call: San Diego, California 619-407-4082 Tijuana, Mexico 83-29-02 and 83-30-05




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Bridging Borders.
Protecting Families.
 
Health Plans

SIMNSA provides a full range of health care services within our health plans. Each plan differs based on small variations in co-pay structure. We invite you to read through the Benefit Packages listed below and determine which plan works best for you, your family or your employees.
 
 
  Our Covered Services:
Physician Services
Surgical Services
Outpatient Services
Lab testing
Radiology
Hospital Services
Emergency Services
Urgent Care Services
Ambulance Service
Prescription Drugs

  Durable Medical Equipment  
Mental Health & Substance Abuse  
Maternity Care  
Prenatal and Postnatal Care
Preventive Care Services  
Immunizations
Birth Control
Cancer Screening Tests
Eye Care Services   		   


 
 


Large Group Benefit Packages:

Premier Access HMO 5/5
Most services require no co-payment at the time of treatment. Some select services require a $5 co-pay, after which all services are covered at 100%.


HMO PremierAccess 7/10
Most services require no co-payment at the time of treatment. Some select services require $7 co-pay, after which all services are covered at 100%.


Premier Access HMO 10/15
Most services require no co-payment at the time of treatment. Some select services require a $10 co-pay*, after which all services are covered at 100%.



  
 
 
 

HMO Saver Plans**
Most services require no co-payment at the time of treatment. Some select services require either a $5 co-pay, $7 co-pay or $10 co-pay, after which all services are covered at 100%.  The network is strategically set up smaller than our Premier Access plan designs.

HMO Saver Plan 5/5
HMO Saver Plan 5/10

HMO Saver Plan 5/5/10

HMO Saver Plan 7/10

HMO Saver Plan 10/15

HMO Saver Plan 10/10/20



 
 
 


Small Group Benefit Packages:

HMO Premier Access 5/5
Most services require no co-payment at the time of treatment. Some select services require a $5 co-pay, after which all services are covered at 100%.


HMO Premier Access 10/15
Most services require no co-payment at the time of treatment. Some select services require a $10 co-pay*, after which all services are covered at 100%.

 

  
 
 


Dental Plans

Dental Plan 1-2
No co-pay on preventative services, reduced co-payment on most services offered in our 1-1 dental plan.

(Espaņol)


Dental Plan 1-6
No co-pay on preventative services, lowest co-payment for most services of all the SIMNSA dental plans.

(Espaņol)


  
 
 

Individual Conversion

An employee or member whose coverage under a Group Plan issued by SIMNSA has been terminated by an employer is eligible for individual conversion coverage.

 
 
 

Affordable HMO Premier

SIMNSA is the highest quality cross-border option available in the market today that features an affordable rate with Mexico's best quality physicians & facilities. We are now pleased to announce the introduction of our new High Deductible plan which was created specifically for those employers how are currently not offering any medical benefits to their employee's due to high cost.

  
 
 


*Emergency services for all benefit designs require a $100/day co-pay and services rendered by non-Plan providers are reimbursed according to usual & customary charges

**Please contact our sales office for availability.