Healthcare, Insurance

U.S. Medicare in Mexico

Doctor and Patient Talking

We recently received this question from one of our readers:

“I have repeatedly heard that Mexico is a country where Medicare is accepted. If so, it would be the only place outside of the States. Once and for all, is this true or just one more expatriate legend?”

The simple answer is: this is a legend. With only the rare exceptions noted below, Medicare is not accepted in foreign countries including Mexico.

Medicare is accepted only in the fifty states of the USA and the District of Colombia, Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa, and the Northern Mariana Islands. Medicare will cover you on cruise ships provided they are within six hours of a U.S. port and the onboard physician treated you and determined you required emergency hospitalization (however, expect to pay the bill yourself and to submit a claim for reimbursement).

The other rare exception would be if you had a medical emergency while traveling in the U.S. and the nearest hospital were in Canada or Mexico. In that case you may be reimbursed for those hospital expenses. The same would be true if you were traveling through Canada on your way to or returning from Alaska.

While the notion of getting Medicare coverage in foreign countries is popular in expat communities, there will be no change to current policy in the foreseeable future.

Fortunately, many expats in Mexico qualify for government-sponsored IMSS health coverage under their voluntary program for about US$50 per month. Although it does not cover pre-existing conditions for the first two years, and has rules and regulations that may seem constrictive to expats, this no-frills coverage is comprehensive and is the same program that covers most working Mexicans.

Of course, there are private insurance options for those who can afford them, and special types of coverage designed specifically for expats such as evacuation insurance and coverage for part-time residents in Mexico.

You also might want to investigate the coverage offered through the many Medicare ‘gap’ programs, some of which offer international emergency coverage. The English Speaker’s Guide to Medical Care in Mexico offers a chapter and analysis of the various insurance options and suggests strategies that might work for you.

When planning your healthcare provision, Medicare is one option that you cannot rely on outside of the U.S.A. and its overseas protectorate states mentioned above.

See also: Healthcare in Mexico

Monica Rix Paxson is an expert in the field of Mexico healthcare. She is author of the English Speaker’s Guide to Medical Care in Mexico, and co-author of The English Speaker’s Guide to Doctors & Hospitals in MexicoeBooks available for immediate downloadShe resides full-time in Mexico.

23 Comments

  1. B. Buckman says

    My experience with IMSS was exactly as Cal explained. One pays 9.000 pesos for an preliminary examination, which is non- refundable, and if pre-existing conditions are determined you will be refused.

  2. Irma Quihuiz says

    What kind of medical insurance would be recommended for me and my husband as visitors for 6 months. We both are 60 and would like to retire soon and live part time in the CA and Mexico.

  3. Fredrica Gross says

    Hello. We were wondering if there was an age limit on signing up for these insurance policies? We currently live in Ecuador, and have government insurance, but with the oil prices dropping services at their hospitals are hard to come by. Thank for any feedback !!

    • Government sponsored programs such as IMSS and Seguro Popular do not have age limits, but they do have other restrictions. For example, most people get IMSS through their employer or a working family member. You can enroll on a “voluntary” basis, but pre-existing conditions are excluded from coverage for 2 years. Seguro Popular will provide coverage, but it is not comprehensive. Although it offers many kinds of treatments, and there are no age limits, not everything is covered.

  4. RF/Retired in Texas says

    I will be traveling solo to Cancun next month for a 3-6 mths retirement visit/research…
    I have read that my Medicare Ins. is valid only in US for any health problems/services and that i can buy add’l “travel insurance” for temp. medical protection while visiting Mexico??

    Will local area clinics handle an expat medical care for illnesses or accidents for “free” or a small fee and if its an “emergency” issue…i would be put on an Evacuation Flight (via travel ins) back to USA for my Medicare needs?

    • Most medical facilities in Mexico do not accept insurance assignments. If you have insurance, you will typically need to pay the provider in cash and then file a claim against your insurance. No, you will not be treated for free although most charges are modest when compared to similar treatment in the USA or Canada. You will need to be prepared to pay in cash before being discharged, although credit and debit cards are sometimes taken. Yes, you could be evacuated if you carry evacuation insurance obtained prior to your need and the circumstances comply with the terms of your insurance (which may vary from one insurer to the next.)

