By Karen McConnaughey
Have you been reading the papers? Does this sound familiar?: “A healthcare plan with no limits, no deductibles, free medicines, tests, X-rays, eyeglasses, even dental work -- all for a flat fee of $300 or less a year.” What do you think? Too good to be true? Science Fiction? The future for America?
Nope…it’s true, it’s now, and it’s not a pipedream, but to get it, you just have to move to Mexico! Bill and I bought our house in Lake Chapala in 2003, and have never once regretted our decision, and, believe it or not, we never even considered the healthcare question…we so lucked out by moving to Mexico!
As we all know, there is perhaps no greater concern for the retiring population in America—living on limited life savings and the fixed income of social security—than being able to afford medical care. And, unfortunately, not just for retirees…healthcare has become a luxury many cannot afford.
As the TV news program 60 Minutes reported, “one sign of the worsening state of health care is that a medical relief organization called Remote Area Medical that was intended to air drop doctors into remote areas of the world like the Amazon jungle, are diverting their efforts to help people in the US who cannot afford necessary treatments. The story of RAM helping hundreds of Americans who are uninsured or under insured was chronicled in a March edition of 60 minutes and included the sad story of a retired woman who could not pay to have her eye glass prescription updated and was left virtually blind.”
Anti-healthcare reform activists often warn that healthcare reform would “lure more immigrants” into the U.S., but they don’t mention that the nation’s current healthcare system is motivating many U.S. citizens to leave. USA Today reports that thousands of American retirees have crossed the Southern border to sign up for the healthcare plan run by the Mexican Social Security Institute (IMSS).
As USA Today reported on September 1, 2009, in an article entitled Mexico & US: Mexico's Health Care System Lures Americans:
“As the United States debates an overhaul of its healthcare system, thousands of American retirees in Mexico have quietly found a solution of their own, signing up for the healthcare plan run by the Mexican Social Security Institute…[IMSS].
“The system has flaws [and] the facilities aren't cutting-edge, and…But for now, retirees say they're getting a bargain.
"’It was one of the primary reasons I moved here,’ said Judy Harvey of Prescott Valley, who now lives in Alamos, Sonora. ‘I couldn't afford health care in the United States. ... To me, this is the best system that there is.’"
As with everything, there are some rules.
“Pre-existing conditions aren't covered for the first two years, and some newer medicines and implants are not free. IMSS hospitals don't have frills such as televisions or in-room phones, and they often require patients to bring family members to help with bathing and other non-medical tasks.
“But the medical care doesn't cost a dime after paying the annual fee, and it is usually good, retirees and health experts say. Most American retirees enroll in IMSS as a form of cheap insurance against medical emergencies, while using private doctors or traveling back to the USA for less urgent care.”
Also, currently, Medicare, the U.S. insurance plan for retirees 65 and older, cannot be used outside the United States. If you make the move to Mexico, you have to make sure that you are covered either by private insurance or through the Mexican social security system. By the way, if you’re thinking about private insurance, check out insurance companies and plans through APRIL Medibroker on the Focus on Mexico healthcare web page. You can write your own provisions and get a list of all the different options available at the price you can afford.
Regarding Medicare, however, there’s a little bit of good news on the horizon…in the September 11 issue of the Guadalajara Reporter there appeared an article entitled Private Hospitals Prepare for Medical Tourism Boom, Medicare. It reports that
“…research done by the Association for Private Hospitals in Jalisco reveals that of the 21.5 million tourists who visited Mexico in 2006, about 160,000 – mostly Americans – came for medical attention.”
Therefore, the Jalisco state government (the state where Lake Chapala is located) … “recently announced it would be investing 4.35 million pesos to bring private hospitals up to the standards required for certification by the Joint Commission International (JCI), an institution that accredits hospitals in Canada and the United States.
“One of the main reasons for pushing for certification is that the North American Free Trade Agreement obligates the Mexican medical system to be on a par with the United States and Canada, allowing for the free flow of patients from border to border and for fair trade, much like in other economic sectors.”
“But there is another huge reason for this interest in JCI certification and that is Medicare.
“According to Paul Crist, the founder and president of Americans for Medicare for Mexico (AMMAC), a non-profit organization dedicated to bringing Medicare coverage to seniors living in Mexico, of the 800,000 American citizens living in Mexico approximately 200,000 are over 60 years old and thus are at or near eligibility for Medicare benefits.
