Health Insurance and Healthcare in Mexico Explained

Jump right in:

• Mexican healthcare system explained
• The public healthcare system in Mexico
• An overview of private health insurance
• How to find a doctor or dentist?
• Giving birth in Mexico

Mexican healthcare system explained

Navigating a new country’s healthcare system is never an easy task. We help you understand the current structure of the Mexican health system, as well as explain how to access both the public and private health sectors and their advantages and disadvantages. Before delving into the topic, we will start with some quick facts, so you can get a sense of how the local system works.

Quick facts about Mexican healthcare

• Public health services do not have reciprocal agreements with other countries. This means that foreign programs, such as US Medicare, do not provide coverage in Mexico. Therefore, both visitors and foreign residents who are not enrolled in the public programs must arrange private healthcare.
• The quality of care across the country is not well-balanced; the best care is centralized in large cities. For example, Mexico City has 2.4 beds per 1,000 inhabitants, while Tlaxcala has only 0.7. Nationally, Mexico averages 1.5 beds per 1,000 people, placing it 121st out of 179 countries. This is well below the 2.5 beds per 1,000 inhabitants recommended by the World Health Organization (WHO).
• Both public and private healthcare systems have their own doctors, pharmacies, physicians, and healthcare. These operate in separate networks. People are usually only allowed to use the services within their network.
• Health care costs in Mexico can vary significantly depending on the hospital, the urgency of the condition, and the medical services required. While both public and private facilities provide emergency care, the final cost will depend on factors such as location, hospital level, and whether hospitalization or diagnostic procedures are needed.
• Mexican pharmacies are divided into two categories: primera clase and segunda clase. On the one hand, segunda clase pharmacies are easy to find, both in big cities and small towns, but be aware that they cannot sell prescription medication. (e.g. psychiatric meds). On the other hand, _primera clase_pharmacies are fewer in numbers, but you will be able to get any type of drug that has been prescribed to you.
• The best hospitals in the country are in Mexico City, Monterrey, and Guadalajara. In the case of any major medical issue, it is best to seek treatment in any of these locations.

Does Mexico have Free Public Healthcare? Mexico’s healthcare system is composed of a mixture of private, public, and employer-funded healthcare schemes. The country began its efforts to provide full healthcare coverage back in 2004, with a program called Seguro Popular. This was designed to make various preventative treatments affordable to those who could not otherwise access them. In 2023, the public healthcare system transitioned to a new model led by IMSS-Bienestar, which now provides free medical services to people without social security coverage.

Now, people without social security will receive free medical care and medicine without restrictions, and they will no longer need to enroll or pay any type of fee. IMSS-Bienestar is a government agency that provides medical services to people who are not covered by the Mexican Social Security Institute (Instituto Mexicano del Seguro Social, IMSS) or the Institute for Social Security and Services for State Workers (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, ISSSTE).

The public healthcare system in Mexico

The Instituto Mexicano de Seguro Social (IMSS) provides healthcare services for both Mexican citizens and expats legally residing in the country. People enrolled in the IMSS program receive full coverage, including prescriptions. To find out if you will qualify for the program, check the IMSS site.

How does public healthcare work in Mexico?

The funds for this program come from the Federal government, employer payroll taxes, employee payroll taxes, and individual contributions from people who are not in formal employment.

Below are two enrollment paths.

• Any person (Mexican national or foreign resident) who is formally employed in the country pays their employee IMSS contributions. It is possible to have other private health insurance to complement it.
• There is an option to voluntarily enroll, which is open to people who are not in formal employment and others who want to enroll on a voluntary basis. Expats who hold either Temporary or Permanent residency status and are not formally employed (e.g. retirees) may apply, same applies for those who are self-employed. Please note that people who are enrolled in the IMSS via an employer get priority over those who enroll voluntarily.

Expats who wish to enroll voluntarily must have legal residency status. In order to qualify, you must either be a Residente Temporal (temporary resident) or Residente Permanente (permanent resident). Foreigners with FMM visitor permits (Forma Migratoria Múltiple) do not qualify.

In regard to coverage in the public system, know that you must have contributed to the IMSS scheme for at least 4 weeks before you are entitled to receive benefits. After this period, you are covered for hospital expenses, primary care, secondary care, surgery, and medication. In the case of an illness or accident that prevents you from working, the IMSS will pay you a percentage of your salary for up to 52 weeks.

