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How to Apply for IMSS

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  • Public Health Care in Mexico (IMSS)

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    IMSS is Available to Foreigners

    To Understand how IMSS works, see the article below  "Health care in Mexico: How the IMSS works" By Michael Forbes,Guadalajara Reporter, Friday, March 04 2011 

    To join the system you must:

    • Have valid visa - Residente Temporal or Residente Permanente
    • Prove Citizenship (Passport)
    • Marital Status (Certificate)
    • Birth Certificate
    • Complete Application Form
    • Provide two pictures
    • CURP Number (Population Code # obtained through Immigration office)
    • Blood tests and other tests as required

    Note! There is no age limit. There are some limitations regarding pre-existing conditions and you will learn all these details and more on a Focus Program. The cost for IMSS is on a per person basis and varies, dependant on age, from $100 to $300 USD per year. Although they quote the coverage as “all inclusive,”  most foreigners (Mexpats) use IMSS coverage for emergencies, but for day-to-day issues, they use local doctors who charge by the visit.

    Prior to 2011 it was a lot easier to join IMSS but since there many people have been turned down due to pre-existing conditions. 

    You will not be eligible for IMSS health insurance if you have any of the following medical conditions:IMSS IMPORTANT NOTE 

    • Allergy or asthma
    • Chronic diseases of the blood
    • Cancer or tumors
    • Diabetes mellitus with:
      • Renal failure
      • Retinophaty
      • Neuropathy
    • Peripheral circulatory failure
    • Heart diseases
    • Liver diseases
    • Nervous disorders or chronic psychiatric issues
    • High blood pressure
    • Rheumatism or arthritis
    • Tuberculosis
    • Stomach ulcer
    • AIDS or HIV positive status
    • Congenital diseases (from birth)
    • Chronic bronchitis
    • Vascular incidents or strokes
    • Deformation or movement limitations by accidents or diseases
    • Alcohol addiction
    • Toxic substance addiction

    If approved, the coverage is quite broad and includes consultations, tests, hospitalization, surgery and medicines. It also includes basic dental and optical; but only within the IMSS structure - their doctors, clinics and hospitals. The facilities are quite basic, the waits are long and you will need to have a translator.

    After you receive your card, you need to go to the local IMSS clinic so that they can assign you to a Doctor, as well as the time (morning or afternoon) when you can be seen for an appointment.

    You will need to take the following with you:

    • IMMS cards given to you when you register
    • Validation of payment
    • Your health questionnaire…if you have used an agent to help make the process easier, make sure you get a copy of this form to take with you.
       

    The new Chapala IMSS (Instituto Mexicano del Seguro Social) clinic is at 95 La Estacion—turn left at the recently refurbished old railroad station and go four blocks or so.

    If you do not speak Spanish, you will need to take someone with you to all appointments. In the first level of IMSS, very few people speak English. You walk into the building and head upstairs to sign in. Turn to your right once you get upstairs. There will be a lady sitting at the desk to whom you will give your paperwork.

    There are some drawbacks to IMSS and you will get the whole story from our health care expert on one of the Focus on Mexico programs. Our Expert Speakers do not speak through rose-colored glasses. You'll get the good and bad so you can make an informed decision. It’s important for you to get the pros and the cons. 

    As with many government run Health Care institutions, the IMSS is not without its bureaucracy. Most foreigners will take the IMSS plan and use it strictly for emergencies. Then they sign up for the Maskaras Clinic Discount Program to cover their day to day issues and annual checkups, etc.

    Due to all the issues with IMSS, Focus on Mexico researched all Health Insurance Options and we are happy to report that we have now put together a Focus Best Doctors Health Care Plan for Worldwide coverage up to $750,000 USD per year, with a low deductible of $3000 USD and an annual premium of only $1090 USD and pre-existing conditions are automatically covered after 12 months. Best of all you are eligible to get a second opinion from the top 5% of the best doctors in the world.

  • IMSS Chapala Mexico Entrance

    The map below shows the location of the IMSS in Lake Chapala.

