Sarah Bennett
Mexico has a range of healthcare services available to its citizens and tourists, including cosmetic surgery, dental care, and eye care. Many US citizens travel to Mexico for medical procedures, including vaccines. While Mexican law heavily regulates the manufacturing, production, distribution, import, export, sale, and prescription of drugs and vaccines, it is unclear whether vaccines are covered under Mexican health insurance. Tourists are advised to consult with a US healthcare professional and review their health insurance plan to determine what medical services are covered during their trip to Mexico.
| Characteristics | Values |
|---|---|
| Vaccines covered under Mexican health insurance | Basic vaccination schemes (CBS) for children under 5 years old include vaccines against pneumococcus, acellular pentavalent, Sabin, and BCG |
| Estimated coverage | In 2018, all states had estimated coverage of less than 32%, with the lowest in the northern region. In 2000, 7 out of 32 states had estimated coverages greater than 80%, and only 2 states were greater than 50% in 2018 |
| Factors associated with incomplete vaccination schemes | Rural areas, households without health insurance or with low levels of schooling, and indigenous communities |
| Mexican public healthcare insurance | IMSS (Instituto Mexicano de Seguro Social) is available to foreign residents on a voluntary basis, providing access to doctors, clinics, hospitals, and some medications |
| Other options for foreigners | INSABI is a free medical service providing preventative health, medical and surgical services, and medicines |
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What You'll Learn
- Foreign residents can voluntarily apply for Mexican public healthcare insurance, IMSS
- IMSS provides access to doctors, clinics, hospitals and some medications
- The cost of IMSS coverage depends on age, and pre-existing conditions may disqualify applicants
- INSABI is a free medical service available to all Mexican residents without other insurance
- Mexico is the only country without universal healthcare
Foreign residents can voluntarily apply for Mexican public healthcare insurance, IMSS
Mexico operates a public healthcare program called Seguro de Salud Para La Familia, commonly referred to as "el IMSS" (Instituto Mexicano de Seguro Social). The program provides defined healthcare services to payroll employees and others who voluntarily enrol in the system.
Foreign residents in Mexico who are not working for an IMSS-enrolled company or are not working at all may choose to buy IMSS health insurance separately for a small monthly fee. This is a good option for foreign residents who have chosen to retire in Mexico. To qualify for voluntary enrolment, non-Mexicans must have legal residency status (Residente Temporal or Residente Permanente). The annual fee for voluntary enrolment varies depending on age; for example, a person in their 60s currently pays $18,300 pesos per year.
IMSS members who are employed and pay their contributions through payroll taxes are given priority over those who enrolled independently and pay a voluntary contribution. The reported quality of care varies depending on location and local demand for health services. Some foreign residents report good care from IMSS, while others report disappointments and shortcomings. As with other large, publicly-funded healthcare systems, the demand for services often exceeds the supply of resources.
IMSS coverage is only available in Mexico and does not include medical evacuation from the country. Hospital treatment under IMSS requires family and friends to provide support and bring amenities to the patient. IMSS does not cover eye care, dental, elective surgeries, infertility treatments, or treatments for self-inflicted injuries. Pre-existing conditions such as cancerous tumours, congenital illnesses, chronic diseases, addictions, mental illness, and HIV are also not covered.
Expats who can afford it often opt for private health insurance, which provides access to top facilities equipped with the latest technology. Private insurance is also recommended as a supplement to IMSS coverage.
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IMSS provides access to doctors, clinics, hospitals and some medications
Mexico operates a public healthcare program called the Instituto Mexicano de Seguro Social (IMSS). The IMSS provides access to doctors, clinics, hospitals, and some medications.
The IMSS is funded by a combination of federal government, employer and employee payroll taxes, and individual contributions. Employees of Mexican companies pay a percentage of their salary each month to be enrolled in the program, and their employers also contribute. This payroll tax is payable even if the employee takes out a private insurance plan.
If you are employed in Mexico, you should be automatically registered in the IMSS program. If you are not employed, you can still enroll in the program voluntarily by paying an annual fee, which varies depending on your age. For example, a person in their 60s currently pays $18,300 pesos per year.
Once enrolled, you will be assigned to a local clinic where you will see your doctor for check-ups and prescription medications. Your assigned doctor is the only person who can refer you to IMSS medical specialists if you require specialist services. Medications prescribed by your doctor can be obtained at no additional cost at the pharmacy connected to the local IMSS office. However, not all medications are available this way, and if the medication you need is not available, the doctor will give you a prescription to fill at a private pharmacy, which you must pay for separately.
