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Mexico Medical Insurance FAQ’s

Mexico on My Mind Provides Resources for Peace of Mind in Mexico

We have collected a list of the most commonly asked questions regarding Mexican health insurance archived here on this page.

If you have a question you do not see an answer to, please contact us at our toll free number of 1-888-461-2099, and we will discuss your specific questions with you.

Since every person has a unique situation it is always best to talk in person with a licensed agent when it comes to medical insurance to make sure you are getting the best coverage possible.

On to the list!

What different plans do you offer and what are the differences?

We primarily focus on four different types of health insurance:

International Major Medical:

International major medical insurance is designed for anyone who lives outside their home country for at least 6 months out of the year. The six months do not need to be consecutive. Your passport stamps will be valid proof of your time spent outside your home country. There are 3 levels of coverage:  Silver, Gold Plus and Platinum.

Retirees who split time between countries and need International Major Medical will have coverage until age 75 as long as continuous premium payments have been met. At age 75, applicants that applied before age 65 qualify for extended coverage for life.  For applicants who apply after age 65, coverage terms at age 75.  However you still have options after age 75.

Mid-length policies:

Mid length policies (also called the Gold Plan) are intended for Missionaries, professional consultants or exchange students who will be living abroad for up to 3 years but intend to go back to their home country to receive domestic coverage after 3 years.

This policy also requires a one time health questionnaire and if your plans change and your remain overseas longer, you may apply for the Gold Plus plan and keep that policy as long as you need it.

Medical Travel Insurance:

This coverage is designed for people who will be vacationing abroad and need international travel medical insurance in case of a medical emergency such as an unexpected illness or accident. There is no underwriting for travel insurance. The application takes about 10 minutes to fill out and coverage can begin as soon as the next day.

Emergency Evacuation Membership:

Our Emergency Evacuation Membership addresses medical emergencies for people located in Canada, Caribbean, Mexico and the United States. MASA is not a health insurance agency, so no physical or underwriting is required. There is no age limit and the application only takes minutes to complete.

Vacation Cancellation Insurance:

Vacation Cancellation Insurance, or Trip Cancellation Insurance, is designed to provide essential coverage for trip cancellation fees, travel and baggage delays, and lost or stolen documents. This insurance will help you recover non-refundable, unused payments and deposits when a trip is cancelled or interrupted for a variety of reasons. Benefits are also provided for travel delays, baggage delays, and emergency medical treatment while you’re away from home.

What are the Deductible options?

Deductible options range from $250.00 US Dollars, to $10,000.00 US Dollars. The higher your deductible, the lower your premium.

What is the age limit for coverage?

Major Medical Insurance

If you have signed up for an International Major Medical policy before the age of 65 and have maintained continuous coverage to age 75, you qualify for the Global Senior Plan. There is no health application for this policy as it is exclusively offered on your 75th birthday. If you have not signed up for coverage before age 65, than coverage terms on the 75th birthday.

Medical Travel Insurance

 

You can obtain short term Medical Travel Insurance up to any age without a physical or health application.

Does this insurance work with Medicare?

Combining your domestic health care policy with an International Major Medical health care policy will provide you with insurance coverage where ever you are in the world (except for the countries excluded above). If treatment initiates abroad, IMG will continue treatment in the U.S. for up to 6 months even if you exclude coverage in the U.S.  Your national insurance is first and your international insurance will come in second.
If you are already receiving Medicare, than the appropriate area of coverage for you, to avoid over-insuring, would be “Worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan”, for a significant savings.

Is there coinsurance? If so, how does it work and what affect does it have on premiums?

Coinsurance is waived for expenses incurred outside the US and Canada. There is no affect on the premium. After the deductible has been met, IMG will pay 80% of the next $5,000 of eligible expenses. Coinsurance is waived for PPO Network expenses.

 

Is My Doctor Included in Your PPO Network?

IMG works with over 17,000 doctors nationwide.  To see if your doctor is included in the network:

Click Here

There is no PPO Network outside the U.S.

Are there specific areas of coverage?

There are two areas of coverage options: “Worldwide” or “Worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan”. There are no substitutions to the area coverages.

Is coverage just major medical or does it include minor medical with doctors for day to day issues and check ups, lab work, etc.?

