IMSS -

One

Possibility

for

Health

Insurance

Coverage

in Mexico…

Well, friends, I really messed up sending out my email notice last week – some of you may have received as many as 4 notices, one right after the other – so sorry. When that happened, I just canceled the whole process and decided to give the computer and me a break!  We’re all ready to give you more info now…

IMSS, Mexico’s national health insurance, is offered to anyone living in Mexico – retirees originating from another country as well.

Many expats decided to forego insurance completely, and just put money aside for anything that may come up.  Remembering, that as long as you are a citizen of the United States, you can return to the States at any time, and have your Medicare take over. That gives a person a bit of a safety net, just in case.

While IMSS health insurance offers a very low-cost option, the annual fee for persons over 60 is approximately 3,500 pesos  (about $260.00 US) a year,  it is not exactly the insurance you are used in the States.  IMSS is sometimes compared more to Canada and Great Britain’s systems – probably because you may have to wait for appointments, especially to specialists – but, shoot, I’ve waited for appointments in the States!

Let’s do a quick walk-through:  For example, you need a doctor:   Your first step, under IMSS, would be to go to Unidad Medicos Familiares (Family Care Clinic), and have a consultation with your family doctor.  All of these clinics include a pharmacy on the premise, but the quality of these clinics can vary significantly, with some better equipped than others – having the capability of lab testing and x-rays.  If you have gone to the doctor for something not significant, you are done – the doctor will probably give you a prescription, which you will fill right there – you go home and get well.  It you need further aid, such as a specialist, then you will be sent by your family doctor to one, who are at either regional clinics, hospitals, or medical centers.  Many of the Family HealthCare Clinics have limited hours – they are not equipped for serious emergencies, so they send you one step higher. 

For an emergency, you would go straight to any IMSS clinic or hospital.  You are assigned to a hospital and that is where it’s preferred you go – but if you are in another area at the time of your emergency, you would go to the nearest hospital.

IMSS health coverage includes dental care (extractions and fillings only), eye, ear, hospital, and medical, and also includes lab tests, x-rays, reconstructive surgery and mental health consultations, and prescriptions.

Hospital care in Mexico is usually up to par with what you are already accustomed to in the States. 

Some of the cons:  You must have the proper Visa.  Your family doctor may be different each time you go to Clinic.  Your files are there, it’s just that the doctor you have seen may not be there when you have your appointment.  And, appointments may take a while to get – get used to waiting – so, make your appointments early, if possible, especially for just checkups, etc.  There is not always someone there who speaks English – I’d suggest taking a friend who knows Spanish pretty well.  You must not let your coverage lapse.  You can and should pay your renewal one month before your actual coverage runs out.  Hours at the Clinics are limited, so work your visits into your schedule and just accept that you may be there waiting all day…after all, it’s Mexico. 

I’ll probably follow up my next article, telling you the process to apply for IMSS…keep reading!  

So, here’s all the rest of the info I promised :) – I feel I owe it to you:

To apply for IMSS, you will need: 

1. Birth certificate,

2. Proof of Marital status,

3. Proof of Citizenship (your Passport),

4. Two photos of the applicant,

5.  Valid proof of your status in Mexico (FM3, Temporary, etc),

6.  A filled out questionnaire, in Spanish.  This is to detect chronic diseases that may preclude IMSS acceptance, and includes chronic degenerative diseases, cancer, HIV, renal disease, diabetes, heart disease and psychosis,

Then, you must undergo a checkup with a family doctor.  If any of the above shows up, you may need to have further tests.  The detection of such diseases in the first six months of IMSS affiliation may lead to being rejected without return of the application fee. However, if a chronic disease develops after the first year of affiliation, you should have no reason to be rejected. 

Certain services, such as care for pregnancy, are not available during the first 10 months of IMSS affiliation. There is also a waiting period of one year for all gynecological surgery, and two years for orthopedic surgery, after acceptance.

After you have received your IMSS Card, you must go to your local IMSS clinic so they can assign a Doctor to you.  Take with you your IMSS cards, proof of payment for your IMSS, and your health questionnaire (in Spanish).

Private insurance is another option for your life in Mexico.

Health, IMSS article by Barbie