By obtaining a residence permit in Mexico, foreign citizens gain access to basic government health care programs. In other words, residents are able to benefit from social health care in the same way as Mexican citizens once they have a CURP — Mexican Resident Identification Number. CURP is available to so-called temporary visitors, temporary and permanent residents, and in addition to Mexican citizens.
There are usually two public health programs available to residents: IMSS (Instituto Mexicano del Seguro Social) and INSABI (El Institution de Salud para el Bienestar; INSABI has changed its name to IMSS-Bienestar since 2023). There are other programs, but they are not available to foreigners.
Both programs are national and quite similar to each other. Both programs have their own hospitals and clinics, and each has its own doctors. The age and characteristics of the infrastructure can range from 1950s-style institutional structures to state-of-the-art newly built medical facilities. It is completely wrong to assume that no payment means poor quality. The medical care offered has the potential to be good to very good, most doctors are board certified and the older doctors are experienced surgeons. In Mexico, it is common practice for a doctor to work in both a private hospital and a public clinic because working in the public sector is considered an attractive option for some specialties due to the generous pension benefits offered. Many institutions are considered teaching hospitals, and nursing interns and students attend numerous medical and nursing schools in Mexico. Trainees provide free medical services in exchange for gratuitous education.
The need for total coverage of the population leads to overcrowding in many public hospitals and long waits for scheduled appointments or operations. For example, if you were admitted to the hospital through the emergency department, you may have to wait until a room becomes available. There is no such thing as having nothing to treat at all, but if you are a foreigner, prepare for the fact that you will be asked to buy a basic set of medications or consumables with your own money.
For those born during the USSR, free healthcare is nothing new. However, in many ways, Mexico's public medical system does offer significant medical care for many people and many conditions. It is necessary to understand that providing a decent level of medicine in all corners of a country with a population of 130 million is not so easy.
IMSS program
IMSS is generally intended for working people, and coverage for most participants is paid through a private sector employer. Anyone who officially works in Mexico should enroll in the program, even if they have other private health insurance. The employee's IMSS contributions are paid by the employer. However, IMSS is also available to resident aliens who are not employed (in other words, the employer does not pay contributions) — then they have the right to pay contributions themselves voluntarily. The amount of premiums will depend on age, what treatment the program covers, and pre-existing conditions. The contribution, paid annually, ranges from 8,550 to 20,500 Mexican pesos (2024), the highest — for people over 80. Unless you have a serious pre-existing (chronic) condition, IMSS is usually the preferred public program for foreigners.
To apply for IMSS, contact the IMSS hospital that serves the area in which you live. One thing you must remember is that with CURP, you become equal to a Mexican citizen for IMSS. They do not have the opportunity to exclude you from the program, but you cannot demand more than that.
The following chronic conditions will limit your participation in IMSS or your coverage will be delayed rather than immediately.
- Malignant tumors
- Chronic degenerative diseases such as late complications of diabetes mellitus, Gaucher disease, chronic liver disease, chronic renal failure, valvular heart disease, heart failure, consequences of coronary heart disease (arrhythmia, angina or myocardial infarction) and chronic obstructive pulmonary disease, diseases with respiratory failure,
- Chronic systemic connective tissue diseases,
- Addictions such as alcoholism and drug addiction
- Mental disorders such as psychosis and dementia
- Congenital diseases
- HIV and AIDS.
It should be noted here that many of these diseases, for example, HIV, tumors, diabetes or mental disorders, are already subject to free treatment in Mexico. In other words, you will one way or another be provided with free medical support, but not as part of your IMSS insurance.
Coverage begins with a delay for the following diseases:
- in 6 months — benign breast tumor,
- in 10 months — pregnancy and childbirth,
- after one year:
- Lithotripsy,
- Surgery of gynecological diseases, except for malignant neoplasms of the uterus, ovaries and perineal fundus,
- Surgery for venous insufficiency and varicose veins,
- Sinus and nose surgery,
- Varicocele surgery,
- Hemorrhoidectomy and surgery for rectal fistulas and rectal prolapse,
- Tonsillectomy and adenoidectomy,
- Surgery of hernias, except herniated intervertebral discs,
- Hallux valgus surgery,
- Strabismus surgery,
- in two years:
- orthopedic surgery.
Insurance coverage does not apply to the following types of treatment:
- Cosmetic surgery,
- Purchase of glasses, contact lenses, intraocular lenses and hearing aids,
- Surgeries to correct astigmatism, presbyopia, myopia and farsightedness,
- Treatment of self-inflicted trauma and trauma resulting from a suicide attempt,
- Treatment of injuries resulting from any sport involving physical risk,
- Preventive medical examination at the request of the insured or his beneficiary,
- Treatment of behavioral and learning disorders,
- Dental treatment, excluding extractions, fillings and cleanings,
- Providing orthoses, prostheses and special accessories,
- Treatment of chronic conditions requiring constant therapeutic monitoring,
- Surgical or medical treatment to correct changes in a couple's fertility,
- Treatment of the consequences of musculoskeletal or neurological injuries of traumatic origin, purchased with caution for insurance,
- Treatment of the consequences of degenerative diseases of the central and peripheral nervous system and the consequences of cerebral vascular diseases, penile vascular insufficiency, including those acquired through insurance.
INSABI program
INSABI offers a program for those who are not covered by IMSS, in other words, effectively for those who are not employed. For example, for farmers or artisans who work for themselves. In fact, the original calling of INSABI — fill the social inequality that has arisen between hired and self-employed workers. This program used to be called Seguro Popular, and you may still hear it called that. But unlike its predecessor, the prospects for providing free services to patients with serious illnesses have been reduced to almost zero.
While basic coverage is considered free, INSABI does not cover the cost of treatment of acute illnesses 100%. In particular, cancer, heart attacks, cardiovascular disease, diabetes, hepatitis C, major surgery and long-term treatment are never fully covered by INSABI insurance. INSABI first makes a determination of what it will or will not fully cover, based on the diagnosis and severity of the person's condition. However, there is not a complete list of diseases and conditions that INSABI does not cover. On the other hand, the payment has the ability to be adjusted on a sliding scale based on income.
You will find additional materials about free medicine under the INSABI program in thispublications.
Now some observations about free treatment in IMSS and INSABI institutions.
Typically, hospital rooms are designed for several people; individual rooms are not provided. The patient's personal needs (assistance with feeding, assistance with showering or drying off in bed, assistance with toileting, emptying a bedpan, etc.) are expected to be taken care of by a family member rather than by nursing staff. Family members often stay at the patient's bedside in shifts.
The necessary medications and supplies will be provided by the hospital, and you will even be given all the medications and vitamins to take home after hospitalization. But the doctor has the right to recommend another medicine, a better solution, from his point of view, or ask a family member to buy basic dressings that need to be changed daily. As usual, someone will run to the nearest commercial pharmacy to get what they need. In principle, this is already familiar to many.
More often than not, doctors and nurses in public health care do not speak English. If you don't speak Spanish, you may not be understood. Be sure to use a translator on your phone. And ask the staff to write down their instructions so that they can be translated or shown to other people.
If the patient is bedridden, it is recommended to hire a student nurse or private charge nurse for support. Since this work often does not require professional skills, you can ask someone you know to perform the functions of a nurse.
Although medicine is free, treatment will be done one way or another, and the treatment will be quite high quality. This is why, for many simple diseases, public health programs are considered an excellent alternative to treatment in expensive commercial clinics.
We talked about death insurance in Mexico in thispublications.