Health Insurance For Extended Stays In Mexico
If you plan to be in Mexico for an extended stay, but dont intent to take-up residence in Mexico for example, you might take a sabbatical, a volunteer job, or plan to stay in Mexico for six months or less, then a short-term travel insurance policy might not cover your needs. In these circumstances, you may consider a private health insurance policy that covers you locally and, if you retain health coverages in your home country, you might also consider taking out a medical evacuation plan in the event of a serious medical incident that requires you to be flown home for treatment and recovery.
Rates And Carriers: Presbyterian Rejoined The Exchange Average Rates Increase But Subsidies Grow Significantly Making Coverage More Affordable For Most Enrollees
New Mexico required insurers to price 2022 Silver plans in a manner that reflects their higher value based on integrated cost-sharing reductions that apply to most people who purchase Silver-level coverage. Specifically, the state instructed insurers that they should assume that consumers will be rational and thus not purchase on-exchange Silver plans if their household income is above 200% of the poverty level. Below that income level, all Silver plans have actuarial values of 87% of 94%, which is well above the actuarial value of Gold plans. So the state instructed insurers to price Silver plans accordingly.
When Silver plan prices increase, premium subsidies increase too. Especially when you consider the more generous subsidy structure created by the American Rescue Plan, and the elimination of the income cap for subsidy eligibility in 2022, its clear that coverage will be much more affordable in New Mexico in 2022 for most consumers.
The NM Office of the Superintendent of Insurance in late August 2021, illustrating just how much net premiums will decrease for enrollees who purchase 2022 coverage through New Mexicos exchange.
The following average rate changes have been approved for 2022 in New Mexico. But again, its important to understand that Silver plan rates increased more than other metal levels, which pushes subsidies higher and makes coverage more affordable for more people:
Health Insurance For Travel To Mexico
Peace of mind while traveling in Mexico
Not all travelers give much forethought to what will happen if they need medical attention during their trip. But it’s certainly a smart thing to plan for. The U.S. Department of State recommends that Americans traveling to Mexico check with their health insurance provider to make sure they’re covered for emergency medical treatment, as well as evacuation in case of an emergency. If not, consider purchasing a travel insurance policy that provides for healthcare while in Mexico.
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Required Documents When Applying For Expat Health Insurance In Mexico
When applying to be enrolled under the public health insurance scheme in Mexico, you need the following documents:
- A valid Identification Document
- The medical questionnaire which is provided by the IMSS
Document guidelines:
- All the documents you submit have to be in their original form along with a copy
- All the documents from your country have to be translated into Spanish and Apostilled before you submit them.
Does Expat Health Insurance In Mexico Cover Pre

If you enroll on Mexicos public insurance yourself, certain pre-existing conditions may not be covered, or, alternatively, if you have certain pre-existing conditions, you may not be able to apply for the IMSS at all. This includes diseases such as malignant tumours, late stages of diabetes mellitus, chronic liver diseases, chronic kidney failure, valvular heart disease, heart failure, among others.
When you apply for IMSS, you should be able to see the list of pre-existing medical conditions not covered under the public health insurance scheme.
Private health insurance: Whether a private health insurance scheme will cover you for pre-existing conditions will depend solely on the company and the plan you purchase. Read the policy carefully. You can find an expat health insurance plan that fits your needs for Mexico at Insubuy, International Citizens Insurance or Foyer Global Health.
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Health Insurance For Foreign Residents In Mexico
If you intend to apply for, or have, legal residency in Mexico, a travel insurance policy wont be valid as these are designed for people who come to Mexico for a short defined period and return to their country of residence. If you have health insurance cover in your country of residence, the policy might cover you if youre living abroad and in most cases you would need to evacuate back to your home country to avail yourself of any coverages. Therefore, if you plan to reside in Mexico, you should consider health insurance coverages that will be valid and provide adequate care for your needs. Here are the options:
Seguro Popular: Health Coverage For All In Mexico
Health personnel demonstrate a Consulta Segura a preventive health checkup given to new Seguro Popular affiliates.
Challenge
In 2002, before the creation of Seguro Popular, only half of the Mexican population benefitted from health insurance, largely through their employer. The self-employed, underemployed and unemployed accessed health services through public providers with a co-pay, or they paid for private care.
