Tuesday, January 5, 2010

Insurance: IMSS - The "Public Option" in Mexico (Day 1)

While the prospect of government involvement in the matter of health insurance continues to pit a lot of Americans against each other over the inclusion of a so-called "Public Option", here in Mexico it's a matter of public policy.
Known as IMSS (Instituto Mexicano del Seguro Social) or the institute of Mexican Social Security, it's available to everyone. That includes those of us who have established residency here from another country.
Here is part of the IMSS charter:
"In its extent, the Article 2 of the Social Security Act (SSA) states that the purpose of the social security is to guarantee the right to health, medical assistance, protection of the means of subsistence, and the necessary social services for the individual and collective wellbeing, as well as the granting of an allowance that, in its case and previous fulfillment of legal requirements, will be guaranteed by the State."(my italics)
Anyone in the States thinking of coming to Mexico (or any other foreign country for that matter) needs to know that Medicare does not apply outside the U.S. So that leaves private insurance companies or, in this case, the Mexican government's health care system.
With this in mind we decided to enroll. Now, health care here is inexpensive in comparison to the States for the minor everyday things. But should something more catastrophic happen, it could still put quite a dent in someone's retirement budget even here.
IMSS does not offer full coverage the first year and for certain pre-existing conditions, the insurance benefits do not kick in until year two or even year three. However, in the first year many basic medical problems are covered and drugs from the IMSS pharmacy are free.
An in-depth investigation by me on various websites turned up a few inaccurate bits of information which I will clarify as we go. Keep in mind I'm operating in the State of Yucatan, but I believe that since this is a Federal program, the rules would be the same everywhere.
As I found when we got our senior discount cards, rules here change either at the start of the new year or a change in political parties.
We decided to start with obtaining photos. All the websites I checked stipulated we needed to bring 2 or 3 (depending on the site) passport sized photos. We actually asked the guy at one of our local photography joints (and they are everywhere!) and he told us that what we need were 2 infantil sized photos. Here's the difference:

That's infantil on the left and if we had taken passport sized photos, that would have been a deal breaker. By the way, the photos come in a set of 6 and cost 50 pesos (less than $5.00). So we have extras if anybody wants one (and who wouldn't?).
Next step was to find the location of the IMSS intake center. In Merida there are actually two of them; one south and one north of the centro. We opted for the closer one in the north. The rest of this will probably just be of interest to those living here or planning on moving here, but what the hell. Stories of governmental red-tape are the stuff of good party chatter no matter where you are, right?
Here is the address of IMSS north:
Calle 7 No. 432 X 32 y 34
Col. Residencial Pensiones C.P. 97217
This is actually easy to find. We came south into Merida on the main drag, Calle 62. At the Mega store we hung a right (west) onto Circuito Colonias. Drive west until the street curves to the left and get ready to turn right just past the Chevrolet dealership. That street is also Circuito Colonias. Just a little trick they like to play on us gringos. Drive down the street a few blocks and on the right you'll see a tall hospital building. Then the street name changes again to Av. Alfretta Barerra. Keep going about 3 more blocks and on the right you'll see this:

This is actually the clinic. We parked around the corner and walked back and to the north (or the left as you're looking at the building) we stumbled upon the intake center. Easy-peasy!

We knew, of course, this was not going to be a one stop deal. It seldom is here which adds to the "Amazing Race" quality of it all. If you watch that program, think of this as a Roadblock.
Let's take a look inside.

This is the line to get a number. When we got our number (which was from a security guard) we were directed to the person just to the left who's name was Alejandro. And Alejandro spoke English!!! This was going swimmingly!
So Alejandro, after finding out what we were up to, asked if we had all the required documentation. He even gave us a checklist to be sure. In Spanish, of course, but you get these when getting or renewing a visa, so we were prepared.

Taking it point-by-point:
"Comprobate de domicillio" That's an original and copy of a utility bill, either Telmex (phone) or CFE (electricity) will do. "Check"
"Identificacion oficial" Think passport for us, and FM2 or FM3 visas and copies of each. "Check"
"Acta de matrimonio" Marriage certificate. "That ain't gonna happen"
"2 fotografias tamano infantil. "Check"
"Acta de nacimiento" Birth certificate. "We've never been asked for that before and none of the websites I checked mentioned that"
CURP si ya cuenta con el. Yep. Got the CURP when we got our senior cards. "Check"
Documento que contenga su Numero de Seguiridad Social. Does not apply to us.
And that long last one is a completed questionnaire concerning our medical history which is done at this center.
Also note the annual cost for the insurance for 60+ years of age, $3211 pesos or $251.00 USD at today's exchange rate. Again, that's per year. This is luring a LOT of retirees to move here. And regardless of any horror stories that people who have never received treatment here like to carelessly spread, I can tell you first hand the treatment is top-notch. And you actually see a doctor, not a physician's assistant.
But I digress.
We explained to Alejandro that we did not have birth certificates with us and that the mere possession of a passport proved that we were indeed born because the U.S. government requires a birth certificate to get a passport. He was very nice and took the time to instant message two superiors to plead our passport argument but both were adamant that we had to have them. And then Alejandro upped the ante: The birth certificate had to be translated into Spanish. "Not a problem", I thought, "We have plenty of friends who would do that for us." Alejandro, seemingly reading my thoughts, kicked it up another notch: These translations had to be from our Consulate. And notarized by them.
Anyone who read about my trip to the U.S. consulate could well understand the feeling of dread I was experiencing at this point. The other shoe had dropped. We would not be joining these happy people today...

To add yet another dimension to the mix, my partner Indra will not be utilizing the service of the U.S. consulate office. She was born in Germany. So we will also be visiting the German consulate. And we're not even sure if her baptismal certificate will count.
This is going to get interesting.

More later,


BigAssBelle said...

Oh my. I can't wait to hear more. Do you have to take actual medical records? And are those also to be translated into Spanish?

Is the US Consulate amenable to translating birth certificates?

Larry said...

Question #1 - You get a physical from your primary physician. No need to bring medical records.

Question #2 - I'll let you know.

Theresa in Mèrida said...

I helped a couple of friends get their insurance at the other office and they didn't need most of that stuff. Of course that was 2 years ago. All they brought was Fm3s and comprobantes.
But as I always say, your milage may vary. Good luck.

Joanne said...

TIM. Good luck!

Marie said...

Larry, thanks for this information, we were planning on using IMSS but didn't know how to go about it. By the way, what is a CURP???


Larry said...

Go here http://yucatanrebirth.blogspot.com/2009_03_29_archive.html

I explain the CURP and how to get one. It's like a social security number in the U.S.

carol said...

Thanks for the info Larry, Paul and I are on our way today..