Tuesday, February 18, 2014

Seguro Popular vs IMSS


I don't usually write about subjects like this because I don't like controversy but it is time for me to renew my IMSS. I am trying to decide if I should go ahead and pay the money or else let it drop and try to get on Seguro Popular instead. I think that most of my readers are living in the United States or Canada and they will not know what I am writing about. It is the two health care systems here in Mexico. IMSS costs around three hundred dollars a year, a little more to get someone to help you sign up. Seguro Popular is free. But you cannot have both. If you sign up for IMSS, you can't get Seguro Popular.

I was just reading some web boards about these two systems and there are conflicting opinions. Some people love the Seguro Popular system and others think that IMSS is the way to go. I have had NO experience with the Seguro Popular system. I do know that many of my expat friends, even the wealthy ones, are signing up for it and ignoring IMSS because of the strict rules for IMSS. You can't even use IMSS for several years and then after paying for it for a long time, they are likely to kick you off when you can use it. I have paid for it for maybe five years now.

I have had three operations since I came here.  I paid for all of them out of pocket and went to private hospitals. I was pleased with all of them. The private hospitals here are wonderful and inexpensive. But if I had a major problem, I wouldn't be able to pay for it. Thus, my concern. Do I continue with IMSS or switch to Seguro Popular?

When I broke my ankle I went to the IMSS hospital in Guadalajara. I sat there for five hours and didn't see the doctor. I was sitting in a straight back chair with my ankle dangling on the floor, growing larger and more painful every minute. Doctors rushed past me. People were on gurneys all around me, in far worse condition than I was so I felt badly about complaining. But how about no toilet paper in the bathroom? And they didn't even have a wheel chair to take me from the car to the hospital. The man who drove me there had to borrow one from another patient. It was a nightmare.

They finally said, yes I could have the surgery but in a week. I would be in a room with several other sick people, catherized and heavily drugged for that week.  I got out of there and went to the private hospital in Ajijic. I had to be on a morphine drip for several days because of the trauma of the other hospital and my blood pressure being so high. That is my only IMSS experience. Needless to say, it was not a good one. By the way, the entire cost of my several days in the Hospital Ajijic and the operation was a little over two thousand dollars.  Best spent two thousand dollars in my life!

So, if anyone out there has had experiences (good or bad) with IMSS or Seguro Popular or any advice, I would really appreciate it. I need to make this decision within the next few days.

19 comments:

  1. Seguro Popular offers coverage via the general hospitals in Mexico -- that is, the hospitals that serve the poorest of the poor. Depending on where you live, the hospitals are more understaffed and under-supplied than IMSS hospitals. The coverage is also less extensive, though that is improving. The entire Seguro Popular program was designed to offer health care to people who are not otherwise covered (IMSS is generally for working people, whose employers pay for the coverage, there are other systems for state and federal government workers). So -- it really depends on the quality of the facilities in your area. Your experience with IMSS is similar to what my local neighbors have -- long waits, delays in treatment, etc. I don't think it would be much better for Seguro Popular. Both systems are under-funded, but if you have no other options, and no savings to pay for emergency care, it does offer some help. For foreigners who have the resources to pay for private care, or private insurance coverage, that makes more sense to me -- to do differently would be to be taking away from a very limited resource designed for those with no other options (that is NOT a criticism of those who use Mexican public health services, just my opinion!). For those over 65, it is very difficult, if not impossible to get private insurance coverage, so IMSS or Seguro Popular is probably a good idea in the case of an accident or catastrophic illness.

    ReplyDelete
    Replies
    1. Thank you so much. Several people have told me to continue with IMSS. Looks like that is what I will do. P

      Delete
  2. Pat,
    Sorry to ask this potentially off-topic question, but...
    Does anyone have any first-hand knowledge about vaccine costs at Dr.'s offices or pharmacies? Specifically the Shingles vaccine. Most insurances in the US only cover it for age 60+. Since I'm 55 it'll be all out-of-pocket. Are vaccines like this available in the Lakeside area? Your experience with your ankle surgery makes me suspect getting a vaccine like this might be cheaper out-of-pocket in Mexico....?

