Mexico Health Care
As per our previous post, we have decided that it's time to stop having a monthly deduction (Can$150.00) taken off our pensions for our British Columbia Medical Services Plan premiums. Due to our extended absence from Canada our previous benefits in Canada have ended. We now have to pay cash at current hospital and doctor professional rates when we return to Canada for a visit. We thought it was better to put the monthly MSP premiums into our pockets and apply that to what might be available to us in Mexico Heath Care systems.
We consulted with doctors, insurance people, hospital people and locals who are using the health care systems here in Mazatlan. As far as we can tell there are four basic approaches available to us retired expats for health care here:
Option 1. Do nothing and hope the local Farmacias can help us with meds if we discover through online self-diagnosis that we need something. That's what we have been doing up to now.... a “pay as you go” approach to our health needs for the past three years even though we paid $6,000.00 Canadian dollars for traveller's insurance coverage the first two years (and we only claimed back $800 of that). It seems pay as you go is much cheaper as long you don't have any very serious emergency-related ailments. It's a good thing we are both healthy and careful. We have been visiting local doctors and buying our daily meds over-the-counter in Mexico and in the Caribbean since we left Canada in 2015, and they are much cheaper here in Mexico than anywhere else.
Option 2. Join the national Ministry of Health – Seguro Popular health plan. Seguro Popular is available to Mexican citizens and to expats who are Temporary or Permanent Residents. It was initially created to help the very poor who have no access to health care here in Mexico.
Documents needed for membership are; copy and original of Residencia card, CURP card, passport, and utility bill proving your address. Membership is reviewed and renewed every three years. Fees for your policy and care depends on what “level” you are assessed at and is based on how you answer questions such as: do you own or rent, do you have cement, dirt or tile floor in your house; do you have a refrigerator and stove; how many TV’s and bathrooms; number of bedrooms; do you work; do you own a car; what is your level of education; your age; number of people in a family; are you a Mexican national vs a Temporary or Permanent Resident, etc? Your answers will also determine what you may be required to pay towards surgery. The highest fee is about 12,000 pesos per annum for a family plan (both of us in one plan).
If you have an emergency you go directly to Hospital General for treatment. There are no pre-existing conditions restrictions to join and there is no age limit. Your insurance starts immediately and is nation-wide. You must always present the enrollment approval form and number along with government issued photo identification when needing care.
Here in Mazatlan there is only one hospital for Seguro Popular patients and it is in dire need of replacement along with the quality of service provided. Wait times for most medical services are very long and are sometimes not even available as part of the plan at this facility. Sometimes they do provide the service but it might not be part of the coverage in the plan so the patients have to pay cash before they leave the hospital. For some, it might take days to gather the money to pay the bill so they are charged for the extra hospital days too. This General Hospital is pretty much available to anyone that shows up at the door provided they are a member of the plan. Quality services are somewhat lacking here in Mazatlan at this hospital - we have heard mixed reviews on using this plan including a few horror stories.
Option 3. Join the national Instituto Mexicano de Seguro Social plan – IMSS – that was created to provide support for Mexican employees. They pronounce the acronym as "eems". It is mandatory for employers and employees to enroll in this plan. IMSS is also available to expat retirees who have made their home in Mexico through the immigration residency process and programs. The annual fee for expats is $7000 to $9000 pesos per person and is renewed annually (increases with age). Those with pre-existing conditions are normally declined as members to the plan. Stuff like degenerative diseases, diabetes, asthma, heart disease related stuff like high blood pressure, cancer and other nasty stuff. We are pretty sure that will eliminate us as there is always a link to this sort of thing with everyone in their families. And, the first year's medical services to new members who do get in are almost non-existent as they don't provide coverage for all services to be sure that you are not hiding a pre-existing condition. The services for the second year are much improved and then subsequent years provide full coverage.
The comprehensive plan protects Mexican workers in the following matters:
occupational accidents and illnesses;
old-age, retirement, and survivor pensions;
disability;
sickness;
medical benefits;
maternity;
day care for children of insured workers; and
social services
We have been told by everyone we spoke with that the medical services provided by IMSS here in Mazatlan are not much better than what is provided by Seguro Popular and that IMSS facilities are much the same too.
Option 4. Sign up for private health insurance through a Mexican insurance company.
