Five Important Factors to Consider When Purchasing Insurance in Mexico

Yes, your agent was very nice, or maybe it was the policy´s low cost that attracted you. But, do you really know how your policy works and what you are covered for?

There are five things you should know about your policy protecting the most valuable asset of your life: your health.

1. Deductibles and Copays
   • In Mexico, most insurance providers have deductibles per event, not per year.
   • Many people are unaware of this, and you can end up paying several deductibles if you use your policy more than once during the year.
   • Does your policy have copays? A copay, also known as coinsurance, is another out of pocket expense that you may page when you use a hospital or doctor that is not within the network specified by your insurance policy.
2. Medical Network
   • If choosing your own doctor or hospital is an important to you, you need to understand if your policy allows that flexibility. Some policies only offer coverage within their network and going out-of-network can mean paying high out of pocket rates.
   • If your policy offers coverage abroad, like in the U.S., it is important to understand how the coverage is applied. Do you have to pay up front and wait to get reimbursed? Or can they directly pay the foreign healthcare provider? Paying a significant amount of money out-of-pocket only to have to wait to be reimbursed may not be a financial option available to you.
3. Claim Assistance
   • Even if you have lived in Mexico for a long time, you may not speak Spanish fluently. And let’s face it, insurance can be a confusing topic even in your native language. During an emergency, you want to be sure your insurance provider understands you. It is important to choose an insurance policy that not only has English-speaking agents but can also provide you with claims assistance in English.
   • A good insurance company knows that their clients may only speak English or may have to be treated in English-speaking countries. All their paperwork should be in English or at the very least they should provide you with a courtesy translation.
4. Sum Insured Amount
   • Sum insured is a very important aspect of any insurance policy that needs to be considered. This is the maximum amount the policy will pay in one year, and it is important you know how much your policy will provide. This is an especially important consideration for medical conditions such as cancer, HIV, heart disease, and other major illnesses or diseases requiring ongoing treatment.
5. Restrictions
6. If there are restrictions placed on your acceptance by the company, how does that affect the benefits you receive? The restriction may incur an extra deductible, a waiting period during which there is no coverage for the pre existing condition, or it may be a complete exclusion of the pre existing condition. Your coverage and any exclusions will be clearly outlined in the certificate of coverage.
7. If you already have a policy and are unsure about these five factors, take the time to review your policy before you need medical care.