This is a major medical policy like you are use to in the U.S.  Adult routine physical examinations are excluded under the Silver plan option, and for the first 12 months for the Gold, Gold Plus and Platinum plan options. Out-patient mental and nervous is excluded for the first 12 months on all plan options. In-patient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold, Gold Plus and Platinum plan options.

Does insurance pay direct to hospitals and doctors or does patient pay and get reimbursed?

In many cases, IMG works directly with the hospital or clinic, including those outside our independent Preferred Provider Organization (in U.S.), for payment of eligible medical expenses.

If you have received treatment in a small, remote clinic who would not accept your IMG insurance and need to be reimbursed for out-of-pocket medical expenses, simply complete the Claim Form and submit the original itemized bills and paid receipts within 90 days. IMG will reimburse the eligible medical expenses after applying the deductible and coinsurance.

Please remember to submit bills and receipts as soon as they are received. Do not hold them until the end of the year. IMG will apply eligible medical expenses to your deductible and coinsurance throughout the year.

IMG will pay the hospital directly for extended hospital stays where treatment was pre-approved so treatment is not interrupted whether there is a direct billing relationship or not.

What is turn-around time for approval?

Every attempt will be made to process applications timely. The specific time frame depends largely on the type of coverage for which is being applied. If you are applying for Medical Travel insurance, IMG will process the application and forward fulfillment materials within one business day.
If you are applying for permanent Major Medical coverage, IMG will process and underwrite the application within three to four business days following the receipt of all required information. Fulfillment materials will be forwarded the same day coverage is approved.

Is a medical exam required?

There is no physical exam required for Medical Travel insurance. For International Major Medical coverage, a physical examination is required to have been completed within the previous 2 years of application. If a physical has not been preformed within 2 years of the application date, then a current physical exam will need to be completed and submitted to the underwriter.

Is coverage permanent?

If you purchase the permanent Major Medical Health insurance, it is renewable up to age 75 so long as premiums have been continuously paid. If you signed up for insurance before the age of 65, than you automatically qualify for the Global Senior Plan. If a member signed up after age 65, than the insurance terms at age 75.

Are pre-existing conditions accepted?

IMG provides flexible underwriting methods to extend coverage. The underwriters will look at your total health history to make determinations.

Standard Issuance

There are two levels of underwriting when all medical conditions have been disclosed and they have not been specifically excluded or restricted by a rider (subject to the foregoing limits and the other terms of the plan*).

The Silver, Gold and Gold Plus…

These plan options provide a $50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of $5,000 per period of coverage after coverage has been in effect for 24 continuous months. This benefit is payable whether or not the applicant has received consultation or treatment for the condition(s) during the 24-month period of continuous coverage.

On the Platinum Plan option:

Conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.

Flexible Underwriting Rider – Where you may have otherwise been declined for coverage, the Flexible Underwriting Rider allows IMG to extend coverage to the applicant. After 24 months of continuous coverage, a disclosed pre-existing condition which has not been specifically excluded by a rider will be covered as any other pre-existing condition so long as in that 24 month period no treatment has been received for that condition. If treatment has been sought or should have been sought, then the 24 month period starts over from the treatment date.

Does a person have to be living a certain amount of time outside the U.S. or Canada in order to get permanent health care coverage?

No. If an applicant is already living outside their home country, than approval begins immediately. Medical Travel insurance begins on the date requested. The application for International Major Medical insurance should begin 30 days before leaving the United States or Canada ( in case you have not had a physical in the last 2 years) and the date of coverage will begin on the date requested.

Does the cost differ depending on how much time one spends in Mexico or outside their home country?

No.   However, since this is an international health care policy, for U.S. citizens, you will only receive 6 months of coverage domestically, per year.

How Do I Apply?

Use the links to the right to find the right policy and apply today!

Read More About
Mexican Health Insurance Products

  • Major Medical FAQ’s
  • Most Commonly Asked Questions
  • Medical Travel Insurance Highlights
  • Trip Cancellation Insurance
  • Immigration Process
  • A Healthy Travel Snack

Application Quick Links

  • Mexico Car Insurance
  • Mexico Homeowners Insurance
  • Mexico Major Medical Insurance
  • Mexico Medical Travel Insurance
  • Mexico Boat Insurance
  • Mexico Motorcycle Insurance
  • Mexico RV Insurance

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