It is important to note that the IMSS does not cover pre-existing conditions, and anyone with such conditions is ineligible for enrollment. Pre-existing conditions include congenital and chronic illnesses, malignant tumors, addictions, and HIV. The IMSS also does not cover eye care, dental, elective surgeries, infertility treatments, or treatments for self-inflicted injuries. Additionally, the IMSS does not provide medical evacuation from Mexico.
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The cost of IMSS coverage depends on age, and pre-existing conditions may disqualify applicants
Mexico operates a public healthcare program called Instituto Mexicano de Seguro Social (IMSS) that provides healthcare services to payroll employees and others who voluntarily enrol. The cost of IMSS coverage depends on the enrollee's age, with fees ranging from $218 to $590 per year. For instance, a person in their 60s currently pays $18,300 pesos per year, while a retired couple in their 60s would pay about $37,000 Mexican pesos per year for IMSS insurance coverage. The cost of IMSS is evaluated and adjusted every February.
While IMSS does not have an age cap, certain pre-existing conditions may disqualify applicants from enrolling in the program. These conditions include malignant tumours, congenital diseases, chronic degenerative diseases, addictions, mental illness, and HIV. If an applicant has any of these pre-existing conditions, they are excluded from the IMSS insurance program. Other specific pre-existing conditions are covered on 'deferment', meaning applicants with these conditions can still join the program but must wait before seeking healthcare services related to their condition.
Additionally, individuals with pre-existing conditions may face longer waiting periods for non-emergency procedures, as IMSS members who receive coverage through formal employment are given priority.
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INSABI is a free medical service available to all Mexican residents without other insurance
Mexico's national healthcare system offers two primary choices: IMSS and INSABI. The IMSS system (Instituto Mexicano del Seguro Social) is a part of the national Social Security program and was designed for employees, though expats who are either temporary or permanent legal residents can also apply. However, IMSS excludes many pre-existing conditions, which might prevent participation in the program or necessitate waiting periods before treatment is covered.
INSABI, on the other hand, is a free healthcare plan established for people with pre-existing conditions and those who cannot participate in IMSS for financial reasons. It is funded by government resources, NPOs, and private companies from different industries and individuals that donate various items. It is the only healthcare system in Mexico that does not require underwriting, and it offers free medical insurance to people who are typically down on their luck. It covers specialized medicine, including diseases or procedures requiring highly modern and specialized technology, such as traumatology, cardiology, and neurology.
According to the Mexican constitution, all citizens are entitled to have access to free healthcare provided through publicly funded programs like INSABI. This benefit also extends to expats with permanent residential status. There is no age limit to enrol in INSABI, although this may change in the future as the program is still under evaluation. To qualify, one must be a resident of Mexico and bring their CURP and ID to the INSABI facilities for enrolment. Additionally, the location of residence is a factor in qualifying, as INSABI is meant for poorer communities in Mexico.
It is important to note that INSABI does not cover all conditions, and more serious medical conditions are not fully covered. Most medicines for major conditions are not provided, and patients are expected to cover between 40-60% of the cost. While INSABI offers free healthcare, the quality of care may be influenced by external factors such as a language barrier and limited resources.
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Mexico is the only country without universal healthcare
Mexico's healthcare system is multifaceted, comprising public institutions overseen by government departments, private hospitals and clinics, and private physicians. The Mexican Constitution guarantees every citizen access to free healthcare and medication. However, the system is not truly universal, with varying accessibility standards across the country. While Mexico has made significant strides in healthcare reform, it lags behind other OECD countries in health status and availability.
In 2020, Mexico introduced universal healthcare, administered by the Instituto de Salud para el Bienestar (INSABI). This system provides free consultations, medications, surgeries, and dental and vision care to all citizens, regardless of their employment status. However, it replaced the Seguro Popular program, which had successfully provided healthcare to the poor, indicating ongoing challenges in equitable access.
Mexico's healthcare system is characterized by ongoing evolution and heterogeneity. The private healthcare sector accounts for approximately 52% of total health spending, with higher activity than its public counterpart. This sector is preferred by medical tourists, but it can be costly for uninsured Mexicans, who may face out-of-pocket expenditures.
While Mexico has made progress toward universal healthcare, it is not yet fully realized. The system faces issues with geographical distribution of professionals, long waiting lists, and varying accessibility. Additionally, many diseases in Mexico, such as those spread by bugs, cannot be prevented with vaccines or medicine, further complicating the healthcare landscape.
Regarding vaccine coverage, Mexico has authorized several COVID-19 vaccines for its citizens. Childhood vaccines are also free in most states, and vaccine doses administered in Mexico are typically valid in the US. However, it is unclear if vaccines are covered under Mexican health insurance, and uninsured individuals may need to rely on county health departments or travel to Mexico for free or affordable options.
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