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Health Insurance Options for Expats In Mexico

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Health insurance
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There are several health insurance options for expats in Mexico, including international health insurance plans, Mexican health insurance plans and the Mexican Social Security Institute (IMSS). Researching your options early will help you manage costs, ensure that you have adequate coverage and allow you to make the best medical choices for you and your family.

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To help sort out the health insurance options in Mexico and better understand them, we turned to several healthcare experts. Brent Judge is the international sales director for U.S.-based International Medical Group (IMG), Puerto Vallarta-based Roberto Castellanos is a co-owner and director of Latin America and Mexico for Novamar Insurance Mexico and Pam Thompson is the owner of Healthcare Resources, which is based in Puerto Vallarta.

International Health Insurance

Thompson defined International health insurance plans as policies for expats who live outside their home country either full or part-time. Most plans can be purchased to either include the U.S. or Canada or exclude them, which lowers the premium.

Judge’s company is a leading provider of international health insurance programs for expats around the world.

“If you are undecided about how long you will stay in Mexico,” Judge said, “then perhaps a short-term solution such as travelers insurance may be best for you, at least initially. But if you are or will be a long-term expat in Mexico, you should be considering an international medical insurance plan, especially one with a high deductible to help you save on monthly premiums, particularly if you are a younger expat.”

International health insurance plans are usually less expensive than U.S. plans, unless you have a low deductible and supplemental insurance to cover things like disability, emergency evacuation and other special requirements.

We asked Judge if using your U.S. health insurance plan abroad is a realistic option. “Generally not,” he said. “The reason is that most U.S. insurers will either have time or geographic limitations on how that plan can be utilized outside of the country. The other thing to consider is that many of them are not set up administratively to handle claims that may come in with physician notes in a language other than English.”

International health insurance plans typically provide the same core benefits as U.S. plans: outpatient/inpatient treatment, emergency room, wellness, doctor visits and prescription drug coverage. In addition, many international plans include benefits for emergency evacuations.

Whether you purchase an international health insurance plan or a Mexican plan, Thompson said it is important to understand how health insurance works in Mexico

“You must provide hospital admissions with a deposit and your insurance information when you are admitted,” she said. “They will then call your insurance company to open a case file so that the insurance company will send a Guarantee of Payment to the hospital in a timely manner. The patient is responsible for any co-pay and/or deductible. The amount of the deposit will depend on the ‘severity’ of the admission. If the insurance company sends the Guarantee of Payment to the hospital, no out-of-pocket is required.”

World healthcare
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IMG and its competitors offer a variety of international health insurance plans for individuals as well as families.

“At IMG, four different benefit levels can be selected, which also contain a number of variables,” Judge said. “Plans are based on age but also based on the amount of coverage that you want between those levels. The gold level plan is our most popular, which provides access to medical care privately anywhere in the world. Premiums are based on age, but our average premium is around US$1,000.”

Emergency medical evacuation can be included in international health insurance plans, but can be used only when there is a real and present threat to life or limb. Also, with most international health insurance plans, if you are accepted into the plan prior to age 65, you will be able to renew your plan indefinitely. But if you join a plan after the age of 65, you most likely will be covered only until age 75.

You can find comparisons of major international health insurance policies at internationalinsurance.com.

Mexican Health Insurance

There are 32 health insurance providers registered in Mexico that provide the same basic services as international health insurance companies. But, you must have permanent resident status to apply for a Mexican health insurance policy.

You should know that sorting through Mexican health insurance options is made more difficult by some bogus insurance representatives who are not licensed by the government and operate in the shadows of a heavily regulated industry in Mexico. Doing due diligence is extremely important when considering purchasing Mexican health insurance.

“Expats looking for health insurance in Mexico should look for companies they can trust, that have been around for a while and, very importantly, provide customer service in English,” Novamar’s Castellanos said. “As an insurance broker, we work with about 15 companies and have created programs specifically for expats.”

One of the main differences between international and Mexican health insurance policies is how deductibles are handled. In Mexico, deductibles are usually assessed by disease or illness.

“If you have cancer, diabetes or any another condition,” he said, “you will pay a one-time deductible that can start at $9,000 pesos or higher based on the plan selected.”

Castellanos tailors a wide range of programs from companies like AIG and WEA to the specific needs of expats living in Mexico and has his own support department to monitor doctors and hospitals and handle claims. Costs for health insurance policies are very competitive with international policies.

“If you are a young couple in your thirties with two kids, you can get a health insurance plan for about US$2,000 per year for the whole family,” Castellanos said. “A single person would pay about US$700 per year.”

Thompson of Healthcare Resources said that Mexican policies are in Spanish, unlike international health insurance programs, and the maximum age to apply for a Mexican policy is 65. Each Mexican health insurance plan specifies a network of hospitals and doctors that must be used. You must also request a factura (bill) at the time of service to submit to your insurance company for reimbursement.

