Mexico Tourism: Health & Insurance

Travel Insurance

Check your existing insurance policies and credit card coverage before you buy travel insurance. You may already be covered for lost luggage, canceled tickets, or medical expenses. The cost of travel insurance varies widely, depending on the cost and length of your trip, your age and health, and the type of trip you're taking, but expect to pay between 5% and 8% of the vacation itself.

Trip-Cancellation Insurance -- Trip-cancellation insurance helps you get your money back if you have to back out of a trip, if you have to go home early, or if your travel supplier goes bankrupt. Allowed reasons for cancellation can range from sickness to natural disasters to the State Department declaring your destination unsafe for travel. (Insurers usually won't cover vague fears, though, as many travelers discovered who tried to cancel their trips after the Sept 11, 2001, terrorist attacks because they were wary of flying.) In this unstable world, trip-cancellation insurance is a good buy if you're getting tickets well in advance -- who knows what the state of the world, or of your airline, will be in 9 months? Insurance policy details vary, so read the fine print -- and make sure that your airline or cruise line is on the list of carriers covered in case of bankruptcy. A good resource is "Travel Guard Alerts," a list of companies considered high-risk by Travel Guard International (see website below). Protect yourself further by paying for the insurance with a credit card -- by law, consumers can get their money back on goods and services not received if they report the loss within 60 days after the charge is listed on their credit card statement.

Note: Many tour operators, particularly those offering trips to remote or high-risk areas, include insurance in the cost of the trip or can arrange insurance policies through a partnering provider, a convenient and often cost-effective way for the traveler to obtain insurance. Make sure the tour company is a reputable one, however: Some experts suggest you avoid buying insurance from the tour or cruise company you're traveling with, saying it's better to buy from a "third party" insurer than to put all your money in one place.

For more information, contact one of the following recommended insurers: Access America (tel. 866/807-3982; www.accessamerica.com); Travel Guard International (tel. 800/826-4919; www.travelguard.com); Travel Insured International (tel. 800/243-3174; www.travelinsured.com); and Travelex Insurance Services (tel. 888/457-4602; www.travelex-insurance.com).

Medical Insurance -- For travel overseas, most health plans (including Medicare and Medicaid) do not provide coverage, and the ones that do often require you to pay for services upfront and reimburse you only after you return home. Even if your plan does cover overseas treatment, most out-of-country hospitals make you pay your bills up front, and send you a refund only after you've returned home and filed the necessary paperwork with your insurance company. As a safety net, you may want to buy travel medical insurance, particularly if you're traveling to a remote or high-risk area where emergency evacuation is a possible scenario. If you require additional medical insurance, try MEDEX Assistance (tel. 410/453-6300; www.medexassist.com) or Travel Assistance International (tel. 800/821-2828; www.travelassistance.com; for general information on services, call the company's Worldwide Assistance Services, Inc., at tel. 800/777-8710).

Lost-Luggage Insurance -- On domestic flights, checked baggage is covered up to $2,500 per ticketed passenger. On international flights (including U.S. portions of international trips), baggage coverage is limited to approximately $9.07 per pound, up to approximately $635 per checked bag. If you plan to check items more valuable than the standard liability, see if your valuables are covered by your homeowner's policy or get baggage insurance as part of your comprehensive travel-insurance package. Don't buy insurance at the airport, as it's usually overpriced. Be sure to take any valuables or irreplaceable items with you in your carry-on luggage, as many valuables (including books, money, and electronics) aren't covered by airline policies.

If your luggage is lost, immediately file a lost-luggage claim at the airport, detailing the luggage contents. For most airlines, you must report delayed, damaged, or lost baggage within 4 hours of arrival. The airlines are required to deliver luggage, once found, directly to your house or destination free of charge.

Keep in mind that in these uncertain times, insurers no longer cover some airlines, cruise lines, and tour operators. The bottom line: Always, always check the fine print before you sign; more and more policies have built-in exclusions and restrictions that may leave you out in the cold if something goes awry.

Health & Safety

General Availability Of Health Care -- In most of Mexico's resort destinations, health care meeting U.S. standards is now available. Mexico's major cities are also known for their excellent health care, although the facilities available may be fewer, and equipment older than what is available at home. Prescription medicine is broadly available at Mexico pharmacies, however be aware that you may need a copy of your prescription, or obtain a prescription from a local doctor. This is especially true in the border towns, such as in Tijuana, where many Americans have been crossing into Mexico specifically for the purpose of purchasing lower priced prescription medicines.

Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883 or, in Canada, 416/652-0137; www.iamat.org) for tips on travel and health concerns in the countries you're visiting, and lists of local, English-speaking doctors. The U.S. Centers for Disease Control and Prevention (tel. 800/311-3435; www.cdc.gov) provides up-to-date information on health hazards by region or country and offers tips on food safety.

