Texans seek medical treatment in Mexico with no copays

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CAMERON COUNTY, TEXAS.- Cameron County employees under the county’s new health care plan will get the chance to travel to Mexico to seek medical treatment with a preferred provider without having to pay any out-of-pocket costs beginning Oct. 1.

Cameron County Commissioners Court Tuesday approved a new health care plan that includes giving employees the option to go to Mexico to seek medical treatment rather than getting it in the United States.

Cameron County Judge Eddie Trevino Jr. said this is the first time the county has offered this option to its employees.

“Aetna has offered this in the El Paso area, so when we were reviewing our health insurance policy with our consultant, he had some familiarity with it, and he was able to discuss it with Aetna. We think it is going to be beneficial because we know a lot of people do go across for their health care needs even if they have health insurance.”

Trevino added, “We think hopefully it will be a win, win for everyone, especially with regards to decreasing our health insurance cost both for the plan and for the coverage itself.”

The typical copays for primary care doctor visits in the United State range from $15 to $40 depending on the health insurance provider. Visits to specialists are about $50 to $60.

According to the county’s health insurance plan, employees will not have to pay any copays if they seek treatment in Mexico.

The county is offering two health care options to its employees. The first is Accountable Care Organization and the second Broad Network Plan. Under the Accountable Care Organization employees will pay $15 a month or $7.50 per pay period to insure themselves. Under the Broad Network Plan, the employee will pay $50 a month or $25 per pay period to insure themselves. Both plans begin Oct. 1, 2022, said Anthony Lopez, an assistant county administrator.

Although the costs differ in both plans, under either plan the employee still has the option to receive treatment in Mexico.

Aetna Insurance has a provider network in Mexico called the Sinergia Medica, which has hospitals, doctors, and pharmacies that are considered in-network, and it has a large representation of available physicians and health care providers in Mexico, said Randy McGraw, a health insurance consultant for the county.

“The benefits for those networks will be a 100% benefit so regardless of which plan you enroll under, if a member wants to seek coverage or services in Mexico if you go to a preferred provider you’ll have no cost share, you won’t owe any deductible or copays to the providers,” McGraw said.

“Everyone knows the cost of health care in Mexico is approximately half of what it is in the U.S.,” McGraw said.

Precinct 2 Commissioner Joey Lopez said that in the 2022-2023 health insurance plan for employees, the county will pay $9,000 per year per employee. The county has roughly 1,649 employees, which means the county will pay more than $14 million in health insurance for its employees. That figure does not include claims.

Lopez said it will be interesting to see what savings the network in Mexico is going to bring to county employees. “Now our employees have the choice to be able to go over there and get everything 100% paid for,” he said.

Source: El Mañana de Reynosa

Mexico Daily Post