Getting health insurance in Mexico: A complete guide

Picking up your entire life and putting down roots in a new country can be incredibly overwhelming. If you’ve relocated due to a professional opportunity, chances are you’ll experience some work-related stress transitioning into your new role, as well as the headache of moving itself. But what about all of those lifestyle-related details that you may not have even thought of yet? Details like opening a bank account or buying a car?

One of those details that can get lost in the shuffle by expats approaching a move is securing proper local healthcare. However, this is an important detail to cover when you’ve relocated to a new country, like Mexico, and don’t know the lay of the land yet. Protecting your health away from home is worth an evening of research, so read on for a complete guide to everything you need to know about getting health insurance in Mexico.

What kind of health care system does Mexico have?

Mexico is highly regarded for its healthcare system. A range of inexpensive, high-quality options are available to the population through private and public channels. These choices are also available to expats, assuming they meet the eligibility criteria.

There are two types of public health care coverage in Mexico. The first and most common is the Instituto Mexicano del Seguro Social (IMSS), which is provided when you're employed full time with a Mexican company, regardless of your nationality. If you don’t meet that criteria, you can pay into the same plan for a pretty modest monthly fee.

The second public type is called Seguro Popular. This service is provided nationally by the Mexican Government to ensure all Mexicans receive healthcare, regardless of their income or employment. Seguro Popular is only applicable to those who aren't eligible for IMSS or private health insurance.

Medical access has expanded significantly in recent years. All medium to large cities in Mexico have at least one first-rate hospital, however quality of care could vary in poorer and more rural areas. The majority of doctors in Mexico have received training in the US or Europe.

From a cost perspective, healthcare and prescription drugs will run about half the cost that they do in the US, and health insurance is also cheaper in Mexico.

Who needs to be covered by health insurance?

There are no requirements to be covered by health insurance in Mexico, but it's very accessible to everyone through the Seguro Popular. For expats who aren't employed but have chosen to retire to Mexico full time, Seguro Popular, would be a conceivable choice after becoming a resident.

How long can I be uncovered by health insurance?

In Mexico, you can live on a visitor's permit (FMM) for up to six months.

If you're an expat who plans to live in Mexico for 180 days or less, and you don’t intend to generate income within Mexico, that you don't need to apply for a resident visa. As far as health insurance is concerned, you'll be ineligible for the public health insurance of IMSS and Seguro Popular if you're not registered as a resident of Mexico.

However, expats living in Mexico on a visitor’s permit will likely be covered by international health insurance. In this case, it’s important to note that many private hospitals don't accept foreign health insurance; you’ll have to pay out of pocket in advance by cash or credit payment. While those fees will feel fairly minimal to expats coming from the US, they can look pretty steep to some Europeans and Canadians who are used to free or inexpensive care.

If you're relying on your international insurance coverage at first, it’s important to discuss with your international health insurance provider or advisor to determine whether or not a particular hospital in Mexico will accept their payment method to ensure coverage.

Private or Public health insurance, which should I choose?

Mexico is well-known for having an excellent quality of care that’s relatively inexpensive. Options are available through public and private providers, or a combination of both.

• Private health care is offered on a free-market system and is available to anyone who can afford it.
• Public health care, on the other hand, is typically provided through full time employment by a Mexican company or via enrollment with a minimal cost attached for IMSS coverage.

Seguro Popular is provided by the government to individuals who aren't covered under IMSS coverage or private coverage. The premiums are charged on a sliding scale based on your income and assets. For the poorest 20% of the population, the cost is free.

If you choose to retire to Mexico or live here full time and become a legal resident, you may apply for Seguro Popular, the universal public insurance program in Mexico. The cost of this coverage is based on a sliding scale, with premiums depending on factors like income and whether you own a home.

Private insurance

There are numerous recognized private insurance providers in Mexico, however expats often forgo this private coverage because it can tend to be fairly expensive, whereas public health care in Mexico is not - on average it costs half or less than half of US pricing.

Public Health Care

The IMSS coverage will be provided if you're employed full time with a Mexican company, whether you’re a local or an expatriate. If you're not eligible under your job, you can also voluntarily apply for this coverage with benefits beginning the month following your approval. With IMSS, your first year of coverage will only cover medical attention, however as of the second year of coverage, you’ll also be eligible for surgeries, medical supplies, prescription drugs and hospital visits.

Application to the program and subsequent services are provided in Spanish only. If you don't speak Spanish, you'll likely need to hire an interpreter or rely on the support of a friend when completing paperwork or receiving treatments.

Seguro Popular, provided by the Mexican government, is available to all Mexicans who aren't covered under other insurance. Premiums are charged on a sliding scale, based on factors like income and whether you own property, and children are fully covered. Foreigners who have a resident visa are eligible to apply for this program.

