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What You Need to Know About Using Medicare in Mexico

Mexico with its laid-back and rich culture is an instant hit among tourists and expats alike. Especially from a healthcare perspective. You’ll hear many expats talk about going to the doctor for only $40 USD without insurance, or having surgery and only paying a few hundred dollars with excellent results. But that doesn’t mean a serious emergency in Mexico can’t cost you thousands of dollars. And with open enrollment for Medicare coming up on October 15th through December 7th 2021 I figured it would be a good time to share information about using Medicare in Mexico. Yes you read that right- using Medicare in Mexico is an option!

In today’s post you’ll learn some very important things you need to know about who qualifies for Medicare, types of Medicare plans that will cover you in Mexico, What they will cover, How to make claims, and Why you need a broker to help you through the process.

Who qualifies for Medicare?

If you are a U.S. Citizen or Resident and are over the age of 65, you’ll have the choice to apply for Medicare. It doesn’t matter if you have pre-existing conditions. There are a few other a few other people in specific medical situations where Medicare may cover them.

If you chose not to apply and forgo getting coverage, there is a late enrollment fee you’ll need to pay later on. The penalization fee you’ll have to pay in the future depends on how long you’ve gone without coverage after the age of 65 and which plan you chose. If you plan on living in Mexico, you should also know that choosing a Medicare Advantage plan can cover you worldwide- including Mexico.

But first let’s talk about what a Medicare Advantage plan is.

Medicare Plans That Cover You in Mexico

While Mexico does have public health insurance programs such as the INSABI or IMSS, you may not want to seek medical attention in an emergency at one of these hospitals. For starters, your wait times can be very long considering it’s a public hospital. And when it comes to your health in the case of an emergency you will probably want to be seen immediately and with a specialist. That is why you should consider enrolling in a Medicare Advantage plan that will cover you in Mexico in case of an emergency.

Medicare Advantage, also known as plan C, is a supplemental plan to Medicare parts A and B that covers you in case of emergencies anywhere in the world. Medicare Advantage plans are run through private health insurance companies and are private health insurance plans accepted by Medicare.

But its worth mentioning that not all Medicare Advantage plans are equal. Some will not cover you if you live in Mexico full time, and some will not cover certain “emergencies” at all.

How To Make a Claim Using Medicare?

Most hospitals in Mexico will not accept an insurance policy from another country, and you’ll need to know how to handle your claims with Medicare Advantage.

You’ll likely need to pay the Mexican hospital out of pocket and make a claim through Medicare Advantage after the fact. Knowing how to navigate this process after a serious emergency can be one of the last things you’ll want to think about. Knowing the process and what to expect in advance can save you frustration and confusion at a Mexican hospital. Get access to our recommended Medicare Advantage Broker to enroll you with the right plan that will cover you in Mexico. Our recommended broker has years of experience enrolling expats in Mexico. He can explain exactly how to make a claim, what emergencies are covered, what to do in case of an emergency, and everything you’d need to know about your Medicare Advantage plan and how to use it in Mexico. His services are 100% free to you.

Our recommended Medicare Advantage Broker is part of our contacts in our COMPLETEMexico Relocation Course

Why Hire a Medicare Advantage Broker?

The right Medicare broker will have a deep understanding of what Medicare Advantage policies cover things like emergencies when you are overseas. Many people don’t know this until it is too late, but some Medicare Advantage policies will not cover you in Mexico if you have been out of the U.S. for more than 60 days. Our recommended Medicare broker not only has years of experience enrolling expats living in Mexico in the right Medicare Advantage plan, but can also help you navigate which policies may give you a hard time when it’s time to make a claim.

But it’s important that you note Medicare Advantage will only cover emergencies in Mexico. Cancer and other chronic diseases that are not considered emergencies of life or death, for example, are not covered. That is why so many people choose to enroll in Medicare Advantage when they move to Mexico. For the small things like a stomach bug, or a common cold they can see a doctor in Mexico for under $50 without insurance. But when it comes to a serious issue where surgery may be needed- such as a broken leg- the right Medicare Advantage policy will cover those costs.

However, having the right person help you chose a policy will help you not only ensure you get the coverage you need but will also avoid you confusion when it comes to actually using your Medicare Advantage policy in Mexico.

Q&A-Using Medicare in Mexico

And in the most recent video post on our YouTube channel, I did an interview with our recommended Medicare Advantage broker. He explains in detail the common misconceptions about Medicare and Medicare Advantage. Plus, he tells you how to sign up, what you can expect the claims process to be like, and more!

Watch the full replay

Mariana Lange

Mariana Lima-Lange was born in Mexico and immigrated to the U.S. when she was a child. She spent every summer visiting family throughout Mexico and is very knowledgeable about Mexican culture, lifestyle, and traditions. She is fluent in both Spanish and English.

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