Poor and uninsured families, whose well-being was vulnerable to the financial consequences of illness or accidents, financed their health-care expenditures out-of-pocket. The budgets for public health care were uncertain and there was no defined package of free health services for the beneficiaries.
In fact, more than half of all health-care expenditures in Mexico were paid for out-of-pocket. By 2008, Seguro Popular counted over 27 million beneficiaries, who could access health services without a co-pay.
However, in 2009 the economic crisis led to a deep, though brief, contraction of over 6 percent of GDP, with increased poverty and pressure on the finances of vulnerable families. Seguro Popular was expanded in order to protect the health and finances of families who lost health insurance when they lost their jobs, as well as families who still lacked health insurance coverage.
Solution
The Project also aimed to improve the administration of the Seguro Popular entitlements by supporting technical assistance to the Commission and the State Health Systems.
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Health Insurance Cost And Plans
Health insurance premiums have been on the gradual rise in Mexico over the past couple of years. Experts attribute this to the higher costs of medicine and hospital fees, as well as the improved cost of living. As such, employer-sponsored coverage through IMSS is a popular choice throughout the country. If youre not able to get coverage through your job, its important to shop around and closely compare plans in order to choose one that suits you and your familys needs.
Protect Your Familys Health You May Qualify For Health Coverage We Are Here To Help
The New Mexico Medicaid Program, beWellnm , and the New Mexico Medical Insurance Pool are working together to help you find health coverage during this unprecedented and challenging time. If you have had a recent change in employment or income, have lost your current plan or wish to become insured for the first time, we may have a good option for you.
All three programs cover comprehensive benefits like doctors visits, hospitalizations, prescriptions, mental health services and more. All testing and treatment related to COVID-19 will be covered at no cost to you.
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Can Unemployed Expats Get Health Insurance In Mexico
If you are a legal resident in Mexico, but not formally employed , you can apply to be enrolled in the IMSS public health insurance program yourself. The procedure is as follows:
Once enrolled, your coverage will start on the first day of the following month.
Companies With Employee Vaccination Requirements
Several companies have announced plans for mandatory vaccinations, including airlines, cruise lines, concert halls, health care facilities and restaurants. Some of the requirements may include mask and testing guidelines, and some may only apply to employees traveling internationally, working in the office or having face-to-face interactions with customers. If any of these applies to you, check with your employer for more details.
Here are some of the companies that have announced vaccination requirements for employees:
- Amtrak
- Walmart
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Private Health Insurance For Expats In Mexico
You can buy private health insurance through international health insurance companies such as Foyer Global Health or insurance brokers such as Insubuy or International Citizens Insurance which allow you to compare plans from different companies online to choose what best suits your needs:
The reason why many US expats in Mexico combine both public and private health insurance is that private insurance gives you coverage in private clinics and hospitals, as well as the opportunity to choose your own healthcare provider.
Private hospitals in Mexico have shorter waiting times, better infrastructure, offer better care, and there are usually more English-speaking doctors, which are helpful for expats.
Although healthcare in Mexican private hospitals is only about half as expensive as it is in the United States it can still be too much to pay out-of-pocket, and so a good private health insurance policy is a must.
How Do I Avoid The Individual Mandate Tax

To avoid this penalty and protect yourself from the potential financial burden of unexpected medical expenses, you can enroll in a health insurance plan during the open enrollment period. For 2021 coverage, the national open enrollment period will take place from November 1st 2020 through December 15th 2020. Some states have extended this period. To learn about your states open enrollment period, read our article, 2021 Obamacare Open Enrollment Dates by State.
If you lose your insurance in the middle of the year, you may qualify for a special enrollment period to purchase an ACA-compliant plan on the public exchange. You may buy an ACA-compliant plan outside the public exchange anytime. Depending on which state you live in, you may be able to enroll in short-term health insurance to help fill any coverage gaps you may experience throughout the year.
Your health and financial well-being are important to us. As the largest online health insurance broker, eHealth offers a variety of health insurance plans to fulfill your coverage needs, wherever you live in the United States. These include on and off exchange ACA-compliant plans, major medical insurance, and short-term health insurance. Let us help you explore your coverage options now. Simply click Individual & Family Health Insurance to find affordable insurance. Our licensed insurance agents are here to help you and share their expertise as you consider your choices.
