# Quality of IMSS Insurance for American Expats in Mexico



## Sojourner2 (8 mo ago)

What level of coverage does IMSS insurance provide? I'm 70 and apparently the annual cost of IMSS insurance for an American living there is about $780 a year. Hard to believe. Which is what makes me wonder if the coverage is worth having. The following screen clip is from Seguro de Salud para la Familia. Is a better level of coverage available that provides access to private providers and hospitals at a cost scaled to the Mexican economy? Tthe international insurance I found is quite pricey.


View attachment 101563


----------



## MangoTango (Feb 8, 2020)

I have high blood pressure and that and diabetes are two things which are important to someone at IMSS. They would like me to come in once a month to have my blood pressure taken and pick up some meds (if they have them). Truth is - no one there really knows how to properly take a person's blood pressure anyway. But - I do go to my clinica perhaps 2 or 3 times a year. But my meds run me about 700 pesos / month at the local discount farmacia - so that is almost half the cost of the insurance. Of course the clinica is clear on the other side of town so I spend about half a day going there.

I have never set foot in, nor would I likely ever consider, going to an IMSS emergency room. 

I have not been to a 'specialist' at IMSS (cardiologist, opthamologist etc) in perhaps two years. I have paid out of pocket 1000 pesos for a visit to one of the best cardiologists in the area and just recently I had my eyes checked out at a local place which is one of the best for eyes in the nation and that cost me I think 350 pesos. But - many of the specialists at IMSS are the same people who have their own private prcactices outside IMSS (they are often times good). It may, however, take months to get an appointment and on the day you show up perhaps plan on waiting 3-4 hours to see the doctor. 

My go to place for a lot of things is Cruz Roja. 100 pesos to get in and you pay for whatever materials they use on you (bandages etc). 

I think in geeral - ignoring the age band increases - the cost of IMSS insurance goes up 10-15% each year.

But it IS so cheap that why not carry it...


----------



## AlanMexicali (Jun 1, 2011)

IMSS has exclusion to join if you have many of the pre-existing medical illnesses so you might not qualify. It also has waiting periods for coverage for other pre-existing illnesses from 3 months to 3 years.

Large city IMSS are usually state of the art hospitals now - not all. The agricultural poorer states still might have crumbling IMSS hospitals. The obvious other thing to consider about poorer smaller, cities IMSS quality of specialists' Dr.s' is these Dr.s only work 4 to 5 hours Mon. to Fri. at the IMSS and then in their lucritive private practice usually making good money but in a poor small cities or large towns it would not be lucritive so the better specislists only work in large cities and the others Dr.s or recently licensed work in these other locations.

Here in San Luis Potosi IMSS has excellent care. We know many Dr.s who work there and I have been in all their facilities. The two older large IMSS hospitals 2 blocks apart in Centro Historico could use major renovations instead of being patched up but function still.

Modern diagnosis and treatment of illnesses is very well know in the World now and is practiced with confidence so does it matter who or where you go anymore to get service?


----------



## maesonna (Jun 10, 2008)

You’ll get a variety of answers that depend more than anything else on location. In general, IMSS facilities in major cities are many tiers above rural facilities.


----------



## citlali (Mar 4, 2013)

yes there are some good hospitals and not so good hospitals, the more rural you go and more chances you get of no medecine, overcrowding etcc..


----------



## MangoTango (Feb 8, 2020)

maesonna said:


> You’ll get a variety of answers that depend more than anything else on location. In general, IMSS facilities in major cities are many tiers above rural facilities.


Well that is particularly true of Mexico City. I once asked a cardiiologist - let's say I have a heart attack - where should I go. His first choice was a local cardiac specific hospital with all the latest gadgets/gizmos etc - but that is way too expensive he said. He thought for a second and said - I would hop in a taxi and tell them to take me to the general IMSS hospital in Mexico CIty. (That would make for an interesting cab ride).


----------



## eastwind (Jun 18, 2016)

I would go for the expensive place with all the gadgets. You only die once.


----------



## MangoTango (Feb 8, 2020)

Actually - after thiniking about it - I think the cardiologist who I was speaking to is on staff at the expensive place  His office was at yet a third location....


