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 USD $40 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, the 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 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 situations where Medicare may cover them.

If you choose 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 by 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 you must 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

YouTube video

Mariana Lange

Mariana Lima-Lange was born in Mexico and moved to the U.S. when she was a child. Every year she would split her time between life in the U.S. and Mexico- which gave her a deep understanding about Mexican culture, lifestyle, and traditions. She is fluent in both Spanish and English. Since 2019, our blog posts, resources, videos, and COMPLETE Mexico Relocation Online Guide have helped thousands move to Mexico the right way!

Reader Interactions

Comments

  1. Joseph McManus says

    Hi Mariana, I need a favor, can you ask your Medicare Advantage Olan specialist to contact me, I am in need of his services.
    Thank you,

    • Mariana Lange says

      Hi Jospeh!

      We only give access to our directory of recommended contacts to our paying customers of the Mexico Relocation Guide. Including our Medicare Advantage specialist.
      If you’re interested in our Mexico Relocation Guide you also get a step-by-step plan on how to move to Mexico.
      Check it out Mexicorelocationguide.com/guide

      Thanks!
      Mariana

  2. David R Smith says

    Your article doesn’t talk about Medicare enrollees who live in Mexico, but have a Texas PoBox and a Texas primary care doctor who they see once or twice a year. This would allow them to have non-emergency surgeries and treatments be covered by Medicare in Texas

    • Mariana Lange says

      Hi David
      It’s covered in the video I attached at the end

  3. David Smith says

    Mariana, Im sorry, but I’m just not going to watch a 45-minute video when I need just a couple of minutes of info. I’ve read a lot online, and nothing has addressed the issue of establishing a relationship with a Texas doctor for Medicare, and I have no reason to believe it would be somewhere in that 45 minutes.

    • Mariana Lange says

      Sorry you feel that way. Research takes time

  4. David Smith says

    I don’t even have Medicare Advantage. I have Original Medicare.

    • Mariana Lange says

      You will need Medicare Advantage to be eligible to use it in Mexico. In very rare cases can you use Medicare in Mexico without Part C

  5. Sally Sals says

    Hi Mariana. How can I get in touch with your excellent health insurance broker from Sacramento? I have a Kaiser Senior Advantage plan, just had a stroke (from which I’m recovering thanks to Wonderful hospital care in Cancun), and need his assistance filing a claim for reimbursement of up front out of pocket expenses. Thank you so much.

    • Mariana Lange says

      Hi Sally
      I am so sorry about your stroke! But I am glad you are better. All of our recommended contacts are included when you purchase our COMPLETE Mexico Relocation Guide
      mexicorelocationguide.com/guide/

      The guide includes all the most important basic information about moving to Mexico and also includes our directory of recommended contacts such as our medicare advantage recommended broker.

  6. Jeffrey says

    Dear Mariana,
    I am just about Medicare age when I may move to Mexico. I watched your videos and I think I will need a Medicare Advantage policy which will cover ER and Urgent Care visits in Mexico. If I have a primary Doc in the US that I see once or twice a year, could I not just go back to US if I need expensive surgery or develop cancer and need Chemo, etc. ? In other words, I am not sure I would also need Mexican health Insurance for use in Mexico if I had a Medicare Advantage policy and could visit ER’s and Urgent Cares in Mexico?

  7. Wayne Woodward says

    my wife has cancer, how can I get her pills shiped to Mexico every 30 days?

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