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USA/MEXICO: Aetna Introduces New Cross-Border Health Insurance

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Cross-border health insuranceFrom International Medical Travel Journal (IMTJ) 

 

Major US health insurer Aetna has followed several competitors in introducing a new health plan that allows members and their families to access health care in California or in the Mexican cities of Mexicali, Tecate and Tijuana. It does so through an agreement with Mexico's Sistemas Medicos Nacionales (SIMNSA), a health management organization that operates similar deals for several other insurers. These are cross-border plans for Mexico and specific border states, not policies with medical tourism options outside Mexico. Unlike other countries, insurance in the US is regulated state by state, so insurers mostly offer individual state plans for individuals, even when they are major international insurers. These cross-border plans accept that many workers in Southern states are Mexican, or of Mexican descent, and that for many their main language is not English, so feel uncomfortable discussing healthcare in English. Some Mexicans live in Mexico but travel across the border to work in the USA, on a daily basis, or just returning home to their families at weekends.

 

Beth Andersen of Aetna says,” Aetna recognizes that it is important for our members to be able to receive health care in a language and cultural setting they understand and feel comfortable with. Vitalidad PlusSM offers employers an affordable health option that lets their employees receive care in whichever setting they prefer. People are more likely to get routine care and stay healthier when they have a primary care physician they can relate to. With access to Aetna's provider network in California as well as the SIMNSA network in Mexico, we believe we can help members achieve their optimal health. Members will be able to participate in Aetna's maternity management, heart health, diabetes and weight management programs, as well as other disease management and wellness programmes."

 

SIMNSA is a comprehensive health care service plan that was developed to provide quality healthcare for the growing U.S. workforce who prefer to receive their healthcare coverage in Mexico. SIMNSA is one of the leading Health Maintenance Organization (HMO) programs in Northern Mexico, and was the first Mexican HMO to be licensed as a health care service plan by the State of California. The network extends through the border cities of Tecate, Mexicali and Tijuana. It offers network services for treatment in Mexico on a range of its own health plans and for various US health plan providers including Cigna, Health Net and PacifiCare.

 

Vitalidad PlusSM California con Aetna is an HMO plan that features 100 percent coverage for qualified preventative care, including immunizations and child and adult wellness exams. Employers can select four different co-payment levels for employees. Members and their family members will select a primary care physician in California or one of the SIMNSA physicians in Mexico. Plan documents and customer service are available in both Spanish and English. In addition, members can visit Aetna's Spanish language web site to search for participating doctors and hospitals, and obtain information on a variety of Aetna health programs and products.

 

Sarah Horton, assistant professor of anthropology at the University of Colorado, Denver, has published extensively on immigrant health and the U.S. health care system and is currently writing a book about cross-border health care for the University of California Press.

 

Research a few years ago claimed that a million people travelled from the USA to Mexico for dental and healthcare, but the figures were very old and the statistical method curious. Gabriel Senior, founder of Travel for Care, a Mexican medical tourism agency sending U.S. and Canadian patients to hospitals in Tijuana and Monterrey estimates that of the 50,000 Americans who travel to another country for medical treatment every year, about 35,000 travel to Mexico. The remaining 15,000 are to destinations in Central America and Asia. Of the 35,000 people who go to Mexico, a large proportion are Hispanic who come naturally to the country on business or visiting family. SIMNSA points out that healthcare needs differ when a border is crossed as insurance may be bought by employees and their families at home in Mexico, while at the same time protecting them from emergencies on the job in the U.S. The failure to understand that people may live in Mexico but work in the USA accounts for why earlier studies overestimated medical tourism by failing to differentiate between where people work and live.

 

How Mexico will Attract 5 Million U.S. Retirees

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Retirees in Mexico

By Maggie Van Ostrand Mexconnect.com 

 

Without fanfare, President Felipe Calderon has been quietly working on attracting millions of U.S. retirees to Mexico by proposing the expansion of retirement benefits and medical tourism. It is anticipated this proposal will be brought up when President Calderon meets with President Barack Obama on an official visit May 19th, sources say. President Calderon, not one to give up easily, already has a Plan B: to raise the same issue later this year, if nothing happens between the two nations on May 19th.

 

Mexico's ambassador to the U.S., Arturo Sarukhan told Miami Herald columnist, Andres Oppenheimer, "It's one of the pillars of our plans to trigger economic and social well-being in both countries. We will be seeking to increasingly discuss this issue in coming months and years."

 

Last August in Guadalajara at a U.S.-Canada-Mexico summit, at the request of President Barack Obama, President Calderon shelved the same idea until the passage of health care reform in the U.S. Now that health care reform has passed, it is time to bring the matter up again. First things first.