----------



## surabi (Jan 1, 2017)

When I decided to use private medical insurance in Mexico (which I no longer have due to the increase in premiums after I hit 70) it was not because I didn't trust that the doctors in IMSS hospitals were competent, but because while my Spanish is pretty good, much of medical and legal terminology vocabulary is outside my understanding. I didn't relish the thought of not easily understanding what medical findings, treatments, or necessary procedures may be, should I end up in the hospital. 

Also, with private insurance, there is the option to choose your doctor from their list, or request another if you don't feel okay about the treatment you are receiving, etc.


----------



## Sojourner2 (8 mo ago)

MangoTango said:


> I have high blood pressure and that and diabetes . . . I have never set foot in, nor would I likely ever consider, going to an IMSS emergency room.


So I gather the IMSS insurance does not provide access to private healthcare facilities with higher standards of care, and that what IMSS provides is the most basic level of servcies? That's what I was trying to get at. And if you don't buy IMSS insurance, then as a exapt resident you would need to obtain insurance from a private for-profit insurance company?


----------



## MangoTango (Feb 8, 2020)

The words private and IMSS do not mix.
As I think I mentioned - they (for some reason) really care about high blood pressure. One year they ran out of money and had no more cardiologists on staff. They sent me to a private hospital to see a private cardiologist - just for an annual check-up. That was interesting because that visit may have been the longest 1-on-1 with any doctor I have ever had - in my life. (But the whole situation was not normal). 
In 10 some years I don't think we ever seriously considered private health insurance.
Even in the priciest of situations - if you look someone square in the eye and say - I have no insurance - the conversation will change - they will work with you (or that has been my experience anyway). Not only that - I have had a surgeon call another hospital and speak to another specialist. They talked about my health and then they talked about my finances (as in out of pocket). 
It is a totally different world from what you might be used to in the US... 

When I had my one and only surgery at an IMSS hospital I was told to disrobe and handed a gown (which barely covered my genitals - I am tall). Then I was pointed towards a row of metal folding chairs, in a long hallway, and told to sit (bare-butted) for my turn. Maybe 5 minutes before it was my turn (after a couple/few hours) the anesthesiologist came and sat next to me. He said - ok - for this procedure we are going to give you a spinal. I replied - no we are not - we are going to put me to sleep - which in the end they did do. btw - I walked on my own two feet (no gurney) into the operating room (a room filled with perhaps 15/20 various staff) and laid down on the table on my own. Mine was not a real life-or-death emergency. To be honest it was a trial ballon for me to get a sense of how things truly worked at IMSS. 

Now if you are/were a government employee (I believe even a teacher) _then_ you may have access to a higher tier of medical care called ISSTE. I think it is free - but I do not believe you can buy into it...


----------



## Sojourner2 (8 mo ago)

MangoTango said:


> The words private and IMSS do not mix.
> When I had my one and only surgery at an IMSS hospital I was told to disrobe and handed a gown (which barely covered my genitals - I am tall).


Not sure how well I could handle that situation. I can't imagine sitting in a corridor with my nuts--much less anything in their general vicinity--on full display for the world to see.


----------



## citlali (Mar 4, 2013)

Then if you cannot handle that you need to get a private insurrance or self insurre or forget about insurrnce in Mexico, that is the reality here- My husband was very large and I ended up buying some very large hospital gowns on Amazon and use them when he went to the hospital.. You just have to be ready if you do not fit the general profile of the population and we have insurrance in the top hospitals.. They still did not have decent gowns for him. So you are forwarn if you are a tall or large size have a couple of gowns at the ready for hospital stays.


----------



## eastwind (Jun 18, 2016)

Well that's a tip I'd never have thought of on my own!


----------



## surabi (Jan 1, 2017)

MangoTango said:


> Then I was pointed towards a row of metal folding chairs, in a long hallway, and told to sit (bare-butted) for my turn.


I once had occasion to sit outside a Seguro Popular hospital for hours when I had to take my worker in for a scorpion sting. He had had a severe reaction, his throat was closing up, and he needed to be put on IV antivenom. Although this took about 3 hours, I was not allowed to leave and come back for him- they said when someone was in the emergency ward, there had to be someone there waiting for them.

