Do You Really Need Healthcare Insurance in Mexico?

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, there’s a federal government healthcare program(similar to Medicare and Medicaid in the U.S.).

There is also a free social healthcare system known as INSABI. 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 keep in mind 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 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 stands for Instituto de Seguridad Y Serivicios 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 go into too much detail about the ISSSTE.

IMSS and INSABI
Waiting lines at IMSS- There are usually no places where family members can wait.

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 if you have a CURP (which, as a resident, you can get).

You pay a yearly premium calculated based on a few factors and considering your age. For example, someone in their 60’s 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. But they offer their services free of charge to the government as a way of doing their social service. 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
  • Wait for days or weeks for more serious surgeries- which can be very uncomfortable

And finally, there’s INSABI– a free social healthcare system created initially for Mexican nationals who do not have the resources for private healthcare and do not claim taxes to qualify for the other two programs. When you sign up for INSABI- which stands for Instituto de Salud Para El Bienestar- plans, you are obligated to use the public hospitals, which are very basic, usually unsanitary, and very overcrowded. Think of this as your last-resort option if you do not have the funds to afford private healthcare and do not qualify for IMSS. In my opinion, most expats shouldn’t seek medical treatment at an INSABI hospital because it could mean you are taking healthcare away from a much more desperate Mexican local.

For this reason, a lot of expats prefer to purchase private international or Mexican health insurance.

Private Health Insurance in Mexico

Private healthcare in Mexico gives you the option of going 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 INSABI or IMSS, you can usually be seen right away and receive comfortable and personalized care.

A private hospital in Puerto Vallarta Mexico

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.

What I’m saying here is 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 expats 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 it is in the U.S. 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, it’s true that medical care in Mexico can definitely be much more affordable.

But I also have to share that a catastrophic event in Mexico without insurance can just as easily bankrupt you if you’re not prepared. 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 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 here is that you can avoid that headache by having health insurance.

What Does Health Insurance in Mexico Cost?

I’ve seen so many expats start GoFundMe campaigns to help them pay for 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 that you’ll come back and pay? No one wants to have the added stress of medical bills after recovering from a traumatic experience or dealing with a chronic illness.

health insurance in mexico

Especially when health insurance in Mexico costs around $100-$300 USD/Month for comprehensive coverage for healthy individuals in their 60’s. A fraction of the total bill. And if you have pre-existing conditions, you can still get coverage but will likely have a waiting period or not be covered for that particular illness.

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

What To Look For In A Health Insurance Broker?

Not all brokers are great, and not all health insurance companies have great coverage. Therefore, it’s important to do your homework and research when working with an insurance broker. You see, health insurance in Mexico is not like 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 case of 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 a challenge 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 an agent/broker who represents more than one insurance company? 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 you may want a policy that gives you international coverage. Some Mexican companies even give you full coverage in the U.S., and they are usually a quarter of the price that 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 who 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. In our COMPLETE Mexico Relocation Guide we only recommend licensed and vetted health insurance brokers.
  • Avoid misleading information- Get everything in writing. Review the policy and make sure everything that was 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.
Age limits may be one of the reasons you might have to self-insure in Mexico.
What About Age Limits?

As we age, naturally, our health insurance premiums will 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. There are a few companies that insure you past 70 but they are expensive, and require a lot of medical exams.

However, most of them cannot cancel coverage if you reach a certain age while insured under their plan. That’s another important reason you should seek getting health insurance in Mexico before you reach an age that is no longer an option.

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. So many people end up in better health after moving to Mexico because the doctors in Mexico genuinely care about your overall health. So many expats have talked about getting off the lifelong list of medications they were taking just 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 just by improving their quality of life. And that can be you too! But I also want to make sure you don’t move here with the notion that medical emergencies won’t cost an arm and leg without some coverage. Moving to Mexico should be about finding a better life, after all.

Mariana Lange

Mariana Lima-Lange was born in Mexico and immigrated to the U.S. when she was a child. She spent every summer visiting family throughout Mexico and is very knowledgeable about Mexican culture, lifestyle, and traditions. She is fluent in both Spanish and English.

Reader Interactions

Comments

  1. David Michael Waggoner says

    Hello Marianna and thanks for this article and good advice.
    What options for private coverage do expats over 75 have….if any?

    • Mariana Lange says

      Hi David
      Most insurance companies won’t insure anyone over 70 in Mexico. There are a few exceptions. In our Complete Mexico Relocation Guide we give you the contact info for the brokers around México that have insurance companies for people over 70 in Mexico.

      Alternatively you could either self insure or enroll in the IMSS

  2. Darrell L Bushnell says

    In your article above you state – All insurance companies in Mexico have an age limit to apply. Usually, that age is 75. But in your reply to a comment you state the age limit for a policy is 70. Which is correct?

  3. Fred Quinn says

    Hi Mariana,
    “health insurance in Mexico costs around $200-$400 USD/Month for comprehensive coverage for healthy individuals in their 60’s.”
    That is as much as a person would pay in the US with Medicare Part B, Part D, Medigap coverage, and a Dental plan, and that is with several pre existing conditions when you initially sign up!
    You can use the public healthcare system in Spain after living there for one year on a buy in plan for expats. It is rated much higher than the healthcare system in the US, you pay no extra for pre existing conditions, and the cost is 170 euros ( much less if you are under 65) or 170 US dollars per month. For these reasons I chose Spain on a Non-Lucrative Visa even though Mexico has nicer beaches. Fred

    • Mariana Lange says

      It’s average. It’s not a total amount. Mexico also has a social security hospital known as IMSS (kind of like Spain) where the insurance is very affordable (less than $170 euros)

      • Fred Quinn says

        The IMSS plan in Mexico requires you to pay up front for 1 full year of coverage and if they deny your coverage because of pre-existing conditions they keep your money and you get no coverage. There are a number of You Tube videos on this subject. There are ways to avoid pre-existing condition penalties in the US, but not in Mexico. Spain, France, Germany and a number of other European countries are light years ahead of both the US and Mexico when it comes to low cost, high quality healthcare.

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