 

About one million U.S. expats already live in Mexico, and that number can grow to five million by 2025, according to estimates based on U.S. Census figures. (Actually, five million U.S. retires already live abroad, mostly in Mexico, the Dominican Republic and Brazil, with an additional 1.5 million in Europe, and 850,000 in Asia.)

 

Enticing even more U.S. retirees to move south of the border is expected to depend somewhat on getting the U.S. Joint International Commission to certify hospitals that meet the standards of U.S. hospitals. Already, nine Mexican hospitals have been so certified, and others are currently awaiting certification.

 

Already certified:

American British Cowdray Medical Center IAP Observatorio Campus
Mexico City
Accredited December 6, 2008

 

American British Cowdray Medical Center IAP Sante Fe Campus
Mexico City
Accredited December 12, 2008

 

Christus Muguerza Alta Especialidad
Monterrey, Nuevo Leon
Accredited July 22, 2007

 

Clinica Cumbres Chihuahua
Chihuahua, Chihuahua
Accredited April 23, 2008

 

Hospital CIA Hermosillo
Hermosillo, Sonora
Accredited December 11, 2008

 

Hospital CIMA Monterrey
San Pedro Garza Garcia, Nuevo Leon
Accredited December 19, 2008

 

Hospital Mexico Americano, SC
Guadalajara, Jalisco
Accredited March 20, 2010

 

Hospital San Jose Tec de Monterrey
Monterrey, Nuevo Leon
Accredited December 25, 2007

 

Hospital y Clinica UCA. S.A. de C.V.
Monterrey, Nuevo Leon

 

Healthcare costs in Mexico are approximately 70 per cent lower than healthcare costs in the U.S. so, if Calderon's proposal to Obama starts with an agreement allowing Medicare benefits to U.S. retirees living in Mexico, instead of Medicare only covering healthcare services in the U.S., the savings would be enormous to the U.S. and also bring needed dollars to the Mexican medical profession.

 

This is being quietly talked about at the highest levels, leaving media attention to the negativity it seems to prefer with both the drug wars in Northern Mexico and healthcare naysayers in U.S. politics.

 

In other words, while the loudmouths roar, the whisperers are getting things done.

 

Myths and Facts about the Healthcare System in Mexico

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Mexico HealthcareBy: Charles Sipe - Mexico Real Estate Investment  

 

For foreigners who are considering a move to Mexico, one important concern is the quality of healthcare. Often images of Third World conditions or swine flu emerge when most people think of “healthcare” and “Mexico.” However, the reality is that for foreigners living in Mexico, the quality of healthcare is far from second-rate.


Mexico has both private and public systems of healthcare that are accessible to foreigners.


The Mexican Social Security Institute (IMSS) provides an HMO-style public health care program. The program is open only to Mexican taxpayers who pay Social Security through their employer and qualified resident retirees (including foreigners).


For a low annual flat fee, participants have access to a health care plan with no limits, no deductibles, no charge for virtually all medicine, tests, X-rays, eyeglasses and dental coverage. Pre-existing conditions are not covered for the first two years but virtually all (with the exception of a very few) medical care costs are covered by the annual fee.


IMSS hospitals do not offer the same frills that US hospitals do, such as in-room phones and televisions, and some require that family members assist patients with non-medical tasks. In most cases, doctors and nurses only speak in Spanish but the quality of health care is often good and with the government increasing its spending on healthcare, it is expected that the quality and access to care will improve. Many US retirees living in Mexico purchase IMSS coverage as a cheap form of insurance against medical emergencies, while traveling back to the US for less urgent care.


Private health systems or insurers provide wealthy and middle class Mexicans and foreigners working or residing in Mexico with access to high quality, state of the art medical services. Typically services are provided on a cash basis or through payment plans. Still costs for these high end services are often much lower than if the same procedure were done in the US. Often doctors and staff at these facilities have an excellent medical education and have trained abroad in Europe or North America. This is a growing sector of Mexico’s economy and many Mexicans who are insured through the IMSS system pay out of pocket to access these services. Top facilities are located in Mexico City, Guadalajara and Monterrey.


Also See:

How Mexico’s Health System Works CBC News

 

 

NBC Money Matters on Living in Baja, Mexico

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George Chamberlin of San Diego NBC's Money Matters interviews Larry French of Baja Real Estate Group and Brian Flock of Flock Dream Homes in Baja, Mexico on home ownership in Mexico, safety concerns, expedited border crossing and healthcare in Mexico.

