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Mexico's Health-Care System in Plain English
Mexico’s Health Care System in Plain English
Mexico fosters three unequal, yet parallel systems of health care. There are six government-run social security institutions that provide care for approximately 50 million of Mexico’s gainfully employed. The uninsured poor, comprised of about 40 million Mexicans, receive limited health-care benefits administered by the Ministry of Health of Mexico. The private sector, which represents about 3 million Mexicans, is comprised of individuals whose health-care funding is met through private insurance carriers. We will limit our discussion to the two health organizations that are accessible to travelers and expatriates living in Mexico.
The largest and most notable social security organization is the Mexican Social Security Institute or IMSS. The IMSS is available to foreigners residing in Mexico and is funded by contributions from employers, beneficiaries, and the Mexican Government. (Click here to learn how to apply for IMSS health insurance.)
Hospitals and clinics that provide medical care for Social Security recipients vary in quality. While major urban institutions may provide adequate to advanced tertiary care, rural hospitals often have outdated equipment, long waits, and inadequate staffing. MedToGo did not review Social Security doctors or hospitals for this guide, so if you choose to see an IMSS doctor, you will have to do your own research. Please note that in the IMSS system, you cannot choose your primary care provider. Therefore, your access to care (and hospitals) is regulated by your assigned physician.
Many of the doctors we have listed in this guide see patients in an IMSS clinic as well as a private practice setting. One way to circumvent the IMSS referral process is to see a doctor with IMSS privileges in private practice. Then, have that doctor refer you to the best IMSS facility for care (through the IMSS system). Social Security costs for medical care and prescription drugs are far lower than in the United States.
The Private Sector
In general, private medical care in Mexico is preferred; up to 25 percent of patients with Social Security benefits or no coverage at all prefer to pay out of pocket for private care. Since health care in Mexico is generally much less expensive than in North America, cash payment is still an affordable option. The cost for a general medical consultation may begin as low as US$20 (of course, costs rise in major cities and tourist destinations). Very few Mexicans have private health insurance, but this sector is growing.
Private hospitals in Guadalajara, Monterrey, and Mexico City offer some of the most advanced tertiary care centers in the world. Tertiary care is advanced care (i.e., cardiovascular evaluation and surgery, neurological evaluation and surgery, orthopedic surgery, hemodialysis, organ transplants, among others) that requires highly specialized skills, technology, and support services. Most of the doctors in these hospitals have had excellent Mexican medical education, and many have trained abroad in Europe or North America.
Be warned: most private hospitals do not accept any form of foreign health insurance, and require cash or credit payment prior to admission or treatment. However, if you are injured or in grave health, a private hospital will attempt to stabilize your condition and then transfer you to a government or Social Security hospital.
There are also very good medical centers in many smaller cities frequented by tourists. Private “hospitals” or clinics in rural destinations tend to be owned by groups of local physicians with varying levels of training. Their facilities and technology are typically outdated, but are adequate to manage minor illnesses.
Patients with advanced care requirements should always be transferred to one of the tertiary medical centers listed in the Mexico: Health and Safety Travel Guide. You should consider any hospital with a 4/5 or 5/5 MedToGo rating as advanced (see book for rating system criteria). Because of the great variability in physicians and hospitals, we highly recommend that you use a reference such as this guide prior to consulting with a private, rural physician.
Ministry of Health
Nearly half of Mexico’s 100 million inhabitants have no health insurance benefits at all. Their preventive care is limited to vaccinations and oral rehydration programs for children. Care in this sector is extremely limited. For example, infant mortality is ten times higher here than in the parallel private sector. Red Cross or Cruz Roja hospitals service the poor and are accessible to anyone in Mexico regardless of their ability to pay. We cannot recommend that travelers seek care in this sector unless there are no other options.
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My bi-lateral shoulder surgery was nothing short of a huge success. I had had a previous arthroscopic surgery in 2010 on my left shoulder that took 2 years to heal and still had pain. Dr. Max evaluated that shoulder in May of 2014 (7 other orthopedics said it would have to be sacrificed as it was too far gone) and felt that he could repair it with probable outcome close to normal.
I have been pain free since about two days after the surgery.