Mexico
Healthcare in Mexico > Mexico Healthcare & Health Insurance FAQ
FAQ about Healthcare & Health Insurance in Mexico
Frequently Asked Questions
- What is INSABI?
- What is a Factura?
- What is Seguro Popular?
- What is IMSS?
- Is payment required upfront at hospitals in Mexico?
- If I retire in Mexico, am I eligible for universal healthcare?
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What is INSABI?
El Instituto de Salud para el Bienestar (INSABI), which is called the Institute of Health for Well-being in English, replaced Seguro Popular on January 1, 2020. INSABI provides free health services to all people in Mexico who do not have Social Security. INSABI is not typically recommended as the primary healthcare option for foreigners living in Mexico, but some older expats who cannot get adequate coverage under IMSS due to pre-existing conditions, enroll in INSABI and pay out-of-pocket for private care as needed.
On paper, INSABI sounds like it offers a good level of basic healthcare for Mexican and foreign residents. If you are considering using el INSABI as your primary healthcare service, you need to be aware of some of the issues that expats and locals have experienced with the system. "AMLO deleted Seguro Popular Jan. 1st. 2020 and instead replaced it with INSABI which is a scaled down medical insurance that has no coverage for anyone with 3rd. tier illnesses which the Seguro Popular used to cover. Any legal resident, whether Residente Permanente or Residente Temporal can go there and legally they could also with the Seguro Popular but a few state governors in some states in the last year or so of its existence illegally blocked Residente Temporals from joining. There was no qualifying because of preconsisting illnesses. If you need tier 3 diagnosis or treatment such as heart surgery, cancer, brain surgery, vascular surgery, etc. INSABI won't - you pay. IMSS if you qualify will cover these illnesses. It rejects people with many pre-existing illnesses and has different lengths of waiting periods for many illneses before coverage starts from 6 months to 3 years - depends. INSABI has no scale of payment. It is free and no need to join. Just be a citizen or legal resident and show your INM resident card and your CURP. For 98 percent of Seguro Popular members it was free. About 2 percent paid a small fee. All IMSS members pay anual fees depending on age up to about $17,000 pesos a year for a 75 year old. It goes up every year it seems," wrote one expat. Another expat cautioned, "Because it is free, you may not get an appointment with a specialist for weeks or months. Sometimes people die waiting for an appointment."
What is a Factura?
"Absolutely essential to getting reimbursed in Mexico: You absolutely MUST have a formal receipt called a FACTURA for either drugs or any medical service. For prescription drugs, you have to have the Factura emailed to you (a new rule as of this year), plus you must have the register receipt. Not getting Facturas is the No. 1 reason anyone would have trouble with this system. This is a must," said one expat.
What is Seguro Popular?
On January 1, 2020, INSABI (El Instituto de Salud para el Bienestar) or The Institute of Health for Well-being in English replaced Seguro Popular.
Please go to our page on INSABI for details on the new healthcare option.
An Overview of the FORMER Seguro Popular System
Seguro Popular was not typically recommended as the primary healthcare option for foreigners living in Mexico, but some older expats who could not get adequate coverage under IMSS due to pre-existing conditions, enrolled in Seguro Popular and paid out-of-pocket for private care as needed.
What Expats Have Said About this Former System
Seguro Popular was not typically recommended as the primary healthcare option for foreigners living in Mexico, but some older expats who could not get adequate coverage under IMSS due to pre-existing conditions, enrolled in Seguro Popular and paid out-of-pocket for private care as needed.
What Expats Have Said About this Former System
One expat explained this former basic level of healthcare in Mexico, "Seguro Publico is generally free, or almost free, depending upon your family situation, home, etc., and is for those without any other insurance coverage. Neither are really insurance, but are socialized medical care programs for legal residents of Mexico; citizens and those with residence visas. Quality of care can vary widely from one area to another and waits can be very long; often requiring arrival at 6:30 AM and waiting much of the day, only to be referred to the next day, or another location or provider. Appointment times can take several weeks; even months."
"Seguro Popular has its own hospitals with different levels of care available. Some are good, some are not. No, you do not get to choose the hospital and get reimbursement. These are public hospitals and are a far cry from the excellent private hospitals you will find in places like Guadalajara, etc," explained one expat.