    JimS.
    Seattle

    ReplyDelete
  3. hi JimS. I do have information about the Shingles shot here. THEY DON'T HAVE IT. I tried in different places. Get it at WalMart or Costco in the states... Those are the least expensive places. They do have other shots here. Sometimes they even give the flu shot. p

    ReplyDelete
  4. Crud, I was afraid of that. I am not surprised. From what I've read the vaccine has not been all that well-received in the US mostly due to the cost, and insurance companies not wanting to cover it-- or it least dragging their feet about it. Guess I'll just have to fork it over.
    Thanks

    ReplyDelete
    Replies
    1. FOR SURE, get the shingles shot. it is a little over a hundred dollars at Costco. My friend didn't get the shot and now has shingles. It is VERY painful... It is well worth the money. p

      Delete
  5. Thanks for the tip, I will get it at Costco. Nobody ever beats them, and paying out-of-pocket sure beats getting painful and possibly recurring case of Shingles. Could make your life totally miserable.

    ReplyDelete
    Replies
    1. Good decision. Well worth the hundred dollars. p

      Delete
    2. I guess it has gone up in price, Costco is charging $186 for it now. But that's still almost $50 less than anybody else, and still beats the you-know-what out of a case of shingles that might have been prevented.

      Delete
    3. That is amazing. The first year I wanted to get one, the cost at the drug stores was a hundred dollars. I thought that was too much and didn't do it. Then the second year the same drug stores were charging over two hundred and Costco was just a little over a hundred but I did it anyway. Well worth it. p

      Delete
    4. The vaccine is not as efficacious as most of us would wish, and not a cheap injection, but still a good investment as I understand shingles to be most unpleasant.

      Delete
  6. I wont get a shingles shot because less than 20% of the population will get shingles and then the vaccine is only about 50% effective. Those odds aren't good enough for me to be scared by the pharmaceutical hype, hysteria and propaganda (advertising). I don't even get the flu shot and haven't had the flu in years.

    ReplyDelete
    Replies
    1. Hi Paty, Thanks for writing. For me, 50% is better than no percent. But I know, it is very expensive. p

      Delete
    2. Paty, I tell ya, one good round of real flu will make a believer out of you. I've had "the flu" a number times, but until I got a good strong of "influenza" and was down for a month, I didn't know what sick was. Definitely took a hit to my income. A flu shot seems like cheap insurance.

      Delete
    3. I sure wish I had gotten the flu shot this year. I have been sick for about two weeks now. Not much better yet. Thanks for writing. P

      Delete
  7. Actually, the CDC says 1 in 3 adults will get Shingles in their lifetime. Although that means 2 in 3 won't, I'm not willing to chance those odds. Especially when $200 (or free if you're 60+) will decrease those odds by 50%. Basically it boils down to: do I want a 33% chance of getting Shingles? Or a 16.5% chance by paying $200? Pretty easy decision for me.
    JimS

    ReplyDelete
    Replies
    1. Hi JimS. I agree with you about the shot. Even though I am over 60, I had to pay because Medicare will only pay if you have part B, which I don't. Thanks for writing. p

      Delete
  8. I haven't gotten the shingles shot, but about 5 years ago a got shingles an extremely mild case of it actually, it was mild pain wise but took 6 weeks to stop. I have a friend that got a severe case of them all over his face and through his eyes he became nearly blind in one eye as a result so I think it's wiser to get the shot if it lessens the chances of going through such a painful process as he suffered with for a few weeks! The cost is outrageous for sure but the ordeal can be extremely disabling and can result in long term damage.

    ReplyDelete
    Replies
    1. Thanks for commenting. I also have a friend who did not get the shot. She got shingles right after I got the shot. She was in terrible pain. I was glad I had paid for the shot. p

      Delete