When I first gave up the practice of law in Toronto in favor of early retirement in Oaxaca, I assumed that the years I would add to my life by leading a much more stress-free existence in Mexico, would be lost by the inferior health care system to which I would be exposed, subjected and restricted. This, then, is my assessment of the extent to which my presuppositions have been accurate, together with information and advice for both vacationers to and would-be ex-patriot residents of Oaxaca.
Aside from the small, private hospitals, often referred to as clínicas, there are four publicly funded and insurance - based hospitals in the city, as well as a hospital just outside of the city offering specialized treatment for a number of serious ailments. There is the Red Cross facility available to all, often used for emergency treatment only. The civic hospital provides free services or treatment at a modest cost based on a sliding scale respecting means. ISSSTE is a federally funded facility restricted to government employees who are members of a union. Finally, there is IMSS, a federal insurance program available to ex-pat residents and Mexican citizens alike, with an extensive network of clinic doctors and a large hospital. It's funding is provided in large part by business owners. Aside from these hospitals, there are several, small, easily accessed clinics scattered throughout suburban and rural neighborhoods.
For the vacationer, and the ex-pat with a VISA permitting residency in the country, the most common means by which to obtain emergency treatment is through Red Cross, IMSS (which accepts patients without coverage on a pay-per-service basis) or a private hospital. However, the last of these three is the only one in which you can be reasonably reassured of being attended in a timely fashion by extremely competent and efficient personnel.
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WHAT TO DO AS A VACATIONER
If you do not have out-of-country healthcare coverage, by all means go out and buy it before leaving for your trip. However, it's advisable to first inquire of your credit card company, to ascertain if in fact you already have at least some coverage simply by virtue of, for example, having a gold or platinum card. You can then make a more informed decision concerned whether or not to purchase coverage, and if so at what level. On the other hand, a broken leg, gastrointestinal problem or other non-life threatening ailment can be attended by a private doctor or clinic without breaking the bank. Of course for an outlay of more than $100, it's nice to be reimbursed.
If you intend to make a claim to your private carrier, credit card company or government funded health care plan, ensure that you not only keep all receipts, but request a written diagnosis and treatment plan, and that the prescriptions you are given indicate for what purpose each medicine is being prescribed (i.e. antibiotic, analgesic, etc.). Many doctors provide all required information simply as a matter of course. Accepted practice, at least except for when narcotic medications are being prescribed, is for the pharmacy to return prescription forms to you. Often medical plans require translations of each document that is presented to them as a prerequisite for processing and reimbursement. When in doubt, submit all documentation with your claim, making sure to determine if originals are required, and keep copies. Frequently, as is the case with Ontario, it's a two step process. Treatment receipts and diagnosis is submitted to the provincial plan. Once you're notified of the portion not covered, prescription receipts together with a request for reimbursement for the amount not covered by the province, is submitted to one's private plan. In theory, between the two plans, 100% reimbursement is achieved.
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