Thursday, January 7, 2010

IMSS - The "Public Option" in Mexico (Day 2)

"A Tale of Two Consulates"
If you'll recall, day one of our journey to obtain Mexican public health insurance (IMSS) revealed among other things that we needed to get copies of our birth certificates, translated into Spanish and notarized and they had to be done by our respective consulates.
In my case, this would entail a trip to the U.S. Consulate in Merida, a trip I made before and chronicled in this blog post. If you haven't read it yet, you should as it will prepare you for today's report and although it wasn't nominated for a Peabody Award, it damn well should have been.
My companion, Indra, being born in Germany, has a German birth certificate which meant we also had to locate the German Consulate in Merida. This was done with very little effort on the internet and with a check of our handy-dandy Merida street map, we were relatively certain we could find it.
So off we went this morning, first to the German Consulate. Ladies first, you know.
When we arrived near the pinpointed spot on our map we were detoured off the main street due CFE (power company) crews replacing a bad transformer. Nonetheless we parked near where we believed the consulate to be and walked to it. Here it is:

Not quite the over-the-top architecture we are accustomed to in our taxpayer funded public buildings, but we have learned to roll with the punches in the past couple of years here, so we strolled up and knocked on the door.

We were let into a small outer office/reception area where we met the very helpful Magdalena. She spoke English, Spanish and German and for all we knew, other languages as well. She registered us in her book and then Indra showed her the birth documents from 1946 Germany. Magdalena looked them over, translated them on the fly for us in English to confirm that they were indeed birth documents and apologized that she could do nothing today due to the power outage going on from the soon to be replaced broken transformer. She noted the fragility of the documents which bear a close resemblance in consistency to the Dead Sea Scrolls and provided Indra with a web address where she can obtain new, updated versions. By the way the new versions from Germany already come translated into five languages including Spanish. Here's Magdalena explaining all of this to Indra...

She called the Consul out from the rear office (I think these were the only offices in the building) and he confirmed he could do the notarization from Xerox copies so Indra could keep the originals. She even offered to translate mine, but I decided that since IMSS wanted it from my country's consulate I'd stick to the rules. We will go back next Monday or Tuesday to pick Indra's up.
At this time we were less than an hour away from my appointment at the U.S. Consulate per my appointed time. Yes, you need to have an appointment which is done online here.
I had popped on to make my appointment Tuesday and the next available time was for today (Thursday) at 12:00 noon. In fact it was the only time available today.
We parked across the street and as we approached I thought it was a good time to get what we in the news media are trained to get: an Establishing Shot.

Unlike the German Consulate, ours comes with anti-crash barriers. As soon as I took this picture, the two armed Yucatan State Police standing in front started yelling and gesticulating wildly something about picture taking of this hallowed edifice not being allowed.

I briefly figured since I was on a public street, I could do what I damn well wanted. But on second thought I realized that I could be arrested for spying and I doubted that Bill Clinton would commandeer a plane to fly down and save my ass like he did for those two young women in North Korea. So I pocketed my camera and as we passed by my cheerful "Buenos Dias" was met with icy stares.
Up we went to the bulletproof booth to announce ourselves and our purpose for being there. Of course the jack-booted, beret-wearing rent-a-cop that U.S. taxpayers employ to check everyone in, spoke no English. This is at the U.S. Consulate! He had to make a call to get another rent-a-cop to come out who spoke a little English. Back in the day, before our armed forces were sent out to fight a couple of wars in the Middle East, these duties were performed by U.S. Marines (Semper-Fi) who, no doubt, enjoyed a little break in the action.
After checking our passports, we were admitted to the screening area. Here we were relieved of the following items before going through the metal detector:
A pack of cigarettes
A lighter
My camera (no photos allowed inside either - State secrets)
Both our sets of car keys
All loose change
A bottle of hand sanitizer (I guess the swine flu media panic had not permeated security either)
A bottle of mosquito repellent
Fortunately we were not asked to remove our underwear.
Then our bags were put through the scanner, our passports checked one more time, and then we were passed through the metal detector. Since I could not take a photo of this, you'll have to use your imagination. I imagine that if given the chance, they may resort to body imaging like this:

This was the first of three checkpoints needed to pass before entering the hallowed area for my "appointment". We cleared the other two without any problems and when we entered the main area we were given a number: 2004. We didn't have to wait as there were, no kidding, in a room with at least 50 chairs and 8 help windows, no other people waiting. I mean it was, except for one of the rent-a-cops and Indra and me, deserted. Said rent-a-cop directed us to the two windows reserved for Americans and we rang the buzzer. Soon a gentleman appeared behind the double-paned bulletproof glass and, through a microphone that continuously shorted out, asked us what we needed. I needed an "appointment" for this?
I explained that the folks over at IMSS told we needed my birth certificate translated and notarized by the U.S. Consulate in order to apply for benefits. The nice man then informed us that, yes, they could notarize such a document for $30.00 USD, but the translation was not done there. For that, I would have to hire a government certified Mexican translator to do the job. Then he/she would bring it over to the consulate, have it notarized, and then return it to me.
He then provided me with a list of certified translators in Merida. This list carries the following proviso:
"The U.S. Consulate Merida assumes no responsibility of liability for the professional ability or reputation of, or the quality of service provided by, the following persons or firms. Inclusion on this list is in no way an endorsement by the Department of State or the U.S. Consulate."
Well, that's a confidence booster.
I told him about what Alejandro at IMSS had said about having it translated by the consulate and the man behind the bulletproof glass replied that they had probably just seen the official consulate seal on the translated document and assumed the translation was done there. "We're going to have to straighten them out on this the next time we see them", came the dubious promise from the man behind the bulletproof glass.
We exited with the list, collected our contraband and headed home.
Indra and the Germans definitely came out on top today. I'll let you know what happens next.

More later,

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,