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James MacDonald
US/CAN: +1 (408) 220-5981
MX: 52 1 (612) 167-8976
La Paz and El Centenario, BCS 23205
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Answers to your questions about the cost, quality and availability of health care services in La Paz, BCS, Mexico

What would happen if I got sick while visiting or living in La Paz? Is medical care here expensive? Is it modern? Is it safe? What kind of health care services can I get here? The answers to these questions can really affect a person’s decision to move to Mexico. Here we share some articles written by expats who have made the move to La Paz about their experiences with the healthcare system here.

Health care in Mexico is definitely tiered: the less you pay, the less service you get. And as it is with every system, there are both positives and negatives to consider. 

In this series we cover:

Option #1  Seguro Popular
Option #2  IMSS
Option #3  Private Hospital Care

Option #4  Private Insurance


OPTION #4: INTERNATIONAL PRIVATE MEDICAL INSURANCE

Private insurance comes in all sizes and costs, with different benefits, exclusions, conditions, qualifications. It’s a confusing product. So much depends on your age, the state of your health, pre-existing conditions, bad habits, your budget, etc.

We asked an insurance broker, Roger Anthony, to help us maneuver through the information and clear up a few questions we had about private medical insurance. Roger is a U.S. expat living in Cabo San Lucas. He is a walking-talking testimonial for International Private Medical Insurance (IPMI).

While Roger was visiting the US, a 1200-pound horse he was riding fell on him! With his pelvis shattered, lung collapsed and ribs broken, Roger almost died. He spent extensive time in the hospital where he acquired various bolts, nuts, plates and screws, along with about a $200,000 medical bill.

The good news is that Roger had IPMI. And when the insurer wrote a check for over $200,000, Roger was so impressed that he decided he could sell this product with conviction. He sought education, became a licensed broker in his home state, and was mentored into the business by experts with 20 years experience. Roger now has almost a decade of experience providing expat insurance exclusively, in Mexico and internationally.

What is international private medical insurance (IPMI)?
IPMI is a product offered to expats (people living outside of their home country) enabling them to be treated locally, or to return home for treatment and including evacuation cover.

Why buy IPMI? 
Because if you can’t afford to self-insure, and you can’t afford hospitalization that could potentially cost hundreds of thousands of dollars, then international medical insurance is an option if you want protection.

How do I know an IPMI product is solid? 
You can know from the financial strength of the underwriter and the legal system of the country where the policy is based.

Why do I need a broker instead of buying on-line? 
Your broker is legally obligated to be on your side in any dispute, and can advise and assist you on the best way to satisfy information requirements of the insurance company if any claims adjudication is required. It doesn’t cost you more to buy from a broker. If you are retired in Mexico for 20 years, you are going to need help or have questions sooner or later. Also, the best policy for your early years of retirement will not be the best for your later years of retirement, and your broker can advise, help you transition and supply you with options.

Why don’t I buy Travel Medical Insurance instead of IPMI? 
Travel Medical only covers accidents and emergencies; it doesn’t cover cancer or hip replacements and is not renewable. IPMI is guaranteed to be renewable and covers everything you would expect a medical insurance policy to cover. Also, IPMI it is not necessarily always more expensive than Travel Medical Insurance. A good broker can offer you the best options.

Why should I buy from a local expat broker living in Mexico? 
A local broker who lives in Mexico can advise you on the best hospitals, can advise you when you get into a dispute with a hospital, make referrals to claims adjusters when you need to return home for medical treatment, or need any local help or assistance. If you buy from a broker back home, they will have no idea about local issues.

Why is the online international insurance world so confusing? 

  1. There is the confusing term “travel medical insurance,” which is really just travel insurance, but when you search for “international medical insurance” all these sites will all come up in a confusing mess.
  2. You have some sites from providers, travel insurers, from brokers masquerading as providers, insurance supermarkets, even domestic insurance will come up, and then local sites from where you want to retire offering information on the subject, then you have local blogs from helpful people that are full of wrong information.
  3. For the beginner who doesn’t know the subject or the right questions to ask, it is overwhelming and can be a minefield unless you read the contract and know what you are buying. Don’t press that “Buy Now” button! Ironically, finding an on-line IPMI solution is hard, very confusing, difficult, and you won’t know a good solution when you see it!

