Top FAQs about Health insurance from expats, digital nomads, and international travelers. These were consolidated from chat and DMs to the admin. We have divided the questions into 3 arbitrary categories.

1. Coverage FAQs- FAQs on conditions/illnesess covered, countries home(USA)and away (Mexico), etc
2. Finances FAQs - FAQs on premiums, deductibles, maximum limits, etc. 
3. Claims & Reimbursements FAQs - FAQs on claims process(cashless/reimbursement model), documents required, etc.

Coverage FAQs

1) Expat health insurance v/s international health insurance v/s tavel health insurance v/s private Mexican health insurance. What's the difference and which one is right for me?

Expat insurance plans typically have global coverage that may or may not include USA. Most of these plans will let you apply until age 74 and you can keep the policy for life. If you end up with a medical condition the policy will continue to cover you until the policy benefit maximum has been reached. This is ideal for a long term solution of a year or more and especially if the person has no plans of returning to their home country. Underwriting is usually required for the insurer to offer coverage. Deductible is per person per year but usually there is a max of 2 deductibles per family. So, a family of 4 with a 2,500 deductible will have a max of 5,000 they pay per year in family medical expenses. 

Travel health insurance is designed for short term needs of under a year. Many of these plans include travel benefits with lost baggage and some will cover trip cancellation. There is no underwriting for these plans and most do not cover pre-existing coverage but if they do, it is limited to the duration of the policy up to a specific amount which is designed to get you home to use your primary insurance. As a person ages the benefit amount decreases on travel plans. Travel insurance can also be used for the long-term traveler or expat if they have a condition that stops them from getting other insurance as long as they maintain an address in their home country. Deductibles can be as low as zero dollars to much higher limits as the traveler chooses. 

Mexican insurance typically covers MX and may have limited coverage outside of Mexico. The max age to apply is 64 and some plans will not allow you to keep the coverage after age 70. Waiting periods are defined up front but there are several different periods based on condition. 

Deductibles with Mx polices are per medical condition and typically do not reset every year. It’s one deductible for that condition. 

2) Health Insurance Policies that cover pre-existing illnesses? Most plans do not cover pre-existing conditions but it really depends on what is going on medically. A person needs to submit an application and see if the insurance company will offer coverage or exclude the condition from the policy. An insurance company could do one of the following in regards to pre-existing depending on the terms of the insurance company:

1. Cover the condition with no restrictions
2. Exclude the condition for a year to be re-evaluated at renewal
3. Exclude the condition for life
4. Cover the condition with a higher deductible
5. Cover the condition and increase the premium 

3) Policies options available for people with residency status(both temporary or permanent) v/s options available for people without residency status. 

Having residency will allow you access to Mexican policies which work a bit differently than expat and travel plans. If you do not have residencey you can most likely get the international plans but each insurance carrier is different. Residency is important for pricing at medical facilities though. If you are a tourist, you will likely be charged tourist rates. 

4) Policies that cover both routine medicinal needs(doctor consults, lab tests, etc) and emergencies (accidents, major surgeries) for expats? Most polices offer a defined amount as a benefit towards routine/preventative treatments. There is usually a 12 month waiting period for this benefit and you do not need to meet your deductible for this. The benefit amount typically ranges from 100.00-500.00 USD with most companies being on the lower end if they offer it. Not every policy has this benefit. 

5) Policies that only cover major surgeries, accidents, and hospitalisation when abroad? This will be your international expat or travel plan. Some travel plans might have limited coverage for an onset of a pre-existing condition with the intention to provide coverage for a short time until you get “home” and use your primary insurance. If our long term expat plan has global coverage then you are covered when you are anywhere abroad. 

6).Does my Private health insurance (Blue Cross- blue shield, United etc) or Medicare or Medicaid program provide coverage in Mexico? 

Medicaid will not offer any benefit outside the USA. Original Medicare (parts A&B) do not offer coverage outside USA. There used to be a plan F that had limited coverage on a reimbursement basis but that plan is no longer offered. If someone has a grandfathered Part F they may have very limited benefits up to a specific dollar amount like 50K USD and only within the first 60 or 90 days of being outside the USA. There are many different supplement plans state to state so there may be some other options out there that vary by state. 



Your local private insurance from home (Blue-Cross etc) might cover you in the event of a life threatening emergency ONLY up to a specific limit of 50 or 100K and you need to pay up front and get reimbursed. This is not in every policy though, most of the time it is not covered at all. On a rare occasion the policy will cover more than this but it is not likely.

Finance FAQs

1) How do things like maximum limit, deductibles, co-pay or co-insurance, affect my health insurance coverage? All of these facors determine the price. Most plans do not have co-pays abroad but the typical rules is that the lower the deductible or co-insurance is, the higher the premium and vice versa. 

2) Best place to buy health insurance? Online or through insurance agents? The price is the same if you buy online or through an agent. It’s much better to buy through an agent so you have someone to assist you if you have questions or need help with claims. So, be sure to pick an agent you know does a good job.

Claims & Reimbursement FAQs

1) Process for submitting Claim request for some of the popular Expat health insurances. 

Claims process can be different with each company but usually in order to submit a claim for something smaller that you have already paid for you will need a medical report describing what the medical doctor treated you for, copy of prescriptions and an itemized paid receipt showing the cost of each treatment and fee. 

If the medical treatment can be pre-approved then all the necessary documents need to be submitted from the medical provider to the insurance ocmapny and money will be sent directly to the provider. 

If someone is admitted into the hospital for something serious then the insurance company will send over a guarantee of payment (GOP) or Verification of Insurance (VOI). The hospital will then send over all of the medical documents and charges to the insurance company so they can send money directly to the hospital and the client will not need to pay up front.

Note, it s very typical of hospitals to charge a deposit before allowing someone into the hospital. They need to refund this once everything settles with insurance but sometimes hospitals are not so eager to process the refund. 

Hospitals also tend to try to overcharge the price of their services so this can cause a lot of negotiating between hospitals and insurance companies and claims take a while to pay out. 

2) Policies that offer Cashless claims(I.e patients don't have to out of pocket) v/s policies with Reimbursement claims(Patient pay the entire bill first, Insurance then reimburses the total amount) Very few companies work this way with cashless uness you are admitted into theo hospital or have a pre-approval as I described above. Geoblue (only avail to US residents) is often times cashless but not always. The company needs to have a direct contract and agreement with the medical provider and MX is not set up with a strong working system like other parts of the world (USA). 

3) Documents required for submitting claim requests for some of popular health insurances. Some insurance companies require a Factura but not all. Each claim will need a medical report describing the treatment and symptoms and an itemized receipt showing the cost of each thing being charged. This also needs to show paid on the itemized receipt. A Credit Card slip will not be sufficient.

4) Any tool or website that provides verified 3rd party reviews from other expats, that compares the Claims process for various health insurances. Not any that I know of without going direct to each insurance carrier to review financials and ratings.