Check out the many options of insurance that are available in Cozumel. Here are two agents that have information on all your insurance needs and speak English:

Cozumel Insurance

987 876 1483 
Calle 14 Entre 15 y 20
Cecilia Desire Sanroman Aranda
Independent Licensed Insurance Agent / Asesor
desiresanromanda@gmail.com

CP Seguro Insurance
Irma Portilla de Cantarell
Asesor en Seguros
Calle 11 between 25 & 30 Ave. No. #598
ima@seguroscantarell.com
987-871-9415

There are two Government funded Medical insurance options available Seguro Popular  and IMSS Insurance:

health insurancehealth insurance3Mexico has a plethora of insurance companies that, for a monthly premium, will give you private health coverage. In the event that you or a member of your immediate family are taken ill or suffer an accident, the insurance company will cover the medical fees.

How much is covered depends on what health care plan you choose to buy. The more cover you need, and the older you are, the more expensive the premiums will become. Other factors (such as whether you smoke or take regular exercise at a gym) may also influence the price of your premiums.

Most large companies offer a health care plan as part of their pay package. As with the USA, health insurance premiums have risen dramatically in Mexico over recent years. It is in part due to the higher cost of medical care, higher cost of medicines and an increase in hospital fees. Having a plan through a large company offers a distinct advantage because the company covers the lion-share of the premium cost, and this means that you, personally, pay less and get considerably more cover under a corporate insurance plan than you would otherwise get on a privately held plan.

If you don’t work for a company that offers health insurance, then a private plan is your only other option. You should shop around for the best deal and find a plan that matches your circumstances, potential needs, and budget.

Companies offering health insurance in Mexico include: ING MexicoGNP MexicoMonterreyRoyal & Sun AllianceMetLife and DVK.

In addition, Mexico’s Banks offer health insurance products as part of their service portfolios although you should check the small print for any limitations.

Obamacare’s Effects on American Expats Living Abroad

Oct. 24, 2013 Update:

This article is for all the Americans traveling or living abroad who have, so far, avoided learning about the Affordable Care Act (ACA). With the currentg Oct. 1, 2013 – March 31, 2014 enrollment period, for ACA – Obamacare, there are bundles of questions that arise affecting US citizens who are outside the USA.

Americans who are NOT residents of the USA, do NOT have to participate if you meet the requirements of being a resident of another country (or if you are outside the USA for 330 days or more per year).   You can find more details below on Exemptions to ACA and how to qualify as a Non-Resident US citizen at:

https://www.healthcare.gov/exemptions/

via ACA – Obamacare’s Effects on American Expats Living Abroad | Surviving Yucatan.

Cozumel Mexican Institute of Social Security IMSS

The IMSS Hospital and Clinic in Cozumel is located at  11th Avenue, crossing with 30th Avenue. The telephone number: (52-987) 872-0639. Most full time workers in Cozumel have medical  coverage either through IMSS or Issste paid for partially by their employer. You may buy into Medical Insurance on your own.  Medical Insurance is available to foreigners holding Immigration credentials. The cost is quite low, although it has risen annually.

There is a new procedure!

You now apply and renew online at:

https://serviciosdigitales.imss.gob.mx/portal-ciudadano-web-externo/home

You will need your CURP card and an email address. Once you are in, click on the box that reads:

“Incorporación al seguro de salud para la familia

Solicitud de incorporación al seguro de salud para la familia”

This will take you through the process including a health questionnaire. I use Google Chrome that automatically translates from Spanish to English. I will add the step by step instructions as soon as I apply for 2017 coverage. Somewhere along the line you will probably have to submit the following:

ORIGINAL Birth certificates & Copy
ORIGINAL Marriage license & Copy
CURP Card
Proof of residence (Utility bill etc.)
Copies of you Immigration documentation
Copies of your passports
Two infantile size pictures in color
They require the birth certificates and marriage license be translated by an approved translator.
Copy of your Social Security Number assigned to you at: www.imss.gob.mx

OTHER FACTS:

The first six months there is no coverage. The second six months only minor things such as colds are covered. The second year everything is covered except broken bones and orthopedic.

The third year covers everything including medication as long as you get them from IMSS. You will not be reimbursed for drugs purchased at other pharmacies. The drug benefit is the only negative I have heard, as they are many times short of medications.

