From our friends at Guardian Insurance – Heading south of the border to escape the cold northern winters or are you making your move full-times and curious about healthcare coverage? The team at Guardian Insurance MX put together a list of the most commons questions asked by expats living south of the border.
Do I need private health insurance, or can I use IMSS or Seguro Popular?
If you are employed in Mexico, you may be enrolled in IMSS (Instituto Mexicano del Seguro Social) a governmental organization that assists with public healthcare. Fees will depend on your financial situation and your age and may not cover pre-existing conditions. Another government health plan is Seguro Popular, a healthcare system that was originally created for unemployed or under-employed Mexican nationals. With these plans, you are obligated to use the public hospitals which are very basic, unsanitary and overcrowded. It is not unusual to spend most of the day at the clinic waiting to see a doctor, and several days or even weeks to receive major treatments or surgeries. For this reason, most expats prefer to purchase private international or Mexican health insurance and have the option of going to private clinics and hospitals. Private medical centers provide prompt appointments and treatment with personalized care.
What if I am injured in Mexico with no insurance?
Understand that if you are involved in an emergency in Mexico and are treated in a private hospital without valid insurance, you will not be released until your bill is paid, and in some cases, you may be turned away without prepayment.
What should I look for in an insurance agent/broker?
Where are they located? Are they here in Mexico, able to assist you in an emergency? Getting things resolved in Mexico can be a challenge so you need a broker who knows their way around the Mexican system. Does the broker have an office and are they established in the community? As experienced and reliable as your agent in your home country can be, insurance is different in every country. Unless your agent is located in Mexico or has a company registered and established here, you cannot expect high-quality service and timely claim resolutions as you can with an agent experienced in Mexico.
Should I choose an agent/broker who represents more than one insurance company?
Yes, your broker should be able to offer you a variety of policies with options to suit your requirements and your budget. Health insurance in Mexico ranges from basic to elite-level companies. You may want a policy that only covers you in Mexico or you may want a policy that gives you international coverage. Some Mexican companies even give you full coverage in the U.S., and they are usually a quarter of the price that you would pay for a policy through a U.S.-based company.
I do not speak Spanish; how will I handle my claim?
Select an insurance broker that offers bilingual assistance. It will be virtually impossible to resolve your claim without a Spanish speaking advocate. You want a broker and an insurance company who can communicate with Mexican officials, hospitals, and other agencies involved in your claim.
Does an insurance agency/broker need a license to sell insurance in Mexico?
Yes, and unfortunately there are many salespeople selling insurance illegally. They may mislead clients and make promises they cannot keep, and the client may end up in bankruptcy with no legal recourse. The insurance license ensures the agent/broker is diligent and complies with the law. It protects clients from errors made by the broker, and the mistakes of omission policy protects the insured. Request proof of their license when shopping for any insurance.
Do I have a choice on which hospital I attend for treatment?
Consult with your broker to determine which hospitals honor your plan. A good number of insurance companies have limited networks and you may not be able to go to any hospital you want unless you pay a penalty which can be as high as 60% of the amount of the claim. Your insurance agent/broker should be able to show you in writing how comprehensive your medical insurance plan is. And the insurance companies that don’t necessarily need you to pay upfront and that allow you to use hospitals with the most updated technology, treatments, and best physicians.
My previous broker made a lot of false promises, how can I avoid this?
Get it in writing. Review the policy and make sure everything that was promised to you during the presentation is in writing. Verbal promises are not going to help you while you are sitting in an emergency room.
What is the age limit for health insurance?
As we age, naturally our health insurance premiums will increase, and at some point, it becomes difficult for seniors to qualify for private health insurance. All insurance companies in Mexico have an age limit to apply. However, most of them cannot cancel coverage if you reach a certain age while insured under their plan. Although insurance companies will not cancel your policy, many of them do reduce coverage and benefits drastically, making the policy less beneficial and fulfilling to your needs or a possible health condition that you have.
Guardian Insurance is fully licensed to sell insurance in Mexico and is focused on providing high-quality service to the expat community.
Guardian employees speak English and Spanish, ensuring ease of communication between you and the broker, and the broker and the authorities involved with your claim.