"Seguro Popular doesn't eliminate on the basis of pre-existing conditions (nor age). (With IMSS there are delays in coverage.) SP has no exclusions like that. They will interview you for financial information (basic questions like whether you rent or own, have a refrigerator or whether your floors are tile or dirt, etc.) but by USA and Canadian standards, the annual payment will be very modest. Also, there are equally modest charges for some surgeries or treatments. Where it may fall short for some people is that the coverage is not comprehensive. Covered treatments and medications are based on an extensive and growing menu design to provide the most needed treatments for the most people. But there are sometimes conditions that fall outside of their menu (dialysis for example). People often tell me that it covered everything for them. But if you are the exception, I think you need to know that there is a small the one thing you need isn't on the menu," explained one expat.
Another expat recalled,"The Seguro Popular hospital in my area literally ran out of every kind of supply recently....some glitch in the funds coming from the Mexican government. Locals have had donation drives and supplied the hospital, at least for a while."
What is IMSS?
Instituto Mexicano del Seguro Social, IMSS, is Mexico's Social Security Institute. If you are working for a public or private sector employer, you should be automatically enrolled in IMSS. If you are retired or not working and wish to enroll in IMSS, you may be eligible to pay into the system. However, visa status (permanent resident visas are preferred, temporary resident visas are sometimes acceptable), pre-existing conditions and age are all factors in eligibility for IMSS. Eligible expats typically pay $300-400 per year for IMSS coverage.
"Some expats have been able to qualify for Mexico's IMSS (socialized medical coverage). What I've observed is that 'little medical problems' are often not worth taking to an IMSS clinic at all. Folks will just go to a local doctor and pay 200 or 300 pesos ($10 to 15 US) to a local general practitioner, and typically 400 to 600 ($20 to 30 US) pesos for a high-end specialist in a major city. When a friend contracted a rare illness however, her IMSS case was 'bumped up' the system, and she was cared for in a leading Mexico City hospital. (costs quoted here adjusted for Feb 2017 exchange rate)," one expat elaborated.
Is payment required upfront at hospitals in Mexico?
Yes, this is often the case at private hospitals in Mexico. "Mexican facilities often require payment 'up front' prior to performing a procedure, and most hospitals in Mexico do not accept U.S. health insurance," stated the US State Department.
"I can tell you horror stories, but it's better to be brutally frank, indeed. You better make sure that your insurance company will cover you for immediate entry into the hospitals of your choice in your vicinity, without first having to come up with a cash deposit. When and if having a coronary or stroke, this can be devastating. Contact the hospital administrators of several places and even verify that they will honor your insurance company's commitment, indeed. Get them even to sign something and carry it around in your wallet. I wouldn't trust social security hospitals and I have many Mexican friends that wouldn't, as well," remarked one expat.
If I retire in Mexico, am I eligible for universal healthcare?
Yes, retirees with a resident visa are eligible to enroll in Seguro Popular, the healthcare option for non-working people. You may also be eligible to pay into the IMSS system.
"Your options would be to pay out of pocket for routine doctor visits & medications, as most do anyway, and to enroll in either IMSS or Seguro Popular, get established with them, and stay enrolled for emergency hospitalization in the public hospitals; a triaged, socialized system. IMSS has fees and will exclude previous conditions. Seguro Popular is usually free for seniors who rent, for example, and has no exclusions. Quality in the public systems can vary widely. Private care is excellent in the larger cities, often superior to the USA," described one expat.
Instituto Mexicano del Seguro Social (IMSS) is Mexico's Social Security Institute. If you are retired and wish to enroll in IMSS, you may be eligible to pay into the system. However, visa status (permanent resident visas are preferred, temporary resident visas are sometimes acceptable), pre-existing conditions and age are all factors in eligibility under IMSS. Expats typically pay $300-400 per year for IMSS coverage.
Seguro Popular (SP) is not typically recommended as the primary healthcare option for foreigners living in Mexico. But, some expats have found it to be life saver and fully understand that it comes with long waits, no-frill hospital stays and other challenges.
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