Will Sleep Apnea Be a Disqualifying Pre-Existing Condition For IMSS?

Halfwaytree wrote:

My hope is to apply for IMSS medical insurance after I get my permanent  residency  status  for Mexico. I realize that some pre-existing conditions can prevent you from qualifying. I can't seem to find any info on the web to confirm whether or not Sleep Apmea is one such condition. Would anyone who applied for IMSS remember if it was a question on the application?

http://www.imss.gob.mx/derechoH/enferme … os-familia

Google Translation:

"Website "Bringing the IMSS to the Citizen"

Home:
Rights, pre-existing diseases and diseases with waiting periods

Pre-existing diseases and diseases with waiting periods

Pre-existing diseases - exclusion to affiliate/join

Malignant tumors. Chronic degenerative diseases such as: late complications of diabetes mellitus; diseases by hoarding (gaucher disease); chronic liver diseases; chronic renal insufficiency; heart valve diseases; heart failure; sequelae of ischemic heart disease (arrhythmia, angina or myocardial infarction); chronic obstructive pulmonary disease with respiratory insufficiency; chronic systemic diseases of the connective tissue. Addictions such as alcoholism and other drug addictions. Mental disorders such as psychosis and dementias. Congenital diseases. Acquired Immune Deficiency Syndrome or Human Acquired Immunodeficiency Virus positive (HIV) among others.

Diseases with waiting periods

Go to the sub-delegation that corresponds to the address of the insured, from Monday to Friday from 08:00 to 15:30 hours with: official identification, birth certificate, CURP and proof of address, if applicable, marriage certificate.

Six months:

Benign breast tumor.

Ten months:

Birth.

One year:

LithotripsySurgery of gynecological diseases, except for malignant neoplasms of the uterus, ovaries and perineal floor.Viric insufficiency and varices surgery.Surgery and nose surgery.Varicocele surgery.Hemorrhoidectomy and rectal fistula surgery and prolapse of rectum.Amigdalectomy and adenoidectomy.Surgery of hernias, except intervetabral disc herniation. Hallux valgus surgery. Strabismus surgery.

Two years:

Orthopedic surgery."

No it isn't listed. I presume you can join the IMSS  then.

alleycat1:

Thank you so much for this. It puts my mind at ease beyond belief!

Dear Halfwaytree,

I am bilingual health care advisor.

I can tell you that COPD (enfermedad pulmonar obstructiva crónica con insuficiencia respiratoria) is listed under Pre-Existing Conditions on the IMSS website.

It is NOT listed under Pre-existing conditions with a waiting period.

Knowing how IMSS works, I can tell you that you are most likely looking at a permanent exclusion for COPD and any respiratory ailments related to this condition.

I suggest you consult with a bilingual consultant in your area who assists English-speaking Expats with IMSS enrollments. These are usually individuals who also help with immigration processing.

Best of luck!
Melanie in San Miguel de Allende

Thanks for your reply Melanie.

If I wanted to acquire the service of a billingual consultant  would putting the word out in Facebook groups be a good way to connect with one?

Sleep apnea is not a respiratory disease. It is a neurological syndrome like narcolepsy. I have asked questions about availability of care for apnea and cost and availability of medication (modafinil) on this forum with no response. I have been on CPAP therapy for over twenty years and can’t live anywhere without the availability of treatment, supplies and medication. Any info would be helpful. Thanks

Hi,
Maybe you or someone can answer this. I have been helping a Mexican resident who has IMSS for 8 mnths, still active. He likely needs dialysis in weeks or a month, and a kidney transplant after that, but there is no medical or otherwise record of his condition to date.
Does he need to be an active IMSS patient for a year for those things? Dialysis? Transplant?
IF they find out before the year, but 8 mnths into his IMSS membership, will they exclude him for either after the year, or he just has to wait for a year?
(note, after applying for IMSS they never asked him to take a physical so they cannot say it was a pre-existing before he applied if the renal failure otherwise would have been an exclusion, but it does seem likely they will find out now, 8 mtnhs after getting the IMSS)

Thanks so much, richard

Dear Raring,

Your best option is to go directly to the source: IMSS.

What I can tell you is that kidney failure is considered a chronic medical condition and as such in rare cases appears in less than 8 months.

His receiving care will depend on continued oversight of his case file.

All advanced specialized treatment of this type requires medical review.

Best of luck!

Melanie -

Right. thank you Melanie

Ps. Fyi:  seems i left out the most important point which is that he's a Mexican national born there, not a foreigner. And I gather imss has very different rules for each of the two types of patients.  Since im not bilingual, I've been getting my information mostly from expat related websites (im in the us) It Seems I've been reading the rules and limitations for foreigners living there, which are dufferent and don't apply to him. Thanks

Hi Richard, since the information seems incomplete from what I read. I am covered by IMSS as a direct contributor (nationals, permanent residents) applying must complete the form regarding your health status and quote any disease that you have or had, pay your annual contribution. Then visit is UMF PrevenIMSS to get is cartilla and again they asked me various questions on the health aspect.
My understanding  of the preexisting conditions applies to both nationals or permanent residents BUT if he would a worker covered by is employer they this could be different.

Adios y buen dia a todos, GyC.

Interesting since he is covered as an employee of a Mex company and while he did fill out a form before being insured, he was not required to take a physical - which we were expecting they would require. He might have slipped through the cracks on that. thanks again