Exclusion Criteria and Insurance Limitations
As a foreigner applying for IMSS, you may not receive treatment for pre-existing illness for the term of your coverage. These exclusions do not include treatment for any other illness that is acquired during your stay in Mexico. Pre-existing illness is defined as:
- Malignant tumors (cancer)
- Chronic degenerative disease such as that which is seen with long-standing diabetes, liver disease (cirrhosis, hepatitis, etc.), kidney disease (renal failure or renal insufficiency), heart disease (previous heart attack, arrhythmia, or valvular disease), lung disease (chronic bronchitis, emphysema, etc.), neurologic disease (multiple), cerebrovascular disease (stroke or TIA), peripheral vascular disease, and many others.
- Drug or alcohol dependency
- Psychiatric illness
- HIV positive status or history of AIDS
- History of traumatic or muscular injury that continues to require treatment
Further, you can not receive medical care benefits for the following conditions:
- Benign breast tumors in the first six months after acceptance
- Births in the first ten months after acceptance
In the first year after acceptance, you also cannot receive the following surgical procedures:
- Lithotripsy for kidney stones
- Surgery for gynecologic conditions except for cancer
- Surgery for vein disorders
- Surgical procedures for the sinuses, nose, hemorrhoids, rectal fistulas, tonsils and adenoids, hernias (except for herniated spinal discs), and other operations that are also considered "elective," or voluntary, rather than required
In the first two years after acceptance you cannot receive surgery for orthopedic conditions. In addition, your IMSS insurance will not cover the following:
- Aesthetic or plastic surgery
- Eyeglasses
- Contact lenses
- Hearing aids
- The surgical correction of astigmatism
- Lasik surgery or the equivalent
- Treatment of self-inflicted injury
- Preventive care
- Treatments for behavioral or psychiatric disturbances
- Dental care (except for extractions)
- Infertility treatments
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