of coverage outside of Mexico. This latter point was the issue I was originally most concerned about - for example, what would happen if I were in an accident here in the US and couldn't make it down to Mexico? - but this policy adequately addresses it.

So... I'm done with our clown-like system.

Submitted by harvey on April 6, 2012 - 2:20pm.

Interesting approach.

Are you concerned about legal recourse if the policy chooses not to pay?

That's a concern I have with American companies, but I would be more concerned with a policy in another country. Our medical system sucks, but our legal system can actually work for the "little guy" (not always, but it's not impossible either...)

Say you actually needed to invoke the unlimited ceiling and the provider decided not to pay - do you think your chances of prevailing in court would be better/worse/the same in Mexico?

Submitted by davelj on April 6, 2012 - 2:46pm.

pri_dk wrote:
Interesting approach.

Are you concerned about legal recourse if the policy chooses not to pay?

That's a concern I have with American companies, but I would be more concerned with a policy in another country. Our medical system sucks, but our legal system can actually work for the "little guy" (not always, but it's not impossible either...)

Say you actually needed to invoke the unlimited ceiling and the provider decided not to pay - do you think your chances of prevailing in court would be better/worse/the same in Mexico?

I'm not overly concerned. I think you'd run into the same issues whether in the US or Mexico. I think it's natural to believe that companies from one's own country are more "honorable" - for lack of a better word - than those of other countries, and particularly developing countries (the "home country bias"). The evidence, however, doesn't support it.

As an aside, my agent - referred to me by my doctor in TJ - has dual citizenship and owns a home on Coronado (where she has an office) as well as in TJ, where she spends most of her time. Most of her clients are wealthy Mexicans that live in both the US and Mexico. When we were discussing the two countries' systems she said, "It wouldn't occur to me or most of my clients to get healthcare in the US - we have the same quality at 1/3 the cost in Mexico." My point is that I think false perceptions drive a lot issues within the health care debate.

Submitted by Diego Mamani on April 6, 2012 - 3:54pm.

pri_dk wrote:
Are you concerned about legal recourse if the policy chooses not to pay?

That's very unlikely to be an issue, especially given the fact that medical care, medicines, etc., are a lot cheaper in Mexico than in the US. They don't charge $5K per hospital day alone (exclusive of doctors' fees) as they do here in the good old USA.

I had to go to an ER in South America a few years back. It turned out that no treatment was needed other than a written prescription. I didn't have my US-issued insurance card with me, so I told them up front that I was going to pay out of pocket. My total cost for the ER visit? The equivalent of US$8. I didn't have to wait in line (it was 5 am), and the facilities were better than OK, and that was a government-run hospital.

Submitted by Jazzman on April 6, 2012 - 10:44pm.

That is incredible! In fact, it is so full of irony, you ought to broadcast it a little more pervasively.

Submitted by EconProf on April 7, 2012 - 7:33am.

Sounds like you have made a shrewd move to escape the wasteful and inefficient US medical care system and achieved almost as good a result with far lower costs.
Our medical care is generally great quality, but is larded up with excessive costs because the participants have no incentive to economize. Our third-party payer system means no doctor, hospital, or drug provider has any incentive to restrain their pricing. The patient, especially the poor and elderly who have no (or very little) co-pay or deductible under medicare and medicaid have every incentive to demand the best and most treatment. Our drug companies spend billions to bring a new wonder drug to fruition, and thus subsidize the rest of the world that copies the drug, but does not need to incorporate this cost into the price they can charge their citizens. Tort lawyers scare doctors into over-testing and over-treating. Consumers are denied the benefits of competition by being unable to shop for insurance across state lines. The list goes on.
Mexico has none of these cost drivers, so can charge a more reality-based price in line with the rest of the world. Our costly, larded-up medical system is entirely our own making, and comes from not taking incentives into account by the lawyer-lawmakers who created it.
Your approach may spread because it makes so much sense--at least for Americans who live near the border.

Submitted by Jazzman on April 7, 2012 - 9:51am.

pri_dk wrote:
Interesting approach.

Are you concerned about legal recourse if the policy chooses not to pay?

That's a concern I have with American companies, but I would be more concerned with a policy in another country. Our medical system sucks, but our legal system can actually work for the "little guy" (not always, but it's not impossible either...)

Say you actually needed to invoke the unlimited ceiling and the provider decided not to pay - do you think your chances of prevailing in court would be better/worse/the same in Mexico?