We went to a local popular insurance company (AXA) and after having a lengthy meeting with a representative in our home we found the annual fees and deductible amounts to be prohibitive. We found out that some private insurers won't sell you insurance if you are over 65 years old. Based on our current ages our joint annual fees amount to CAN$4,300.00 and each incident has a deductible of about CAN$2,930.00. So if both us have one significant medical incident that costs more than the deductible, the combined cost to us would be a minimum of CAN$9,628.00 in that year. Each added significant medical incident will cost another deductible amount of CAN$2,930.00. Having several incidents would be a non-starter for our limited pension income.
After meeting with hospital officials, we were advised that some insurance companies take up to one year to make payments to the hospitals, as there is usually a lengthy clarification process that takes place regarding payments. Private hospitals therefore charge insured patients more for services than those patients who come in without insurance. The high insurance premiums to us expats reflect that situation.
What to do....
All of this is somewhat complicated, and as newbies we need to continue to do our research and cost comparisons before forging ahead.
But we did find one other short term – if not long term – solution to getting some medical help if needed. We found a new family doctor close to home, Dra. Libia Zulema Paez Garcia, and she charges $300 pesos for her time for a consultation / visit (about CAN$20). She also makes house calls, and she will attend the hospital with us in the event of an emergency. At the same price. Amazing.
We started looking into and visiting several private hospitals and what their charges are for services. The most expensive (and the newest one) is located in the northern section of Mazatlan – Mazatlan Marina Hospital – and caters to many affluent Mexicans and expats in the area. The second most expensive one is Hospital Sharp Mazatlan. Their fees for services are more reasonable - about 1/2 of Marina Hospital - see list below.
And that leads us to a variation to the do nothing option – join the Sharps Hospital user incentive program and perhaps combine that with one of the two government options (if we can get accepted) at some point in the future. In the meantime we will continue to buy meds using the over-the-counter option until we sort out next steps.
Sharp Hospital is very close to our home in Mazatlan and is a modern well equipped professional facility with excellent staff with many of them speaking English. It opened in November of 1994 and was built to American standards using the model of Sharp Hospital in San Diego, California. It has 44 beds (33 private general rooms and 12 VIP suites) and room to expand.
So, we joined the Sharp Hospital incentive program – it is not an insurance policy and is not designed to take the place of medical insurance, but it does provide some cost savings for medical services. Membership is personal and its benefits are non-transferable. It currently costs $325.00 pesos per person, and each of us get the following benefits and discounts for a two (2) year period:
Medical Alert Wallet Card: photo ID with Blood Type and Allergies noted thereon plus a written direction in Spanish asking for transportation to Hospital Sharp Mazatlan in event of emergency.
Emergency Contacts in your home country and in Mexico are kept on your file at Hospital Sharp.
Doctor's consultation available at Sharp's ER department, even for non emergency visits i.e., health inquiries, etc.
Annual Medical Check-Up packages at special reduced rates are offered to members.
S.H.A.R.P Card Members receive the following medical service discounts:
30% Hospital Room (Normal and VIP)
30% Emergency Consult (General Practitioner)
15% Radiology
15% laboratory
15% Use of Emergency Room
15% Physiotherapy
10% Cath Lab
10% Surgery Room
5% Intensive Therapy Room Rental
And here are the current rates (as of this writing) for professional services at Sharps Hospital – our discounts come off these rates listed below ($15 pesos = CAN$1.00) - compare these to any hospital in Canada or USA. Looks pretty doable if we need to use them:
EMERGENCY SERVICES - all costs in Mexican Pesos
injection medicine application 35
taking blood pressure 31
use of emergency room 136
use of gypsum room 692
use of shock and trauma room 2571
daytime internal consultation 621
nighttime internal consultation 746
Surgeries
use of operating room 1 hour 1650
Hemodynamics (Heart)
perfusion angiography room diagnostics 3120
perfusion angiography room therapy 6240
Hospital Stay
Room rental 2084
Room rental Junior Suite 3160
ICU
cradle per day 696
cradle per day isolated 1371
radiant heat cradle 227
radiant heat cradle intermediate therapy 1371
RADIOLOGY AND IMAGING - all costs in Mexican Pesos
chest xray 278
food, ankle, hand and oblique 250
paranasal sinus waters 149
ultrasound abdominal 1066
ultrasound pelvic 620
ultrasound renal 620
crossover multislice CT scan 2000
tac mutislice of abdomen 2606
coronary angio tac 9000
calcuim score in arteries 1800
MRI 3200
MRI with gadolinium (chemical) 4400
LABRATORY - all costs in Mexican Pesos
herbal biometrics 168
general urine test 138
electrolytes 394
blood chemistry 412
blood clotting time / partial blood count 137
lipid profile 739
liver function profile 713
thyroid profile 860
blood protien 215
stool sample analysis 194