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IMSS Mexican Public Health Insurance

Thu, 29 Apr 2021 11:50:43 +0000

How Do I Enroll in IMSS?

In 6 minutes (or less!), Know Everything You Need to Know to about Public Health Insurance in Mexico

We’ve filtered through the bureaucratic nightmare that sometimes arises when government and insurance intersect. We’ve created this easy guide to enrolling in IMSS, Instituto Mexicano de Seguro Social.

With this quick read, we cut to the chase giving you all the needed information so that you know:



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What is IMSS?

The Mexican Healthcare System offers both public (government-funded) and private options for insurance and care. Their primary public option is IMSS, but it is important to understand the entire system. Health insurance in Mexico can be broken down into three categories:

  1. IMSS: Public healthcare usually comes through the IMSS, Instituto Mexicano de Seguro Social . If you legally reside in Mexico and you are formally employed in Mexico, you and your employer are required to enroll you in IMSS. Deductions are automatically deducted from monthly salaries. If you are self-employed, you can apply for IMSS insurance. IMSS can also be obtained by foreign residents by voluntarily enrolling and paying an annual fee.
  2. Private Insurance: Private medical insurance policies can be purchased by an individual. This would consist of a plan of their choosing provided by a non-governmental agency which uses private medical professionals. These plans typically provide the same core benefits as a plan in the U.S. and often have many options available such as dental, vision and even emergency evacuation coverages. They are often purchased by individuals covered by IMSS who desire more benefits and less wait time for medical services.
  3. INSABI: Public healthcare that provides health care to individuals who are not covered by IMSS or their own private insurance.

The cost of annual IMSS enrollment

EconomicIntermediateGoodDeluxe
ExteriorStucco, Vinyl PaintBrickStone FacadeMarble, Polarized Glass
FloorTile, Vinyl TileLow Quality CarpetQuality Carpet, Ceramic TileMarble or Granite, Fine Rugs
WallsStucco, or plaster and paintKnockdown, Vinyl Paints, WallpaperDecorative Plaster, Good Quality, Ceramic or Wood TrimImported Wood Trim, Upholstery Fabrics, Mirrors, Textured Plaster
BathroomsMinimal and AustereMedium Quality White Fixtures, TileGlazed Ceramic Coatings, Marble colored Fixtures, Marble, GraniteImported and Decorated Ceramics, Quality Mirrors, Textured Plaster
Window FramesThing Gauge GlassDouble PaneTwo Inch wide Aluminum FramesGreater Than Two Inch Wide Aluminum Frames
Door LocksCommonMedium QualityHigh Quality or ImportedHigh Security Plates, Imported, Controlled Key Reproduction, Digital system or Magnetic Access
CarpentrySimple Doors and Closets, Pine or EquivalentVarnished Pine WoodImported or Exotic Woods (Cedar, Mahogany, or Similar) closets with Quality FittingsFine Wood Doors, Specialty Designed Closets, Fine Wood, High Quality Fittings

*Fees for IMSS as of March 1, 2021
**Annual Fee is in MXN
Source: https://www.gob.mx/imss/articulos/homoclave-imss-02-014?idiom=es


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The Application and Registration Process for IMSS

According to the IMSS website, you will need the following documents to enroll in IMSS:

  • Certified copy of your Marriage Certificate (if applicable) – must be translated to Spanish and apostilled/notarized
  • Valid official identification (i.e., passport)
  • Unique Population Registry Code (CURP – Clave Única de Registro de Población)
  • Proof of payment of the anticipated annuity (for each member of the family group)
  • Certified copy of applicant’s birth certificate – must be translated to Spanish and apostilled/notarized
  • Proof of address
  • IMSS application
  • Medical questionnaire provided by the IMSS
  • Two recent passport-size pictures

Once you have enrolled, you may begin using IMSS medical services (medical-surgical, pharmaceutical and hospital assistance) on the first day of the following month.

A Note from the experts at MexInsurance.com® on language assistance:

  • Webpages: If an IMSS webpage appears in Spanish, and you would like to view it in English you should be able to translate the page into English on your computer. Give us a call or email us if you are having trouble viewing the page in English. We are happy to help.
  • Registration Forms (also referred to as “Procedures”): While some information and forms are translated, a working knowledge of the Spanish language is recommended for navigating the system. If you are not a fluent speaker, it is advised that you have a native speaker assist you in the process.

Once you have enrolled, you may begin using IMSS medical services (medical-surgical, pharmaceutical and hospital assistance) on the first day of the following month.

A Note from the experts at MexInsurance.com® on language assistance:


FIND LOCAL IMSS OFFICE AND REGISTER


ENROLL FOR IMSS ONLINE HERE

Is IMSS the right choice for YOU?

Some foreigners choose to use the IMSS system. Yet, the preferred choice of expats is to opt for private international
health insurance. Why? This is because private plans [link to health insurance page] are often surprisingly affordable
for the significant increase in the quality of care they provide compared to the IMSS option. IMSS can be an
acceptable choiceif you have the right temperament. Ask yourself the following questions as you consider which
Mexican insurance option is best for you.