What I saw in those 3 hours, sitting on the waiting room chairs in the outside courtyard made me never want to rely on Mexican public health care. (Although I realize that IMSS is supposedly a tier above Seguro Popular)

Women in advanced labor left writhing in pain on the hard plastic chairs for hours (there were several of them).

A guy had been brought in who had electrocuted himself. I believe he was dead or almost, on arrival. The doctors would not tell his wife and parents, who had brought him in, that he was dead, instead waiting until more relatives showed up, were told, and had to break it to the ones who had been sitting there for a couple of hours, assuming their husband and son was receiving care.


----------



## MangoTango (Feb 8, 2020)

I'm just mentioning this in case in helps someone down the road. Where I live we would go to Cruz Roja for a scorpion sting (not SP - I think Cruz Roja is the _only_ place you can go). It will cost something like 700 or 800 pesos (which is kind of pricey for a Cruz Roja visit). If you have a gardener (who you pay 500 or so pesos) keep that in mind should he need treatment. btw - if you can, note the color of the scorpion...

One of the most generous gestures I have seen in Mexico - I was a patient in a private hospital, which was pretty much empty because it was so expensive. If there were 20 rooms (on my floor) perhaps 5 were occupied. This was at the peak of covid. The hospital basically opened its doors to women in labor to get them out of the public hospitals (and limit the potential exposure to covid). And they just kept pumping these women in and out rapidly. So I pretty much found myself in a maternity ward - which actually felt pretty good all things considered.

The dicotomy of life and death in Mexico is something I still have not gotten used to. Death seems to be more accepted than say in the US. I'm exagerating a little - but it is almost an - oh well - attitude. And for the life of me I can't understand the low value put on life by these people who shoot each other up at night - sometimes apparently over some really small things. Like an argument amongst friends while drinking beers. I wish religion truly played a larger part of people's lives...


----------



## citlali (Mar 4, 2013)

Religion plays a large part.. death is something every one has to go through , it is a passage to another stage or whatever and people here totally expect it and accept it. They all will tell you that people are in a better place and they they can finally rest.. It is a very fascinating part of living here.. Ther is not much separation between life and death.. as it is reflected in the language , it is something that does not last.. you go on to a better place so ythey say esta muerto.. using estar in this case it a pretty interesting reflection of the way people look at it.. The attitude about death in this country is way more sane and healthy than in the US..
When my husband was laying down on the floor, friends told me to cover his bare feet because he was going to be cold... or looked cold.. They are helping his face to relax and look good. There was a tenderness that was very touching.. They told me that a dead body could never be left alone. Here death is truly part of living and it is a way better attitude than in other countries like th eUS or France wher it is feared..and disliked..
People here are very fatalistic and I think it is a very good thing. It is not placing less value on life , it is lloking at death as a natural ending of life that everyone will go through one day or another.


----------



## surabi (Jan 1, 2017)

MangoTango said:


> Where I live we would go to Cruz Roja for a scorpion sting


Unfortunately there is no Cruz Roja facility in my area- the Seguro Popular hospital was the closest place to take him and it was an emergency situation. I first drove by our local govt. clinic, but they were closed.



MangoTango said:


> I wish religion truly played a larger part of people's lives..


But that is exactly what leads people to claim it was "God's will" instead of taking precautions to minimize fatal accidents, or learning a lesson from it.

I see Mexicans barreling down the highway, Dad driving and Mom in the passenger seat, their luggage piled up behind the cab, with their little kids in the back of the pick-up truck, right up against the tail gate. If they get rear-ended, those kids can easily be dead. While they will be devastated, they will say it was God's will. No it wasn't, it was inattention to safety practices. I realize that the average Mexican can't afford an SUV with seat belts for the whole family, but at least put the kids right behind the cab with the luggage in the rear as some protection.

Same for having the baby balanced on the moto seat in front of them, or driving drunk, or messing with the electrical wiring without turning off the breakers first, or any one of a host of other preventable accidents.


----------



## maesonna (Jun 10, 2008)

Sojourner2 said:


> So I gather the IMSS insurance does not provide access to private healthcare facilities with higher standards of care, and that what IMSS provides is the most basic level of servcies? That's what I was trying to get at. And if you don't buy IMSS insurance, then as a exapt resident you would need to obtain insurance from a private for-profit insurance company?


