IMSS - Pre-Existing Medical Condition

[GnJ.in.MX]

My husband had what was an equivalent of a heart attack, only it occurred in his intestine while we were in Mexico. Needless to say, this really "threw a wrench in the works" with respect to our plans on moving there.
We are back in Canada right now and everything seems to be A-OK with him and we hope to go back to Mexico in January 2010.

My question is: My husband will probably have to be on the blood-thinner Coumadin for the rest of his life become of this. Will be still be eligible for coverage under IMSS using the "2-year rule"? I.E., After 2 years, will they cover him should this same medical condition flare up again?

Thanks.

[RVGRINGO]

Only IMSS can really tell you. One doesn't have 'heart attacks in the intestine'. Did he have an aneurism? Some previous conditions can eliminate you from IMSS eligibility for any coverage.

[GnJ.in.MX]

Originally Posted by RVGRINGO

Only IMSS can really tell you. One doesn't have 'heart attacks in the intestine'. Did he have an aneurism? Some previous conditions can eliminate you from IMSS eligibility for any coverage.

I didn't say he had a heart attack in his intestine. I said he had what was an equivalent of a heart attack in his intestine. At least, that's how his doctor here described it to us.
Anyway, not an aneurism. Some arteries were blocked which was inhibiting blood flow to his intestine, killing his intestine slowly. The ambulance took a long time coming (90 minutes) so he lost about 1 metre of intestine. Lucky thing we have lots.

Have you ever read, "Mexico: The Trick is Living Here" by Julia Taylor? She doesn't have anything good to say about IMSS.

Julie

[jlms]

[QUOTE=GnJ.in.MX;198671
Have you ever read, "Mexico: The Trick is Living Here" by Julia Taylor? She doesn't have anything good to say about IMSS.

Julie[/QUOTE]


Hmm,

IMSS (and ISSSTE and several others) are the only thing defending many people in the Mexican population from destitution when they get gravely sick. If you just get a minor ailment then, yes, go private by all means, but for big things you want proper coverage.

It is certainly not the greatest service, but to think it would not exist is just unbearable.

Of course the situation for expats is different, since they may have provisions on their country of origin, but if you manage to ride the bureaucracy the IMSS may be a god's sent.

[jlms]

Originally Posted by RVGRINGO

Some previous conditions can eliminate you from IMSS eligibility for any coverage.

Do you have any reference for this?

I skimmed quickly through the respective law (updated to May 2009) and could not find a reference to this.

My understanding is that IMSS will cover your no matter what as long as you are able to work.

[RVGRINGO]

No, I don't have 'documentation' but I have heard of people being denied coverage due to pre-existing conditions. Since that information is anecdotal, one should simply apply to IMSS and see what happens. I have no further details available.

[HolyMole]

Originally Posted by RVGRINGO

No, I don't have 'documentatio' but I have heard of people being denied coverage due to pre-existing conditions. Since that information is anecdotal, one should simply apply to IMSS and see what happens. I have no further details available.

This is another instance where no one seems to know what's covered and what isn't. I'm at a loss to understand how the average guy in the street is expected to make decisons on health care insurance when there is such obvious confusion surrounding an absolutely critical issue like "does it cover pre-existing conditions?"

In my own case, I'm faced with a decision to take out-of-Canada insurance that will cost me about $2000/year in premiums.....but I can't get simple answers from the insurer as to what they cover, and, more importantly, what they do not cover.

In a relatively poor country like Mexico, it seems inconceivable that the public health care plan would exclude pre-existing conditions. That kind of nonsense is usually restricted to so-called civilized countries like the USA.

[RVGRINGO]

It is not a 'public health care plan' and they don't have to take you with pre-existing conditions. The application form will give some clues.
If you can get coverage for $2000 Canadian per year, you should have absolutely no complaints and I wonder why you would even be interested in IMSS with that kind of inexpensive coverage available.

[bournemouth]

Originally Posted by HolyMole

This is another instance where no one seems to know what's covered and what isn't. I'm at a loss to understand how the average guy in the street is expected to make decisons on health care insurance when there is such obvious confusion surrounding an absolutely critical issue like "does it cover pre-existing conditions?"

In my own case, I'm faced with a decision to take out-of-Canada insurance that will cost me about $2000/year in premiums.....but I can't get simple answers from the insurer as to what they cover, and, more importantly, what they do not cover.

In a relatively poor country like Mexico, it seems inconceivable that the public health care plan would exclude pre-existing conditions. That kind of nonsense is usually restricted to so-called civilized countries like the USA.

Here is a link that might answer some questions:

How to Apply for IMSS :: MedToGo International

[HolyMole]

Originally Posted by RVGRINGO

It is not a 'public health care plan' and they don't have to take you with pre-existing conditions. The application form will give some clues.
If you can get coverage for $2000 Canadian per year, you should have absolutely no complaints and I wonder why you would even be interested in IMSS with that kind of inexpensive coverage available.

Then I'm mistaken, for I was under the impression that all Mexicans are covered by some form of basic health care, which makes it a "public health care plan", doesn't it?

IMSS may be a "Tier 2" kind of coverage, subject to premiums, but if it's administered by the government, that makes IMSS a public health care plan too.

I can see how $2000/year for a health care plan might sound dirt cheap to some, but the question still remains....what do I get for my $2000?
For example, it does not cover "hospital charges"....which apparently includes the room charge and "normal hospital expenses". And it covers surgery, but "not if the physician is an employee of the hospital." Ask what that means and all I get is silence. The plan I'm considering is one made available to retired Federal public service employees, so it's not some fly-by-night outfit.....but asking for simple explanations as to what is or is not covered is like pulling teeth.

And I've been unsuccessful so far in trying to find out if the relatively inexpensive IMSS coverage would fill-in the gaps of my own coverage.