Everyone who works in Mexico is enrolled in the public healthcare sector by their employer, regardless of whether the employee is an expat or a citizen. However, many who can afford it, choose to get private health insurance as well, in order to have access to the better quality of healthcare available in private hospitals.
Understanding the Mexico Healthcare System
There are two main types of public health insurance in Mexico: the Instituto de Salud para el Bienestar (INSABI) and the Instituto Mexicano del Seguro Social (IMSS), as well as the private insurance sector.
- The INSABI scheme (which means Institute of Health for Wellbeing) is a health insurance program for unemployed Mexicans and those who cannot afford to enroll voluntarily. It offers them health services and treatment free of charge. It has replaced the Seguro Popular scheme, which was in effect until December 2019.
- The IMSS scheme is health insurance for employees working for private companies, regardless of whether they are a Mexican citizen or an expat.
Does Mexico Have Universal Healthcare?
Yes, since the introduction of the INSABI scheme in January 2020, Mexico has universal healthcare for all its citizens and expats.
Who Exactly Needs Expat Health Insurance in Mexico?
Everyone who lives in Mexico as a legal long-term resident, either working, accompanying a family member, or retired, will have to enrol in a health insurance scheme.
On the other hand, you can simply use your international travel insurance if you are in Mexico under one of the following scenarios:
- You are in Mexico under a visitor’s permit (FMM)
- You will stay in the country for less than 180 days during which time you will not work.
Mexico Health Insurance Options for Expats
Expats in Mexico have the following health insurance options:
- Public health insurance (IMSS). All employed expats are enrolled under the IMSS scheme. Additional private health insurance is optional.
- Private health insurance:
- Local: You buy private health insurance for a local company in Mexico, but you will not be covered if you decide to go back to the US for a visit or if you travel abroad.
- International: You can compare and purchase Mexico health insurance online from Insubuy or International Citizens Insurance. You are covered in Mexico, the US, and worldwide, depending on the policy.
Public Health Insurance for Employed Expats
If you are working for a Mexican company, your employer will automatically enrol you under the IMSS health insurance scheme. You do not need to apply yourself. Both you and your employer pay contributions to the scheme – your part of the contribution is deducted from your salary.
You cannot opt-out of IMSS and subscribe solely to a private health insurance company. You can, however, take out an additional insurance policy from a private provider, which will give you access to private healthcare and more flexibility on where you are treated.
Unemployed expats must apply for the IMSS themselves or just opt for a private insurance scheme.
Private Health Insurance for Expats in Mexico
You can buy private health insurance through international health insurance companies, or insurance brokers such as Insubuy or International Citizens Insurance which allow you to compare plans from different companies online to choose what best suits your needs:
- Enter your personal information.
- Browse through the plans that suit your profile. Read the policies carefully to learn what they include.
- Select the plans you think are most befitting to your needs.
- Click on the “Compare” button and you can see detailed comparisons of the policies side by side.
- Select which way you want to pay and whether you wish to pay on a monthly, quarterly, or semi-yearly or yearly basis.
The reason why many US expats in Mexico combine both public and private health insurance is that private insurance gives you coverage in private clinics and hospitals, as well as the opportunity to choose your own healthcare provider.
Private hospitals in Mexico have shorter waiting times, better infrastructure, offer better care, and there are usually more English-speaking doctors, which are helpful for expats.
Although healthcare in Mexican private hospitals is only about half as expensive as it is in the United States it can still be too much to pay out-of-pocket, and so a good private health insurance policy is a must.
Can Unemployed Expats Get Health Insurance in Mexico?
If you are a legal resident in Mexico, but not formally employed (such as a retiree), you can apply to be enrolled in the IMSS public health insurance program yourself. The procedure is as follows:
- Collect the required documents (see below).
- Apply online at the IMSS website or apply in-person at the local IMSS office.
- Pay the annual insurance fee, for yourself and any family members included on the scheme.
- If you do not speak Spanish: Make sure you have a translator with you since the application process is entirely in Spanish.
Once enrolled, your coverage will start on the first day of the following month.
