About three months into my expat experience in Mexico, I got sick. Really sick. A local friend connected me to doctor who spoke English and made house calls (yes, they do that in Mexico!) After an examination and several questions, he gave me two medications and a bill for the equivalent of $24USD. With healthcare prices that low, did I really need medical insurance while living here? And if I did, how did I go about getting medical insurance as an expat in Mexico?
If you plan to live in Mexico full or part-time, you should consider the options available to you in Mexico and how to get medical insurance that will match your needs.
Find What You Need
Do I Need Medical insurance as an Expat in Mexico?
Ultimately, that’s a personal choice. Most routine care and procedures may be affordable enough to pay out of pocket. Medical costs in Mexico are generally 25-30% less than in the United States with a much better standard of care–especially if you use private providers.
But, if you require ongoing care, have a chronic condition, or suffer a major incident, the costs can add up quickly.
That’s why some expats opt to get catastrophic health insurance to cover accidents or emergency evacuation. This type of health insurance typically has a high deductible and is for emergencies only.
Can I use my US-based Medical Insurance, Medicare or VA Coverage in Mexico?
Most US-based insurance carriers do not cover medical care provided in Mexico. There are exceptions to this, so be sure to inquire with your carrier. Outside of some select emergencies, Medicare and Veterans Affairs coverage do not cover medical care provided in Mexico.
For this reason. some expats choose to travel back to the United States for major medical procedures or maintenance care.
Additionally, Mexican providers may not accept payment from U.S. insurance providers. Prior to receiving treatment, you may be required to pay using a credit card or make other arrangements to pay. It’s important to note that you can be denied care if you are not able to pay.
In most cases, you will need to pay out of pocket and seek reimbursem*nt from your insurance carrier.
Does Mexico Have Universal Healthcare? If so, are Expats Included?
Yes, Mexico does have what is considered universal healthcare. The public healthcare system in Mexico, Instituto Mexicano de Seguro Social (IMSS), is funded by the government and payroll taxes.
Yes, expats are permitted to enroll voluntarily if they have legal residency status (either temporary or permanent). Also, if expats are employed in Mexico they may contribute through their employer.
Expats can apply for the program either online or in person at an IMSS office, but don’t expect English forms or services. Application appointments, forms, and services are all conducted in Spanish. You may want to hire a translator or obtain assistance from an expat services company. Any documents provided during the application process must be in Spanish and notarized (apostilled, is the term in Mexico) if needed.
While universal healthcare sounds great, understand that it comes with tradeoffs. Those using IMSS are limited to certain providers and facilities. You can expect long lines, crowded offices, and a harder time scheduling appointments.
Also understand that people who are enrolled in IMSS through an employer get priority over those who enroll voluntarily. For these reasons, many expats (and Mexicans) opt for private medical insurance.
How Much Does Medical Insurance Cost in Mexico?
For IMSS, there is a monthly cost for the program and it is typically based on your age. Participants age 50 and over can expect to pay the equivalent of at least $550 annually.
If you opt for private insurance, costs range based on a few factors:
- Your age
- Family size
- Deductible amount
- Hospital options (local and national)
When my family of four applied for insurance, we were given three options:
- Option 1 with an annual premium of approximately $2,394USD
- Insured up to $6.5 Million USD per condition
- $950USD deductible covered one per condition (not annually)
- Coinsurance 10%
- No deductible for accidents (expenses must be over $100USD)
- Coverage abroad up to $100,000USD with a $100USD deductible for medical emergencies
- Highest hospital levels nationally
- Basic dental care
- Option 2 with annual premium of approximately $1,956USD
- Same as option 1 but with a deductible of $1,400USD
- Option 2 with an annual premium of approximately $1,766USD
- Same conditions as option 1 but lower hospital level and fewer options at the national level
Some carriers require that monthly installments are paid through a Mexican bank account. You may be permitted to pay bi-annually, quarterly, or monthly for an extra charge.
What Do I Need to Get Private Healthcare Insurance in Mexico?
If you opt for private healthcare insurance in Mexico, you will need to provide your medical history as well as proof of your residency (temporary or permanent), your passport, a utility bill, employment information, and an address from abroad as a reference only.
You should also review any information regarding coverage for pre-existing conditions. If your carrier covers any of these conditions, they will provide you with the waiting periods.
The Bottom Line
To get medical insurance as an expat in Mexico, you first have to decide what best fits your budget and medical needs. Whether you choose public or private medical insurance, you will need to have your documents in order and go through an application process.
For either option, legal residency status is required. Persons visiting Mexico on a tourist visa should check medical coverage provided by travel insurance. Travel insurance typically covers you for a limited period of time, so it is not ideal for those residing in Mexico long term.
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