Healthcare in Mexico

Mexico operates a public healthcare system known as Instituto Mexicano de Seguro Social (IMSS) which provides universal healthcare to Mexican families and foreign residents enrolled in the system.

The IMSS healthcare service is funded by a combination of the Federal government, employer payroll taxes, and employee payroll taxes or individual contributions where the service is taken on an independent/voluntary basis such as for temporary or permanent residents/ex-pats.

Voluntary Enrollment:

This is open to those not in formal employment for example, foreign residents who are retired in Mexico. Foreigners who wish to enroll voluntarily must have legal residency status (Residente Temporal or Residente Permanente, formerly FM3/FM2) to qualify; foreigners in Mexico with FMM (tourist visas) visitor permits are not eligible.

Costs:

The price for annual enrollment varies depending on your age. For example, a person in their 60s currently pays $10,350 pesos per year (equivalent to around US$45 per month) for IMSS insurance coverage in Mexico.

Preexisting conditions:

Some preexisting conditions are not covered and these include malignant tumors, congenital diseases, chronic degenerative diseases, addictions, mental illness, and HIV—among others. If you have any preexisting excluded conditions, you cannot enroll into the IMSS insurance program. These pre-existing conditions are much less stringent than any of the private healthcare options.

Other specific preexisting conditions are covered on ‘deferment’ and these don’t preclude you for joining the program, but are subject to specific waiting periods before you can seek healthcare services within the IMSS system related to them.

Application and payment:

You can begin the application online or in person at your local IMSS office. You’ll need to attend your local IMSS office to present your paperwork (original and copies) duly completed, which includes:

Your current passport(s)

Your current residency permit(s)

Proof of address, e.g. your latest electricity bill

Marriage certificate* (if applicable)

Birth certificate(s)*

Application form and health questionnaire provided by IMSS

Two photographs, same format and rules as those for your residency permit

Bank payment receipt for the first-year’s premium (made on the day you visit the local IMSS office)

You can see the list of required documents on this page

* If you have foreign-issued marriage and/or birth certificates these will need to be Apostilled (sometimes referred to as ‘notarized’) and translated into Spanish before you can submit your application.

On enrollment:

Upon enrollment, your coverage begins on the first calendar day of the following month of your application.

After you’re enrolled, you’ll be assigned to a local clinic, where you will go to see your doctor, go for regular check-ups, and obtain prescriptions for any medications you may need. If you need the services of a specialist, referrals are made to IMSS medical specialists only via your assigned doctor.

Medications prescribed by your doctor can be obtained for no additional cost at the pharmacy associated with the local IMSS office. However, not all medicines are available this way and if the medication you need is not available there, the doctor will give you a prescription to get the medicine at a private pharmacy and you will have to pay separately for this.

IMSS Exclusions:

Your IMSS insurance does not cover eye care, dental, elective surgeries (e.g. plastic surgery, weight loss), infertility treatments, or treatments for self-inflicted injuries.

Speed and quality of care:

There are waiting periods for non-emergency procedures, and IMSS members who get their coverage as part of their formal employment are given priority over those who enrolled independently.

The reported quality of care varies, and the experience you have will likely depend on where you are in Mexico and what the wider local demand is on health services when you’re seeking treatment. Some foreign residents report good care from IMSS, others report disappointments and shortcomings.

Limit of resources under IMSS: It’s fair to say—as with all large, publicly-funded healthcare systems world-wide—that the demand for services usually exceeds the supply of resources available and compromises must therefore be made.

Hospital treatment under IMSS: If you are interned in a public hospital in Mexico, your family and friends will be expected to provide support and bring amenities to you while you are admitted. This is something that is quite different to private healthcare coverage, where everything covered is ‘laid-on’ (and billed to the account). Ask your assigned IMSS doctor about this if a treatment or operation you are undergoing will require your hospitalization.

Options for Healthcare in Mexico:

Many foreign residents living or retired in Mexico avail themselves of private medical insurance if they can afford to do so, and attend private doctors, clinics, and hospitals in Mexico.

Private healthcare

Most expats opt for private health care, which they finance through private health insurance. Although private hospitals are more expensive, they are better equipped, provide greater access to specialized procedures and generally provide higher quality care.

Expats utilizing private healthcare for non-emergency treatment will avoid the waiting periods that are commonly associated with the public system. Private hospitals also tend to have more English-speaking staff.

Pharmacies and medication

Pharmacies are prevalent in Mexican cities and most medications are available in Mexico. There are 24 hour pharmacies which can be found throughout Mexico. Not all pharmacies have English speaking staff, so expats might prefer visiting pharmacies which are attached to larger hospitals, where there is generally a higher chance of English being spoken. Some pharmacies have medical clinics attached to them, in which doctors can provide medical consultations.

Emergency services

911 is the general emergency number in Mexico. Not all operators speak English, so it might be useful for expats to learn enough Spanish to memorize key medical phrases and to be able to explain their location. Paramedics are relatively well trained and some private hospitals have their own ambulance services.

Ambulance response times vary by region and can be slow in certain areas. Consequently, many private ambulances operate in Mexico which eases the demand placed on public emergency services. However, these private ambulances often charge large fees.

For roadside assistance, many expats rely on the ‘Green Angels’, which is a bilingual and tourist-orientated service that provides mechanical, first aid and general emergency assistance. They can be reached at 078 from a Mexican number.

One popular methodology is to buy private insurance with a high deductible and pay out of pocket for regular non-catastrophic services. Here is an example that would apply for a spinal issue:

Costs

• Initial consultation with orthopedist + examination + follow-up visit: $800 pesos ($43.24 USD)

• MRI of lumbar spine without dye: $9,082 pesos ($490.91 USD)

• Total Actual Cost (Mexico): $534.16 USD

So, how much would this have cost in the U.S.? According to Mayo Clinic’s online price estimator to determine what the out-of-pocket costs for the same services without insurance would be in Rochester, Minnesota:

• Office visit, new patient: $415 USD

• MRI of lumbar spine without dye: $3,427 USD

• Total Estimated Cost (U.S.): $3,842 USD

Contact Brett Lamar regarding privat health insurance:

brett.l@expatinsurance.com or WhatsApp: +52 322 274 0391

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Lamar

Ever wish your vacation lasted a few more weeks? What about years? We left the daily grind in California to live and work in Mexico and now help others do the same! From assistance with residency visas to property rentals and purchases to digital nomad networking, we are here to help people take that leap towards living in paradise. DM us your questions! Or follow us on Instagram for a peek at what it’s like to live the #mexicolife