Common Ailments

High-Altitude Hazards -- Travelers to certain regions of Mexico occasionally experience elevation sickness, which results from the relative lack of oxygen and the decrease in barometric pressure that characterizes high elevations (more than 1,500m/5,000 ft.). Symptoms include shortness of breath, fatigue, headache, insomnia, and even nausea. Mexico City is at 2,100m (7,000 ft.) above sea level, as are a number of other central and southern cities, such as San Cristóbal de las Casas (even higher than Mexico City). At high elevations, it takes about 10 days to acquire the extra red blood corpuscles you need to adjust to the scarcity of oxygen. To help your body acclimate, drink plenty of fluids, avoid alcoholic beverages, and don't overexert yourself during the first few days. If you have heart or lung problems, talk to your doctor before going above 2,400m (8,000 ft.).

Treating & Avoiding Digestive Trouble -- It's called "travelers' diarrhea" or turista, the Spanish word for "tourist": persistent diarrhea, often accompanied by fever, nausea, and vomiting, that used to attack many travelers to Mexico. (Some in the U.S. call this "Montezuma's revenge," but you won't hear it called that in Mexico.) Widespread improvements in infrastructure, sanitation, and education have practically eliminated this ailment, especially in well-developed resort areas. Most travelers make a habit of drinking only bottled water, which also helps to protect against unfamiliar bacteria. In resort areas, and generally throughout Mexico, only purified ice is used. If you do come down with this ailment, nothing beats Pepto Bismol, readily available in Mexico. Imodium is also available in Mexico and is used by many travelers for a quick fix. A good high-potency (or "therapeutic") vitamin supplement and even extra vitamin C can help; yogurt is good for healthy digestion.

Since dehydration can quickly become life-threatening, the Public Health Service advises that you be careful to replace fluids and electrolytes (potassium, sodium, and the like) during a bout of diarrhea. Drink Pedialyte, a rehydration solution available at most Mexican pharmacies, or natural fruit juice, such as guava or apple (stay away from orange juice, which has laxative properties), with a pinch of salt added.

How to Prevent It: The U.S. Public Health Service recommends the following measures for preventing travelers' diarrhea: Drink only purified water (boiled water, canned or bottled beverages, beer, or wine). Choose food carefully. In general, avoid salads (except in first-class restaurants), uncooked vegetables, undercooked protein, and unpasteurized milk or milk products, including cheese. Choose food that is freshly cooked and still hot. In addition, something as simple as clean hands can go a long way toward preventing turista.

Bugs, Bites & Other Wildlife Concerns -- Mosquitoes and gnats are prevalent along the coast and in the Yucatán lowlands. Repelente contra insectos (insect repellent) is a must, and it's not always available in Mexico. If you'll be in these areas and are prone to bites, bring along a repellent that contains the active ingredient DEET. Avon's Skin So Soft also works extremely well. Another good remedy to keep the mosquitoes away is to mix citronella essential oil with basil, clove, and lavender essential oils. If you're sensitive to bites, pick up some antihistamine cream from a drugstore at home.

Most readers won't ever see an alacrán (scorpion). But if one stings you, go immediately to a doctor. In Mexico you can buy scorpion toxin antidote at any drugstore. It is an injection and it costs around $25. This is a good idea if you plan to camp in a remote area where medical assistance can be several hours away.

More Serious Diseases -- You shouldn't be overly concerned about tropical diseases if you stay on the normal tourist routes and don't eat street food. However, both dengue fever and cholera have appeared in Mexico in recent years. Talk to your doctor or to a medical specialist in tropical diseases about precautions you should take. You can also get medical bulletins from the U.S. State Department and the Centers for Disease Control and Prevention. You can protect yourself by taking some simple precautions: Watch what you eat and drink; don't swim in stagnant water (ponds, slow-moving rivers, or wells); and avoid mosquito bites by covering up, using repellent, and sleeping under netting. The most dangerous areas seem to be on Mexico's west coast, away from the big resorts.

What To Do If You Get Sick Away From Home -- Any foreign consulate can provide a list of area doctors who speak English. If you get sick, consider asking your hotel concierge to recommend a local doctor -- even his or her own. You can also try the emergency room at a local hospital. Many hospitals also have walk-in clinics for emergency cases that are not life-threatening; you may not get immediate attention, but you won't pay the high price of an emergency room visit.

If you suffer from a chronic illness, consult your doctor before your departure. For conditions like epilepsy, diabetes, or heart problems, wear a MedicAlert identification tag (tel. 888/633-4298; www.medicalert.org), which will immediately alert doctors to your condition and give them access to your records through MedicAlert's 24-hour hot line.