  5. Gloria Hildebrand says

    I have lived in Monterrey Mexico for 3 years I have Medicare I am 72 years old I would like to have a general check up I have no major illness. What would be my best option.

    • Monica Rix Paxson says

      You have a number of options Gloria.

      The most straightforward would be to establish a relationship with a local doctor in his or her private practice. The price for an office visit will typically be very affordable and you can get a referral from a friend, neighbor or local expat group. Luis Felipe Garcia Perez and I also wrote “The English Speaker’s Guide to Doctor’s & Hospitals in Mexico” to provide expats with local doctors who speak English. I always recommend that you have a local doctor who knows you because you don’t typically want to be doing this type of research when you are ill.

      While your Medicare won´t work in Mexico, you can still use it in the USA and that might be an option for something more serious, (or if you visit the USA) but remember that travel isn’t always possible when you are ill. However, there are many private hospitals that can serve you and most private physicians in Mexico have a relationship with one or more of these. Again, you would need to pay out of pocket for these services, but they would be much more affordable than they would be in the USA.

      Public healthcare may also be an option for you if you have a resident’s visa and CURP. Both IMSS and Seguro Popular are programs that would be available, but there are “tramites” involved (bureaucratic application processes). So, while they are great if you are looking for more healthcare coverage, if your immediate and only need is for a checkup, a private physician is the most direct route.

    • Merry says

      Since Monterrey is only a couple of hours from the US border, I’d drive to Laredo and use my Medicaid there.

  6. Lau'ana says

    I have Segurro Popular insurance and I am
    very happy with it. It pays 100% and all
    my testing and medicines are FREE and
    my understanding is that I have three hospitals to choose from in Guad if an
    emergency and it is paid for in full. If I
    want a different hospital….the DIFFERENCE
    is what I pay for the more expensive
    hospital…… I am very happy with my
    experience with this…..

    • David Macon says

      I appreciate and share Lau´ana´s experience. I also have Seguro Popular and , so far cannot exaggerate on the quality and warmth of my medical care. Two years ago, my physician at SP though there was something irregular with my blood and suggested a battery of blood tests. When she got the results, she suggested I have them done again, and both tests completely free.
      When she got the new results, she suggested I see a hematologist-oncologist. I went to two of the finest private medical centers, first, which both told me my insurance covered only partially the expected costs, and had to cough up myself the rest. I wound up going to HOSPITAL GENERAL in Ave. Cuauhtemoc in Mexico City, where upom a full list of tests I was diagnosed with Leukemia. That was 2 years ago, and so far I am still fine and feeling well taken care of. And upon qualifying for Seguro Popular, no one asked me for immigrant status or nationality, so I just hope this will be always the same. GREAT CARE and GREAT COUNTRY!!!!

      • Monica Rix Paxson says

        Thanks Lau’ana and David for sharing your experience of Seguro Popular. Mexico’s healthcare really is great, isn’t it?

        One of the major differences between IMSS and Seguro Popular is that SP has a schedule of benefits rather than comprehensive care. But the menu of treatments and tests available through SP is expanding all the time and new hospitals are being built to accommodate more people , so it reaches more all the time. Also, given how affordable medical care is generally in Mexico (especially compared to USA), it is possible for many people to pay for uncovered charges out of pocket like David did.

        So, the picture on Seguro Popular is rapidly changing. The increases in enrollment in recent years have literally been in the tens of millions. However, I still remind expats that this is a program that was designed to insure the poorest Mexicans: those who cannot get insurance through jobs, etc.

        I would not discourage anyone who needs highly affordable coverage from enrolling in SP—and what you are charged for coverage is based on your ability to pay—there are other options for many expats. And it is important to realize that while this system is set up to offer those services most needed by the majority of people, not everyone is going to get everything they want or possibly even need. It sounds like Lau’ana and David have the right level of realism about this.

        • Chris Sparks says

          My partner and I are deciding to move to Mexico. We are both male and unmarried at the present. We will eventually get married as I am retiring early at 55 and my pension requires me to be married before putting him on as beneficiary. In my partner’s situation he is 65 and although we currently got him Medicare, he will not keep it as State Medicaid is paying his premiums. Once he leaves the country that goes away. So I am trying to find a suitable health care for him and I am hitting many walls. One is the age. Most companies seem to insure up to 64. Since I am going to be paying for his medical, what I get charged may make the difference of whether we move to Mexico or not. I am really getting stressed on this issue. I would like to think that he’d be able to get SP but being that we’ll be married that might change things, unless Mexico doesn’t recognize same sex marriages. We plan to move to Rosarito Beach. Can you help me get in the right direction?