What’s the average cost of health insurance?

For those enrolling in IMSS coverage, you can expect a yearly fee of the equivalent of about US$400, which must be renewed annually. Deductibles aren't paid annually, but rather by diagnosis. For accident-related fees, the deductible is typically US$250. A non-accidental deductible costs on average US$800.

Private insurance costs can vary, but on average insured expats would pay approximately US$1,700 per year, with a deductible of US$5,000. If you’re enrolling in private coverage prior to arriving in Mexico and need to make payments overseas, you can save on fees by using Wise to reduce transfer costs and make sure you’re getting the real exchange rate. Most banks and transfer services add something called a spread - a markup of an average of 4-5% to the exchange rate - which means you could be paying far more than you need to. Wise, on the other hand, gives you the real exchange rate - the same on you find on Google. Meaning you can save a lot in comparison when you send money abroad.

Who’s covered by public health insurance? And in what scenarios?

The most common criteria for enrollment in National IMSS coverage is being formally employed in Mexico. Deductions are automatically removed from your salary each month, and the amount is matched by your employer. If you fall outside of this criteria, you can enroll voluntarily - this is a common choice for foreign residents and retirees in Mexico.

What about pre-existing conditions, are they covered?

Under IMSS, if you have pre-existing conditions you'll not be approved for coverage. Like in any country, there are many conditions that count against your insurability, so it’s a good idea to look over the full list of uninsurable pre-existing conditions on the IMSS website (in Spanish only).

Are there any deductions I can make for medical expenses in my Mexican taxes?

Medical, dental and hospital expenses paid for in Mexico by check, wire transfer, credit card or debit card by an individual for him/herself or his/her dependents that haven’t been reimbursed by insurance, can be claimed on your Mexican income tax return.

How do I sign up for medical insurance?

The application process involves filling out a questionnaire with personal information and gathering your required documents, including:

• your passport
• FM3 or FM2 visa
• birth certificate (translated into Spanish by a certified translator)
• your CURP (Unique Population Registration Number)
• proof of your legal address
• marriage certificate (if applicable)
• 4 (2.5x3 cm) black and white photos

From there, you'll visit an IMSS office, where you'll be issued a number if you have all of the correct information. Once your number is called, you'll be asked questions about your application. It’s fairly likely that the agent will speak English, but it’s a good idea to either call ahead to make sure you can work with an English-speaking agent or bring a translator with you just in case.

If all of your documentation is correct, you'll receive paperwork and should proceed to your bank in order to pay the annual fees. Banks that offer this service include:

• Banamex
• Scotiabank
• HSBC

Upon completing the payment, you’ll return to the IMSS office with your proof of payment receipt - make sure you bring 2 copies.

Once you’ve given your receipt of payment to the IMSS attendant, you’ll be provided the carnet (form of paperwork) and address of the clinic where you’ll need to visit within the next month.

When you visit the clinic in the following month with all of your paperwork, you’ll receive a date for your appointment with the doctor and the name and number of your doctor’s office. You’ll also be provided with your ADIMSS card.

Finally, you’ll go to the ADIMSS module and provide all of your paperwork including all of the documents outlined above. You’ll have your photo taken and be fingerprinted. Once the process is completed, you’ll be all set with your insurance card.

The health card

As mentioned above, upon completing your application to IMSS, you’ll receive an ADIMSS card.

Seguro Popular uses a family-based health card that was originally launched in 2006, and information is loaded on the card about the family’s medical records and past visits. This eHealthcare format ensures privacy of patients through secured personal data and has drastically reduced administration costs.

These cards are issued to those covered under Seguro Popular, and as a result, not covered under any other form of health insurance in Mexico.

Which Insurance company should I choose?

When investing in private health insurance, it’s important to do your research about coverage specifics and weigh that against your health needs.

Depending on which area you’re planning to reside in, check out the local hospitals and make sure they'll accept coverage from the specific provider you’re interested in signing on with.

Check out these popular leading private health insurance companies in Mexico:

• GNP Seguros
• Royal and Sun Alliance
• Metlife

How do I submit a claim to my insurance company?

While the details of submitting a claim will vary from provider to provider, it’s essential to obtain your official receipt called a “factura” for drugs or medical services if you plan to submit the charges for reimbursement.

For prescription drugs, the factura is emailed to you as well as given to you at the register. You MUST have both in order to be eligible for repayment.

As you settle into your new life as an expatriate in Mexico, be prudent and research the best health insurance option for you and your family. Knowing that you have your healthcare coverage in hand can give you the peace of mind to truly enjoy your experience in Mexico should you or your loved ones need medical attention while in your new country.