Health Insurance in Mexico: A Guide for Expats
Moving to Mexico as an expat is exciting, but you’ll also have plenty of worries. US citizens in particular worry about the cost of healthcare. It makes sense, as healthcare has been perhaps our primary expense in the US, and the cost of care might even be a big reason why we’re looking to live elsewhere.
It’s no longer true that healthcare in Mexico is ‘so’ affordable for US citizens that you need no form of insurance. Understanding health insurance options in Mexico is critical, especially for residents who want peace of mind around medical costs for preventative care, emergencies and ongoing end-of-life care.
Why Health Insurance Matters in Mexico
Medical expenses generally top the list of end-of-life costs. In the US, the average person spends about 50% of their non-housing wealth on healthcare in their last year of life, even with Medicare or private insurance. Health insurance policies in the US rarely cover everything, and high deductibles and out-of-pocket limits leave many Americans with medical debt.
It’s no surprise, then, that US-born expats often ask: “What about health insurance in Mexico?” Fortunately, Mexico offers a variety of public and private health insurance options, as well as the ability to pay relatively affordable out-of-pocket rates.
As with most things, and perhaps all things end-of-life, the earlier you plan, the more options you’ll have available to you.
Using US Medicare in Mexico
Nearly every U.S. citizen qualifies for Medicare at age 65. But if you spend significant time in Mexico, it’s important to know: Medicare generally does not cover healthcare abroad. Mexican hospitals and pharmacies cannot submit claims or accept Medicare as payment. Medicaid can be even more restrictive, usually limiting coverage to the US state of issuance.
Some exceptions exist. Certain Medicare Supplement (Medigap) or Medicare Advantage plans may reimburse emergency care abroad, usually only within 60 days of leaving the US. Some expats near the border use cross-border travel to access US healthcare and pharmacies, which can be convenient, but is not typically sustainable long-term.
If you’re paying for Medicare coverage while living in Mexico, it may be worth evaluating whether an international or Mexican health care plan (or saving your money for direct pay care in Mexico) would better serve your needs.
In Mexico, you might have public health insurance, private health insurance, or a combination of the two.
Public Health Insurance in Mexico
Mexico offers two government-run healthcare options:
INSABI
Instituto de Salud para el Bienestar (INSABI) provides free health services and medications for those without social security coverage in Mexico. INSABI aims to make healthcare accessible for all, though quality may vary depending on location and funding. As an expat living in Mexico, you have free emergency access to healthcare via INSABI, regardless of your immigration status.
IMSS
Instituto Mexicano del Seguro Social (IMSS), founded in 1943, administers care for workers and their families, but non-workers can enroll for a modest annual premium. Coverage requires a health exam, and pre-existing conditions may be excluded. IMSS premiums are usually much lower than private insurance, making it an affordable option for many expats. As with INSABI, facilities and the availability of appointments will vary considerable depending on the region of Mexico you live in. You must be a temporary or permanent resident, and under the age of 65, to apply.
Private Health Insurance in Mexico
For expats seeking additional coverage or avoiding the limitations of public healthcare, private health insurance is often a better option. However, it’s important to differentiate between travel insurance and long-term international health plans:
Travel insurance often only covers emergencies and short trips (typically up to 60 days).
International health insurance is designed for residents, usually on annual policies and can be typically used in the US or Mexico.
Mexican private insurance is designed for residents, is usually sold via an annual policy, and is for use while you are in Mexico.
Private plans may operate on a reimbursement basis, meaning you pay upfront and submit itemized receipts to your insurer. If you go with a reimbursement plan, know that deposits at private hospitals can reach $30,000 USD or more, even for procedures costing less. Can you put down that kind of money up front? Working with a trusted insurance broker is crucial, both to navigate paperwork and to ensure you can access reimbursement when needed.
Before any major procedure, always get pre-approval and maintain clear, detailed receipts. In emergencies or if you cannot manage your policy, having a health advocate or broker is invaluable.
Paying Out of Pocket
Healthcare in Mexico is often far more affordable than in the US, and many expats choose to pay cash for routine care:
Annual checkups, blood tests, mammograms, dental cleanings — costs can be as low as 10% of what you’d pay in the US
Minor illnesses and prescriptions are also relatively inexpensive and readily accessible.
That said, having insurance for major surgeries or chronic illness is wise. For instance, heart surgery in Mexico City can cost $30,000–$80,000 USD, depending on the complexity. A private health plan can help offset these costs and provide peace of mind.
Choosing the Right Option
Deciding between public, private, or a mix of both depends on:
Your residency status and location
Your health needs and risk tolerance
Your age and any pre-existing conditions
Your budget for premiums vs. out-of-pocket payments
Many expats use a combination: public coverage for routine care, private insurance for emergencies or complex procedures, and selective cash payments for minor healthcare needs. This flexibility allows you to maximize affordability without compromising access to high-quality care.
Tips for Expats in Mexico
Research local clinics and hospitals before choosing insurance.
Check coverage details carefully, especially for pre-existing conditions.
Work with a bilingual broker familiar with expat needs.
Keep copies of all receipts if your plan requires reimbursement.
Consider proximity to U.S. border towns if occasional access to US care or pharmacies is important.
Conclusion
Health insurance in Mexico is manageable, flexible, and often more affordable than in the US. Understanding your options, Medicare limitations, public programs (INSABI and IMSS), private international plans, and out-of-pocket payments, allows you to make informed choices for your health and financial security.
With advance planning, you can enjoy the peace of mind that comes from knowing medical care is accessible and affordable, letting you focus on living your life in Mexico to the fullest.
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We welcome questions or comments below. Alternatively, join the discussion in our private Facebook community, where we’re talking about end-of-life planning and care.