          • Monica Rix Paxson says

            Marriage between same-sex partners is the law of the land nationally in Mexico because of a judicial action last year. But that doesn’t mean it is accepted by the majority of the Mexican population and protests against same-sex marriage are a growing phenomena. Some localities are likely to only perform same-sex marriages if forced by law. Mexico City is an exception since it has been legal there for some time. I don’t know the particulars of Rosarito Beach, but I highly recommend an investigatory visit before making plans to move there to discover how tolerant the locals are or aren’t. Having recently been through the marriage process in Mexico myself (I married a Méxicano), I highly recommend you marry in the USA. Your partner should qualify for Medicare in the USA without requiring payment as all citizens are at age 65. He needs to apply right away. If you live near the border, he can receive treatment in the USA. If you both have permanent or temporary resident’s visas, you will be able to obtain coverage through Seguro Popular. While the coverage will include pre-existing conditions, it is not comprehensive although the list of nearly 300 covered conditions and procedures is quite extensive and many expats are highly satisfied with the treatment and coverage. Premiums are based on income. (http://www.npr.org/sections/parallels/2015/06/16/414964843/how-mexico-quietly-legalized-same-sex-marriage)

  7. Monica says

    Someone requested information by email about Mexico’s Seguro Popular program. This blog post was addressing a very narrow question about Medicare benefits. I addressed Seguro Popular in the book The English Speaker’s Guide to Medical Care in Mexico and Mexperience describes it briefly here: https://www.mexperience.com/healthcare/mexico-healthcare.php#2. Perhaps I shall devote a future post to the topic, but meanwhile I will simply say that Seguro Popular provides very basic medical services (vaccines, diabetes testing, blood pressure monitoring, for example) in a clinic-style setting and is intended to provide care for the poorest people in Mexico who cannot afford IMSS. Care is not comprehensive and it is not the equivalent of Medicare. I recommend its use by foreigners and travelers only in emergencies.

    • David Macon says

      Dear Monica, Sorry to dissent, but my own case confirms that IN ADDITION to all the causes you mention, SP covers hundreds if not thousands of conditions, some of them rather complicated. What is true is that you cannot duplicate care so if you belong to IMSS, ISSSTE, PEMEX, or private coverage of some type, SP is limited.

      • Pat says

        Currently there are about 280 conditions that are covered by Seguro Popular. Fee for services are based on your income so you may have to pay 1000-2000 pesos for a surgery. For most gringos, there will be a small fee for most services you require.

  8. Monica says

    Thanks for pointing that out Paul. If I recall correctly, you must live in Canada for six months of the year to qualify for medical benefits, so perhaps you can confirm either way whether Canadians living full time in Mexico still receive their medicare benefits in Mexico.

  9. I should point out that most Canadians are covered by their medicare up to what it would cost in Canada. I had the chance to test this out in Mazatlan this year.

    • Peter Braun says

      Hello We have gone to Mexico every year for a couple weeks or months, we always purchased travel insurance and from what you state I seem to get that you use Mexican insurance, is it available to purchase online or while we’re there and will it cover as well as travel insurance purchased in Canada thank you, Peter

      • Monica Rix Paxson says

        If you are only in Mexico a couple of weeks a year, you probably already have the best solution, although your insurance agent can confirm that. The type of coverage we are discussing here (IMSS and Seguro Popular) are Mexican government programs that generously include coverage for those foreigners who have FM2 or FM3 resident’s visas and not for those with visitor’s visas. If you ever decide to retire here, these programs might be options for you.

        • Cal says

          Isn’t it true that many pre-existing conditions totally disqualify enrollment in IMSS? Mention is made that pre-existing conditions are covered after 2 years, but that is not always the case. Applying for IMSS is also quite complicated.

          • Pat says

            Seguro Popular will enroll anyone with any pre-existing condition. IMSS is more restrictive.

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