Private Health Insurance in Mexico for Expats and New Residents

Hospital discount memberships are sold in some cities. They are not insurance; read what they actually pay for.

Mexican policies use their own vocabulary. Compare these points side by side:

• Suma asegurada: the maximum the policy pays, per illness or in total.
• Deducible: the deductible, the amount you pay first for each illness or accident.
• Coaseguro: coinsurance, the percentage of the remaining bill you pay (often 10% or more).
• Tope de coaseguro: the cap on your coinsurance. A policy with a low cap protects you from very large bills.
• Nivel hospitalario: the tier of hospitals you can use. Top private hospitals in big cities are usually in the most expensive tier.
• Pago directo vs. reembolso: direct billing (the insurer pays the hospital) vs. reimbursement (you pay and claim back).
• Periodos de espera: waiting periods before certain treatments are covered.
• Preexistencias: conditions you had before the policy started.

Many Mexican policies focus on hospital care. Outpatient visits, prescriptions and checkups may not be covered unless you add them.

These are the two issues that surprise new residents most:

• Pre-existing conditions. Insurers ask detailed health questions. A condition you already have may be excluded permanently, covered only after a waiting period, or covered at a higher price. Answer honestly: an undisclosed condition can be a reason to deny a claim later.
• Age. Premiums rise as you get older, usually at each renewal. Many insurers do not accept new applicants above a certain age, and the limit differs between companies. If you are near retirement, get quotes before you move and keep continuous coverage.

If you cannot get private coverage, IMSS voluntary enrollment accepts older applicants, though it also has exclusions.

Usually not for long stays:

• US Medicare generally does not pay for health care outside the United States, apart from a few narrow exceptions. Some retirees keep Medicare for care during trips back to the US. See moving to Mexico from the USA.
• Canadian provincial plans require you to live in the province for a set part of each year. Long stays in Mexico can end your coverage. See moving to Mexico from Canada.
• UK NHS care is based on living in the UK. See moving to Mexico from the United Kingdom.

Check with your home program before you give up any coverage.

1. Decide where you want care. Mexico only, or Mexico plus other countries?
2. Check the hospital network in your city. Coverage is only useful if good hospitals near you accept it with direct billing. If you are still choosing a city, see Mexico City, Guadalajara or Mérida.
3. Compare total out-of-pocket risk, not just the premium: deductible, coinsurance and the coinsurance cap.
4. Read the exclusions and waiting periods in the general conditions (condiciones generales).
5. Use a licensed agent or buy directly from a regulated insurer. Insurers are supervised by the CNSF. You can check that a financial company is registered, and file complaints, with CONDUSEF.
6. Keep the policy renewing. A gap can mean new exclusions when you reapply.

Mexican temporary and permanent residency based on financial solvency is decided on income or savings, not on proof of insurance. Consulates may still ask for extra documents in some cases, so check your consulate's list. See financial solvency and retiring in Mexico. Even when it is not required, insurance is strongly advisable: private hospital bills in Mexico can be high.