 

To get more details on private international medical insurance, contact Roger Anthony at:

Protex International Insurance Services
Call from U.S./Canada Toll Free 1-800-608-5743
Call from Mexico Toll Free 01-800-681-6730
Mexico Cell: 624-129-2179
Websitewww.protexcare.com
Email: roger@protexplan.com 


OPTION #3: PRIVATE HOSPITAL CARE

Care in the local private hospitals is generally excellent. To give you an overview, I met with Dr. Salvador Belilty, the Medical Director of The Medical Centre (locally and fondly known as ‘The White Hospital’).  Founded 8 years ago by a group of specialists as a day-time walk-in clinic, the hospital is now a full-service facility, 24 hours a day, and includes emergency services and ambulance.
 
This small hospital is equipped to handle a huge range of issues, from minor boo-boos to brain surgery. Their spacious private rooms include sleeping accommodations for family members, big screen TVs, Wifi and telephone, as well as a professional staff who are at your side within seconds of calling.
The Medical Centre has the only dedicated ICU unit in the city, an in-house lab, X-ray, ultrasound, access to consulting specialists nationwide at 46 networked hospitals through a dedicated Internet platform…and much more. The list of specialists working in the hospital is impressive; there are too many to mention them all…but include a cardiologist, a neuro-surgeon, the only hand specialist in the state, a trauma specialist, and ob-gyn and more.  In other words, a specialist for pretty much anything you need.  They accept all private insurance and work with many insurance companies directly for payment.

Since Robin and I are from Canada, we are used to longish waits to see a specialist or for an emergency room visit.  I have found private care in La Paz to be quite different.  The few times we have needed emergency services, we were in within 45 seconds!  One can generally have an appointment with a specialist within 24 hours of your call at a cost of around 700 pesos.
 
What’s the downside? Well, depending on the state of your pocketbook, private care isn’t cheap.  But compared to other places in the world, it’s very reasonable.  There are quite a few private hospitals in La Paz, and rates vary between facilities.  An overnight (36 hour) stay at the White Hospital with a doctor, all-call specialist, heart monitoring, medications, private room and good nursing care, recently cost a friend of ours 14,000 pesos.

Part of the supportive and close family culture that exists in this country provides every courtesy for family to be with the patient at all times in the hospital.  Patient care is a family affair, which makes for a calmer experience.  So, although we have and would again make use of public hospitals, we use private whenever necessary and affordable.

-Miriam Welldon


OPTION #2: IMSS

An employed Mexican citizen is eligible for a higher level of medical care than the basic Seguro Popular (see Option #1), and this is called IMSS (Instituto Mexicano de Seguro Social). IMSS is a system funded equally by the employee, the employer and the federal Mexican government. 

Luckily, expats are also eligible for IMSS if they meet the medical criteria and pay an annual fee. The main hospitals in La Paz for this level of care are the Hospital IMSS on Calle 5 de Febrero and the IMSS specialist hospital on Calle Toronja.

How to Apply for IMSS: Take your documents and photos to the IMSS intake center in the Soriana mall on Abasolo in La Paz.

For each person applying bring the following:

  • Passport plus 2 copies
  • Residente Temporal or Residente Permanente visa plus 2 copies
  • 2 copies of your marriage license, if applicable
  • 2 copies of your CURP card
  • 2 copies of your most recent CFE or phone bill in your name
  • 3 passport/visa photographs
  • Application form disclosing pre-existing conditions


This entire package will be reviewed, you will be given a basic medical exam and you will be accepted or rejected. The process will take about a month in total. 

Pre-existing conditions that may disqualify you:

  • cancer
  • diabetes
  • organ disease
  • stroke
  • drug or alcohol dependency
  • HIV
  • obesity


If you are accepted by IMSS, you will have medical coverage for as long as you pay your annual fee. You cannot be disqualified. Obviously, you want to get this insurance while you are still healthy! However, even with all the necessary paperwork and without prior conditions, IMSS can still deny your coverage and no reason will be given. You then have the option to apply for Seguro Popular, where no one is denied. 

With IMSS all your medical care is without cost. All prescription medication, the consultations with the doctor, the specialists’ appointments, blood tests, pap tests, mammograms, dental extractions, plaque removal, x-rays, etc., are all included in your annual fee. Some level three care is not available here in La Paz, so patients with certain  serious medical conditions will be flown to other cities on the mainland to receive care. For example, back patients might be flown to Ciudad Obregon, Sonora for surgery, and certain types of cancers will be sent to Guadalajara for radiation.  

HOW IS THE QUALITY OF CARE?

This most crucial question is a tough one to answer. If you ask that about ANY healthcare institution anywhere, you’ll hear good and bad, but my personal experience with IMSS has been excellent, and I have confidence in the medical care I am receiving. I don’t always enjoy the lineups for bloodtests or the time slots for appointments, but that is a small price to pay for full medical coverage.

