Guide to Health Insurance and Healthcare System in Mexico | InterNations

how health works in mexico

Navigating the healthcare system of a new country is never an easy task. We help you understand the current structure of the Mexican health system, as well as explain how to access the public and private health sector and its advantages and disadvantages. In short, here we will explain and organize all the information you need to properly understand the Mexican health system. Before we delve into the topic, we’ll start with some quick facts, so you can get an idea of ​​how the local system works.

data on health care in mexico

  • Public and private health systems have their own doctors, pharmacies, doctors and medical care. these operate independent networks. people can generally only use services within your network.
  • Health care costs vary based on a number of factors, including hospital, severity of condition, location, and more. To give you an idea, for an emergency visit you can expect to pay a basic sum of between 350 and 500 mxn (15 and 25 usd).
  • a medical visit will cost you about the same as a trip to the emergency room: around 400 mxn (18 usd).
  • Mexican pharmacies are divided into two categories: first class and second class. For one thing, second-class pharmacies are easy to find, both in big cities and small towns, but be aware that they can’t sell prescription drugs. (for example, psychiatric medications). On the other hand, _first-class_ pharmacies are less numerous, but you will be able to get any type of medicine that has been prescribed for you.
  • the best hospitals in the country are in mexico city, monterrey and guadalajara. For any major medical problem, it’s best to seek treatment at any of these places.
  • Does Mexico have free public healthcare?

    Mexico’s health system is made up of a combination of private, public, and employer-sponsored health plans. The country began its efforts to provide comprehensive health coverage in 2004, with a program called Seguro Popular. this was designed to make various preventative treatments affordable to those who might not otherwise be able to access them. As of January 2020, this program has been superseded by the Health Institute for Wellness (INSABI).

    Reading: How much is health insurance in mexico

    Now, people without social security will receive free and unrestricted medical care and medicines, and will no longer need to join or pay any type of fee. insabi is a government agency that provides medical services to people who are not covered by the mexican social security institute (imss) or the institute of social security and services for state workers (institute of security and social services for state workers). status, issste).

    what does public health cover in mexico?

    The country’s health system has resources available at three different levels:

    • The first level is the insabi. this program focuses on those who are not covered by imss or issste.
    • the middle level are the national health programs of the public sector, which are the imss and the issste. Expats who are employed in Mexico are eligible for IMSS coverage, but if you are self-employed, for example, you can also choose to voluntarily enroll and pay contributions directly into the system.
    • the upper level is made up of private clinics and hospitals. These last two levels are the most applicable to expats.
    • As in most places in the world, the private system offers more modern facilities compared to those operated by the government. If you are an expat who is covered by IMSS, you may want to consider purchasing supplemental insurance. this is particularly useful if you will be residing in a more rural area where the public care facilities available are very basic.

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

      Insabi’s main function is to provide quality health care to all people residing in Mexico who are not covered by employment-based systems. this covers the following:

      • Free primary (eg general practitioner or nurse practitioner) and secondary (eg specialist physician) medical care. tertiary care (ie highly specialized treatment) is subject to fees.
      • all conditions, no exceptions.
      • catastrophic and life-threatening diseases, such as cancer and hiv, are covered.
      • medicines and supplies necessary for the treatments.
      • That said, there are discrepancies between what the government promises and what is actually materializing. reports suggest that in some hospitals, medications and medical supplies (eg, gauze, ointments) are not readily available and patients must pay out of pocket.

        Please note that public hospitals and health centers in Mexico are overwhelmed. Expats should consider purchasing private health insurance. private hospitals in mexico are also equipped with the latest technology, you will get a more personalized treatment and you will have shorter waiting times.

        how does health work in mexico?

        the mexican social security institute (imss) provides health services to both mexican citizens and expatriates residing legally 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.

        Funding for this program comes from the federal government, employer payroll taxes, employee payroll taxes, and individual contributions from people who are not formally employed.

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        Below are two enrollment paths.

        • Any person (Mexican national or resident abroad) who is formally employed in the country pays their contributions to the IMSS as an employee. it is possible to have other private health insurance to complement it.
        • there is the option of voluntary affiliation, which is open to people who do not have a formal job and others who want to join voluntarily. Expats who have temporary or permanent residency status and are not formally employed (for example, retired) can apply. Please note that people who enroll in IMSS through an employer have priority over those who enroll voluntarily.
        • Expats who wish to voluntarily enroll must have legal resident status. To qualify, you must be a temporary resident (temporary resident) or permanent resident (permanent resident). Foreigners with fmm visitor permits (multiple migratory forms) do not qualify.

          the issste (mexican institute of services and social security of the civil service) is a federal government organization, which partially administers the health and social security systems of mexico. assists federal workers in cases of disability, old age, high-risk jobs and death. imss and issste provide medical care to 55-60% of the population of mexico. the insabi covers people who do not qualify for the issste or the imss.

          health costs in mexico

          for the imss, the costs depend on your age and there are some restrictions and limitations. You can check tables with rates on the Mexican government website. just to give you an idea, a person in their forties currently pays around 7,000 mxn a year (320 usd), a person in their fifties pays around 8,500 mxn (385 usd); a person in his sixties is around 12,300 mxn (560 usd).

          imss does not cover some pre-existing conditions, such as malignant tumors, congenital diseases, chronic degenerative diseases, addictions, mental illnesses and hiv. If you have any of these conditions, you will not be able to enroll in the IMSS insurance program. IMS covers other specific pre-existing conditions in deferral, which means you will be subject to specific waiting periods before you can seek health care services under the program.

          pros and cons of the Mexican health system

          A good way to explain the Mexican health system is to shed light on its advantages and disadvantages. We have compiled this list to help you better understand the situations you will face in your new home.

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          advantages

          • public health care is affordable. Keep in mind that the older you get, the more you pay. But, even if you are a retiree, it will still be more affordable than in many developed countries around the world, including the United States. just to give you an example, a retired couple will pay around 2,200 mxn (100 usd) per month for health insurance for both of them.
          • many mexican doctors and dentists do at least part of their training in the united states and continue to go to the united states or europe for continuing education. this means they speak English, which makes it easier for expats to communicate with medical staff.
          • If you opt for private medical insurance, or take out complementary insurance, you will have access to the best facilities, equipped with the latest technology.
          • disadvantages

            • care is provided by several social security institutes that are not interested, this means that in certain situations (for example, losing your job), the continuity of your care may be interrupted. Because the institutions have developed independently, decisions about medications and treatment options differ.
            • Public health services do not have reciprocal agreements with other countries. this means that foreign programs like us medicare are not available in mexico. therefore, both visitors and foreign residents who are not enrolled in public programs must make private health care arrangements.
            • the quality of care across the country is not well balanced; the best attention is centralized in the big cities. For example, it will be a very different experience to receive care in Mexico City, where there are 2.4 beds available for every 1,000 inhabitants, than anywhere in the state of Chiapas, where there are only 2 beds for every 2,000 people.

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