Forget cross-state health plans, cross-border plans are gaining steam in California

Even as some U.S. cities tout themselves as “destination” vacation spots for medical tourism, lots of U.S. citizens have other ideas. They’re heading south of the border for their care. Americans pay far more than other countries per capita for health care, and aren’t getting what they pay for.

A Los Angeles Times reportpoints out that outcomes in the U.S. are worse, with shorter lifespans, for Americans than they are in other developed countries, as determined by the Organization for Economic Cooperation and Development. And to drive that point home comes a report from the San Diego Union Tribune about a cross-border health plan licensed by the state of California. Yes, you read that correctly; U.S. workers getting coverage for a plan that provides their health care in Mexico.

Says the report, “Patients come to SIMNSA [Sistemas Medicos Nacionales, S.A. de C.V] for everything from dental care to medical tests to physical therapy to consultations with specialists—all covered under SIMNSA’S cross-border health plan. Nobody here is complaining about crossing the border; in fact, many of them prefer it this way.”

Cheaper copays, no out-of-pocket deductibles, even elective treatments not covered by U.S. plans—what’s not to like? SIMNSA is not the only plan providing care to U.S. residents instead of their seeking coverage within the U.S. According to SIMNSA, its premiums are 60 to 70 percent lower than those of comparable U.S. health plans.Another growing alternative in Baja California for insured workers from San Diego and Imperial counties are two Mexican plans overseen by the state of California.


It’s not just those with a cross-border insurance plan heading to Mexico for health care. According to Pacific Standard Magazine, as of 2015, about 65 percent of those traveling for medical procedures were not covered by insurance, according to the Medical Tourism Association’s most recent survey. Mexico is among the top medical destinations for Americans because of its proximity and affordable medical costs. The Medical Tourism Index ranksMexico 29th in the world for its volume of medical travelers.

And with the Trump administration’s efforts to dismantle the Affordable Care Act already costing people coverage, it’s likely to become a lot more common, the report adds. While trips to the doctor may be waning in the U.S., that’s definitely not the case for the medical tourism industry.

The Dallas-based Medical Tourism Corporation, it says, “facilitates medical care for about 500 to 600 patients who travel from the United States and Canada to Mexico every year.” That doesn’t mean they’re all uninsured; many have medical insurance that doesn’t cover needed surgery, or dental work that even with insurance is too expensive for them to afford. So they leave the country to get it.

They don’t necessarily have to go just to border towns like Tijuana or Mexicali; Cancun, Guadalajara and Puerto Vallarta can also provide that blend of care and carefree. Even Canadians head for Mexico to avoid long waits for covered care, rather than going to the U.S.