Health Insurance in Mexico- Do You Really Need It?

Many people move to Mexico for various reasons, including better weather, lower cost of living, a new adventure, and affordable healthcare. But there’s a saying in the expat community “Don’t leave your common sense at the border.”

What do I mean by that?

Well, it’s simple. But unfortunately, many expats living in Mexico have learned the hard way that even though routine and outpatient medical care is generally more affordable in Mexico, it doesn’t mean that a catastrophic event can’t leave you bankrupt.

Let me explain…

First, Let’s Talk About The Healthcare System in Mexico

Mexico’s healthcare system is broken up into a few parts. First, a federal government healthcare program, IMSS (similar to Medicare and Medicaid in the U.S.), exists.

And then there is private healthcare and insurance. To help you understand how each one is different, I’ll give you a brief description of each one.

Please remember that I am neither a doctor nor an insurance broker in Mexico. This information is solely for your research, and I recommend working with an expert who can help you navigate your health and insurance policy.

Federal Employees Healthcare Program

Let’s start with federal employees in Mexico whose employers pay social security taxes and have access to a healthcare program known as ISSSTE.

Unlike the Social Security program known as IMSS- which I will cover further down- the ISSSTE is charged with providing benefits for federal government workers only. The acronym is Instituto de Seguridad Y Servicios Sociales Del Los Trabajadores Del Estado. (Whew! That’s a mouthful!)

Most of us do not qualify because we do NOT work for the Federal Government in Mexico, so I won’t discuss the ISSSTE.

IMSS- Bienestar

One of the most popular healthcare programs you’ll probably hear about is IMSS– which stands for Instituto Mexicano del Seguro Social. You can enroll if you’ve been employed in Mexico or have a CURP. That means you first have to receive your residency in Mexico to qualify.

You pay a yearly premium calculated based on a few factors and considering your age. For example, someone in their 60s without pre-existing conditions would pay around USD 700/Year or MXN 14,000.

But some pre-existing conditions will unqualify you from enrolling at all. IMSS has its own hospitals and clinics, and its doctors are well-trained specialists who usually have private practices. The downsides to having IMSS as your form of health insurance are:

• Waiting periods for certain conditions.
• Long lines and wait times- there are only so many IMSS hospitals and many patients.
• Availability of specialists during off-hours or holidays.
• And in some cases, run-down facilities with outdated equipment.
• You usually do not have a private room.
• No English-speaking staff in most cases.
• Medications can sometimes be scarce.
• You are assigned a local clinic, depending on where you live.
• Wait for days or weeks for more serious surgeries- which can be very uncomfortable.

With all those negatives, why would someone want to enroll in IMSS for healthcare? Well, for many, this is the only option for having affordable healthcare in Mexico. And even though some of the IMSS hospitals lack medications or services, for many, it is a far better option than not having any medical coverage.

Private Health Insurance in Mexico

Private healthcare in Mexico allows you to go to private clinics and hospitals of your choice without waiting for hours or days.

Private hospitals are usually the most modern facilities with up-to-date equipment, private rooms, a cafeteria, a lounge area for family members, and English-speaking staff. And unlike IMSS, you can usually be seen immediately and receive comfortable and personalized care.

Now, don’t get me wrong. I am not bashing the public healthcare system in Mexico. On the contrary, I am very thankful that the lower-income families in Mexico have access to some form of healthcare even at the lower poverty levels.

I’m saying here that if you can afford to pay for private health insurance in Mexico, then I wouldn’t think about it twice.

What About Self Insuring?

Some foreigners prefer to self-insure or pay out of pocket for medical treatment in Mexico.

And I join entirely in the sentiment that Mexican healthcare is usually far more affordable and better in Mexico than in the U.S.A.

For example, you can get a CAT Scan the same day without an appointment for less than USD 300 without insurance. You can get a comprehensive lab panel done for less than USD 100 without insurance. And you can quickly see a specialist like a cardiologist or orthopedic doctor for about USD 40- not including treatments and medications.

You can even have major surgery for a 1/3 of the cost of what it would be in the U.S.- Like my friend Pat, an 80-year-old ex-pat who had invasive back surgery in Guadalajara and paid out of pocket without breaking her bank. Yes, medical care in Mexico can be much more affordable.

You May Be Interested in Learning About Pat’s Surgery in Guadalajara

https://youtu.be/gTnDWKPE7pc?si=pdM6D-vwMujMJrRa

But I also have to share that a catastrophic event in Mexico without insurance can just as easily bankrupt you if you’re unprepared.

For example, if you were to have a heart attack in Mexico and needed a stent plus a week of hospitalization, you could be looking at USD $30,000-$40,000 without insurance. And something like cancer can quickly add, costing around USD $100-200k total in medical treatments if you don’t have insurance.

And in Mexico, treatment at a private hospital without insurance means you won’t be released until you pay your bill. But the important message is that you can avoid that headache with health insurance or savings.

Age Limits and Pre-Existing Conditions?

