Home Health Care How To: Private Health Insurance Coverage in Mexico

How To: Private Health Insurance Coverage in Mexico

by Brent May

If you’re thinking of moving to Mexico and want to know about health care coverage, you have basically 3 choices according to your situation.

 

What is the IMSS?

If you are an expat living or working in Mexico with a visa other than a tourist visa, you can subscribe to the IMSS system (Instituto Mexicano del Seguro Social). If you are employed, you are automatically covered by this system through your employer. Both you and your employer pay contributions to this coverage system.

If you have temporary or permanent resident status, are self-employed, unemployed or retried, you can choose to subscribe to the IMSS system. You will apply for IMSS coverage yourself in this case. This is a public health insurance option that you can supplement with additional private health insurance for more flexibility. (Or you can choose a private health insurance. More on that below.)

 

How to Enroll in IMSS

If you choose to enroll in the IMSS system, you will need to first collect the required documents:

    • Valid ID
    • Certified copy of your marriage certificate if applicable
    • Certified copy of birth certificate/s
    • Your CURP – Unique Population Registry Code
    • Proof of payment of the fee for each member of the family
    • Proof of address
    • Your personal information
    • The medical questionnaire which is provided by the IMSS

Note about the documents: Documents must be in their original form along with a copy.  Documents from your country like a marriage or birth certificate must be translated into Spanish and apostilled (legalized) before you submit them.

Then you can visit the IMSS website or apply in-person at your local IMSS office. Here you will pay the annual fee. Both the site and the visit to the local office are in Spanish so you should take a translator if you do not speak Spanish. Once you have gone through the process and your file is accepted as complete, your coverage will start on the first day of the following month.

Read more: IMSS for the Expat: It’s a Viable and Affordable Option

 

How much does IMSS coverage cost?

The cost of the IMSS subscription ranges from about 4,650 MXN (approx. USD 218) per year to MXN 12,750 (approx. USD 590) per year. The cost is determined by age range.

The IMSS then provides for a certain level of care and sometimes beyond that, you pay services according to your means. The care you will receive can largely be determined by the medical installations and services in the area where you live.

Read more: How To: Health Insurance for Expats in Mexico

 

What is the INSABI?

The second option, the Instituto de Salud para el Bienestar (INSABI) is an option for those who have lost their job or who cannot afford to enroll voluntarily. This system replaced the Seguro Popular in 2019 and has taken some time to get up and running in all states in Mexico. It is the government’s solution to universal healthcare. Those who are not covered by the IMSS can be covered by INSABI since January 2020.

 

Private Health Insurance

The third option is private health insurance. If you are in Mexico or going as a tourist for up to 180 days at a time, you can use your international travel insurance. If you choose to subscribe to private health insurance, you have 2 options.

You can buy private health insurance from a local company in Mexico. This will cover you in Mexico but not abroad (like going for a visit to the U.S.) Or you can subscribe to an international health insurance policy. You can choose to be covered in Mexico, the U.S. and abroad.

The advantage to private coverage is that you can choose to be treated in a private clinic or hospital. These private service providers can have shorter wait times and more modern infrastructure. But this can again largely depend upon the area where you live. In some areas, the public system is solid, has excellent doctors and provides quality health care services.

The private system in Mexico provides good patient care, good quality facilities, doctors are less stressed and spend more time with you, emergency rooms are fast and specialists are usually quick for appointments.  You can always request a price quote. Pricing is sometimes negotiable.

Another consideration is that private care in Mexico is about half the cost as in the U.S. It could still be too much to pay out of pocket. This is when a good private insurance will benefit you.

The cost of private health insurance will vary depending on your personal situation: age, medical history, level of coverage you would like, if you also want to be covered in the U.S., etc. Some options will only cover you in Mexico, some will cover you in Mexico and the rest of the world beside the U.S. and some will also cover you in the U.S. Check out your options according to if you are living or just traveling to Mexico. There are many.

Read more: My Experience with a Small Surgery in Mexico

 

Can I use my health insurance from the U.S.?

This all depends on your private insurance. The only way to know is to call them and find out. Medicare, for example, is not valid outside of the U.S. Some insurances will cover an accident.

 

More on healthcare pricing

You can always visit a doctor at the pharmacy for simple things. Pay 50 pesos. Pay more for a shot or stitches. At a private clinic, pay about 200 pesos for an appointment. For a specialist appointment like dermatologist, pay around 600-800 pesos. Always ask for the price list.

You will find many doctors online at doctoralia.com. Many times you can make a same day or week appointment.

Read more about How to Find a Doctor Online.

Contracting health insurance is a personal decision. Many expats who have no health issues decide against getting insurance because they figure health care is cheap enough in Mexico and feel fine paying out of pocket if anything comes up. Others feel more at ease contracting insurance. In the end, you will make the decision that is best for your personal situation for your Mexico life!

Our blog offers many healthcare articles.  Go to mexicoliving.org and type in “healthcare” by clicking on the search icon on the right side of the screen by the BLOG button.

Read more:

Mike McQuaid, Our Local Real Estate Agent Talks About Having his Knee Replaced in Puerto Escondido

My Emergency Room Experience in Mexico

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