Surviving Mexico

August 18, 2018 · 7:00 am

Overview of Travel MedEvac Insurance

Remember I mentioned that travel by ambulance isn’t a free service provided by the Red Cross? When my mother-in-law was in the hospital after being hit by a police officer driving excessively fast for no reason, she was taken to an IMSS hospital since she worked as a street cleaner for the presidencia (town hall). When I arrived, hours after the accident, she had not yet been seen by a doctor, although a nurse had bandaged her leg and taken x-rays. When the doctor finally arrived from Morelia (apparently there wasn’t a doctor on staff), he insisted that she be transported to the Regional Hospital that was better equipped to handle her injuries. The family had to arrange ambulance transportation because she was not in stable enough condition to be moved by other means. Our local Red Cross has the only ambulance in the area. The cost was not covered by IMSS. It took hours to make the arrangements. When she finally arrived at the hospital, she was admitted to ICU. Her spleen had been ruptured in the accident and she was bleeding internally.

The admitting doctor suggested she be transported to the hospital in Leon, GTO, a 4-hour drive. Again, there was the issue of ambulance transport to arrange. For some reason, the family member in charge would not sign off the transfer. My mother-in-law contracted a respiratory infection in the hospital and died.

So believe me when I say that the universal health care Mexico provides through Seguro Popular and IMSS may not be enough in some situations.

Today I’d like to highlight one insurance company’s policies for US and Canadian citizens while they are in Mexico in order to provide a baseline of what type of coverage to look for when purchasing additional insurance.

Travel MedEvac Insurance’s slogan is Medical Transport Home when the Unexpected Happens (which of course, nobody hopes for but unfortunately is a possibility).

The MedEvac insurance covers evacuation by air transport to a hospital of your choice in your home country (US or Canada) and transfer by air or ambulance to another hospital in Mexico as needed if you are medically unable to travel internationally. So in the event of injury or illness, MedEvac will make sure you are taken to a hospital, whether in Canada, US, or Mexico, that will be able to treat your condition. This is especially helpful if you are in a rural area in Mexico where the medical facilities are understaffed and lacking updated (or even functioning) equipment.

What about your family? Well, MedEvac offers transportation for a traveling companion, spouse, and dependents to the hospital where you been evacuated in your home country. If you are unable to be air-lifted out of Mexico, MedEvac provides transportation for your immediate family to the hospital where you are receiving treatment.

What about your stuff? MedEvac will transport your vehicle, RV, motorcycle, and watercraft from Mexico to your home country. If you are discharged but not able to drive, MedEvac will make sure your vehicle is returned to you in your home country.

What happens if you die? MedEvac will prepare your body for transport and complete the repatriation process up to $50,000 USD. This may include embalming or cremation, casket, and transportation.

So what are your options?

MedEvac offers daily and annual plans. Daily plans are good for up to 90 days in Mexico and best for vacationers, cruisers, business travelers, students, missionaries, church groups, timeshare owners, and volunteers who do not plan on staying more than 90 days in Mexico. There are plans available for groups of 10 with additional plans in increments of 10 at special group rates.

Annual plans are offered for both 6 month and 12 month periods. The Classic Plan covers you if you travel to Mexico several times a year but never longer than 90 days. The Extended-Stay Plan covers you if you live in Mexico part of the year but do not stay longer than the 180-day tourist visa limit. Either plan would work for Snowbirds and frequent travelers.

As of April 2018, a third policy has been added to MedEvac’s plans specially designed for expatriates that live in Mexico more than 180 days per year. In this situation, medical evacuation could include transfer to another hospital for treatment in Mexico rather than in your original country. If your stay is more than 2 days, traveling companions and dependents will be given transportation to their homes. If you are in the hospital for more than 7 days, MedEvac will provide for the transportation of a visitor for a single visit to your bedside.

There are some things to consider.

If you are older than 84 or have been advised by your doctor that you should not travel, you would not qualify for this type of insurance. It’s also important that your passport be current, otherwise, there may be complications in leaving Mexico or entering your home country.

Additionally, there are some situations where accident or injury would not be covered under MedEvac’s policies. If injuries are self-inflicted or sustained in a war zone, you wouldn’t be eligible. If you are injured while piloting your own plane or canyoneering, you wouldn’t be eligible. If you are traveling specifically to seek treatment whether or not medically necessary, you would not qualify for the plans above. (I’ll talk about Medical Tourism in another post.)

There are also some restrictions which you might need to take into consideration when living or traveling in Mexico. You might not be able to be evacuated from areas which the U.S. government has issued travel restrictions (See U. S. Travel Restrictions for Mexico) or areas where civil unrest or natural disaster has temporarily shut down air traffic.