As we age, our health insurance premiums will naturally increase, and at some point, it becomes difficult for seniors to qualify for private health insurance. All insurance companies in Mexico have an age limit to apply.

Usually, that age is 70. A few companies in Mexico insure you past 70, but they are expensive and require a lot of medical exams. And if you have any pre-existing conditions, you will likely have difficulty getting private health insurance in Mexico.

But we have a solution!

I take my research at Mexico Relocation Guide very seriously. And I receive about 100 emails each month from people concerned they won’t be able to get insurance in Mexico. That’s when I found Greg.

Greg Hovey runs Safe Travels in Mexico– a travel insurance company with great health insurance in Mexico for foreigners -Canadians, Europeans, Americans, etc.

He can insure anyone under 79, even if you have pre-existing conditions. And even if you only plan to live in Mexico part-time. Check out my Q&A with Greg below

What Does Health Insurance in Mexico Cost?

I’ve seen many expats start GoFundMe campaigns to help them pay medical bills in Mexico because they didn’t realize you can’t go home until you pay your account!

Can you imagine that? Not being able to go home until you pay?

Because there’s no way for the hospital to guarantee you’ll return and pay? No one wants the added stress of medical bills after recovering from a traumatic experience or dealing with a chronic illness.

Especially when health insurance in Mexico costs around $100-$300 USD/Month for comprehensive coverage for healthy individuals in their 60’s. Or $30-70 USD a Month for Catastrophic coverage in Mexico.

A fraction of the total bill. And even if you have pre-existing conditions, we have solutions that will cover you in an emergency in Mexico.

I am not advocating for the health insurance companies either because, let’s face it- they’re a very profitable business. They don’t really care about you as the client. Your health insurance broker is the one who truly cares about you and will look at your entire medical history to suggest the best plan.

What To Look For In A Health Insurance Broker?

Not all brokers are great, and not all health insurance companies have great coverage. Therefore, doing your homework and research when working with an insurance broker is important. You see, health insurance in Mexico is unlike health insurance policies in the U.S.

There are a lot of nuances that you might not know about because you don’t know what questions to ask. You need to find a great broker who understands this and has experience working with expats. That way, they will thoroughly explain your policy, its coverage terms, and what to do in an emergency.

Here are some questions you can ask yourself when doing some research:

• Where is the broker located? Are they here in Mexico, able to assist you in an emergency? Getting things resolved in Mexico can be challenging, so you need a broker who knows their way around the Mexican system.
• Does the broker have an office, and are they established in the community? As experienced and reliable as your agent in your home country can be, insurance is different in every country. Unless your agent is located in Mexico or has a company registered and established here, you cannot expect high-quality service and timely claim resolutions as you can with an agent experienced in Mexico.
• Should I choose a broker representing multiple insurance companies? In my opinion, YES! A good insurance broker should be able to offer you a variety of policies with options to suit your requirements and your budget. Health insurance in Mexico ranges from basic to elite-level companies. You may want a policy that only covers you in Mexico or one that gives you international coverage. Some Mexican companies even give you full coverage in the U.S., usually a quarter of the price you would pay for a policy through a U.S.-based company.
• Does my broker speak English? Select an insurance broker that offers bilingual assistance. It will be virtually impossible to resolve your claim without a Spanish-speaking advocate. You want a broker and an insurance company that can communicate with Mexican officials, hospitals, and other agencies involved in a claim.
• Request proof of their license when shopping for any insurance. Unfortunately, there are many salespeople selling insurance illegally in Mexico. They mislead clients and make promises they cannot keep, and the client may end up in bankruptcy with no legal recourse. An insurance broker should have a license that ensures the agent/broker is diligent and complies with the law. It protects clients from errors made by the broker, and the mistakes of omission policy protect the insured. Our COMPLETE Mexico Relocation Guide only recommends licensed and vetted health insurance brokers.
• Avoid misleading information- Get everything in writing. Review the policy and ensure everything promised to you during the presentation is in writing. Verbal promises are not going to help you while you are sitting in an emergency room.

Take Your Healthcare Seriously

There are few things in life we can truly control. We can control how we live, our lifestyles, the foods we eat, and the stressors we add to our lives.

Our health is one of the few things in life we have some control over. Sure, no one can predict chronic diseases or catastrophic events. And as unfortunate as they are when they happen to us, there’s something about having insurance that can help you sleep at night.

In Mexico, healthcare is much more available and far more affordable. Many people end up in better health after moving to Mexico because the doctors in Mexico genuinely care about your overall health. I’ve chatted with many Canadians and Americans living in Mexico who have talked about getting off the lifelong list of medications they were taking by making a few changes to their lifestyle and diet based on their Mexican doctor’s instructions.

And so many retirees have found that they feel more energized and younger by improving their quality of life. And that can be you too! But I also want to make sure you don’t move here because medical emergencies won’t cost an arm and leg without some coverage. Moving to Mexico should be about finding a better life, after all.