Understanding IMSS: Mexico’s Healthcare System
Mexico’s social security system, the IMSS (Instituto Mexicano de Seguro Social) is accessible for expats moving into the country for work, while employed individuals should be automatically registered due to a small fraction of their salary going towards cost coverage.
Discover the world's top
health insurers.
Compare quotes with
a click of the button.
In this blog post by Pacific Prime, we will be going over Mexico’s IMSS healthcare system to ensure expats living in Mexico can access quality healthcare in Mexico.
Introduction to the IMSS
The IMSS, short for Instituto Mexicano de Seguro Social, is Mexico’s social security system that is free for Mexicans and eligible foreigners. Foreigners who are eligible for the IMSS include expats with residency status who are employed full-time by IMSS-registered companies.
On the other hand, foreigners in Mexico who aren’t working in an IMSS-registered company or those who aren’t employed can buy IMSS health insurance separately for a small monthly fee. Under the IMSS, those who work for Mexican companies will pay a small percentage of their salary each month.
In addition to granting access to healthcare in Mexico, the IMSS also provides insurance coverage for the employees’ salaries in case they are unable to work due to illnesses or injuries.
Enrolling in IMSS
When enrolling in the IMSS, two ways expats can enroll include enrolling through employment or voluntary enrollment. Do keep in mind, however, that the entire application process, along with the information and healthcare services, is completely in Spanish.
You will need a Spanish-speaking friend or translator to help you navigate through the application process if you cannot speak Spanish. Below are the two main methods of enrolling in the IMSS.
Employment in Mexico
Mexican nationals or expats officially employed in Mexico must pay for their employee IMSS contribution (which is approximately 2.78%) regardless of whether or not they have any other private health insurance plan.
Voluntary Enrollment
For those who are not employed in Mexico and would prefer to enroll independently, voluntary enrollment for the IMSS is a viable alternative. This option would be appropriate for expats who wish to retire in Mexico. The enrollment cost will vary depending on your age.
For instance, an IMSS voluntary enrollment will cost around USD $63 (approximately 1,119.67 Mexican pesos) for those aged 50-59 and around USD $93 (approximately 1,652.84 Mexican pesos) for those aged 70-79.
However, keep in mind that if you wish to enroll for the IMSS voluntarily, you will only be eligible if you have legal residency status (Residente Temporal or a Residente Permanente, foreigners with the FMM Mexico Tourist Visa are not eligible) in Mexico.
IMSS Application
You can apply online or at your local IMSS office. If you wish to apply at your nearest IMSS office, you will need both the originals and copies of the required documents below.
- Current passport(s)
- Current residency permit(s)
- Proof of address
- Marriage certificate (if any)
- Birth certificate
- The IMSS application form and health questionnaire
- Two passport-sized (2in X 2in) photographs
- Proof of payment of the fee for each family member
Note that documents from your country such as the birth and marriage certificates must be translated into Spanish and apostilled (legalizing documents) before submitting.
After Your IMSS Enrollment
Once you have successfully enrolled, your coverage will start right on the first calendar day in the next month and you will then be assigned to a local clinic where you’ll see your doctor for checkups and prescription medications.
Your assigned doctor will make a referral to IMSS medical specialists if you need specialist services.
When the doctor prescribes medications, you can obtain them at no additional cost at the local IMSS office-connected pharmacies.
In case the medication is not available at the pharmacy, the doctor will provide a prescription allowing you to buy it at a private pharmacy but you will have to pay for the medication separately.
IMSS Healthcare Quality in Mexico
Much like the public healthcare sector in any other country, there will be waiting periods for non-emergency cases and public hospitals can be crowded. However, IMSS members who are covered as part of their employment are given priority over those who are independently enrolled.
Healthcare quality will vary depending on where you are in Mexico and the demand for healthcare services when you seek treatment. Expats have expressed both satisfaction and dissatisfaction when it comes to IMSS healthcare quality.
Due to potentially long waiting times and crowded public hospitals, investing in an additional private health insurance policy is strongly recommended due to its additional perks and coverage.
However, regardless of whether it’s the public or private healthcare sector in Mexico, you will be happy to know that Mexico is a popular medical tourism destination among expats thanks to inexpensive medical treatment in comparison to the US or Canada.
Public Health Insurance Coverage in Mexico
Public health insurance for expats in Mexico covers basics such as accidents and emergencies along with prescription medication. Below are the various areas public expat health insurance in Mexico covers.
- Accidents and emergencies (during your first year of coverage).
- Surgeries and other health conditions (second coverage year onwards).
- Prescription medication by your doctor.
