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
join the system you must:
There is no age limit. There are now many 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 $150 if in your 20's up to to $350 USD per year (if in your 70's). Although they quote the coverage as “all
inclusive,” most foreigners (Mexpats) use IMSS coverage only 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 (and this is only a partial list):
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:
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.
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.
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.
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. In the last few years more people have been turned down than accepted due to pre-existing conditions. One of the downsides is you pay your fee when you apply and once your medical tests are done, if they turn you down, they do not refund you the fee. We have also had some cases where people were in IMSS for some years and then had a serious medical issue and were told this was a pre-existing condition and they were not covered.
Due to all the issues with IMSS, Focus on Mexico realized we needed to find an alternative for our Clients. After a lot of research of many Health Insurance Options we found a fantastic alternative. We are happy to report that we have now put
together our 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.
The map below shows the location of the IMSS in Lake Chapala.
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
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
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
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
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
Referral to specialists (in non-acute cases) can take up to as much as two
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)
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
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:
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
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:
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
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
The cost of living in Mexico
for American and Canadian retirees, and for that matter expats from other
Western World countries, is a fraction of what it costs to retire reasonably in
one’s former homeland. Although upon reaching the golden age of 60 the annual
premium for participation in the Mexican national healthcare plan (IMSS –
Instituto Mexicano del Seguro Social) increases, medical coverage is still a
bargain, both using private doctors and hospitals, and IMSS.