So, as part of a comprehensive medical insurance program, travel insurance, like the policies offered by MedEvac might be something you should seriously consider.

This information is provided for informational purposes only. Please refer to the MedEvac’s page for current plans and prices, requirements and restrictions.

************************

Alternative Medical Practitioners in Mexico

The indigenous people of Mexico believe that for every physical ailment there is both a physical and spiritual cure. Both must be treated for a full recovery. That belief is the primary reason that curanderos still exist in Mexico today.

The general term curandero (coming from the same root word as the English cure) can be used to refer to a variety of specialties, although these often overlap. The nature of the illness or condition determines which specialist should be consulted.

Yerberos are primarily herbalists. They may prescribe certain herbal remedies to aid in healing. Within this classification are several specialty groups. Yerberos who work primarily with tobacco are known as tabaqueros. Those who work primarily with ayahuasca are known as ayahuasqueros. Yerberos who work with peyote are known as peyoteros.

Hueseros are bone and muscle therapists who treat physical ailments. Sobadores are massagers. Either may be recommended for pregnancy complications such as breech positioning especially in areas where there are limited medical facilities. My father-in-law had several sessions with a sobador after he was hit by a truck on his bicycle to help alleviate lower back pain.

Parteras are midwives and have long held positions of respect in the community. A partera is often a skilled sobadera, huesera and yerbera as well.

Oracionistas work primarily through the power of prayer. Don’t be surprised if the oracionista calls upon the assistance of certain saints or the Virgen de Guadalupe herself. The curandera that I met with was a devout Catholic.

Brujos are witches. They deal in spellwork, the casting or removing of curses. Brujería (witchcraft) has been determined to be illegal in Mexico since 2010 however brujas and brujos abound. In this category are the hechiceros (sorcerers) and santeros. In fact, so popular is witchcraft in Mexico that there are even tourist attractions and markets centered around brujería for those so inclined.

As with any profession, there are levels of competence and experience. It’s also good to keep in mind that some may be complete quacks. My father-in-law went to a curandero in town who told him that he had a parasitic growth in his stomach and that he would need to pay $30,000 pesos to have it removed otherwise he would die. He went to the clinic for confirmation before forking over that huge amount of cash. The lab results showed a stomach virus, nothing more.

Have you met with any alternative medical practitioners in Mexico?

A Little about Healthcare in Mexico

Navigating the healthcare system in Mexico isn’t easy. The US embassy even has a page or two available for hospitalized citizens in Mexico and a list of Air Medical Evacuation Services if needed in the worse case scenario. Unfortunately, air ambulance service is not covered by most insurances and must be paid for upfront. In the event of emergency air evacuation, having an insurance policy that covers the cost, would be a good idea.

For none life-threatening medical scenarios, however, with a few bits of information and a little practice, you’ll be sailing through these high changeable medical seas in no time. The good news is that Mexico has universal health care which is divided into three categories. Seguro Popular is for residents without formal employment. IMSS (Instituto Mexicano del Seguro Social) is provided by employers. ISSTE (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado) is only for government workers. Even as a foreigner, you may be eligible for coverage under one of these three setups.

This is where you apply for Seguro Popular in our town.

Here’s How to apply for Seguro Popular:The head of the household should take an official id (INE, passport, driver’s license) to the affiliation office which you can find by entering your state and municipal here. If you are not a Mexican citizen, you can use your temporary or permanent residency card. You will need to present a comprobante de domicilio reciente (proof of residency such as electric bill, phone bill or predial). If you live in an area with a population less than 250 residents, you can ask for a letter from the local authorities to verify your address. In our area, this letter can be requested from an office in the presidencia (town hall). You will also need the CURP (Clave Única de Registro de Población) for each member of the family. If including an unmarried son or daughter between the ages of 18 and 25, you will need to present a comprobante de estudios (proof that he or she is a student). If you are renewing your policy, you must present the expired policy. You’ll get a sheet with a barcode on it. Keep this, it’s your póliza (policy). You’ll need it for every transaction. I’ve seen some people laminate their policy but just slipping it into a plastic sleeve should do the job. The policy has the expiration date, family members covered and whether there is a co-pay or not. No contributiva (non-contributive) means there is no co-pay for most treatments. You might also get a little booklet that lists what Seguro Popular will cover. It’s helpful but there seem to be yearly changes so your booklet might not be up to date. When you go for appointments, take the policy, your CURP (which also has a barcode) and your official ID. If you do not qualify for coverage under these three groups, you can apply to a private insurance company. This is not a comprehensive list, just a place to start. Check each company’s requirements to see if it would meet your medical needs and if the private medical facilities accept that particular insurance.

