How to Obtain Public Health Care in Mexico

Mexico has an excellent Private Health Care system that is both extensive and inexpensive. Additionally, for expats who want to join the national public health care system, there are two options. Seguro Popular, translated as Popular Insurance; and IMSS (Instituto Mexicano de Seguro Social).

At the time of this writing (early 2020), Seguro Popular is being combined into IMSS on a state by state basis. Each Mexican state will have slightly different qualifications and coverages so it is best to go to your local office for more information. It is advised to apply for Seguro Popular if it is not already part of IMSS; you may maintain some benefits that you might otherwise lose in the process.

Despite the method of health care that you choose, most services are provided in Spanish so if you are not fluent, you will want to bring along a friend or interpreter when you apply and when you go for treatments.

I have provided these guidelines for you as a general idea of how the systems work. Please confirm specifics before you head to the offices to make application. The websites provided will help but each community has slightly different requirements.

Seguro Popular

Seguro Popular has over 60 million members throughout Mexico. In general, their hospitals are better staffed and equipped than the IMSS counterparts. Most university hospitals belong to the Seguro Popular network. They are where the majority of research and patient-centric care are performed. Depending on the type of care you need, you will find world- class medical facilities in Mexico City; and most of the best hospitals in the country belong to the Seguro Popular network.

In order to apply, you may appear in person at the local offices (find them at the Gobierno de Mexico website listed above). There may or may not be an application fee but you will need to bring documents (confirm these requirements at the above website):

• Official Identification with Photo
• Proof of Residence – electric bill, etc.
• Official Birth Certificate

You may call for more information at 01 800 767 8527. Once you apply, your nationwide insurance begins immediately. There is no age limit nor pre-existing conditions. More than 90% of medical issues are covered but there are some exceptions. For example, dialysis is not a covered treatment.

Fees and length of contract are determined at the time you apply. They vary from no fees in some states to small fees in others. When Seguro Popular is combined with IMSS there will be a higher fee per year, and coverage will change in regard to pre-existing conditions and length of contract. At this point these changes are not published but the answers will be available at the office where you make application.

If you have an emergency you should go directly to a hospital for treatment.

Hospital fees for specific services vary according to the hospital’s evaluation of your ability to pay and type of care needed. Any questions or problems at the hospital should be discussed with the health manager (Medico Gestor). If you require any medications, most are covered and supplied at the hospital. In some situations, you may be required to get a prescription from your doctor and get the medicine from a pharmacy.

IMSS

IMSS is a government healthcare program primarily for employees. However expats who have temporary or permanent residency may join. You may enroll through your Mexican employer or as a voluntary enrollment. The first step is to go to the local IMSS office and present the proper paperwork, including:

• Your current passport(s)
• Your current residency permit(s)
• Proof of address, e.g. your latest electricity bill
• Marriage certificate* (if applicable)
• Birth certificate(s)*
• Application form and health questionnaire provided by IMSS
• Two photographs, same format and rules as those for your residency permit
• Bank payment receipt for the first-year’s premium (made on the day you visit the local IMSS office)

* If you have foreign-issued marriage and/or birth certificates these will need to be Apostilled (sometimes referred to as ‘notarized’) and translated into Spanish before you can submit your application.

The annual fee for IMSS is higher than Seguro Popular. It varies with age from about 3900 pesos per year to 10,800 pesos for 80 years or older. The average retired expat in their 60s would currently pay 10,350 pesos per year ($44USD; $60CAD per month).

After you are enrolled you will be assigned a local clinic where you will go for checkups and care. Your assigned physician will help you find specialized care if needed.

You should be aware that in the IMSS system, some preexisting conditions are not covered but some that can be covered on a “deferment” basis subject to certain waiting periods. And certain care is not covered at all (eye, dental, etc.) Also, since IMSS is publicly funded, the demand for care is usually higher than the supply so there may be waiting periods. However, people who are enrolled through their employment will get priority.

Another thing to note is that if you are required to be hospitalized under the IMSS program, your family and friends are expected to help care for your basic needs during your stay – this is very different from the private health care system. Be sure to ask your doctor about specifics.