Required Documents When Applying for Expat Health Insurance in Mexico
When applying to be enrolled under the public health insurance scheme in Mexico, you need the following documents:
- A valid Identification Document
- A certified copy of your Marriage Certificate (if applicable)
- A certified copy of Birth Certificate/s (if you have children)
- Your Unique Population Registry Code (CURP)
- Proof of payment of the fee for each member of the family group
- Proof of address
- Your personal information
- The medical questionnaire which is provided by the IMSS
- All the documents you submit have to be in their original form along with a copy
- All the documents from your country (such as marriage and birth certificates) have to be translated into Spanish and Apostilled (or otherwise legalized) before you submit them.
What Does Expat Health Insurance in Mexico Cover?
Public health insurance in Mexico covers:
- Accidents and emergencies in the first year of coverage.
- Surgeries and other health conditions, starting from the second year.
- Medication (only when prescribed by your doctor).
- Part of your salary if you are unable to work due to an illness or accident for up to 52 weeks.
Private health insurance for expats offers coverage for the following:
- In-patient and out-patient medical treatment.
- Dental and vision treatment.
- Mental health care.
- Pre-existing health conditions.
- Evacuation or repatriation.
- Travel health insurance.
- Coverage in private hospitals, which have a higher quality of care and where the doctors are more likely to speak English, making for easier communication.
Remember: If you are enrolled only in the public health insurance scheme, there are specific doctors and clinics which you can visit, depending on locale. This means you cannot choose your doctor and you cannot be treated in private clinics or hospitals, otherwise, you pay from your own pocket.
Does Expat Health Insurance in Mexico Cover Pre-Existing Conditions?
If you enroll on Mexico’s public insurance yourself, certain pre-existing conditions may not be covered, or, alternatively, if you have certain pre-existing conditions, you may not be able to apply for the IMSS at all. This includes diseases such as malignant tumours, late stages of diabetes mellitus, chronic liver diseases, chronic kidney failure, valvular heart disease, heart failure, among others.
When you apply for IMSS, you should be able to see the list of pre-existing medical conditions not covered under the public health insurance scheme.
Private health insurance: Whether a private health insurance scheme will cover you for pre-existing conditions will depend solely on the company and the plan you purchase. Read the policy carefully. You can find an expat health insurance plan that fits your needs for Mexico at Insubuy or International Citizens Insurance.
Can I Use My US Health Insurance in Mexico?
No, in most cases, you will not be able to use the health insurance you have in the US for treatment in Mexico. Your American health insurance policy, such as Medicare, will not extend outside the borders.
Even if you have an insurance policy with international coverage, you still have to pay out-of-pocket initially, before being reimbursed back in the US. Or, if you have expat health insurance in Mexico but have continued your insurance policy in the US as well, you may use the latter for evacuation to the States for treatment, but there is usually a time cap on this.
Naturally, depending on your health insurance provider back home, there may be exceptions, therefore, you should check your insurance policy or contact your providers for more information.
How Much Does Health Insurance for Expats in Mexico Cost?
If you subscribe to the IMSS health insurance scheme, the cost of Mexican health insurance ranges from MXN 4,650 (appx. USD 218) per year to MXN 12,750 (appx. USD 590) per year. Here the cost of expat health insurance in Mexico by age range:
|0 to 19 years||MXN 4,650|
|20 to 29 years||MXN 5,500|
|30 to 39 years||MXN 5,850|
|40 to 49 years||MXN 8,100|
|50 to 59 years||MXN 8,450|
|60 to 69 years||MXN 12,250|
|70 to 79 years||MXN 12,700|
|80 and over||MXN 12,750|
Cost of private health insurance in Mexico
When it comes to private health insurance for Mexico expats, the cost will depend on the specific company you purchase from, your age, medical history, the amount of coverage you choose, and the policy you subscribe to.
If you regularly travel to the US, you should choose a policy with worldwide coverage, including the USA. However, this will bring up the price of your premium, considering the high cost of healthcare, but it is better than facing those prices without health insurance.
If you do not intend to go back to the USA, then you can choose a policy that does not include the US, thus pay lower monthly/annual premiums.