Understanding Health care options in Mexico

By Audrey Royem

If you are planning on living in Mexico full time, or even staying for a couple months, understanding the medical landscape of Mexico will make you feel safer and help you navigate any sorts of health concerns that might arise. In this article I will provide a brief explanation of the mainstream health care providers accessible to foreigners in Mexico.

Private Medical Care While there are several private companies that offer healthcare insurance coverage in Mexico, private medical services are quite accessible in regards to time and costs and do not require any sort of insurance. Most clinics and doctor offices have same day availability and once you are a client, most doctors give you their cell phone so you can call them at any time, day or night.
Many doctors speak good English, while their staff may not. Doctors usually charge a flat consultation fee (in the Puerto Vallarta area $500MX is common), which can include the use of their equipment, like for ultrasounds, or medical samples that treat your ailment. Although you will want to verify that the doctor is a qualified professional, Mexican hospitals and clinics have sophisticated equipment and doctors are highly trained. Pamela Thompson (healthcareresourcespv.com) is a fantastic resource for expats in the Bahia de Banderas area who makes doctor recommendations.
IMSS The IMSS (Instituto Mexicano del Seguro Social) was created by the government to provide health insurance to workers, however, IMSS is applicable to most individuals residing in Mexico, including foreigners. Each application process is different if you are an employee, boss, retired, and the general public. IMSS covers all doctor visits, diagnostics and lab work, hospital procedures and costs, and prescription drugs.
Family Health Program (El Seguro de Salud para la Familia) is a way of applying for access to the IMSS services as the general public. A minimum of two people who are related must apply at a time, and any other family member will be listed under the same policy. An annual fee apply and registration filed one a day and month before you need to get any treatment, so this is not an option if you are in need of emergency care.
Although prices are subject to change, the older you are the more you will have to pay per year. Health insurance cost is calculated based on what age category you fall into based on a 20 year increment. So people age 0-19 will pay the least for their health insurance ($1,600MX), while people over sixty pay the highest rates ($4,400MX+) per year.
The application includes filling out a health form, where you are to divulge any information regarding pre-existing conditions and current health condition. You should be aware there are a large number of medical conditions not covered by IMSS, which include pre-existing conditions, cancer, arthritis, diabetes, etc. If you have any existing health problems check to see if the insurance will cover it, or if they will accept your application before applying.
Once your IMSS application goes through, you and your beneficiaries will receive care in any of the IMSS medical unit closest to your residence. To renew your coverage you have to go back to an IMSS office with the same information within 30 days of it expiring. If you don’t renew your coverage, it will expire and you will have to apply again with any conditions that may have been discovered since your last application.
Seguro Social Seguro Popular is an opportunity for residents of Mexico to receive social health care when they are not receiving IMSS or another form of government health care. It was initially created to provide health services to individuals who work for themselves, or in rural areas where IMSS did not provide proper access. Seguro Popular, as it´s name implies, is a government program that serves the masses: it provides implements major health initiatives, like vaccinations; it easy to apply for and covers most common health concerns; a Centro de Salud is available in most pueblos, where there are in house doctors and nurses. You can register for free, the day that you get treated if need be- emergency care is available!
By affiliating to Seguro Popular you receive quality treatment from experienced doctors and nurses, free prescriptions; pregnancy, birth and kids are all covered, and full coverage on many medical treatments. Foreigners with legal residency (Temporary or Permanent Residency) can affiliate just like Mexicans. You must bring the following requisite documents to the nearest registration place (usually a hospital, not a Centro de Salud):
2. INM visa
3. Passport
4. Recent CFE bill
5. (and a copy of each of the aforementioned items)
This government program provides wide scope health care, including preventive medical care, general and specialty consultations, hospitalization, surgery, ancillary diagnostic studies and medications, as well as the attention of immediate families that are registered within the membership policy. If you need emergency care and are not affiliated, you can still receive medical attention, however, not at the reduced cost (it depends on the treatment, limited coverage on certain treatments, even for affiliates).
Which is Right for You? The treatment at Seguro Popular, IMSS or a private healthcare provider you will receive is all good. The type of service you seek will depend on a variety of factors you must weigh before you need these services:
Your activity and economic resources- are you an employee, do you have your own business, are you retired on a pension, for example;
Accessibility- is there an IMSS hospital or a Centro de Salud near you, or will you use a private clinic for certain reasons and the public clinic for another; the equipment and doctors available; and ultimately the comfort level you feel at each facility- do you speak Spanish, are you familiar with Mexican bureaucracy, are a few of the questions you may ask yourself.
Many of the same doctors that you see at a private hospital or clinic also work at IMSS or Seguro Popular. It is a way for young doctors to get more experience, doctors who have been with the system for years to get retirement pay, and a service to their country.
You should look into the services in your area offered by both organizations to see if it is beneficial for you to apply. However, while both offer reduced costs and qualified service, longer wait times, lack of availability of drugs and/or other limited treatments can vary and dissuade more financially-able customers from accessing their services. Private health institutions offer health care that is affordable and accessible compared to US standards, however, IMSS and Seguro Social might be even more affordable and accessible depending on the treatment or situation.
Originally published in Mexi-Go! Fall 2014