- Part of your salary if you are unable to work due to illnesses or accidents for up to 52 weeks.
Depending on the location in Mexico, if you are enrolled only in the public health insurance scheme, there are specific doctors and clinics you can visit. However, this also means you can’t choose specific doctors nor can you get treatment in private clinics or hospitals without upfront payment.
Public hospitals and clinics may also lack bilingual or multilingual doctors, which can be incredibly problematic for non-Spanish speakers.
Private Expat Health Insurance Coverage in Mexico
On the other hand, despite higher premiums, private health insurance for expats in Mexico makes up for it with a greater range of coverage areas such as dental and vision care and
rehabilitation. Below are the additional areas private expat health insurance covers.
- Dental treatment
- Vision treatment
- Mental healthcare
- Inpatient treatment
- Outpatient treatment
- Physiotherapy
- Rehabilitation
- Pre-existing conditions
- Evacuation or repatriation
- Travel Insurance
Where private health insurance in Mexico shines is the higher quality of care and giving expats freedom when it comes to selecting specific doctors they would like to seek treatment from. This is especially beneficial for non-Spanish-speaking expats seeking treatment in Mexico.
IMSS Exclusions
The IMSS will not cover the following pre-existing conditions.
- Congenital conditions
- Chronic degenerative conditions
- Malignant tumors
- Addictions
- HIV
Anyone with the aforementioned conditions will not be eligible to enroll in the IMSS health insurance program. On the other hand, certain pre-existing conditions may be covered on deferment, which is when healthcare services are covered under the program after the waiting period is over.
Frequently Asked Questions
Who pays the IMSS in Mexico?
Individuals employed in Mexico are automatically enrolled in the IMSS system and their IMSS contribution will be deducted from their salary. Those who aren’t employed in Mexico can also enroll in the IMSS system but they’ll have to pay annual contribution fees.
How can I register with the IMSS system in Mexico?
You can apply online or in person at the nearest IMSS office available. When applying in person at the office, you will need to submit the required documents, both original and their copies.
What are some benefits of IMSS in Mexico?
IMSS-registered employees are entitled to healthcare services ranging from general consultations to specialized treatment and hospitalization.
What are some benefits and drawbacks of public and private healthcare in Mexico?
Public healthcare is more affordable but at the cost of longer waiting times and the inability to choose specific doctors and clinics. Meanwhile, despite being more expensive, private healthcare grants greater coverage and free specialist selection, which is great for non-Spanish-speaking patients.
Are pre-existing conditions covered?
The IMSS will not cover any pre-existing conditions and anyone with such conditions will be deemed ineligible for enrollment. These conditions include congenital and chronic conditions, malignant tumors, addictions, and HIV.
Conclusion
In conclusion, you can either enroll in the IMSS health insurance system either through employment with a registered Mexican company or you can enroll independently. If you are enrolled in the IMSS through your employment, however, you will be given priority in hospital waiting times.
During the application, keep in mind that the entire process will be in Spanish so it is highly recommended that you have a Spanish-speaking friend or a translator help you throughout. Remember to also submit all required documents along with copies and make sure to legalize specific documents.
As a leading international health insurance broker, Pacific Prime has over 20 years of helping match both local citizens and expats to a health insurance plan that matches both their budget range and their unique healthcare needs.
Whether you’re a local citizen in Mexico or you’re an expat living in Mexico, our team of specialists is more than happy to help you find the right health insurance plan you need. And if you have any further questions, please get in touch with us.
Enjoyed this article? Check out our other articles below!
Best International Health Insurance for Expats in Mexico
Serena earned her Bachelor’s Degree in Psychology from the University of British Columbia, Canada. As such, she is an avid advocate of mental health and is fascinated by all things psychology (especially if it’s cognitive psychology!).
Her previous work experience includes teaching toddlers to read, writing for a travel/wellness online magazine, and then a business news blog. These combined experiences give her the skills and insights she needs to explain complex ideas in a succinct way. Being the daughter of an immigrant and a traveler herself, she is passionate about educating expats and digital nomads on travel and international health insurance.
- A Guide to Hospitals in Turkey for Expats and Visitors - October 11, 2024
- Hospitals in Cuba for Expats - October 11, 2024
- AXA Thailand: Top Thailand Insurance Provider For Expats - October 11, 2024
Helpful Articles
Thailand Vs. The Philippines – A Travel Guide
Best COVID Travel Insurance In Thailand For Travelers
LUMA Health Insurance in Thailand: For Expats and Travelers
Travel Insurance For Thailand Resident: Types Of Plans
Comments
Comments for this post are closed.
We'll notify you
when our team replies!