Generally speaking, health insurance in Mexico works as a two-tiered system.
On the one hand, there are the public institutions governed by the two main Mexican Social Security organizations (IMSS, ISSTE). And, on the other hand, there are private hospitals and clinics.
Medicine is much better in the private sector, but also more expensive.
This is why it is important to choose an international policy with good health insurance coverage in Mexico. No matter if you are an expat or coming for a long vacation.
Find out how the Mexican health care system works. And what insurance options are available to you.
Health Insurance Coverage in Mexico With the Public System
The health insurance system in Mexico is relatively similar to the one in some European countries.
Does Mexico Have Social Security?
Yes, it does. The Mexican Social Security system is composed of a compulsory plan (IMSS) and a voluntary plan (ISSTE) whose coverages and costs vary.
IMSS: Instituto Mexicano del Seguro Social (Mexican Social Security Institute) which covers Mexican employees, but also resident foreigners.
ISSTE: Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (Institute of Social Security and Social Services for Civil Servants), which covers self-employed workers, public sector workers and expatriates holding an FM3 or FM2 visa.
These organizations guarantee their members’ rights to health coverage, medical assistance, social protection, and social services.
Social protection covers the insured person, his/her spouse or partner, his/her children (up to 16 years old, or 25 years old if they are students). Parents are covered if they live with the insured.
The Ministry of Health takes care of the health of unemployed people through the Seguro Popular.
Services Covered by Health Insurance in Mexico
The IMSS covers hospitalization, medical care, surgery, and medication. However, only care provided by public health institutions and by the attending physician is covered.
In the event of illness or accident resulting in an inability to work, the IMSS pays a portion of the salary for up to 52 weeks.
Each insured person is affiliated with a primary care physician, but this one is assigned by the IMMS and it is difficult to change.
Cost of Social Security in Mexico
Mexicans earning the minimum wage are exempt from paying the fees. In this case, the employer pays the full cost of their Social Security.
For other employees, there is a fee to be paid each month. This is usually about 10% of the salary.
How Do I Join the Mexican Social Security System?
All employees working in Mexico are normally registered with the IMSS by their employer. If the employer does not register them, they can do so by filling out an application form.
An insurance number is provided via a certificate of registration with the Social Security system. This number is essential to be able to benefit from medical assistance.
Social Security is valid health insurance in Mexico for expats. If you are a resident, you have rights in one of the two entities, depending on your status.
The Mexican public health system has limitations. It’s overburdened, and the care provided is not always effective due to a lack of investment and personnel.
Drug shortages are not uncommon, and waiting lines are often very long.
To have access to a better health care system, it is possible to purchase a private policy.
Private Health Insurance in Mexico
There are private facilities that provide high-quality care, but the fees are very high.
The cost of healthcare in Mexico is very accessible. Private facilities are of very high quality,
To be properly taken care of without paying a fortune, the majority of residents and many locals get private health insurance in Mexico.
This ensures them access to competent and available health professionals.
By choosing private insurance, you can visit the doctor of your choice and any health facility. It also means choosing to receive quality care.
A private policy allows you to be reimbursed according to the terms of your insurance contract.
Local Health Insurance in Mexico for Expats
An expatriate can take out an insurance policy with a Mexican company. The way these insurances work, designed for a Mexican audience, is however very different from what is practiced in Europe or the US.
It is therefore important to take into account their specific clauses when making your choice.
The quality of coverage chosen depends on the following factors:
“Deducible” (deductible): amount to be paid by the insured before the insurance starts to pay for the care. One of the particularities is that the deductible can be annual (same as a deductible) or fee-for-service
“Coaseguro” (co-insurance): the percentage of costs that the insured must pay for any procedure after paying the “deducible” (usually 10% of the costs)
“Tabuladores de honorarios” (fee tables): tables of the ceilings applied by the insurance company for each type of procedure
“Antigüedad” (waiting period): the period imposed by insurance companies between subscription and coverage of certain diseases or services. These periods generally vary from one to five years.
“Emergencia en el extranjero”: emergency coverage abroad, with a limited amount.
However, these private insurances do not cover routine or preventive care (visits, analyses).
And they only offer derisory help concerning maternity. In addition, repatriation and care provided in another country are not covered.
Choosing this type of health insurance in Mexico can be an interesting option for an expatriate. Especially if your employer covers all or part of the fees.
If this is the case, it is nevertheless preferable to make sure that the contract’s coverages are appropriate for you.
Choosing International Health Insurance for Mexico
Since private local insurances are not always ideal, there are other plans specifically designed for expatriates.
There are two main options for international health coverage while in Mexico.
One is getting a supplementary policy to reinforce the Social Security coverage. The other is purchasing insurance at the 1st euro.
Supplementary Social Security Policies
In some cases, you might be covered by your country’s Social Security. Although its reimbursements are very limited most of the time.
But you have the chance of subscribing to a supplementary plan with a third-party company.
Social Security will cover your expenses only up to the cost of care in your country. The remaining will be paid by the supplementary policy.
Its downside is that you might need to contact two different entities every time you need coverage.
Choosing Private Policies for Expats in Mexico
There is another type of international health insurance for Mexico. It’s a plan known as “first euro” (or “first dollar”), and it’s specifically designed for expats.
Unlike supplementary policies, there is only one organization handling all the procedures.
The 1st euro contracts are more flexible. And allow you to obtain higher reimbursements and better coverage.
There is the chance of getting extended coverage beyond the risks related to health, related to the daily life of an expatriate.
These insurances cover all the health expenses of the member from the first euro spent. With them, you will get access to:
An international third-party payment service
A high-quality health care network
Coverage for care provided in your home country or other countries.
However, all companies that market this type of product require a medical questionnaire upon enrollment. This can lead to exclusions from coverage or an increase in the insurance cost in the event of chronic illness or a declared history.
Despite this, the diversity of offers at the 1st euro and their good quality-price ratio make them very popular health insurance in Mexico for expatriates. Travelers to Mexico also prefer this type of insurance.
International health insurance in Mexico provides essential coverage for expats: routine care, hospitalization, and repatriation assistance.
This coverage works in Mexico, but also in the rest of the world. It allows for example the coverage of care during short stays in the country of origin or trips to the ones neighboring Mexico.
The international insurance market has also developed many formulas with varying degrees of protection that allow for more or less coverage.
This way, each individual can find something that suits them, depending on their needs and budget.
Among these guarantees, we can mention civil liability or the protection of luggage, identity documents, or airline tickets.
In addition to offering comprehensive coverage, taking out international insurance with a company from your country offers several advantages:
A contract protected by your national insurance legislation
Assistance in your language
A simplified contract and procedures
Access to trusted partner health care providers and institutions.
For all these reasons, an international health insurance policy is the preferred solution for expatriates in Mexico.
In light of the current health crisis, it is even more important to be well insured when you are an expatriate in Mexico.
International health insurance generally covers health care costs involved in a suspected or detected coronavirus.
However, PCR tests are generally only reimbursed by your insurance if prescribed by a doctor.
From a health point of view, Mexico is a relatively safe country. The main risks can come from
Mosquitoes and insects that can carry diseases such as dengue fever, malaria, or leishmaniasis
Wild animals that can carry rabies.
However, be careful with water and food, which can carry bacteria that we are not used to consuming and which can cause gastric problems.
No vaccinations are required to enter Mexico. However, vaccinations against diphtheria, tetanus, and polio are recommended.
In Mexico, some medications (such as antibiotics or painkillers) are usually available by prescription without consulting a doctor.
Please note that insurance companies only reimburse prescription drugs.