Public healthcare costs Mexico Health Care Costs

• For the IMSS, the costs depend on your age and there are some restrictions and limitations. You can check tables with rates at the Mexican government site. Just to give you an idea, a person in their forties currently pays around 14,000 MXN per year (700 USD), a person in their fifties pays about 14,500  MXN (725 USD); a person in their sixties around 20,000 MXN (1,000 USD), a retired couple will pay around 3,000 MXN (150 USD) a month for public health insurance for both of them.

Disadvantages of public healthcare

• In Mexico, access to public health care is affordable. The main downfall is that as most public healthcare systems, the demand is higher than the offer, so the system is overcrowded and waiting times are long.
• Care is provided by various social security institutes that are not interconnected. This means that, in certain situations (e.g. losing your job), the continuity of your care may be disrupted. As the institutions have developed independently, decisions differ on medication and treatment options.
• As in most places in the world, the private system offers more modern facilities compared to the government-operated ones. If you’re an expat who is covered through the IMSS, you may want to look into purchasing supplemental insurance. This is particularly useful if you will reside in a more rural area where the available public care facilities are very basic.
• The IMSS does not cover some pre-existing conditions, such as malignant tumors, congenital diseases, chronic degenerative diseases, addictions, mental illness, and HIV. If you have any of these conditions, you will not be able to enroll in the IMSS insurance program. The IMSS covers other specific pre-existing conditions on deferment, which means you must wait a certain period before accessing healthcare services within the program.

An overview of private health insurance

How does health insurance work in Mexico? If you decide to take out health insurance or supplement public care with a private policy, you will want to understand the ins and outs of the private system. If health coverage is not offered to you as part of your employee benefits package, and you can afford it, you might want to consider it, as it will allow you to choose the level of care you get, and how and when it is provided.

In Mexico, private hospitals and specialist clinics have much shorter waiting lists and better infrastructure. Most expats who can afford private medical insurance will take out a plan. Private plans will cover your specific needs and provide you with direct access to private doctors, clinics and hospitals in the country. Policies are tailored to your individual situation, and premiums will depend on factors such as your age, level of coverage, and the deductible you agree to pay in the event of a claim. Bear in mind that healthcare services are mainly provided in Spanish and may not be available in English. Even though many Mexicans also speak English, particularly employees in the medical system, you should not assume that you will be seen by English speaking staff. Luckily, most private insurance providers include telephone support for their clients. They may help you find a local translator, or even provide the interpretation directly over the phone.

Types of private health insurance plans

Mexico has various trusted providers. If you decide to invest in private health insurance, it is essential for you to do serious research on what each provider covers and weigh that against your specific health needs. Look into the local hospitals in the area where you will reside and find out if they accept coverage from the provider you are considering.

Some private health insurance companies popular among expats:

• GNP Seguros
• Seguros Sura
• MetLife
• Cigna
• IMG Global Medical

What does private health insurance cover?

Just like Mexico’s public healthcare system, its private counterpart covers a wide variety of conditions, procedures, and medical needs. You will need to make sure you find a private healthcare plan that covers all your requirements. Generally, you will be able to take out either a personal or family insurance package, and premiums will depend on the level of coverage, age, pre-existing medical conditions, and lifestyle (e.g. smoking, alcohol consumption).

International health insurance companies provide different levels of medical insurance coverage. You will need to consider the services you will realistically need or use, which will depend on your overall health, among other factors. Moreover, there are many supplements that can provide you full coverage, including dental care, maternity, cancer treatments, mental health conditions, and even medical evacuation and expatriation costs.

Cost of private health insurance

Are you wondering how to get health insurance in Mexico and what it costs? When you have a clearer idea of your needs and requirements, you can find many comparison sites online, which will help you make an informed decision based on your specific needs. The costs will vary depending on the type of medical insurance, level of cover, the number of family members covered, among other factors. Costs can range from 8,500 to over 35,000 MXN (500 to 2000 USD) per year, depending on factors such as age, number of people covered, and level of coverage.

How to submit a claim your insurance company The specifics on submitting a claim vary depending on your provider. However, one necessary step for all private insurance companies is to request and keep your receipt, which is called a factura. For prescription drugs, the factura is usually both emailed and given to you at the register. Please note that you must have both to receive reimbursement.

How to find a doctor or dentist?

It is important that you know how to find a doctor and dentist when you arrive in Mexico, as your health should always be top priority. A good way to start is to ask colleagues or friends for recommendations. If you do not know a lot of people yet, why not ask other expats for advice? You can use InterNations to easily connect with people who've already spent some time in the country.

How to find a family doctor If you enroll in the IMSS, you will be assigned to both a local clinic and a family doctor or GP (médico general). This doctor will be your first point of contact. With them you will be able to attend regular check-ups and obtain prescriptions for the medications you require. If you wish to choose a doctor, then you will have to take the private health route where you will have the freedom to decide which doctors you want and have more treatment options.

