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Catastrophic Insurance Coverage

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CHILLIN
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Post by dvinton Thu Jun 17, 2021 2:54 pm

My wife, who's 77, had been covered by Best Doctors, but that coverage is no longer available, through no fault of hers.

Our agent recommended coverage through VUMI. The first-year premium is between $10,000 - $13,000 USD, depending on the deductible!!! Coverage the following year drops to $1880 USD.

My wife has a clean bill of health with no pre-existing conditions.

We're going to meet with a different insurance broker to see what alternatives are available.

Any constructive feedback and recommendations appreciated.

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Post by gringal Thu Jun 17, 2021 5:53 pm

Is that $1880 US for the entire year? Doesn't sound right, considering the first years' cost.

One option is paying out of pocket for medical expenses. Even with heavy use, it's saved money after we dropped the Medicare Part B coverage for both of us, shortly after we moved to Mexico. Private insurance is very expensive as one gets older.

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Post by CHILLIN Thu Jun 17, 2021 8:03 pm

Someone should submit a complaint to the Mexican insurance regulators about Best Doctors conduct in this Focus on Mexico fiasco. Firstly, under Mexican law an insurer cannot just drop coverage anytime they want. This law may only apply to Mexican owned insurers however, I am not sure. Secondly, this bait and switch has the characteristics of classic insurance fraud. The company, especially the agent, should be properly audited.

I would like to know if it was Focus on Mexico which decided to longer provide Best Doctors group policy or was it Best Doctors decision? No one is saying anything. When Boomers Best Doctors is up in December, will that be suddenly dropped as well? That is certainly a fraud if you are prepaying for a service that the vendor knows will be cancelled.

A lot of people are really upset about this situation. Myself, I am OK with INSABI, but it will take at least two years to clear up the mess AMLO created. Enough time to build up peak health. You are going to now need that in Mexico.
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Post by Gamina Thu Jun 17, 2021 11:35 pm

Best Doctors did not have a license to sell insurance in Mexico. Otherwise, they would not have been allowed to back out like they have. As I have been told by two other agents while trying to find insurance.
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Post by dvinton Fri Jun 18, 2021 3:59 pm

gringal wrote:Is that $1880 US for the entire year?  Doesn't sound right, considering the first years' cost.

One option is paying out of pocket for medical expenses.  Even with heavy use, it's saved money after we dropped the Medicare Part B coverage for both of us, shortly after we moved to Mexico. Private insurance is very expensive as one gets older.

Yes, $1880 US for the 2nd year premium.

A $12,000 to $15,000 US outlay for the first two years for "catastrophic coverage" is a test I can't see passing. As noted above, the way this transition from Best Doctors to VUMI was handled has left us a little stunned, to say the least. What if VUMI goes away next year?

It looks like figuring out the balance between insurance, and out-of-pocket medical costs will be a frequent exercise. Of course, we're prepared to fund the majority of medical expenses out-of-pocket. But, for a truly catastrophic case, i.e., cancer, a severe car accident, ... Unless you have deep pockets, how do you protect yourself?

Like Gringal, I've read about many who've eschewed all US coverage and gone strictly out of pocket for decades, and on the other hand, some feel having a medical evacuation policy is a must...




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Post by gringal Fri Jun 18, 2021 4:43 pm

I understand the concern about catastrophic health situations. The problem is finding an insurer who will take on a person with some pre-existing conditions such a heart or lung problems once they reach "old age" without exempting those very conditions from coverage.
In other words, if you live long enough, you're basically on your own.
That's probably why many are willing to pay for Part B of Medicare and are also willing to pay for coverage that will fly them back to the States in the event of serious illness. The "catch" there is finding a doctor who accepts such people and funding an extended stay in the U.S. if one doesn't have relatives or others who will take one in and care for them during their out-patient times.

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Post by BisbeeGal Fri Jun 18, 2021 5:30 pm

Since 2008, we've paid out of pocket here for routine care, tests such as x-rays and MRI's and minor emergency treatments.  

I'm having hand surgery next month; I priced the cost here vs. having it done under Medicare in US.  When I added in US house rentals, flights and car rental it was cheaper to do it here.  Though I will add that while it was cheaper here at the current 20:1 exchange rate, it was a draw at a 10:1 exchange rate.  We've enjoyed 20:1 for several years, but when we first started visiting MX, 10:1 was the norm for many years.  No one knows the future.

We keep our Medicare coverage; while it won't help us for an accident, it will cover us for big ticket items like hip replacement (which looms in my future) and cancer treatment, heart bypass, etc. (god forbid).

I have read about shortages of chemo supplies here in MX as well as high prices for them.  And while surgery/hospital costs are far lower here, medical devices such as hip replacement parts are subject to global pricing.

I'm hesitant to cancel our Medicare as many folks we've known here who said they'd never ever return to US, did when they faced high medical bills and/or medical disabilities.  The Medicare penalty for dropping coverage then re-instating it is quite severe.  

We are also concerned about rising costs locally.  MX has had a lot of inflation, and also a burgeoning middle class---both are reflected in the higher cost of living over the past 10+ years.  It could be paying out of pocket becomes far less competitive.
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Post by Jreboll Fri Jun 18, 2021 9:35 pm

Just a couple of real life occurrences:
Some years ago my mother-in-law was told she would probably need a pacemaker so she could start shopping around.
Knowing that I worked with pacemakers my brother-in-law asked me if I could get her one. I had heard of patients shopping for prosthetic parts but never thought i would be taking part in such a scenario. Luckily she ended up not needing one.
In another instance a patient needing open heart surgery came to a hospital seeing if he could get it done here NOB since he could not afford it in Mexico. The cardiovascular surgeon admitting him as an emergency needing immediate bypass surgery and the hospital was obligated to foot the bill. All thanks to the family knowing a friendly surgeon willing to bend the rules to make a few bucks.

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Post by CHILLIN Thu Jul 01, 2021 5:39 pm

dvinton. Check your email, how to get back on Best Doctors with new policy number. By July 9
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Post by acohenphd Fri Jul 02, 2021 6:53 pm

We have Bellon who got us covered on Mexican Insurance which costs about the same as Medicare.one is covered differently by disease and there is a lot ofpaperwork like back in the day. They will create any type of plan for you base on cost or any specific medical needs.

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Post by CHILLIN Fri Jul 02, 2021 9:38 pm

I don't know, there are still a lot of holes in Mexican insurance. I am OK with INSABI public and general hospitals but the good ones make you pay a portion. For example, a hip replacement, all the surgery and hospital stay would be covered but you are expected to pay for the appliance and any prescriptions you are on. The IMSS covers everything but is difficult to get on if are not an employee who has been paying in for years. I would pay for an insurance to cover these extras. Also, depite many promises, no company has come up for a policy which covers long term care homes or assisted living.
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