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Kenito
Site Admin
Joined: Wed Feb 11, 2009 1:30 am
Posts: 648
Location: Rosarito, Baja California, MX
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 Health Net Adds Cross Border Coverage Health Net Adds Cross Border Coverage
HEALTH CARE: Lower Costs Drive Consumers to Mexico for Medical Services
By HEATHER CHAMBERS
San Diego Business Journal Staff
Americans in need of low-cost health care without the wait used to cross the U.S.-Mexico border carrying little other than identification and dollar bills. But as growing numbers of health insurers extend their coverage into Mexico, U.S. workers are finding themselves carrying health insurance cards, too.
Just last week, Health Net became the latest in a long line of health insurers to offer cross border coverage through a plan it calls Salud HMO y Más. The plan provides coverage to U.S. workers who prefer to visit doctors in Tijuana, Mexicali, Rosarito or Tecate without a referral. Eligible dependents who live within 50 miles of the border also qualify for receiving care in Mexico.
Ana Andrade, vice president of Latino programs for Health Net, said it has contracted with a network of 200 physicians, through Mexico’s Sistemas Medicos Nacionales, S.A. de C.V., aka SIMNSA, and 11 hospitals. As employers operating close to the border demand care for their Latino workers, Andrade said the company saw an opportunity to serve the population, which makes up the largest percentage of the uninsured.
“Our goal was to increase our penetration of the Latino market and also to meet that need of services across the border,” she said.
Health Net serves more than 175,000 members in San Diego County.
Attractive To Businesses
Lambert Hsu, president of Benefit Pro Insurance Services Inc. of Mission Valley, said that the cross border plans are attracting employers that face rising costs associated with health insurance premiums.
“Traditionally, we’re finding with the cross border type a quarter to a third of the U.S. premiums,” he said.
It was perhaps SIMNSA’s entrance in the market in 2000 as the first cross border HMO, and one that quickly grew to more than 20,000 members, that called attention to a nearly untouched market — the working uninsured.
In California, there are an estimated 2.9 million working uninsured, according to the Center on Policy Initiatives. It’s unknown how many of the 500,000 people without health insurance in San Diego County fit this category.
In 2000, Blue Shield of California began offering a cross border HMO called Access Baja. The plan, designed as an add-on to other HMO or PPO plans for employers, offers coverage to Mexican citizens, U.S. citizens or U.S. resident aliens who receive a salary and benefits from a California employer. Others soon followed suit.
Six years ago, Jim Arriola left his job overseeing cross border health care at Blue Shield to introduce Sekure Healthcare, a Chula Vista-based limited benefits plan targeting employers operating businesses near the border.
While most cross border plans reach health care providers only in Baja, Sekure’s network reaches deep into Mexico.
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