Pack prescription medications in your carry-on luggage, and carry prescription medications in their original containers, with pharmacy labels -- otherwise they won't make it through airport security. Also bring along copies of your prescriptions in case you lose your pills or run out. Don't forget an extra pair of contact lenses or prescription glasses. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.

Contact the International Association for Medical Assistance to Travelers for tips on travel and health concerns in Mexico and lists of local English-speaking doctors. The U.S. Centers for Disease Control and Prevention provides up-to-date information on necessary vaccines and health hazards by region or country.

Over-the-Counter Drugs in Mexico -- Antibiotics and other drugs that you'd need a prescription to buy in the States are available over the counter in Mexican pharmacies. Mexican pharmacies also carry a limited selection of common over-the-counter cold, sinus, and allergy remedies.

Emergency Evacuation -- In extreme medical emergencies, a service from the United States will fly people to American hospitals. Global Lifeline (tel. 888/554-9729, or 01-800/305-9400 in Mexico) is a 24-hour air ambulance.

Staying Safe

Crime -- I have lived and traveled in Mexico for over a decade, have never had any serious trouble, and rarely feel suspicious of anyone or any situation. You will probably feel physically safer in most Mexican cities and villages than in any comparable place at home. However, crime in Mexico has received attention in the North American press over the past several years. Many feel this unfairly exaggerates the real dangers, but it should be noted that crime rates, including taxi robberies, kidnappings, and highway carjackings, have risen in recent years. The most severe problems have been concentrated in Mexico City, where even longtime foreign residents will attest to the overall lack of security. Isolated incidents have also occurred in Ixtapa, Baja, Cancún, and even traditionally tranquil Puerto Escondido. Check the U.S. State Department advisory before you travel for any notable "hot spots."

Precautions are necessary, but travelers should be realistic. Common sense is essential. You can generally trust people whom you approach for help or directions -- but be wary of anyone who approaches you offering the same. The more insistent the person is, the more cautious you should be. The crime rate is, on the whole, much lower in Mexico than in most parts of the United States, and the nature of crimes in general is less violent. Random, violent, or serial crime is essentially unheard of in Mexico.

Although these general comments on crime are basically true throughout Mexico, the one notable exception is in Mexico City, where violent crime is serious. Do not wear fine jewelry, expensive watches, or any other obvious displays of wealth. Muggings -- day and night -- are common. Avoid the use of the green Volkswagen taxis, many of which have been involved in "pirate" robberies, muggings, and even kidnappings. These taxis are also common in incidents where a passenger is "hijacked," and released only when the limit on their ATM bank cards have been withdrawn. Car theft and carjackings are also a common occurrence.

Bribes and Scams -- As is the case around the world, there are the occasional bribes and scams in Mexico, targeted at people believed to be naive -- such as the telltale tourist. For years Mexico was known as a place where bribes -- called mordidas (bites) -- were expected; however, the country is rapidly changing. Frequently, offering a bribe today, especially to a police officer, is considered an insult, and it can land you in deeper trouble.

If you believe a bribe is being requested, here are a few tips on dealing with the situation. Even if you speak Spanish, don't utter a word of it to Mexican officials. That way you'll appear innocent, all the while understanding every word.

When you are crossing the border, should the person who inspects your car ask for a tip, you can ignore this request -- but understand that the official may suddenly decide that a complete search of your belongings is in order. If faced with a situation where you feel you're being asked for a propina (literally, "tip"; colloquially, "bribe"), how much should you offer? Usually $3 to $5 or the equivalent in pesos will do the trick. Many tourists have the impression that everything works better in Mexico if you "tip"; however, in reality, this only perpetuates the mordida attitude. If you are pleased with a service, feel free to tip, but you shouldn't tip simply to attempt to get away with something illegal or inappropriate, whether it is crossing the border without having your car inspected or not getting a ticket that's deserved.

Whatever you do, avoid impoliteness; under no circumstances should you insult a Latin American official. Extreme politeness, even in the face of adversity, rules Mexico. In Mexico, gringos have a reputation for being loud and demanding. By adopting the local custom of excessive courtesy, you'll have greater success in negotiations of any kind. Stand your ground, but do it politely.

As you travel in Mexico, you may encounter several types of scams, which are typical throughout the world. One involves some kind of a distraction or feigned commotion. While your attention is diverted, a pickpocket makes a grab for your wallet. In another common scam, an unaccompanied child pretends to be lost and frightened and takes your hand for safety. Meanwhile the child or an accomplice plunders your pockets. A third involves confusing currency. A shoeshine boy, street musician, guide, or other individual might offer you a service for a price that seems reasonable -- in pesos. When it comes time to pay, he or she tells you the price is in dollars, not pesos. Be very clear on the price and currency when services are involved.