    Detail Location of IMSS in Chapala Mexico

     

     

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    IMSS LogoHealth care in Mexico: How the IMSS works 

    By Michael Forbes,
    Guadalajara Reporter, Friday, March 04 2011

    The  Instituto Mexicano de Seguro Social (IMSS) offers a low-cost health care option for foreigners resettling in Mexico. The service, however, lacks many of the comforts that users of HMOs or insurance plans in the United States are accustomed to. In a sense, the IMSS is more comparable to Canada’s or Great Britain’s national health systems. 

    The IMSS works on a three-tiered basis. On the first level (primer nivel) there are Unidad Medicos Familiares (Family Care Clinics), where beneficiaries must go for primary consultation with their medicos familiars (family doctors). The quality of these clinics can vary significantly; some are much better equipped than others and are able to do lab testing and x-rays. All include a pharmacy on the premises. It is the duty of the family doctor to pass patients on for specialist consultations, which take place at either regional clinics or hospitals (segundo nivel) or medical centers (tercer nivel), such as Guadalajara’s well-equipped Centro Medico.

    Each local IMSS clinic is assigned a regional hospital, where patients are sent for specialist treatment or hospitalization. For example, the corresponding hospital for the Chapala IMSS clinic is in Tlaquepaque.

    For emergency treatment, beneficiaries can go to any IMSS clinic or hospital, although it is recommended that they use the one assigned to them if possible. It should be noted that many family care clinics have restricted opening hours and are not equipped for serious emergencies.

    The state of Jalisco has 109 family care clinics, 15 second-level hospitals, three specialist (third level) hospitals and 95 child-care centers. According to the latest figures, 3.3 million Jalisco citizens are enrolled in the IMSS – around 56 percent of the population.

    Advantages of IMSS 

    The cost. The annual fee (as of 2011) for a person aged over 60 is only 3,472.10 pesos a year. It is considerably less for younger people (see story left).

    Insurance includes hospital, medical, surgical, eye, ear, dental care (extractions and fillings only), prescriptions, lab tests, x-rays, reconstructive surgery and mental health consultations. Cosmetic surgery is not included.

    Foreign enrollees must be in Mexico on a  Residente Temporal or Residente Permanente and have a Mexican address (and cannot apply under a Tourist Visa).

    Third-level specialist medical treatment (for example at the Centro Medico in Guadalajara) is equal to, if not better than, most private hospitals in Guadalajara, some local doctors say.

    Most foreign residents enrolled in  IMSS report excellent treatment by staff.

    Disadvantages of IMSS 

    Non-Spanish speakers will need an interpreter if a non-English speaking doctor is assigned to them. Few nurses speak English.

    Doctors can only prescribe medicines from a basic list, some of which may be less potent than other patented drugs. Some IMSS drugs are often in short supply.

    Family doctors cannot be consulted by telephone. Substitution of doctors is frequent, especially when family doctors are on vacation or on a course. Lack of physician-patient rapport is commonly reported. Many IMSS doctors seem permanently stressed, perhaps due to the heavy workload.

    Patients may not choose the clinics or hospitals they attend.

    Lengthy waits are common (even with an appointment) to see family doctors and specialists.

    Referral to specialists (in non-acute cases) can take up to as much as two months.

    Visiting times for patients at IMSS hospitals are strictly regulated.

    It is unusual to be accommodated in a private room at an IMSS hospital. Usually three to four patients share a room, with screen dividers.

    IMSS coverage: How to sign up 

    The service isn’t always a model of efficiency, but the Instituto Mexicano de Seguro Social (IMSS) is the cheapest way to receive across-the-board health care in Mexico. IMSS health coverage includes check-ups, hospitalization, surgeries, lab testing, X-rays, basic dental treatment, specialist consultations and even prescription medicine, as long as it is in stock in IMSS pharmacies, which isn’t always guaranteed.

    All private sector employees in Mexico are entitled to be insured under the IMSS health-care system. Employers are obliged to register their permanent staff and pay a premium equal to roughly nine percent of the worker’s salary. The employee pays approximately three percent.

    Self-employed Mexican citizens and foreign residents (retired or otherwise) in Mexico may also enroll in the IMSS under the program known as Seguro de Salud para la Familia.   All foreigners, regardless of immigration status, are eligible to enroll, as long as they have a Mexican address.

