The three most frequently asked questions by expats about mexican health insurance

Over the course of more than thirty years helping the expat community in Mexico and serving thousands of clients each year, the questions we address the most are those related to your health insurance policy. Here are the top three:

• • Why do hospitals ask for guarantees of payment when entering the hospital if I have a medical expense policy?
  
  While your health insurance Policy will make direct Payments to the hospital for any medical emergency covered in your policy, it is important to understand the hospital’s procedure during the admission. When you enter the hospital, your insurance card will be used to identify your insurer and contact information. We recommend having the card in your wallet always.
  
  In most cases, the hospital will ask you to leave a guarantee of payment. This is typically a credit card where they retain a portion of the estimated charges until they receive the specific coverage approval from the company for your treatment. This is required by the hospital so they have a guarantee they will receive payment should the client’s policy be inactive, expired or in case the coverage is excluded due to an undeclared preexisting condition in the policy.
  
  For this reason, we recommend our clients to have a credit/debit card with an available limit of at least $3,000 dollars. Should you have a medical emergency, the deposit will be available to avoid a delay in hospital admission. Once the hospital treatment is finished the hospital will only charge your deductible.
  
  
• • Do the policies cover pre-existing medical conditions?
  
  The short answer is no, but there are exceptions. Health insurance Policies are subject to underwriting during the application process. This means that the insurance company evaluates the client’s medical history and, in most cases, pre-existing medical conditions and treatments are excluded.
  
  The applications are all evaluated case by case and each insurer may proceed differently on their pre-existing conditions restrictions. Here are some of the possible exceptions:
• a) GeoBlue covers pre-existing conditions but their premiums are typically $10,000 USD plus per year.
• b) Mapfre can remove the exclusion on the condition after two years if it meets certain criteria of stability through this period.
• c) Plan Seguro may cover pre-existing Hypertension or Diabetes if the rest of your health profile is excellent including Body Mass Index.
• d) Other companies are open to evaluate the exclusion during the policy renewal if medication is taken off and/or the health improved
• • What is co-insurance?
  
  Co-Insurance is the client’s out of pocket participation after meeting the deductible. Typically, it is 10% of the remaining and subsequent expenses. If these copays add up to $40,000 pesos, the client will pay no more copays on those conditions. This is called the copay limit and, in most cases, we have a $40,000 peso copay limit on our policies.

Of course your health is very important. It is also very important to work with an experienced and licensed health insurance broker familiar with the insurance contracts and underwriting requirements to explain options to you and present as complete an application to underwriters as possible. Contact us and we will gladly review your current insurance policy. If you do not have one, we will design one to suit you.

For more information you can visit us on our website
México Insurance
Or contact us at
México - 322-297-6440
USA / CANADA - 949-274-4111