Do you mind waiting for an appointment?

The reality is that the quality of care with IMSS is decent, but the waits are not what foreigners are typically accustomed to. Sometimes it takes months to get in to get in to see a specialist.

Are you enrolling in the plan as an individual or through a Mexican employer?

If you are not enrolled in IMSS through a Mexican employer, but rather purchase it voluntarily as an individual (or family), you should know that employed participants receive priority treatment and services.  You should consider whether you mind if others have priority access to services.

Do you prefer to pick your own doctors?

You do not have a choice in doctors with IMSS. They are assigned to you. Your assigned doctor will be your first stop for medical care. Your assigned doctor is where you will attend regular check-ups and get needed prescriptions.

Do you want a policy that includes dental, vision or emergency transportation to your home country?

IMSS does not offer these options.  International, private insurance includes these options for coverage.

Do you have many prescriptions that you would like covered?

IMSS covers a more limited number of prescriptions than private insurance.

Is language and cultural fluency an issue for you?

For some people, language and cultural differences can be an issue with IMSS. Thankfully, many Mexican health professionals speak English, but most services are provided in Spanish. If language is of concern to you, it is helpful to know that most private insurance carriers offer customer service and help with the language barrier via phone or live chats. For example, Cigna, our preferred Mexican health insurance provider, even offers case management services for their customers.  A case manager that speaks your preferred language can be assigned to you.  Your assigned case manager is then available to help manage your care and help you navigate the Mexican healthcare system in your native language.

Do you have pre-existing conditions?

Not all pre-existing conditions are covered by IMSS. Some conditions require a waiting period before being covered by IMSS as well. You should seek more specific information from IMSS regarding coverages if you have a chronic or pre-existing condition.

Pre-existing conditions include tumors, chronic degenerative diseases (late complications of diabetes mellitus), hoarding diseases (Gaucher disease), chronic liver diseases, chronic kidney failure, valvular heart disease, heart failure, sequelae of ischemic heart disease (arrhythmia, angus, or myocardial infarction), chronic obstructive pulmonary disease with respiratory failure, among others.

Chronic conditions include: chronic systemic diseases of the connective tissue, addictions such as alcoholism and other drug addictions, mental disorders such as psychosis and dementias; congenital diseases and Acquired Immunodeficiency Syndrome or Human Acquired Immunodeficiency Virus (HIV)

Will you be in an urban or more rural area?

Medical services in Mexico are more readily available in big cities.  They are sometimes limited in small towns and rural areas.  If you’re going to be in a remote location, you should find out what type of care is more readily available in that area—IMSS or private practices.

Do you have a solid network of friends or family in Mexico who can act as nurses and provide some level of assistance if needed?

Public (IMSS) hospitals in Mexico do not provide full nursing services.  They depend on the patient’s network of friends and family to provide services that a nurse would normally perform in U.S. and Canadian hospitals. For example, IMSS does not provide a night nurse.  If a patient needs help getting to the restroom, they need a family member or a friend to stay the night with them.  IMSS hospitals are dependent on the familial culture to provide this type of assistance. On the other hand, private hospitals are able to provide these services and insurance will be billed for the added level of care if there is a charge for them.

Will you need care in other countries or in your native country?

IMSS covers care in Mexico. Private plans have options for coverage in multiple countries.

Do you prefer to have things in order and predictable or are you pretty go-with-the-flow?

Chances are that you are headed to Mexico to live your best life.  You are going there in pursuit of less worry, not more.  We want you to sleep easier and enjoy your time in Mexico knowing that if something unfortunate happens, you’re covered. You want the process to match your temperament not to add to the stress of being sick or injured.

To this end and to appreciate IMSS, you should definitely be a go-with-the-flow kind of person and someone who is not in a hurry—even if you or a loved one are sick—if you want to be satisfied with IMSS as your insurance.

If you prefer more stability and certainty, you may want to consider private insurance. International private insurance most closely mimics what residents of the U.S. and Canada are most accustomed, too.  You will receive services faster and the private system has a more predictable flow and offers more comprehensive coverage.

Are you on the fence at all?

At the end of the day, health insurance is a highly personal decision especially since there is no legal obligation to get health insurance in Mexico (note: there is a legal obligation to get insurance for driving in Mexico).

If you are on the fence about which Mexican health insurance option is best for you—IMSS or private insurance— contact us or get a free quote here . We would be happy to discuss your options.  We are not your stereotypical, shady, alarmist kind of salespeople.  Pinky promise!

We pride ourselves in telling you the truth at MexInsurance.com® even if it’s not to the benefit of our business.  We will always tell you if you DON’T need insurance and, when you do need insurance in Mexico, we will only offer you the best.

Why? Because we don’t want you to be miserable, left uncared for, and confused in a foreign country. And, well, frankly, it’s just the right thing to do. And THAT integrity, my friend, helps us sleep better at night.

Important Emergency Numbers

Although response time can be slow, in the case of an emergency, in Mexico, dial:
FIRE 068
AMBULANCE – 065
POLICE – 066

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