Overview of the Mexican Healthcare System
Overall, the healthcare system in Mexico offers good standards and operates efficiently. Healthcare is affordable and large cities, in particular, have superb hospitals and clinics. A large number of Mexican doctors go to medical school or do extra training in the United States or Europe. As such, there is a high percentage of doctors who speak excellent English. And, remarkably, many still perform house visits, a rarity in modern medicine. However, there are still a large number of people who cannot afford more than the most basic care. As well, the Mexican government has one of the lowest per capita healthcare expenditures of all OECD countries.
The Healthcare System in Mexico: Understanding Three Tiers
The health care in Mexico focuses on a 3-tier system. The Mexican social security program, known as the IMSS, covers employees in the private and public sectors. In short, if you work for a Mexican company, you directly quality for medical coverage under the IMSS. The employee’s portion of the costs comes directly off from their paycheck. Workplace HR staff do all the paperwork, making participation in the IMSS very easy. The cost of the coverage through IMSS is very affordable, costing approximately US$500 per year.
A second option for participating in Mexico’s public health insurance system is the Seguro Popular program. The Seguro Popular was set up to provide for those who don’t qualify for the IMSS tier, either due to financial reasons or because of pre-existing conditions. Those covered by Seguro Popular are primarily the unemployed, the homeless, and those with exclusionary medical conditions. Theoretically, between Seguro Popular and IMSS, everyone in Mexico should be covered through the public system at a price they can afford.
The final tier in Mexico’s health care system is provided through private insurance. This is a desirable option for many people as the private healthcare system offers greater comfort and privacy. However, it is very expensive compared to the public system.
Who is Eligible for the IMSS – Health Care in Mexico
In theory, at least, signing up for healthcare in Mexico is easy for citizens and legal permanent residents. For most people, to be eligible for the IMSS you have to be fully (and formally) employed in Mexico. As such, your employer makes the necessary arrangements with paperwork and to set up paycheck deductions.
Alternatively, if you aren’t formally employed you can also still join through voluntary enrollment. This is an option open to those who aren’t employed but still meet the requirements of being a legal resident of Mexico, such as expat retirees.
Mexican citizens who grew up with the IMSS are familiar with the system and it feels natural to them. For expats in Mexico, however, the IMSS is entirely new. Without the support of a formal employer, voluntary enrollment might seem intimidating. You begin the application process by visiting a local IMSS office in your community and filling out multiple forms. Unless you read and write excellent Spanish, bring along a local friend or hire an interpreter to help you with the formalities. Occasionally, applying might require you to revisit the office on several occasions to supply the staff with all the paperwork they need.
Costs of the Mexican Healthcare System
The healthcare system in Mexico is part of the national social security program. It’s funded in part by employees and employers who contribute to the IMSS each month. It’s further augmented by funding from the federal government, which is raised through general taxation.
A simple doctor’s office visit costs about 400 pesos or roughly US$20. Diagnostic tests can cost up to a third less in Mexico compared to the United States or Canada. However, costs can quickly add up for more complicated procedures. Tourist and expats should be aware that certain healthcare facilities in areas with large international tourist populations have been known to inflate medical charges. Even short term travelers should carry comprehensive insurance.
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The Differences Between Private and Public Care
Like many countries, there’s a gap in the quality of care found in rural areas versus urban areas. Public hospitals are often crowded and the primary language spoken will be Spanish, especially in rural areas. Private hospital rooms, a greater range of specialists, and shorter waiting times are some of the perks you can expect to enjoy if you supplement your coverage. While it’s generally not a problem to find an English speaking doctor, private health insurance all but guarantees it, along with private rooms in more comfortable and modern facilities. This difference in standards of coverage is a primary motivator for people to carry supplemental health insurance.
Healthcare Options for Expats and Foreigners in Mexico
For expats, the IMSS is fantastic for offering comprehensive healthcare insurance at a low price. However, it has one major drawback. Pre-existing conditions preclude participation. Such conditions include but are not limited to cancer, diabetes, heart disease, and addictions. A full list of exclusions can be found here. As such, private health insurance coverage is a more comprehensive option. If you’re not able to get coverage through your job, compare private health care plans to choose one that offers the best value and coverage.
Tourists and other short term foreign visitors aren’t eligible for any public health insurance coverage and thus should travel with their own travel medical insurance and emergency coverage.
It’s a smart idea for all visitors to keep a reserve of cash on hand in your bank. In many cases, clinics and hospitals in Mexico don’t participate in direct billing programs for international insurance. Patients have to pay before leaving the hospital and submit the relevant paperwork in for reimbursement. And, in some cases, you’re even required to pay before you are treated.
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Special Information About Pharmacies
Pharmacies in Mexico have a unique set up that’s not found anywhere else. There are two classes of pharmacies in Mexico – and it’s not the same as the usual pharmacy versus drug store distinction found in many other countries.
In Mexico, pharmacies are broken into two basic groups: Segunda Clase and Primera Clase. Segunda class pharmacies are incredibly common, both in big cities and small towns. However, this group isn’t allowed to sell regulated medicines. Think of it as a kind of ‘pharmacy-lite’. Common antibiotics and other everyday drugs like cholesterol medication and allergy treatments are available there. However, regulated medications which pose a high risk of abuse aren’t found at a Segunda Clase pharmacy. The Primera Clase pharmacy, which is a bit harder to find, has no restrictions at all. You can get any medication you have a prescription for, including pain killers and other drugs which are potentially addictive. Hopefully, you will never be so ill to required this class of medication but, if you are, ask for your doctor for directions to the closest Primera Clase pharmacy.