If medical insurance still seems beyond your financial grasp, take heart. Medical procedures in Mexico are often a fraction of the cost when compared to the United States. In fact, the prices on some procedures are so good, a whole tourism industry sprouted up to take advantage of them. And that’s just with major health issues. Most farmacias (pharmacies) have a doctor available for consult for around $40 pesos for minor medical emergencies like colds, stitches, scorpion stings, or a bean up the nose. So where can you go for treatment? If you live near Mexico City you are in luck. CDMX (Mexico City) has several high-quality hospitals including the Hospital de la Mujer and Hospital Nacional Homeopatío. Several states also boast having a Hospital Regional de Alta Especialidad. There are even three hospitales psiquiátricos in Mexico should you or someone you love need to avail yourself of their services. If you live in a rural area and you have Seguro Popular, your first stop will be at the hospital comunitario (community hospital). Don’t expect to be able to waltz right in and see a doctor. Head to the information desk and ask what the procedure is. You ought to do this before anyone needs a doctor. Go in for a family checkup. Everyone will get a routine physical and a little booklet to keep track of appointments. More importantly, you’ll be in the system so making an appointment gets just a bit easier.

Hospital Regional (General) in Uriangato, Guanajuato

If your condition is more than that hospital comunitario can handle, you’ll be given a referral to the closest hospital regional or general. You’ll need to head there and find out what the procedure is for making appointments as well. You can ask the security guard to send you in the right direction. Odds are you’ll need to head to Archivos (archives) first. Be aware that each department has its own process. There’s one process for seeing the doctor but a different process for getting lab work done. Keep asking until you understand what it is you need to do. Expect this procedure to change. The newest little hoop to jump through at the hospital I go to is to have the head chemist sign off on your prescription before you can pick it up at the pharmacy. Of course, she isn’t always there. In fact, she’s only there about 2 hours in the morning. So getting your prescription filled is just that much harder. Pharmacies outside of the hospital don’t typically ask for prescriptions. This makes it much easier to avoid the long and tedious process in order to get medication, especially for chronic illnesses. The best approach is to have an empty bottle of the medicine you need and hand it over to the pharmacist. Ask if there is a generic version and you can save even more money. If you aren’t sure, take a list of the generic varieties that you’ve downloaded from the internet with you.

Pharmacy with adjoining doctor’s office.

If you aren’t exactly sure what you need, ask the pharmacist to recommend something for the symptoms you describe or go ahead and get a consultation from the doctor next door. Wait time is typically less than 30 minutes. If there’s a long line, it’s not much effort to find another consultorio adjoining a different pharmacy. Of course, you can always find a private doctor if you have the means. You’ll get more personalized service and I’ve heard some doctors even make house calls. You might even have round-the-clock service via the doctor’s personal cell phone. Some areas have a Red Cross facility. This might be your best bet if it is a real emergency. There is a paramedic on call at all times and usually an ambulance. Arriving at a hospital in an ambulance will cut through the red tape for admission. However, be aware that the Red Cross is not a charitable organization. There are fees involved for everything, including the ride to the hospital, and you’ll need to pay up front.

Another thing you might not expect is you’ll have to line up your own blood donors if you require surgery even if you aren’t going to get a blood transfusion. If you are in an accident, that requirement might be waived temporarily but know that you will be expected to get a certain amount of “replacement” blood before being released. If there’s anything I’ve learned in navigation the medical ocean in Mexico it’s that you need to be your own best advocate. That may include getting your own blood work done at private laboratories, doing some intensive research on the internet, translating it into Spanish and handing it to your doctor. Don’t meekly go along with diagnosis or treatments before checking out alternatives and in some cases, the facts. Don’t allow your level of Spanish mastery to interfere with your health. Bring someone to interpret if need be. Being your own advocate won’t make you the most popular patient in the waiting room, but it might just make you the healthiest.

***********************

2 Comments

Filed under Health

Tagged as doctors in mexico, health insurance options in Mexico, how to apply for seguro popular in Mexico, Seguro popular in Mexico, where to go to the doctor in mexico

August 6, 2018 · 12:03 pm

Banking in Mexico

Banking has been one of my least favorite activities. That hasn’t changed since moving to Mexico. In fact, I believe I enjoy it even less. All the banks in Moroleon are within a two-block area smack dab in the center of town. Seriously. There is a Bancomer now at the shopping center, but that’s technically in Uriangato, so it doesn’t count.

At many banks, you can open an account provided you are residing in Mexico legally (and can prove that with proper documentation) and have a proof of address like internet, electric, water, or cable bill called a comprobante de domicilio. If you rent or live in an area where are are no utilities, it’s much, much more difficult to open an account but not impossible. Since La Yacata has no such modernizations, my employer at the school opened an account for me to receive my paychecks using the school address and her own good name to vouch for me. However, since she is the daughter of the owner of Corona, she’s got a bit of clout at the bank that the average person might not have.

