What Will You Do About Healthcare?

Before moving to Puerto Vallarta, understanding healthcare and insurance should be part of your planning — not something you first investigate during an emergency.

People living in Mexico may use a combination of private Mexican health insurance, international insurance, IMSS when eligible, and direct cash payment for private medical care.

As MedMextravel (Wendy North) often emphasizes in her guidance for expats and retirees in Mexico, the key is not choosing one perfect system, but understanding how the different options can work together based on your personal situation.

IMSS

IMSS is Mexico’s social-security system, and there is more than one way a person may become insured.

Foreigners who are independent or self-employed workers in Mexico can voluntarily enroll through the IMSS Personas Trabajadoras Independientes program. IMSS states that foreign independent workers must demonstrate legal stay in Mexico, have a CURP and obtain an NSS.

This program provides substantially more than basic medical insurance. Coverage includes medical consultations, medications, hospitalization, surgery, emergency and specialty care, as well as other social-security benefits. Eligible legal beneficiaries can also receive coverage.

There is also a separate program called Seguro de Salud para la Familia, designed for people who do not have coverage through another public social-security institution. This program has different eligibility requirements and specifically includes restrictions concerning certain pre-existing conditions, waiting periods and exclusions.

Because the IMSS programs are different, newcomers should determine which enrollment category actually applies to them rather than assuming that everyone living in Mexico can simply purchase the same IMSS coverage.

Private Insurance and Cash Pay

Private Mexican or international health insurance is another option. Policies can differ significantly in deductibles, hospital networks, age requirements, waiting periods, exclusions and treatment of pre-existing conditions.

As Wendy North (MedMextravel) frequently points out, many expats assume their U.S. coverage will follow them abroad — but in most cases it will not. Americans should also understand the limitations of their U.S. coverage before moving. Medicare generally does not cover healthcare received outside the United States except in limited circumstances.

Many Puerto Vallarta residents also pay cash for routine private healthcare, including doctor visits, dental treatment, laboratory work and imaging, while maintaining insurance or another plan for potentially expensive hospital care.

There is no single healthcare solution that works for everyone.

Your age, health history, medications, budget, residency and employment status, and how much time you spend inside and outside Mexico can all affect the best combination of healthcare and insurance.

Before moving, know where you would go for routine care — and where you would go at 2 a.m. in an emergency.