 

 

International Health Insurance Options for Travel to Mexico

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By: Roxanna McDade 


Travel to Mexico Insurance

Travel to Mexico can be an exciting adventure, but it can also bring many unpredictable situations, especially if you should need medical attention. International Travel Health Insurance is available for your Mexico trip and will ease the stress of an unfamiliar culture or medical systems.

 

Whether you need individual coverage for a vacation, assignment, or group coverage for employees, there is a Mexico health insurance product that will meet your needs.

 

Health insurance products for travel to Mexico are designed for both US and non-US citizens, including any student traveling or living abroad.


Note:
These products not only provide medical insurance coverage in the US, Canada and Mexico, but worldwide. Short-Term, or Patriot, policies are only valid for other countries, not the traveler’s home country. Long-Term, Global, policies have an option to select worldwide coverage, including the insured's home country. 

 

Short-Term International Health Insurance Products

 

Short Term Mexico Travel Insurance plans cover US citizens and foreign nationals needing temporary medical insurance while traveling for business or pleasure, anywhere outside their home country. These policies can be purchased for a minimum of five days and a maximum of 12 months. Policies can be renewed for up to two years after a minimum three-month policy period.

 

Short-term travel insurance is available for:

With short-term medical insurance plans you can also purchase an optional Extreme Sports Rider that provides coverage for mishaps that occur as a result athletic endeavors and foreign adventures. Short-term policies automatically includes Terrorism coverage.

 

Long-Term International Major Medical Plans

 

Long-term International travel medical insurance plans offer coverage while traveling in Mexico and other foreign countries. For an additional fee, you can opt to purchase coverage in your home country as well, if traveling back and forth. A wide variety of international clientele are covered under these policies, including expatriates, international executives, diplomats, students, entertainers and other international travelers. These policies provide long-term, worldwide medical coverage for individuals and their families.

 

With long-term medical insurance plans you can also purchase optional riders. The Extreme Sports Rider provides coverage for athletes and those partaking in foreign adventures. Injuries and illness incurred as a result of an act of Terrorism are covered under the Terrorism Rider.

 

Trip Cancellation / Medical Evacuation Insurance

 

International insurance policies are available in Mexico that will cover you in the event of a catastrophic medical emergency. These policies include trip cancellation/interruption travel assistance. Mexico insurance policies are also available which cover emergency medical evacuation to a qualified medical facility in Mexico. These policies also provide travel and accommodations resulting from the evacuation, and travel to the country of residence.


 

Group Travel Mexico Medical Insurance Plans

 

Group Medical Insurance Plans are for groups of five or more persons traveling together to Mexico, as long as Mexico is not their home country. Group plans are available to students or cultural exchange participants, including schools. Travel insurance for Mexico is also available to missionaries and church groups of five or more who are traveling to Mexico, as long as they are not citizens of Mexico. Employers can purchase the Global Employer Option to ensure medical insurance coverage for staff working in Mexico.

 

Missionary Programs

 

Various medical insurance for Mexico options are available to Missionaries traveling abroad. Coverage can be purchased for a minimum of 10 days to long-term, renewable policies.

 

Tailor your Premium to Match your Travel Budget

 

Premiums can be tailored to match your travel budget. Customers can select from a wide range of deductibles and maximum benefit levels in order to create a medical insurance package that fits their needs and is affordable.

 

If you have further questions about International Health Insurance, contact the International Insurance Professionals at http://internationalhealthins.iigins.com

 

International Insurance Plans Needed for Foreigners in Mexico

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Health Insurance in Mexicoby Tom Hamrick 


It is advisable to have international health insurance while traveling or living as an expatriate in Mexico. Having an international health plan gives a person, family or group a variety of choices when it comes to health care. For example, a person covered by such a plan can choose a private hospital or any approved physician for their care.

 

If a person is living between countries, an international insurance plan may cover them in both countries and even worldwide, for a choice of policy limits that range from $50,000 USD to as much as $8,000,000 USD.

 

However, not having appropriate international health coverage might expose one or one's family to a significant financial liability and impede appropriate care.

 

Some things to consider:

 

  • Many traditional domestic insurance plans won't cover a person outside his or her home country.

  • Usually Mexico auto insurance plans are limited to $2,000 USD per person, or less.

  • Medicare doesn't cover outside of the U.S.A.

  • A medically necessary air ambulance can cost $30,000 USD or more. Companies that offer only air ambulance insurance might have a 90-day waiting period for pre-existing medical conditions.

  • International health insurance plans allow multi-country flexibility for full benefits coverage. Canadians and Americans can stay outside their home country for much longer periods.

 
 
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