Opening an account isn’t easy. There’s a lot of waiting and signing and more waiting and signing. Then there’s going out to get copies because one set is just not enough. Of course, it’s just your luck that the printer has just run out of ink, so you’ll have to wait while someone heads to the store to get more ink. Or perhaps the person needed to verify your information is out sick today, so you’ll have to come back tomorrow. Read about Dos Tortas banking experience here. Make sure to read the fine print before opening your account. Some banks have minimal initial deposits or none at all. Others charge a hefty fee each month if you drop below the minimum amount required. Some banks only allow you 3 withdrawals per month before charging fees. Others charge for every withdrawal.

Banco Azteca requires you to have your fingerprint digitally read to withdraw money from your account. This was always a problem for my husband because he has calluses on his fingers from work and the digital reader could never read his fingerprint. So the whole taking out of money from the bank teller process was much longer than it needed to be.

You can find a list of all banks found in Mexico here.

Bank lines are out of this world on the 15th and 30th of every month, when the majority of Mexicans receive their pay. It may be tempting to use the ATM but there are some things to keep in mind before you do.

Always use ATMs that are part of a bank rather than stand-alone ATMs to reduce the chance of your card being cloned. Even then, there’s a possibility your information can be compromised.

All banks charge fees when you use the ATM. If you request a receipt from the ATM, there’s another charge associated with that. Some banks charge even if you are just checking your balance and you don’t request a receipt. As of 2017, the highest ATM fees belonged to Santander, Banorte, Banamex, Banco Multiva and Scotiabank. To reduce fees, try to take out larger sums. However, each bank has its own withdrawal limit and some are quite low in order to force you to pay the withdrawal charge several times. As you muddle your way through the screens on the ATM, be careful to read each section before hitting accept. In order to withdraw money, you need to accept the charge but you are under no obligation to donate to the charity of the month to get access to the money in your account. We’ve had accounts at Banamex, Bancomer, and Banco Azteca and were not really happy with any of them. The next best thing for a foreigner to do is open a virtual account.

Charles Schwab Bank and Capital One 360 both have very good reviews. I opened an account with Capital One 360 and have been quite pleased. I was able to apply online from Mexico. Then I was able to go through the verification interview using Skype. I had my card sent to my friend’s house in the US who then shipped it via DHL to me here in Mexico. The only problem I had initially was the $20 deposit to activate my account. I could not deposit it via my computer from Mexico, so had my mom write me a check and deposit it via my sister’s computer in the US. It took about 2 weeks for the check to clear. So if you were in the mind to set up a Capital One 360 account, it might be easier to do it before you leave the US.

I was able to associate my Capital One 360 account with my Paypal via a phone call. I can send and receive money with no additional charges to accounts in the US via Zelle. I can have checks direct deposited to my account and withdraw it from any ATM here in Mexico. Right now I have been using the HSBC ATM because it only charges about $33 pesos per transaction. The last time I tried Bancomer, the fee was $80 pesos!

I can use my Capital One 360 account to make purchases at Amazon.com and Amazon.com.mx. Online shopping has never been so easy!

I only use my card at Amazon. I NEVER use my card to buy things in Mexico. We had very negative experiences with our Banco Azteca card. We used it to buy groceries at Soriana and there were several large unexplained purchases made before we caught it. We got a different card and used it to buy gas. Lots more charges were made and we again canceled the card. Even after we had no card, there were charges made to the account at Elektra which we refused to pay. As a result, all our local transactions are cash on the barrel as Charles Ingalls would say.

I’ve never written a check here in Mexico either. People here are suspicious of checks and with good reason. Once, I received a tax refund which was a check. Instead of going to the bank to cash it, I endorsed it over to my husband who took it to a liquor store that changed it for cash for a small fee. I think it was $50 pesos or so. He took the check, my passport, and his ID and voila! Trato hecho!If you happen to have some US currency, you can take it to the bank to exchange it for pesos or to a Casa de Cambio. You might just get a better exchange rate at the Casa de Cambio, so ask around first. It seems like banks are not required to give you up to the moment exchange rates. Neither the banks nor the Casas de Cambio accepts coins in our area, only bills. If you find you have a lot of change, you might want to find someone that is visiting relatives here in Mexico and ask if you can swap your change for some bills. If you are looking to remodel your house, start a small business, or need a small infusion of moolah, you might want to check out places like the Financiera Popular En Comunidad for microloans with affordable repayments. Each agency has its own list of requisitos (requirements) but often gives better rates than a bank.