Mexican Health Care

Hope for the best, plan for the worst

In any foreign country, non-citizens have four basic concerns about health care: Access, quality, cost, and what happens if you die.

ACCESS

A general overview of health care in Mexico. In essence, Mexico offers access to several tiers of health care. Here is a detailed summary of the options.

1. Cruz Roja (Red Cross): Available to everyone, emergency treatment everywhere in the country, limited overnight in-patient rooms, prescriptions to fill at local pharmacies.

2. Onsite consultation at some neighborhood pharmacies by a licensed physician: Available to anyone, usually $3 USD (sometimes free), free sample medicine (if in stock), a prescription for drugs to buy at the pharmacy.

3. Private offices and clinics: Available to anyone (cash only), walk-in medical care by private doctors.

4. Hospital Civil: Available to anyone without other coverage including undocumented non-citizens, in-patient government-owned hospitals in major cities throughout the country, private-practice doctors under contract with the government, discounted cash payment after an interview to establish the ability to pay.

5. Instituto Mexicano de Seguro Social (IMSS): Government universal medical insurance program for taxpaying employed citizens and non-citizens with legal immigration status, annual enrollment fee with modest premiums, large and small in-patient facilities throughout the country, waiting period for existing conditions, appointments available but often with waits of several days.

6. Seguro Popular: Free government-run universal health care program: available to uninsured Mexican citizens and legal non-citizens, emergency services and walk-in clinics throughout the country, coverage for a wide range of health care including free check-ups and immunizations, long waiting lines. First-come/first-served from 7:30 a.m. - 8 p.m., including Sunday.

7. Private hospitals: Available to anyone who has money or insurance. Medical care by private doctors. Many accept private medical insurance plans available through Mexican or international companies, some of which have offices in the hospital lobby. A few accept major USA health insurance (Aetna, BCBS, CIGNA, etc.) with pre-approval. Payment or insurance approval required before leaving the hospital

Different people, both Mexicans and foreigners, have different opinions about which health care option is best. I am a permanent resident in Mexico with U.S. citizenship and am enrolled in Seguro Popular. This gives me access to walk-in doctor clinics and if I have an emergency I can go straight to emerge at their hospital, just as in medical facilities in the United States. The reality is, I use Seguro Popular only for emergency treatment. When stabilized I would fly or drive up to my Medicare doctor in the U.S. I tried using the private doctor section of Seguro Popular but I do not have the patience (socialized medicine) or the Spanish to survive there. I have a complete physical annually with my Medicare doctor in the U.S. 

In general, Mexicans are content with the health care they receive as members of IMSS or Seguro Popular, although many Mexicans who can afford to pay for private health care prefer to bypass these government programs.

QUALITY

The overall quality of health care in large urban centers across Mexico is as good as many places in the U.S. Part of this is due to medical school training in Mexico, particularly at the university in Mexico City or at the University of Guadalajara. In addition, bilingual doctors and dentists in urban centers performed their residency requirements in major U.S. hospitals and proudly display their framed credentials on their office walls. Outside the urban centers, healthcare isn't as good, just as in less-populated places in the U.S. As in other countries, not every medical outcome in Mexico is perfect.

COSTS

Overall costs of health care in Mexico are less expensive than costs in the U.S. based on my personal experience. In general, patients in Mexico have to pay the total costs for the hospital and doctors before leaving the hospital. Therefore, foreigners without private insurance need to analyze the costs and benefits of paying cash in Mexico against returning to their home countries for medical care. Government-subsidized programs such as Medicare in the U.S. might cover almost all costs, and hospitals back home might agree to bill patients later.

Foreigners can buy private insurance from many international firms to cover medical treatment in Mexico and other countries. Premiums vary widely from less than $1,000 a year for catastrophic insurance to more than $12,000 a year for expanded coverage. Enrollees may have to pay annual premiums in advance. After patients meet requirements for deductibles, these insurance plans usually pay all remaining costs. Most of these plans require a physical, and many require a letter from a personal physician attesting to no pre-existing conditions. A few private hospitals and doctors in major cities in Mexico accept insurance coverage with pre-approval from companies such as Aetna, BlueCross/BlueShield, and Cigna. In such cases, the hospitals bill the patient directly then the patient puts a claim in to the insurance company. Almost all larger hospitals in Mexico have offices to explain coverage to patients before hospital admission. Some large private hospitals have special offices with English-speaking staff to explain coverage and assist patients in submitting forms for reimbursement from insurance companies. As in the United States, it isn’t easy to sort through the details of health care insurance in Mexico and find the cost of premiums.

DEATH

There are many laws, regulations, and bureaucratic rules if a foreigner becomes ill and dies in Mexico, just as in other countries. Planning is critical and should include registering with the foreign Consulate. At a minimum, just in case, foreigners should arrange for a personal physician in Mexico and a mortuary.  Procedures in Mexico are different depending on whether the death occurs in a hospital, at home, in a public place, or in an accident somewhere. Even with planning, many foreign deaths in Mexico involve lengthy police interviews, removing the body to a government morgue, and embalming. Authorities often override personal and religious preferences regarding autopsy, embalming, and cremation.  To alleviate some problems, foreigners should have a Notario prepare a Certificate of Ratification, which can cut through much of the Mexican bureaucracy surrounding death. The document must be in Espanol, certified and legally filed by a Mexican Notario. An immigration professional can arrange all of this. If a personal physician is able to certify the cause of death at home or in a hospital, this document may bypass the coroner and an autopsy. Even with the Certificate of Ratification, next-of-kin must provide specific documents to prove a relationship to settle a foreigner’s estate—a birth certificate, driver’s license, passport, and any documents with name changes such as marriage certificates and divorce decrees. If the Certificate of Ratification specifies a mortuary, this may bypass the government morgue. The mortuary can obtain the necessary permits to send the body to another country for burial, or facilitate cremation and transport the ashes. Be prepared to pay cash to everyone involved. All of this is more critical if the next-of-kin is unable to travel to Mexico immediately after your death.

THE FUTURE

As you might expect, entrepreneurs are looking at all the ageing Baby Boomers in the U.S. and seeing an excellent opportunity to cash in on medical tourism in Mexico. One of the most authoritative sources of information about health care in Mexico for non-citizens is a May 2010 report by the International Community Foundation. It helps explain why international medical tourism for U.S. residents is a growing industry in Mexico, with lower medical costs, short travel times and many vacation options. Some medical tourism companies are associated with specific hospitals and doctors–particularly for dentistry, weight reduction surgery, and cosmetic surgery–and can facilitate appointments, transportation, housing, and financing for treatment in Mexico.