“Crist, a former senator’s aide in Washington and now a hotel owner in Puerto Vallarta, says if Medicare is extended to Mexico, the program would only work with healthcare providers approved by JCI.”
If you would like to read the full article, please see News updates...
For those of you who are not familiar with the IMSS healthcare system:
What is IMSS?
IMSS stands for Instituto Mexicano del Seguro Social. It’s about as close to socialized medical coverage as you can get. Many working people qualify for IMSS and many employers make a contribution toward the IMSS coverage. All of us who live here think it’s great that Mexico has allowed retirees and other visiting residents to buy the IMSS coverage. They base the cost on what the payment would be if you were working full time at minimum wages. This year, Bill and I together paid a little over $600 for our IMSS coverage.
IMSS gives you complete coverage including prescription meds except for certain preexisting conditions that have varying time periods before they are covered. For an explanation of pre-existing conditions, click here. (LINK TO A WEB PAGE ON OUR WEB SITE)
As the USA Today article goes on to say:
“The program has helped people such as Ron and Jemmy Miller of Shawano, Wis. They decided to retire early, but knew affording health care was going to be a problem.
“Ron was a self-employed contractor, and Jemmy was a loan officer at a bank. At ages 61 and 52, respectively, they were too young to qualify for Medicare, but too old to risk not having health insurance.
"’We knew that we couldn't retire without Medicare,’ Jemmy Miller said. ‘We're pretty much in Mexico now because we can't afford health care in the States.’
“The couple learned about IMSS from Mexico guidebooks and the Internet. They moved to the central city of Irapuato in 2006, got residency visas as foreign retirees, and then enrolled in IMSS.
“The IMSS system is similar to an HMO in the United States, Jemmy Miller said. Patients are assigned a primary care physician and given a passport-size ID booklet that includes records of appointments. The doctor can refer patients to specialists, a bigger hospital or one of the IMSS specialty hospitals in cities such as Guadalajara or Mexico City.
“In 2007, Ron Miller got appendicitis and had emergency surgery at the local IMSS hospital. He was in the hospital for about a week and had a double room to himself. The food was good, the nurses were attentive, and doctors stopped by three or four times a day to check on him, he said. At the end of it all, there was no bill, just an entry in the ID booklet.
“The Millers may soon move back to the United States, but Jemmy Miller said they want to try to maintain the IMSS coverage. ‘If something big really comes up, we'd probably come back to Mexico,’ she said.”
One of the more interesting replies to this article appeared on the USA Today forum page
Advocate: “I’ve lived in Mexico for more than 15 years and have used their healthcare system frequently.
“Every word in the USA TODAY article is the truth.
“The doctors in Mexico seem to have this quaint goal of diagnosing and curing your health problem instead of wasting time with expensive and unnecessary tests.
“My wife and kids use the Cruz Roja (Red Cross) hospital system for typical ailments. $60 pesos (about $6.00) to see a General Practitioner, and $90 pesos ($9.00) for a specialist.
“The difference? The doctors don’t need expensive malpractice insurance. If they screw up and it is their fault, it is a criminal matter and they lose their licenses and do some prison time.”
Bill and I have not yet used the IMSS system. We have had only one serious health problem, and that’s was Bill’s heart surgery. Unfortunately, it was so serious that we couldn’t wait to go through the system. It was discovered on Monday, and Bill was being operated on the following Thursday. It was such an emergency we couldn’t even wait to go back to the States for the operation under Medicare, which Bill could have used since he was over 65. However, upon checking into costs later, we found the cost of his entire surgery (including doctor, hospital stay, anesthesia, etc.) was less than the 20% he would have spent going through Medicare. Of course, this included flying back to the states, staying in a hotel, the additional tests Medicare would have required (since they would not have accepted the Mexican doctor’s reports!), plus, plus, plus! He had two procedures, two different hospital stays, and the cost for everything was around $20,000!
For our regular every day health care, we use one of the clinics here at Lake Chapala and have been very happy with our care. There are so many to choose from, it’s hard to make a decision. When you come down here, you’ll definitely want to check with your friends to get their opinions on which doctor they like the best.
