Medical And Dental Treatment And Coverage In Oaxaca, Mexico

When I first gave up the practice of law in				home. In effect she had a free trip to Oaxaca,
Toronto in favor of early retirement in Oaxaca, I				and returned home with extra money in her
assumed that the years I would add to my life				pocket.
by leading a much more stress-free existence in				Our personal experience with dental treatment
Mexico, would be lost by the inferior health care				has been extremely positive. Cost tends to be
system to which I would be exposed, subjected				about a third to a half of American and Canadian
and restricted. This, then, is my assessment of				prices, for example for crowns and bridges,
the extent to which my presuppositions have				implants, root canals, gum and bone work, etc.
been accurate, together with information and				While the use of nitrous oxide (laughing gas) has
advice for both vacationers to and would-be				not yet arrived in most Mexican cities, a dentist
ex-patriot residents of Oaxaca.				with a gentle touch can more than make up for
Aside from the small, private hospitals, often				that lack of temporary high while in the chair.
referred to as clínicas, there are four				RESOLVING THE EX-PAT CONUNDRUM
publicly funded and insurance - based hospitals in				Get whatever coverage is made available to you
the city, as well as a hospital just outside of the				both in your homeland and in Mexico, subject of
city offering specialized treatment for a number				course to affordability.
of serious ailments. There is the Red Cross facility				To my thinking, with IMSS coverage costing
available to all, often used for emergency				under $400 annually for a couple, why not go for
treatment only. The civic hospital provides free				it regardless of what other coverage you already
services or treatment at a modest cost based on				have. Then supplement IMSS with international
a sliding scale respecting means. ISSSTE is a				coverage for catastrophic injuries unless you have
federally funded facility restricted to government				other similar insurance from another source. Our
employees who are members of a union. Finally,				Oaxacan friends tend to disagree, but theirs is a
there is IMSS, a federal insurance program				different mindset where insurance in general has
available to ex-pat residents and Mexican citizens				historically not been stressed or valued, be it
alike, with an extensive network of clinic doctors				home, car or health.
and a large hospital. It's funding is provided in large				Some American acquaintances swear by IMSS
part by business owners. Aside from these				since it provides regular care including preventive
hospitals, there are several, small, easily accessed				procedures, all dispensed by government
clinics scattered throughout suburban and rural				employed physicians including specialists, together
neighborhoods.				with lab tests, medication and hospitalization.
For the vacationer, and the ex-pat with a VISA				There are restrictions the first year of enrolment,
permitting residency in the country, the most				and there are caveats. The level of cleanliness in
common means by which to obtain emergency				the clinic environment tends to be below the
treatment is through Red Cross, IMSS (which				standard to which most of us have become
accepts patients without coverage on a				accustomed growing up in the US and Canada.
pay-per-service basis) or a private hospital.				Many physicians have not received the quality of
However, the last of these three is the only one				medical education of their private counterparts.
in which you can be reasonably reassured of				The medications provided through the clinic
being attended in a timely fashion by extremely				pharmacy are often not the best available in the
competent and efficient personnel.				marketplace for treatment of a particular ailment,
WHAT TO DO AS A VACATIONER				because of cost. Often the wait to see your
If you do not have out-of-country healthcare				designated doctor or for your lab tests can be
coverage, by all means go out and buy it before				long, requiring a half day commitment for each
leaving for your trip. However, it's advisable to				step in the process: visiting a general physician,
first inquire of your credit card company, to				going for one set of tests, then for another, and
ascertain if in fact you already have at least				finally seeing a specialist.
some coverage simply by virtue of, for example,				So why bother with IMSS at all, with all these
having a gold or platinum card. You can then				downsides? It's a failsafe, another form of
make a more informed decision concerned				assurance that you'll be cared for in the event of
whether or not to purchase coverage, and if so				a lengthy and serious illness. As suggested earlier,
at what level. On the other hand, a broken leg,				often it's the largest hospitals such as IMSS which
gastrointestinal problem or other non-life				have the best equipment, and surgeons with
threatening ailment can be attended by a private				private practices who perform some of the
doctor or clinic without breaking the bank. Of				surgeries. And there is no additional cost for
course for an outlay of more than $100, it's nice				hospitalization once you have full IMSS coverage.
to be reimbursed.				While attending a private clinic is more akin to
If you intend to make a claim to your private				your experiences before moving to Mexico, if you
carrier, credit card company or government				must remain in hospital for a lengthy period of
funded health care plan, ensure that you not only				time, the cost of doing so in a clinic could be
keep all receipts, but request a written diagnosis				prohibitive...just like back home.
and treatment plan, and that the prescriptions you				Visiting private physicians, and even biting the
are given indicate for what purpose each medicine				bullet and getting your tests done at privately
is being prescribed (i.e. antibiotic, analgesic, etc.).				owned laboratories, reasonably assures you of a
Many doctors provide all required information				familiar quality of care. Coupled with IMSS
simply as a matter of course. Accepted practice,				coverage, you can now be confident that you're
at least except for when narcotic medications are				covered in almost all respects. In the event of a
being prescribed, is for the pharmacy to return				protracted hospital stay you can afford to be
prescription forms to you. Often medical plans				there for as long as necessary. The best locally
require translations of each document that is				available equipment will be used in your diagnosis
presented to them as a prerequisite for				and treatment, and you have a reasonable
processing and reimbursement. When in doubt,				likelihood that attending surgeons are those who
submit all documentation with your claim, making				split their time between private practice and clinic
sure to determine if originals are required, and				work, and performing procedures in one or more
keep copies. Frequently, as is the case with				large hospitals.