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Box A: Medicare Abroad Policy Model
To estimate the effects of various policy options, a model could be developed that would have, at its core, an accounting of the number of Medicare-eligible Americans and Mexicans living in Mexico, their use of medical services , and changes in their behavior that would be induced by alternative policies. The conceptual model diagram below shows, from left to right, these model inputs and outputs. The model would include estimates of how increased demand for care by Medicare-eligible individuals in Mexico, combined with Medicare certification requirements, could induce changes in the quality and price of care in Mexico. In addition, the model would include estimates of changes in satisfaction with care and how they could induce additional utilization of care in Mexico relative to the United States among Medicare-eligible individuals.
The model would require detailed data regarding the numbers of individuals, their utilization and location of care, and the cost of care in order to assess the following: the total change in Medicare expenditures, the total change in health care spending in Mexico, and the total out-of-pocket expenditures of Medicare-eligible individuals in Mexico . These estimates, together with estimates of satisfaction with care and changes in the quality of care, would allow us to determine the net benefits of each policy change for each of the key groups of players .
Hospitals And Clinics In Mexico
Mexicos best hospitals and clinics are based in Mexico City, Guadalajara and Monterrey. If you are seeking specialist hospital treatment in Mexico you will probably have to travel to one of these cities.
Your insurance company may give you a list of hospitals you may make use of in Mexico or, if you have an open choice, then your local consulate will be able to provide you with a list of hospitals and clinics in the local area. Also talk with friends, colleagues or neighbors to ask them about local hospitals and clinics they may recommend.
Note that private hospital and clinical treatments are expensive in Mexico. You will need to have proof of private medical insurance or present a credit card with sufficient credit to cover several thousand dollars worth of treatment when you are admitted. Even if you have medical insurance, the hospital may still request a credit card imprint while the insurance policy and its details are confirmed it can take up to 24 hours for this to happen.
In recent years, there has been a significant increase in the investment of private clinics and hospitals in Mexico, especially in areas popular with tourists and foreign residents, particularly retirees. For example, a new medical center in Merida has been receiving extremely good reviews from retirees in the area: the center was built, in part, to provide services to the increasing number of foreign retirees living in that region.
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Medicare’s Lack Of Coverage Abroad
The U.S. Social Security Medicare Program does not cover health services outside of the United States. Medicare-eligible beneficiaries who travel or reside abroad must obtain some form of supplemental insurance to cover health care costs incurred abroad or pay out-of-pocket. The policy may be a disincentive for retirees in the United States to travel or live abroad and certainly presents an inconvenience for those who do travel or live abroad. On the surface, this policy may be viewed as a potential cost-saver for Medicare: Medicare is not required to reimburse costs incurred abroad nor to develop what could certainly be a costly administrative infrastructure to certify providers and reimburse for care abroad.
Many Medicare beneficiaries purchase Medigap policies to cover gaps in their Original Medicare coverage, such as coinsurance, co-payments, and deductibles. Medigap policies are standardized private health insurance policies designed to supplement Original Medicare. Of the standard Medigap policies A through L, C through J offer a Foreign Travel Emergency Benefit up to plan limits. However, the benefit applies only when beneficiaries are away from the United States for six weeks or less, covers emergency services only, and requires the beneficiary to pay a separate deductible of $250 USD per year.
What To Look For In Health Insurance In Mexico
Its not the same in all countries so in case you arent used to Mexican insurance, here are the main things to make choices on:
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Washington Dc Individual Mandate
- Effective date: January 1, 2019
- Requires individuals and their dependents have ACA-compliant health insurance
- Imposes a penalty on residents who go without health insurance but can afford it
- Provides exemptions to the tax penalty for circumstances such as financial hardship, pregnancy, or eviction
Individuals who go without qualifying health coverage for a full year and dont file for an exemption may owe a tax penalty. The penalty amount is either 2.5% of the gross family household income or $695 per individual and $347.50 per child youll pay whichever amount is greater.
According to dchealthlink.com, the maximum penalty for not having coverage in DC is based on the average premiums for bronze level health plans available on DC Health Link. In 2020 this amount is $3,448/year per person and, for households with more than one person without coverage, it is multiplied by the number of people in the household without coverage up to a maximum of five household members. So, potentially, a household of five or more that went the entire year without health coverage would have a penalty cap of $17,240 in 2020.