 |
Cabo House Calls
|
 |
|
|
24 hour emergency medical service
Signs and Symptoms Quick Reference
|
So you have health insurance, and you are wondering if it is any good while you are in Mexico, or are you going to have to pay for health care and be reimbursed by your insurance company when you return home. That is going to depend on what type of insurance you have. It will also depend on the physician and hospital where you seek care. Generally physician consultations are paid for out of pocket; ask for a receipt for reimbursement. Many hospitals and clinics will not work with your insurance company to reduce your out of pocket expenses.
There are four major types of Insurance products that are seen here in Los Cabos, the last two are what most part time and full time residents should carry. They are U.S. Medical Insurance, Travelers Insurance, Mexican Health Insurance and Expatriate Insurance.
U.S. MEDICAL INSURANCE
This is a typical health insurance that most people in the U.S. have; it falls into two broad categories. The first is Medicare/Medicaid. The second category encompasses the type of insurance that one receives as an employment or retirement benefit or private health insurance that one pays for out of pocket.
Medicare/Medicaid: Neither of these will pay for your health care in Mexico directly to the physician or hospital. You must pay for your care directly to your provider and submit a claim for reimbursement when you return home.
Employment, Retirement and Private Insurance: Whether the insurance company will pay your provider directly will vary greatly from insurance company to insurance company as well as the physician and hospital taking care of you. Typically the hardest part is finding a physician and hospital that will work with your insurance company. Once your insurance company is notified that you require health care they will pre-certify your claim and they will make a decision on payment. There are two options, either the insurance company will pay your health care provider directly, with a co-payment that varies from $200.00 USD to $2,000 USD or requiring that you pay up front and seek reimbursement at a later date.
You must contract this before you come to Mexico; usually it is available through a travel agent. Once again how well it works depends on your physician and hospital and there willingness to work with the insurance company.
This is for people that spend a lot of time in Mexico. There are two major types: public sector health care (IMSS) and private insurance. The public sector (IMSS) is a bureaucratic system (think Canada) with its inherent delays. Private insurance is similar in function to the U.S. They will not pay for out-patient procedures directly. In order to have the private insurance pay for inpatient care, you must be in the hospital for at least 24 hours and there must be a service contract between the insurance company and the hospital; other wise you pay and then seek reimbursement.
This is my personal favorite for anyone that spends more than six months outside of their home country. Some policies have world wide coverage, others have geographical limitations. They are much less expensive than a comparable policy in the U.S. They generally will have medical evacuation (Life Flight) as part of the coverage, and the policies are accepted by U.S. and overseas hospitals
|
