Health Insurance for Expats & Digital Nomads

As with most other things, if you are someone with a preexisting condition, if and how you are accepted for private health insurance will be determined by the companies you apply to and the condition(s) that you may have.

Uninsurable Conditions: These conditions appear on a list provided by each insurance provider, and it varies between companies. If you already have one of these conditions unfortunately you would not be eligible for insurance with that specific company. They usually include the more severe illnesses like Parkinson’s, Fibromyalgia, Insulin-dependent Diabetes, Alzheimer’s, etc. A person must be Cancer-free for at least 10 years to be eligible for insurance with most companies.

If you have a preexisting condition, but it does not appear on that list, then you are still eligible for insurance. These conditions are taken on a case-by-case basis, so it is hard to know up-front how your condition will be accepted. The best we can do is submit an application, and then most companies will ask for some lab testing and a medical history report completed by a physician. They may also ask for supplemental forms to be completed regarding the specific condition, as well as any past documents that outline the diagnosis, treatment, evolution and current condition of the illness. Based on this information they make their decision. 

The common outcomes we see are:

• The condition gets included in the coverage like normal
• The condition is included in the coverage, but with a higher deductible, extra premium, or lower sum insured maximum
• The coverage is permanently excluded from coverage
• A moratorium is placed on the condition, in which case it starts off excluded, but can be reviewed at each renewal, with updated medical information, to determine if it can be included in the coverage

All private health insurance providers have a waiting period for certain diseases. A waiting period means that once you are accepted under a policy, and coverage begins, you cannot be diagnosed with any of these certain illnesses until the waiting periods have expired. If you are diagnosed with a disease before its waiting period has expired, this disease would be permanently excluded from coverage as a preexisting condition for the life of the policy.

The waiting periods vary by company. Some of the more elite providers have a standard 60 day waiting period for all diseases. So have them leveled off, like for example, 3 months for kidney stones and mental disorders, 6 months for heart issues, 1 year for cancer, etc. HIV/AIDS is almost always 2 years.

When applying for a new private insurance, if you will be insured with a different private insurer until the time you are accepted by the new company, most companies will let you transfer your seniority to them. That means that any consecutive months or years you were covered by your old policy can be carried over to the new policy to eliminate that amount of time off any waiting periods.

There are 2 main ways that deductibles work with private health insurance in Mexico:

Per Year: This means that your chosen deductible will replenish at the renewal every year. It also means that ANY incurred medical expenses throughout one policy year can be added towards this deductible. The benefit of this option is that you are only needing to meet 1 deductible every year.

Per Event: This means that you need to reach your chosen deductible for each separate illness or disease. But these deductibles expand through the years, and that is where the benefit of this option comes in. If you contract a major disease like Cancer, instead of needing to meet a new deductible every year, you just meet the deductible 1 time for any Cancer-related costs, and then the Cancer is completely covered by the company for the life of the policy.

Also most deductibles are per person, however with certain companies, if there is a family group of 3 or more people on the policy, they reduce the deductibles to 2 or 3 per family unit.

The actual deductible options vary by company but can go as low as 250 USD per year, and as high as 10,000 USD per year.

Age Limit of Acceptance: With both annual private medical insurance and travel medical insurance there are age limits for acceptance. With the private insurance, if you are accepted for a policy by that age, you are able to renew for life. The company cannot cancel you due to age. With travel insurance, once you reach that age limit you are no longer eligible for their insurance, so you cannot get a policy with them. The age limits very for both private and travel insurance, depending on the company, but generally the range is from 65-75 years old. So if you get travel insurance until you are 75, you are no longer eligible for any type of insurance because the cut off age for the private insurance is also 75.

Length of Coverage: With private insurance, once you are accepted you can renew your policy for life. The insurance company cannot cancel the policy due to age or use of the policy, etc. The only reason the policy can be cancelled by the insurance company is because of a lack of payment. With travel insurance, most policies can be bought for 365 days at once, but you can only have coverage for 2 consecutive years at a time. After the 2 years you would need to switch to another company for 1 year, before you could go back to the first company for another 2 years

Renewing vs. Repurchasing: Whether you only buy a travel policy for the few weeks or months per year, while you are out of your home country, or if you plan to use travel insurance as an annual plan in place of private insurance, you are never able to renew a travel insurance policy. It is always considered that you are purchasing a completely new policy. Because of that you are never able to accumulate seniority or any benefits that you normally get with private insurance as you renew your policy through the years.

Preexisting Conditions: As a continuation of the above point, because you are not renewing a travel policy, preexisting conditions are treated differently. With private health insurance, once you are covered by a policy, any injury or disease would be covered for the life of the policy (to the maximum sum value contracted). With travel insurance there are 2 examples of the difference. You buy a travel policy to cover you abroad for 5 months. Then you go back to your home country, so you no longer have the policy. If in that time you contract any disease or suffer any injury, the next time you go to purchase a travel policy to travel abroad, any medical expenses related to those conditions would be excluded as preexisting conditions. It works the same way if you use travel insurance in place of private insurance. Even if you have a travel insurance policy for 365 days, and buy a new policy to start on the 366^th day, so there is technically no lapse in coverage, because you are repurchasing and not renewing, any conditions that may have been covered by the prior policy would now be excluded as preexisting conditions by the second policy.