The legal profession is part of the problem in the US.

Submitted by outtamojo on April 7, 2012 - 1:20pm.

EconProf wrote:
Sounds like you have made a shrewd move to escape the wasteful and inefficient US medical care system and achieved almost as good a result with far lower costs.
Our medical care is generally great quality, but is larded up with excessive costs because the participants have no incentive to economize. Our third-party payer system means no doctor, hospital, or drug provider has any incentive to restrain their pricing. The patient, especially the poor and elderly who have no (or very little) co-pay or deductible under medicare and medicaid have every incentive to demand the best and most treatment. Our drug companies spend billions to bring a new wonder drug to fruition, and thus subsidize the rest of the world that copies the drug, but does not need to incorporate this cost into the price they can charge their citizens. Tort lawyers scare doctors into over-testing and over-treating. Consumers are denied the benefits of competition by being unable to shop for insurance across state lines. The list goes on.
Mexico has none of these cost drivers, so can charge a more reality-based price in line with the rest of the world. Our costly, larded-up medical system is entirely our own making, and comes from not taking incentives into account by the lawyer-lawmakers who created it.
Your approach may spread because it makes so much sense--at least for Americans who live near the border.

Yes, and if anyone thinks electronic health records and CPOE are going to help, think again.

Submitted by 5yes on April 7, 2012 - 3:47pm.

I love this! We are looking at international healthcare options for our family, I think that there are so many great options beyond what we are encouraged to subscribe to as American taxpayers.

Submitted by dumbrenter on December 24, 2012 - 9:20am.

ok, I'm just about done with the medical system here.

In my case it is not the cost of care, but the paperwork and nickel & dime game between the doctor's office and the HDHP provider. I wish I could just walk in, get care, pay for it and move on with my life.

Davelj, have you had to use the mexican insurance since you got it? Can we just pay cash for medical services in mexico? Are there any such providers in San Diego? Thanks.

Submitted by davelj on December 27, 2012 - 12:34pm.

dumbrenter wrote:
ok, I'm just about done with the medical system here.

In my case it is not the cost of care, but the paperwork and nickel & dime game between the doctor's office and the HDHP provider. I wish I could just walk in, get care, pay for it and move on with my life.

Davelj, have you had to use the mexican insurance since you got it? Can we just pay cash for medical services in mexico? Are there any such providers in San Diego? Thanks.

I have not had to use my insurance which shouldn't be surprising as there's a $6,000 deductible. As inexpensive as things are in Mexico it would take something pretty major to work through the deductible. It's really just a catastrophic policy.

My primary physician works out of Hospital Angeles (http://www.angeleshealth.com/doctors). I've been down there three times in maybe 18 months for minor issues (bursitis in my elbow, removing a lipoma cyst on my back, and a standard check-up). I pay cash each time. Removal of the cyst and the check-up were ~$100 each. The bursitis required some fluid examinations and an x-ray - I think I paid $225 total. The appointments were handled the same day in two instances, the next day for the other. I've had nothing but positive experiences.

One thing to consider, however, is the border wait returning to the US. If you're crossing at the wrong time on the wrong day you can be in line for up to 2 hours, although a normal wait is more like 45 minutes (I walk). I've got a Sentri pass, so I get through in 10 minutes even if the standard line is very long. So, if you go down this path I'd recommend getting a Sentri pass (which, unfortunately, takes about 4-5 months to obtain) - just makes everything easier.

Regarding San Diego, I'm sure there are cash providers. I'm also sure that they're unbelievably expensive - regardless of payment method. Our system is irretrievably f*cked, in my view.

Again, I've had nothing but good experiences in Mexico. Best of luck!

Submitted by dumbrenter on December 27, 2012 - 1:38pm.

davelj wrote:
dumbrenter wrote:
ok, I'm just about done with the medical system here.

In my case it is not the cost of care, but the paperwork and nickel & dime game between the doctor's office and the HDHP provider. I wish I could just walk in, get care, pay for it and move on with my life.

Davelj, have you had to use the mexican insurance since you got it? Can we just pay cash for medical services in mexico? Are there any such providers in San Diego? Thanks.

I have not had to use my insurance which shouldn't be surprising as there's a $6,000 deductible. As inexpensive as things are in Mexico it would take something pretty major to work through the deductible. It's really just a catastrophic policy.

