Saving money with Mexican health care
In the pile of mail waiting for us this week was a notice that as of July 1, our monthly health insurance premiums would be increasing by 14%. Thatâ€™s just the base annual uptick for people with no new claims in the same age bracket.
As mostly self-employed people here in the United States, the cost of health insurance for Jak and myself is already debilitating. Worse, in less than three years we will both â€˜level upâ€™ to new age brackets, which means about a 25% price jump in addition to the annual one.
Happy birthday to us.
At this rate, the cost of our premiums will double in just four years. Which brings us to one of the major reasons Americans move to Mexico: cheaper health care. And not just cheaper, but seemingly better in almost every conceivable way.
Private health care
The expats Iâ€™ve spoken to — even those who are disenchanted with other aspects of Mexican life — universally rave about how wonderful Mexican doctors are. Most doctors speak fluent English. Many have been trained in the U.S. or Canada, others in internationally-renowned Mexican universities.
The thing that seems to strike most people, however, is the genuine caring and compassion shown by Mexican doctors for their patients. After the cattle-call rush treatment of doctorsâ€™ offices in the States, the idea of a doctor who will spend as much time as you need, patiently and carefully answering your questions, is flat-out amazing.
While some rural areas of Mexico may lack new facilities, the area weâ€™re looking at is just 40 minutes from Guadalajaraâ€™s world-class hospitals. Lab tests are reportedly a third or less of their cost in the States. An office visit with any doctor or specialist will cost you, in total, around $25 — about as much as the copay on most U.S. insurance policies. And if you need continued care, the doctor will likely make house calls for the same amount.
Yes, you read that right. House calls.
State health insurance
While the United States wages a bitter internal war over even minor health insurance reforms, Mexico has been slowly rolling out a whole new universal health care plan. Seguro Popular is a fully socialized system which aims to provide complete health care to all Mexican citizens and residents, regardless of age, income, and preexisting conditions.
Seguro Popular is still relatively new and not well-tested, but early reports from expats are very positive. The coverage is comprehensive; if we want or need to use it for preventative and routine care, we could. The quality of facilities and care seem to be in the very good to excellent range; the main difference from private care is increased wait times for non-emergency issues.
This means that for some amount between $0 and about $600 per year, depending on our income, we should be fully covered for treatment in case of medical calamity, up to and including AIDS and cancer. Thatâ€™s a $4k savings over our current annual premiums — not even factoring in the hefty deductible and 20% copay in case of actual medical need, none of which would apply in Mexico.
I am lucky in that the one medication I must take daily (and indefinitely) went generic a few years back, bringing the cost down to about $3-4 per month (instead of $140). So I knew that a lot of medicine was said to be cheaper in Mexico, but wasnâ€™t too worried about pricing anything in particular.
However, during our last week in Mexico, the friend that was housesitting for us back in Seattle reported that pet hair had been aggravating her asthma and she had used up her last remaining albuterol inhaler. This was nontrivial, as she said each inhaler costs her about $60.
I decided to find out if we could replace her inhaler for less than that in Mexico. Not being asthmatic myself, I was unfamiliar with the medication and had to research everything very carefully.
The international name for albuterol is salbutamol, and in Mexico it is an over-the-counter drug. Having been warned about potential strength differences between U.S. drugs and Mexican equivalents, I carefully cross-checked the active ingredient percentages. The Mexican salbutamol that I found was actually slightly stronger than the U.S. equivalents.
Cost? 54 pesos, or about $4.20 with the exchange rate at the time. Per inhaler. This was at the nearest farmacia; I didnâ€™t even price-compare. We brought her three, as a thank you for putting up with our shedding critters.
I was due — overdue, actually — for a teeth cleaning and checkup when we left, so I decided I would take the opportunity to experience one aspect of Mexican medicine first-hand.
We donâ€™t have dental insurance; Iâ€™ve run the numbers and given our options, it makes more sense for us to pay out of pocket. I have an excellent dentist in Seattle, but neither Jak nor I have needed anything more complicated than cleanings in at least a decade. Fees have been rising, and my dentistâ€™s current quote for a cleaning and checkup is $197. (In August 2011, Checkbook determined that $169 was the average charge for a periodic exam & cleaning in the greater Puget Sound area.)
In Mexico, I got a dentist referral from a new friend who, in turn, had been referred by other expats in the community. (The expat network, Iâ€™ve decided, is the greatest resource available to newcomers. You can find out nearly anything and get vetted providers for pretty much any service.)
I called and was told a cleaning and checkup would be MX$350 — about $27. Based on other reports I suspect that may be on the high side, but again, I did not price-shop, being at that point ecstatic with the cost (let me just say that again: $27!) and more interested in having a positive experience than squeezing out a few more dollars of savings.
How did a $27 dental visit in Mexico compare to a $197 one in Seattle? Very favorably. Iâ€™ll give a detailed rundown in a future post.
Best of both worlds
Our tentative plan — and the route that many expats take — is to pay for routine and minor care privately (using HSA funds from our time in the States), and sign up for Seguro Popular as a backstop for major misfortune, the sort that would run tens of thousands of dollars or more.
Of course, Seguro Popular might turn out, over the next few years, to be unsustainable. If that system faltered, we would have to either buy catastrophic insurance on the private market, or go without.
Either way, itâ€™s clear that we would be better off for healthcare in Mexico than anywhere in the U.S., simply because the costs — even of private care — are so much more reasonable. Our health expenses should be somewhere between one-sixth and one-tenth of what they would be here, something that will only become more relevant as we get older.