California Allows WC Payments to Mexican Health Providers — And It Works

  Wednesday, April 24th, 2019 Source: Risk & Insurance

In California, the option to seek care in Mexico is producing better outcomes and reduced cost of claims in workers’ comp. In Southern California, U.S. workers have long sought health care just across the border in Tijuana when their employer-sponsored plans wouldn’t cover things like elective procedures. Likewise, many Mexican nationals who work in that region prefer to receive care administered and approved by their native country. This gave rise to Mexican HMO Sistemas Medicos Nacionales, S.A. de C.V. (​SIMNSA​). Though based in Mexico, SIMNSA is licensed by the state of California and often offers cheaper alternatives to U.S.-based health care systems for California workers. SIMNSA’s premiums are reportedly 60 to 70 percent lower compared to U.S. plans.

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