Avoid These 7 Expat Health Insurance Claim Mistakes in Mexico

Living in Mexico is a dream, but dealing with an expat health insurance claim can be a nightmare…unless you know the rules.

If you’re tired of throwing money away on premiums and paying more out-of-pocket than you should, all you have to do is avoid these 7 expat health insurance claim mistakes.

#1 Not Reading or Understanding Your Policy

This may seem obvious, but it’s one of the biggest mistakes expats make. 

Failing to understand your policy’s maximum coverage, allocated PT sessions, and copays can lead to unexpected out-of-pocket expenses.

Exceeding your limits or not using your allocated benefits means you’re paying for services you could have had for free.

Take the time to read your policy thoroughly.

If you need clarity, call your broker. And do it before you need medical attention.

#2 Failing to Follow the Expat Health Insurance Claim Process

International health insurance companies use a reimbursement model. 

This means you pay for medical procedures upfront and then file a claim to get your money back.

Yes, there are exceptions to the rule, but for the most part, you file a claim and then get reimbursed. 

And if you don’t follow the correct procedure, your claim could be delayed or denied.

We can’t stress this enough: Understand the claims process BEFORE you need it. 

This includes knowing what documents to request from medical providers to submit, where to send them, and the deadlines you need to meet.

[Related Read: Expats Guide to Health Insurance Reimbursement in Mexico] 

#3 Assuming All Medical Procedures Are Covered 

You know what they say about assuming…it’ll bite you in the butt if you aren’t careful. 

Every policy has exclusions.

For example, elective or cosmetic surgeries, podiatric care, over-the-counter drugs, and homeopathic treatment are often not covered.

If you assume a procedure is covered, and it’s not, you’ll be stuck with the bill.

Review your policy carefully to understand what is and isn’t covered. 

If you’re unsure, ask your broker or the insurance company for clarification.

Again, do it BEFORE a medical issue arises.

#4 Not Gathering the Proper Documentation

Missing documents are the #1 reason claims get delayed or denied. 

Make sure you have all the required paperwork, such as facturas (official invoices of Mexico), proof of payment, and complete doctor’s notes on their letterhead.

Keep organized records of all your medical expenses. 

And make sure you get the necessary documentation from your healthcare providers at the time of your appointment.

#5 Not Filing within the Specified Time Period

If you don’t file your claims within the specified time limit – typically within 180 days – you risk losing your reimbursement.

It’s as simple as that.

Late claims often result in denied payments and can leave you footing the bill.

Avoid paying more than you should and stay as organized as possible.

Get all supporting documentation at the time of the medical procedure (if you can) and make sure to file your claims sooner rather than later to avoid missing the deadline.

#6 Rushing the Claim Evaluation Process

Another expat health insurance claim mistake that’s pretty easy to avoid is to rush the evaluation process.

The turnaround time for reimbursement is typically 2 weeks to 30 business days. 

If you rush the process or submit incomplete claims, it will only delay your reimbursement.

Be patient and follow up with your broker or the insurance company if you haven’t received a response within the expected timeframe.

#7 Failing to Follow Up with Your Broker or Insurer

The expat health insurance claim process can be tricky and frustrating.

Your broker is there to help and guide you.

Make sure to stay in touch with your broker and the insurance company throughout the claims process.

And don’t be afraid to follow up!

If your claim is taking longer than expected or you have questions, reach out to your broker or the insurance company.

They can provide updates and help you resolve any issues.