The one we use is Clinica Maskaras. Dr. Garcia (one of our expert speakers on the Focus on Mexico 8-Day Educational Program) offers a yearly package that is perfect for our needs. The following information is from the workbook you get when you come on a Focus program:
Maskaras Clinic
Clinica Maskaras offers 24-hour emergency service. The clinic also provides overnight care and has an on-site pharmacy, under the direction of Dr. Carlos Garcia.
Clinica Maskaras is bilingual, fully equipped with laboratory, x-rays, pharmacy and much more and has access to nearly every specialist you could want. They also provide an extremely economical plan they offer to Mex-pats (foreigners), where for one annual fee you can have as many doctor visits as you need and get a variety of other benefits and discounts. Even though some of the Focus on Mexico team have private insurance, for day-to-day medical issues, several of us use this clinic.
The Clinica Maskaras Program costs $2300 pesos (approx US$230) per year (adjusted to US dollar exchange rate), and, among other things, it allows for unlimited Clinica Maskaras office visits during normal office hours, with Dr. Carlos Garcia, no “previous condition” restrictions, and two free house calls per year as well as discounts on such things as dental service, x-rays, lab tests, eye exams, etc.
Unlimited office visits and two house calls per year? You can’t beat that!
The IMSS system is somewhat similar to HMOs in the US (and I assume to the socialized system in Canada) where the starting point for everything is the family doctor. If the problem is something the family doctor can’t handle, he approves your visit to a specialist.
Bill and I use Dr. Garcia as our ‘family’ doctor. He does all the initial preparation…lab tests, x-rays, etc. If he discovers something serious, and it’s not an immediate emergency, you take all your results (even the x-rays) with you to the local IMSS Clinic in Chapala and stand inline to wait your turn. The doctor you’ve been assigned to when you first registered at the Clinic will look through all your paperwork, and if he agrees with your family doctor, you will be authorized to go to the Second Tier of IMSS where there are more English-speaking doctors. And, lastly, that doctor can authorize you to go to the third tier where there are even more English-speaking doctors, nurses, etc.
As shown above, the IMSS is a 3-tier system. Medical staff members, both family physicians and specialists, are paid a fixed salary according to the number of hours they work, not the number of patients they see. There are no performance-based incentives. Physicians work six-hour shifts. On average, each family physician sees 20 patients per shift, and the specialists provide a similar number of consultations. The family medicine clinics provide ambulatory care 12 hours a day; those offering emergency services are open 24 hours a day.
Basically, the breakdown of tiers is as follows:
Stage I hospitals, clinic type facilities.
Stage II hospitals, which have excellent emergency care
Stage III hospitals, handle critical medical problems, advance surgeries and care for patients with heart problems, cancer, kidney problems and so on.
Bill and I feel lucky. We have lived here for almost six years now, and we are thankful we got here ahead of the other Baby Boomers who are definitely coming…and soon! And, affordable health care is just one of the many reasons.
If you come on a Focus on Mexico 8-day Educational tour, you’ll find even more reasons to be grateful that you found us when you did. You’ll learn about the economy of, and investing in, Mexico, your alternative healthcare options (definitely more than in the United States and Canada), immigration, the legal system and so much more.
As we say on our web site: Transform Your Life in One Extraordinary Week! Focus on Mexico presents a unique and exciting program offering you the opportunity to investigate an alternative location that has fondly become known as 'One of the Last Best Places on Earth.'
Join us on a Focus 8-Day Educational Program where you will experience a full week of the most empowering, educational and entertaining days of your life. During your week on the program, you will discover how to create an extraordinary quality of life here in Ajijic, Lake Chapala, Mexico . We’ll give you all the tools to step into a whole new chapter in your life journey; you’ll come away with everything you need to know to make your dream life in Mexico a reality.
Seriously, at the end of your program, you will know without a doubt whether Lake Chapala, Mexico, is for you!
Come on down…we’re as close as your local airport. We’re here waiting for you!
Karen McConnaughey: Operations Manager for FocusOnMexico .
Focus On Mexico offers 8-Day Educational Programs to Ajijic and Lake Chapala, Mexico (2nd Best Climate in the World). Join us on a Focus program and learn why thousands of Americans and Canadians chose to retire in Lake Chapala.