How to find specialists If you need treatment for something more specific, only your assigned doctor can refer you to an IMSS medical specialist. As already mentioned, if you want to freely decide who will be your GP, or specialist, you will have to attend private healthcare facilities. Be aware that the IMSS does not cover eye care, dental care, elective surgeries (e.g. plastic surgeries), infertility treatments, or treatments for self-inflicted injuries.

How to find a dentist Medical tourism in Mexico is huge, especially in dentistry. For this reason, many Mexican dentists speak English. There is a wide range of providers, with varying levels of quality, so make sure you do proper research and go to a licensed dentist. You can certainly find quality, highly trained dentists in Mexico. To give you a clearer idea of why dental tourism is so common in the country, here is a general price comparison between common dental procedures in Mexico and the United States. While prices may vary by region and clinic, treatments in Mexico are often 50–80% less expensive than in the US.

Consulation costs A doctor’s consultation in the public sector typically costs between 350 and 950 MXN (around 18 to 48 USD), depending on the level of care and whether it’s a general or specialized service. In the private sector, consultations with general practitioners usually range from 600 to 1,200 MXN (30 to 60 USD), while appointments with specialists can cost up to 2,500 MXN (125 USD) or more.

Average wait time to see a doctor in mexico Even if you are enrolled in the private system, you may have to wait a couple of days to see a GP. To see a specialist, you may have to wait a week. However, wait times within the private system are minor in contrast to the public system.

In the public network, to get a GP appointment you have to follow a drop-in scheduling system. People start forming a line very early in the morning to get an appointment and may be seen that same morning or get scheduled for the afternoon. The average wait time for surgical procedures is around 14 weeks. The average wait time for diagnostic procedures is around 11 weeks.

Giving birth in Mexico

If you are planning on having a baby after you relocate, you will need information on giving birth in Mexico. Here, we will explain what it is like to deliver a baby in Mexico, how much it costs, if giving birth in the country automatically gives you Mexican citizenship, plus other important details.

Having a baby in Mexico as a foreigner

Most women decide to give birth in a maternity hospital, which can either be public or private. The mother must bring all important information with her to the hospital, as well as any documentation associated with her pregnancy. Parents usually bring everything their newborn will require during the hospital stay (e.g. diapers, toiletries, baby blankets).

The cost of having a baby in Mexico

Giving birth in Mexico as a permanent resident will be a different experience depending on whether you deliver your baby in the private or public system.

There is no set price for giving birth in Mexico. Costs will fluctuate based on specific birthing needs and hospital requirements. As a point of reference, a hospital package that inlcudes. basic medications, nursery and room for 1-3 days, plus the doctors and the pediatrician ranges from 30,000 to 50,000 MXN (1,700 to 2,900 USD) Consider that in private hospitals, costs may be significantly higher depending on the city, the neighborhood, and other factors.

Within the private system, you will find different birthing packages, including a range of supplies and extras. Some of the benefits of giving birth in Mexico with private insurance are that you will be able to tailor a birthing package. For instance, you will be able to select the type of room you want (e.g. junior suite, suite, master suite). All your choices will affect the final cost. Within the public system, you will have less autonomy, and you will find that many of the decisions are made for you.

Please note that you must let the private hospital or clinic know in advance that you want a package. Otherwise, they will charge you item by item, which will likely be more expensive. There are packages available for both regular births and C-sections. If you unexpectedly have to switch to an emergency C-section, you will only be charged the price difference. The OB/GYN usually bills you separately (including the nursing staff), and you will need a pediatrician for the baby following the birth.

Giving birth in Mexico without health insurance If you do not have private medical insurance and are not enrolled in the IMSS, you will still be able to give birth in the public system, but it will come at a cost. Delivery for non-affiliated individuals ranges from 10,000 to 40,000 MXN (600-2,300 USD), depending if it’s a C-section or a natural birth. If additional hospitalization is required, each extra night costs 3,000-5,000 MXN (170-300 USD). This option offers limited control over your birthing experience. Within the private system, the price will vary widely depending on the location, type of birth, and type of room, among other factors.

Giving birth in Mexico for citizenship Under Mexican law, a person born in the country is entitled to Mexican citizenship, regardless of the parents’nationality. Any exceptions to this right or specific considerations are detailed in the Law on Nationality and Naturalization.

In other words, if you give birth in Mexico, your child will be a Mexican citizen, but you will not automatically gain citizenship. Nonetheless, you will be eligible for Permanent Residency (residencia permanente).