    Annual fees are calculated based on age. People aged 60 or over are in the highest payment bracket and currently pay 3,472.10 pesos for a year’s coverage. The fee is as low as 1,320 pesos for those aged 19 and under. For ages 20-39 the cost is 1,543.70 pesos a year; 40-59 year-olds pay 2,307.10 pesos.

    Carlos Lozano, chief of the IMSS affiliation office in Guadalajara, says the requisites for joining IMSS are:

    1. A copy of your birth certificate.

    2. Original and copy of official identification (FM-2, FM-3, passport).

    3. A printed copy of the applicant’s official personal identification number or Clave Unica del Registro de Poblacion (CURP). (One’s CURP can be obtained from the Edificio del Archivo in Guadalajara, Av. Alcalde 1855, ground floor, online at curp.jalisco.gob.mx, as well as from some municipal offices, including Chapala city hall).

    4. Two photos of the applicant, child size (“tamaño infantil,” available at most places where instant photos for identification are taken).

    All applicants must also fill out an IMSS questionnaire, in Spanish. The purpose of the questionnaire is to detect any chronic diseases that would preclude IMSS affiliation. Those include any chronic degenerative diseases such as cancer, HIV, renal insufficiency, diabetes, heart disease and psychosis.

    In the past, applicants were not usually subjected to a medical examination as a requisite for IMSS affiliation. Nowadays, however, new members are required to undergo a check-up with a family doctor in order to detect any chronic diseases and to assess general health.  If the doctor suspects the presence of any chronic illness, he may order further tests, most of which will be done in Guadalajara.*

    The detection of such a disease in the first six months of IMSS affiliation may lead to being rejected without return of the application fee. Should a chronic disease develop after the first year of affiliation, an individual should have no reason to be rejected from the institute.

    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.

    Applications for IMSS coverage must be made at the sub-delegation office corresponding to your address:

    • Residents of Tlaquepaque, Tonala and the Reforma and Libertad sectors of Guadalajara must apply at office located at Calzada Independencia Norte 580, corner of Juan Alvarez in Guadalajara.
    • Residents of Zapopan and Guadalajara’s Sector Hidalgo must go to the office at Avila Camacho 1696, beside the Volkswagen dealership.
    • Residents of Jocotepec and the Juarez Sector of Guadalajara have to go the IMSS office at 16 de Septiembre 868, in front of the Agua Azul park in Guadalajara.
    • Chapala residents can apply at the Chapala IMSS clinic at Calle Jose Navarro 95 (formerly Estacion), opposite CFE administrative headquarters from 8 a.m. to 2 p.m. Take the stairs at left of clinic’s front door,to the Direccion office located at right on the second floor. The secretary has the application form with the attached list of requirements.

    All payments (both first time and renewals) are only handled in Guadalajara at Calzada Independencia Norte 580, from 8 a.m. to 2 p.m.

    It is always a good idea to get there early to beat the line-ups. The room is filled with chairs and there are long line ups. It is not unusual to be there the whole day, only to be sent home as something is incorrect.

    Note: Focus Participants, you will want to contact our Immigration Specialist to help you through the process to save your sanity! :-)))  

    Focus Alumni can sign up with Focus to receive all changes to Immigration as soon as they occur.   

    It is important that IMSS members do not let coverage lapse. It is recommended that renewals be paid one month before coverage runs out. Making a renewal requires you to bring last year’s payment receipt, your IMSS credential and two identification photos. Costs for renewal are the same as first-time membership.

    If all this seems too much bureaucracy to handle, there are service providers in Guadalajara and Chapala who will carry out all the paperwork for you.  

    * IMSS correction from the newsletter release:

    Dear Sir,


    A recent issue of the Reporter had an extensive article about IMSS that included, “How to sign up.” One thing the article said was, “Applicants will go through a medical examination with a family doctor to check for pre-existing chronic conditions.”


    Julia Vargas, our Focus Immigration Specialist says you have to go through IMSS for your medical examination, etc., to determine if you can be covered under IMSS, and if something is found to be wrong, your IMSS fee will not be returned.   Julie does suggest that you may want to go to your family physician before applying to IMSS to find out first if anything is wrong. That way you will not be out the fee if the tests determine that you have a pre-existing condition.


    Karen McConnaughey, Focus on Mexico
     

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