Because medical costs in Mexico are significantly lower than the U.S. and other developed countries, many expats pay for healthcare costs out-of-pocket and use health insurance primarily for emergencies or major health problems.

IMSS Healthcare Service

Nurse checking a patient's pulse
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The IMSS healthcare service is funded by the Mexican government and employer and employee payroll taxes and provides healthcare to those employed in Mexico and those who enroll on a voluntary basis. Expats who wish to consider this healthcare option require temporary or permanent resident visas.

IMSS has an extensive network of public hospitals throughout Mexico, although wait times for services can be long for non-emergency procedures. IMSS members who are covered through their employment receive preference over independent enrollees.

Quality of healthcare in IMSS facilities varies by area within Mexico but a recent IMSS customer satisfaction survey showed that 83 percent of its users were satisfied with medical services provided by IMSS.

As a government public health service, some IMSS facilities are very over-crowded and, of course, Spanish is spoken, not English.

Some preexisting conditions are not covered by IMSS and others are covered on a deferment basis, which requires specific waiting periods. Be sure to check with the IMSS on the specific conditions if you decide to enroll.

Annual costs for IMSS per person are currently about $7,000 pesos a year, which is less than US$400.

Some generally older, retired expats who need a low cost health insurance solution opt for enrolling in IMSS since U.S. Medicare does not extend beyond U.S. borders. However, most Medicare supplements cover medical emergencies, but for just the first 60 days you are out of the U.S.

18 COMMENTS

  1. We had a Mexican health plan for most of the 10 years we’ve lived at Lake Chapala. We thought it a good option at a fair premium. This year, we regrettably discovered what we had was not what we thought we had in coverage. A friend and medical colleague informed us of Segura Popular, the Mexican universal health plan that is offered to expatriates also. Being age 60+, we were offered coverage with access to the community clinic and hospital at NO premium. We can still self-insure and use private physicians, clinics, and hospitals at very reasonable costs compared to the U.S. and the savings from premiums paid + deductibles and co-pays we had with our private Mexican Plan support the self-insured concept. It’s a personal call/choice for each individual, but Segura Popular is an option out there if interested.

  2. I have moved to Puerto Vallarta but still have a home in the US. I am applying for Medicare. Should I use my US address or my Mexican address? Will Medicare do me any good down here?

        • Evacuation insurance is great if you have friends and family back in the US and a relationship with medical professionals there. But there are many of us who simply don’t now or never did. After having lived in Mexico for over a decade, I cannot imagine being flown back to the US for medical care. My family and friends are here now and so is my doctor. Being evacuated might be a way to take advantage of Medicare, but that’s simply not the best option for everyone.

  3. We are looking for health insurance in Mexico’ SanFelipe to be exact. We are both in our 70s and have imms coverage right now, but was not impressed with my treatment last year in Mexicali. We are wondering if there might be something better.

    • Roy, I am a certified insurance agent in Mexicali and speak fluent english. i can gladly assist yoy in any doubts you might have for your insurance options . You can contact me at my cel phone (686) 2620850 calling from Mexico and if you need to reach me from us you would dial 01152-686–2620850 Alma Montoya (insurance and finance counselor)

  4. Roy, we would suggest contacting Roberto Castellanos, who is a co-owner and director of Latin America and Mexico for Novamar Insurance Mexico. He has representatives who can help answer your questions, and they speak English. Just click on the Novamar link in the article to take you to his website and then use their contact form. One thing to remember, if you are over 74 years old you will not qualify for Mexican health insurance.

  5. IMSS is not the only government plan. There is also Seguro Popular, slightly different than IMSS, but not much. As usual in Mexico, A LOT depends on your location. There are IMSS clinics that you don’t want to be in, and public hospitals (i.e. Seguro Popular system) that will put little private rip-off places in Cabo and Cancun to shame.

  6. Why is it that when Mexicans come to the United States they’re called “immigrants” but when Americans move to Mexico they’re called “expats”

    • Hola, you may be interested in reading my Mi Vista blog from January https://www.expatsinmexico.com/what-is-an-expat/ where I explain what an expat is. Those expats who choose to spend the rest of their lives – legally with visas – in Mexico can be called immigrants to the country. The overall term expats, though, applies to a wide variety of situations, including those working in Mexico on temporary assignments, “snowbirds” and other situations. Hope this helps.

  7. I would like a quote for med insurance for myself and my husband he is 61.5 with diabetes and I am 58 and healthy. We are thinking of moving to mazatlan

  8. my husband live in mazatlan mx and we are now living on my ssi which is $965.00 a month. does anyone know if we qualify for low income insurance and how or where do we go to get it? im 64 years old.thank you.

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