My primary physician works out of Hospital Angeles (http://www.angeleshealth.com/doctors). I've been down there three times in maybe 18 months for minor issues (bursitis in my elbow, removing a lipoma cyst on my back, and a standard check-up). I pay cash each time. Removal of the cyst and the check-up were ~$100 each. The bursitis required some fluid examinations and an x-ray - I think I paid $225 total. The appointments were handled the same day in two instances, the next day for the other. I've had nothing but positive experiences.

One thing to consider, however, is the border wait returning to the US. If you're crossing at the wrong time on the wrong day you can be in line for up to 2 hours, although a normal wait is more like 45 minutes (I walk). I've got a Sentri pass, so I get through in 10 minutes even if the standard line is very long. So, if you go down this path I'd recommend getting a Sentri pass (which, unfortunately, takes about 4-5 months to obtain) - just makes everything easier.

Regarding San Diego, I'm sure there are cash providers. I'm also sure that they're unbelievably expensive - regardless of payment method. Our system is irretrievably f*cked, in my view.

Again, I've had nothing but good experiences in Mexico. Best of luck!

Thank you. I'll try the hospital reference you provided.

Submitted by zzz on December 28, 2012 - 10:43am.

Davelj.....Curious, how would you handle something life threatening but chronic, like cancer, yet not terminal (don't qualify for Medicare) and requiring continuous treatment and even frequent hospitalizations...so proximity of care is important? I think you could burn through the 100k pretty quickly in the US with certain cancer treatments.

My concern with not having US insurance has less to do with typical things - IE a routine doctors visit as I wouldn't have a problem paying 200-300 out of pocket for a visit, but more to do with if they discover something that requires ongoing treatment.

Have you looked at Anthem plans? I don't know how young you are, but I took on an Anthem policy last year for a few months in between Cobra and the next job. In my mid 30s so I was paying like $80/month for a high deductible plan ( I think it was $8500). I'm considering going back to that as I'm on the better half's crappy work plan insurance right now and paying $60/week for access to HMO insurance. I basically don't use it at all.

Submitted by davelj on December 28, 2012 - 11:52am.

zzz wrote:
Davelj.....Curious, how would you handle something life threatening but chronic, like cancer, yet not terminal (don't qualify for Medicare) and requiring continuous treatment and even frequent hospitalizations...so proximity of care is important? I think you could burn through the 100k pretty quickly in the US with certain cancer treatments.

My concern with not having US insurance has less to do with typical things - IE a routine doctors visit as I wouldn't have a problem paying 200-300 out of pocket for a visit, but more to do with if they discover something that requires ongoing treatment.

Have you looked at Anthem plans? I don't know how young you are, but I took on an Anthem policy last year for a few months in between Cobra and the next job. In my mid 30s so I was paying like $80/month for a high deductible plan ( I think it was $8500). I'm considering going back to that as I'm on the better half's crappy work plan insurance right now and paying $60/week for access to HMO insurance. I basically don't use it at all.

If that were to arise I would just use my Mexican insurance in Mexico... and go to TJ for treatments. I wouldn't bother with the US system at all. (Also, my Mexican insurer wouldn't pay for US treatment unless it was an imminently life threatening situation.) The proximity isn't an issue for me, personally, as the hospital is a 5-minute drive from the border.

I think I actually had Anthem insurance several years back for a couple of years. What I recall is that the premium skyrocketed after the first year or two, then I moved to Assurance and the same thing happened - I locked in a reasonable rate for a couple of years and then they doubled it on my upon renewal. Then I just said, "This thing's broken - I'm through."

Normally, when someone says, "It's not about the money; it's the principle of the thing," it's actually about the money. In my case, the money's not a big issue - the whole thing just began to irk me. It's just all so nonsensical that I couldn't allow myself to participate anymore. Now, if in 20 years we've moved to a more rational system then I'll be happy to return... but I'd bet against that.

Submitted by dumbrenter on December 28, 2012 - 2:26pm.

Can we use the HSA across the border?
I guess the answer is a No, but cannot help asking.

Submitted by davelj on December 31, 2012 - 3:13pm.

dumbrenter wrote:
Can we use the HSA across the border?
I guess the answer is a No, but cannot help asking.

No idea.

Submitted by scaredyclassic on December 31, 2012 - 4:31pm.

Very intriguing. Given the worries many have about switching jobs and losing insurance this could at the very least be a great security blanket if a workers in an uninsured position for a number of years.

Also ... As a parent, if I can, I always want some insurance on my kids if they don't get it, since I'd sleep better. This could be a great backup

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