My partner and I were both deemed eligible in 2011, and we paid 2300 pesos ($120 US) each for the year. The annual premium goes up a bit each year, and when you reach age 60 there is a comparatively large jump. So now at age 64, my cost is 7,300 pesos ($370 US) a year.

On Day 1, we were assigned to a certain “door” in the hospital clinic and to the attending doctor there. Every visit to the clinic we are weighed, blood pressure is taken and height is measured. (That last one always makes me smile.)  

Not long after we became clients, it was discovered that my partner had a heart issue and I had a thyroid problem. Without IMSS it might have been several more years before we were diagnosed and treatment started.

A few years ago, I was concerned about some possible skin cancer. My doctor sent me to a specialist, and a month later I was in the IMSS specialist hospital awaiting surgery. Wow, you’d think they were prepping me for a heart transplant...I was as sterile as the operating theater! Two nurses, two surgeons, soft music, and me in my bonnet and boots. I was thoroughly impressed with the professionalism, organization and facilities. But more than that, I felt treated well…not just another body on the table. Yes, I had to jump through a few hoops to get there, but the care was warm, professional and inexpensive! And that about sums up my opinion of IMSS: It’s not the easiest and fastest route, but it is inexpensive and first-rate. 

-Fern Corraini


OPTION #1: SEGURO POPULAR

Back in 1992, Mexico created a program to provide health care for anyone who does not qualify for employer-supported medical insurance. There are pluses and minuses to the system but it remains a great way to provide you and your family access to wellness. Known as Seguro Popular, or public insurance, it forms part of the social health protection system administered by the Secretary of Health and the National Health Commission.

Expats in Mexico on either a permanent or temporary visa are eligible for this same coverage at a very low cost.  It is a basic no-frills option, but no one is denied on the basis of pre-existing conditions.  Here in La Paz, the hospital associated with Seguro Popular is the Hospital General Juan María Salvatierra on Avenida de los Deportistas. 

We thought you might like to hear about Seguro Popular from someone in our community who has it.  Thanks to Warren Jorgenson for sharing his experience:


In our preparation to retire and move to La Paz, Mexico, we did a lot of research on the medical system and capabilities of the Mexican healthcare system.  We were amazed to find the major hospitals and even the smaller private ones have the same advanced equipment that we were used to seeing back at our trauma center in the USA. We were even more surprised when we started talking with a few doctors and ambulance paramedics to find out that the advanced technology also was out in the ambulances. We found that doctors go out of their way to find out the root cause of your problem, spending much more time than we are accustomed to for an office visit. And, if you can’t get to the office they will come to your home. It is strange to have a surgeon come to your house to check on you and also remove your stitches while he is there. 

Now you are probably wondering what all of this great care costs.  We had the same question when we came here. To give you an example, my wife and I both worked for state government in the US, so we had really good insurance. When we retired in 2010 we got the bad news: our insurance premium for just the two of us was going to be $1438 per month, ouch!  Now for the good news…

When we got down here to beautiful La Paz and started looking for insurance we were directed to the Segura Popular program, the public insurance for all Mexican citizens. Foreign residents are required to pay a small annual fee based on their ability to pay.  To sign up, we met with some very nice people who asked a few questions about our finances. We found out that our insurance rate was going to be the highest that the Seguro Popular program had. Yes, in 2011 the HIGHEST rate was 1417 pesos or about $123 US for the entire year!  In 2017 the same coverage cost only $83 due to the strength of the US dollar!

Now you might be wondering if Seguro Popular is worth it or not?  Is it any good?

                                 
 
In 2016, my wife fell and smashed the knuckle on the top of her left femur. We went to the big hospital in La Paz and met with the leading surgeon for these types of injuries. She spent 11 days in the hospital. Nine (9) hours in surgery! This was a large six digit hospital bill. I asked for a few extra tests to be done that were not covered by the insurance, and after getting a discount with my Mexican seniors' card, the total bill when we left the hospital was $83.10 US!!  It would have been $0.00 without the extra tests. 
 

Any person taking advantage of the Seguro Popular system must learn the norms of hospital protocol and what the hospital expects of the patient. For example, one is expected to bring his/her own pillow and blankets. During the day, patient care is A1, but staff is reduced during evening hours and at night you are expected to have a family member stay with you to help with basic nursing routines. Once you know these things, you will find the service great. We would rate the quality of service to be an A. 

A month after surgery, my wife was walking well, without pain in her hip or bone. Eighteen months later, she continues with no pain at all from her hip injury and pin repair.

So is Seguro Popular insurance worth it?  I guess you will have to decide that. To us it was and is a retirement savings account savior!!

- Warren Jorgenson, Comitan resident