Ontario, it's a two step process. Treatment				We maintain IMSS coverage, but rarely use it,
receipts and diagnosis is submitted to the				preferring to tap our Oaxacan social networks for
provincial plan. Once you're notified of the portion				referrals to specialists to the extent they are
not covered, prescription receipts together with a				required. And in any event, after having been
request for reimbursement for the amount not				resident in Oaxaca for a few years, those of us
covered by the province, is submitted to one's				who are in our fifties or older have already been
private plan. In theory, between the two plans,				introduced to a broad range of specialists. As
100% reimbursement is achieved.				strange as it still is to be a Canadian and subscribe
You can ask the manager of your hotel or bed				to the pay-as-you-play philosophy of medical care,
and breakfast to do you a favor by translating				it serves our purposes, with the IMSS safety net
each of your supporting documents, to save you				just in case.
the trouble upon your return home. Make a note				Under certain circumstances you may not want
of the then prevailing rate of exchange, and				to rely on even the best Oaxaca has to offer.
submit a calculation to your plan with your				Indeed the stream of Oaxacans traveling to
documentation, to more easily facilitate payment.				Mexico City flows briskly and wide. The middle
When a member of a clerical staff is processing				and upper classes with contacts in the nation's
your claim, he'll be less inclined to put yours aside				capital, there quickly seek out the best in terms
for another day or week if it already contains all				of physicians and state-of-the-art equipment, for
the necessary and relevant data, organized in a				diagnosis and for treatment of life-threatening
readable format.				diseases.
Concerning where to go in the event of illness or				Even doctors working in Oaxaca at the IMSS and
emergency, your accommodations host should be				ISSSTE hospitals can make arrangements for
able to make recommendations for English				patients to receive treatment not available here,
speaking physicians with private practices, and for				to be attended in Mexico City or other larger
private clinics. Regarding competency of the				centers. However, the process can be slow. We
former, while there is a medical school in Oaxaca,				know of one case, that of a two-month-old baby
many doctors travel out-of-state for their				with heart problems, who was finally sent to
post-graduate training such as to universities in				Puebla for surgery at ISSSTE, only to die before
Mexico City or the US, and regularly attend				the procedure could be performed.
conferences and upgrading courses. Some travel				The solution, unless you have quality foreign
abroad within the context of their specialization				coverage perhaps as part of your retirement
training. Indeed the Oaxacan populace appears to				pension plan, is to buy insurance which will pay for
take notice of and prefer those physicians who				treatment in Mexico City, or better yet
are able to display foreign diplomas.				throughout the world as long as you can make
Our personal experience with emergency				your way to one of the participating
treatment over the past 10 years has been				top-of-the-line hospitals. In my case, I have a low
nothing but positive for ourselves, our family and				annual premium, with high deductible which is
our guests, at hospitals Carmen and Molina, both				waived in the event of accident. Again, it's a
downtown ... in terms of competence, speed with				failsafe mechanism in the event of, for example,
which one is attended, and the presence of				a serious car accident, or cancer, stroke, heart
English speaking ER doctors. On the other hand,				attack, or other catastrophic ailment which would
we cannot recommend the emergency				otherwise not be affordable. Oaxaca has less than
departments at the civic hospital or IMSS because				the best of diagnostic equipment and treatment
of delays in receiving treatment, and at minimum				facilities. My plan provides for a $10,000 deductible,
in the case of IMSS unavailability of competent				$2,000 annual premium, with member private
medical personnel 24 hours a day to attend to				hospitals in Oaxaca, Mexico City and elsewhere in
even a commonplace emergency (i.e. suturing).				the republic, and of course abroad including the
Having said this, many excellent surgeons with				US, with the Mayo Clinic in Rochester being a
private practices perform surgery at the				participant.
non-private hospitals where there tends to be the				In summary, my medical coverage and plan for
more state-of-the-art and sophisticated				treatment is the following. We have our regular
equipment.				family physician, who, along with our Oaxacan
The normal range in price for a consultation with a				friends, refers us to specialists in which we have
family doctor, specialist or dentist, is $20 - $50 (all				the utmost confidence, and to whom we pay per
figures are stated in US dollars and are				visit. The same holds true for dental treatment.
approximate for 2008 unless stated otherwise).				We have IMSS coverage which we reluctantly
PURELY ELECTIVE AND COSMETIC				(because we don't use it) renew on an annual
PROCEDURES				basis, but believe it's worth the price in the event
Over the past several years Oaxaca has become				we need extended hospitalization, or to have
a popular destination for Americans and Canadians				surgical procedures performed not available in
seeking both plastic surgery and extensive dental				private clinics. And I have my catastrophic
work. Word has spread of the competence and				coverage which hopefully I'll never need to access.
quality of work of both nip-and-tuck and dental				Medical care and coverage can be inexpensive,
surgeons, and of course of their extremely				and just as easily it can be costly. It's a matter of
reasonable charges relative to those paid to				the individual or family having a philosophy, or set
hometown practitioners. Many foreigners, as well				of priorities, before electing to move to Oaxaca.
as Mexicans from Mexico City and other regions				You have to determine how you want to lead
of the country come to Oaxaca for face lifts,				your life in terms of balancing having less
breast reductions and augmentations, liposuction				disposable income as a result of medical and
and other appearance enhancing procedures. A				insurance costs, with having greater peace of
friend who attended for plastic surgery in Oaxaca				mind in knowing that whatever is thrown your
by a well-known plastic surgeon a couple of years				way will be looked after as best possible given
ago, recently commented that she had read an				your new life in a foreign land. If you cannot
article in a Canadian magazine indicating the cost				achieve a level of comfort in the resolution of
for the same procedure which she had				these issues and decisions, then perhaps the
performed for $500, was $3500 - $5000 at				move is not for you.

Ms Ranch

Medical And Dental Treatment And Coverage In Oaxaca, Mexico