IMSS Family Insurance this insurance entitles you to IMSS hospital, surgical, medical care, and pharmaceutical supplies for you and other members of your family.  Advance payment of annual fees is required and rates are determined by the age range of the person to be included in the insurance.

Annual costs Advance Fees:

Ongoing from 1 February 2016 to 31 January 2017

Age range     Annual quota

0 to 19 years            $ 2,250.00

20 to 29 years         $ 2,700.00

30 to 39  years       $ 2,850.00

40 to 49 years         $ 4,000.00

50 to 59 years         $ 4,250.00

60 to 69 years         $ 6150.00

70 to 79 years         $ 6,450.00

80 and more          $ 6,500.00

The amount of annual contributions is updated in February each year.

Insurance can now be purchased individually or at least two people, ie, the owner and immediate family such as: spouse, partner, daughters, mother, father or additional family such as: grandparents, grandchildren, nieces and nephews, etc.  If you reside abroad, you can also purchase this insurance for your family in Mexico as head of the family.

Exceptions

They cannot ensure people who have:

Pre-existing diseases, such as malignant tumors, chronic degenerative diseases, late complications of diabetes mellitus, diseases Hoarding (Gaucher disease), chronic liver disease, chronic renal failure, heart valve disease, heart failure, sequelae of ischemic heart disease (arrhythmia, angina or myocardial infarction), chronic obstructive pulmonary disease with respiratory failure, among others.

chronic systemic connective tissue diseases, addictions like alcoholism and other substance abuse, mental disorders such as psychosis and dementia; Congenital and Acquired Immune Deficiency Syndrome or Human Immunodeficiency Virus (HIV) disease.

The Mexican Social Security Institute will not make full or partial repayment of the payments made. It is very important that all information provided is accurate and complete, especially referring to pre-existing conditions.

When you have acquired the Family Health Insurance, you can renew it 30 days before the due date.

health insurance1

SEGURO POPULAR

Seguro Popular is a Medical Coverage Program for Citizens and residents ran by the Mexican Federal Government. It is intended for all those that do not qualify for IMSS (Social Security) insurance, ISSTE or other working insurance coverage that is federally funded.

UPDATE as of 2019 CHANGE in Qualification:

If you are a permanent resident Seguro Popular is now only available as EMERGENCY ASSISTANCE for a one-time three-month period.

Naturalized and Mexican Citizens qualify for this insurance long term. Renewals in this case is for a three-year period.

The office is located at Cozumel general hospital on Calle 11 South between Avenues 20 South and 15 Bis C South. As you enter the front of the hospital turn right and follow the hallway to the end, make a right hand turn and you will see the Seguro Popular Module.

Copies to Bring:

Permanent Resident Card. If Citizen your INE

CURP

Utility Bill for proof of residence

The young woman who processes the application will ask some basic questions:  Name, Address, Own or Rent, phone number, Birth Date, Age, Marital Status, Working or Not. THEY NEVER QUESTIONED INCOME.

She will then scan all your finger prints one at a time into the computer for their records starting with the thumb on your right hand.

She will print out two copies of your insurance policy. You sign in three places. She stamps some official seal on everything, hands you one of the originals and wham, you have insurance for the next three months if you are a resident, the next three years if you are a citizen FREE OF CHARGE.

You must make many copies of your policy, as you are to give a copy to the service provider at each visit.

Originally, they assigned you to a Seguro Poplar Clinic closest to your home. The clinics opens at 7 a.m. Monday – Friday and appointments are made on a first come first serve basis. At this clinic, you may see a general Practitioner for all non-emergency medical needs and preventive care. This includes Dental and Eye Care. If you need a specialist, they will refer you to one. If there is none on the island, they will send you to an affiliate in the mainland. Cozumel General Hospital is now designated as a caregiver for preventive care. The country is currently going through a health care reform; I expect that things will continue to change as the reform takes effect.

All Seguro Popular Emergencies are handled by Cozumel General Hospital. The hospital and ambulance ride if necessary are free of charge. There are also small pharmacies at the clinic. Their stock of medicine is very limited, but if they happen to have what you need, it is also free of charge.

They give you a handbook of rights and description of services that is in Spanish, but there is a website: http://www.seguro-popular.gob.mx/ that has all the same information. It is also in Spanish; remember to use the Google Chrome Translation feature.

Aura Holguin-Resch
The Cozumel Sun News
RFC: HORA500201TP1
987-118-4453 CELL
386-445-8702 USA auraholguin@thecozumelsun.com