Not exactly. In a big city (like Mexico City) the IMSS hospitals provide much more than just basic levels of services. The doctors aren’t necessarily second-class either; many of them work in private practice during the hours when they aren’t working at IMSS.
Also, if you have IMSS, there is nothing stopping you from going to a private doctor or a private hospital instead of IMSS, it’s just that you’d have to pay for it yourself. And lastly, whether you are an expat resident or a Mexican national is irrelevant.


----------



## Maxkjo (Sep 6, 2021)

Many interesting and thoughtful replies by foreigners. An interesting perspective. I have imss social security medical insurance. My girlfriend, who works in the prisons, has issemym, and they saved her life. I'm quite happy with imss, except for the bureaucracy, that's really bad, but the doctors are excellent. To have imss, you need at least c1 Spanish.


----------



## Isla Verde (Oct 19, 2011)

Maxkjo said:


> Many interesting and thoughtful replies by foreigners. An interesting perspective. I have imss social security medical insurance. My girlfriend, who works in the prisons, has issemym, and they saved her life. I'm quite happy with imss, except for the bureaucracy, that's really bad, but the doctors are excellent. To have imss, you need at least c1 Spanish.





Maxkjo said:


> Many interesting and thoughtful replies by foreigners. An interesting perspective. I have imss social security medical insurance. My girlfriend, who works in the prisons, has issemym, and they saved her life. I'm quite happy with imss, except for the bureaucracy, that's really bad, but the doctors are excellent. To have imss, you need at least c1 Spanish.





Maxkjo said:


> Many interesting and thoughtful replies by foreigners. An interesting perspective. I have imss social security medical insurance. My girlfriend, who works in the prisons, has issemym, and they saved her life. I'm quite happy with imss, except for the bureaucracy, that's really bad, but the doctors are excellent. To have imss, you need at least c1 Spanish.


What is c1 Spanish?


----------



## Bobbyb (Mar 9, 2014)

AS others have stated it depends where you live. In small towns it can be almost 3rd world. I have been to one of those little clinics. The EKG machine is out of paper. Been that way for 2 years. The beds and tables are rusty. The floors are dirty. Anything beyond a simple visit we go to a great private hospital.


----------



## Takingiteasy (Aug 12, 2021)

@Isla Verde C1 is part of a language proficiency system. A1 being a beginner, there is A2, B1, B2 then C1. Its a standardised international system but to learn your exact level you have to take a test I believe. There is a C2 and I'm not sure what comes after that. I think people can do fine in mexico without being quite that good. B1 or B2 should get them through and you will be learning fast. C1 means you can communicate fairly well. I'm not even sure what my level would be, I'm fairly fluent so maybe C2 but I never took the test


----------



## Isla Verde (Oct 19, 2011)

Takingiteasy said:


> @Isla Verde C1 is part of a language proficiency system. A1 being a beginner, there is A2, B1, B2 then C1. Its a standardised international system but to learn your exact level you have to take a test I believe. There is a C2 and I'm not sure what comes after that. I think people can do fine in mexico without being quite that good. B1 or B2 should get them through and you will be learning fast. C1 means you can communicate fairly well. I'm not even sure what my level would be, I'm fairly fluent so maybe C2 but I never took the test


Thanks for the information. Since I have spoken fairly fluent Spanish for many years (I started off my professional life as a Spanish teacher), I have never needed to have my Spanish ability validated. Is this system used in the United States? When you wrote that you "need" a C1 level of Spanish to use IMSS, what did you mean? I enrolled in IMSS a few years ago (though I never used it) and was never asked to verify my level of Spanish proficiency.


----------



## Maxkjo (Sep 6, 2021)

Isla Verde said:


> What is c1 Spanish?


a1 is a new beginner (breakthrough) and c2 is mastery. The scale is a1,a2 (beginner), b1,b2 intermediary, and c1,c2 (advanced). It is the European Common model of language which the European Union has been using for some time, although Spain only in 2012 harmonized the exam (dele). Before that, the dele was very Spain-centric (bleech). I know in the US they have the actfl thingy, which I don't know much about. What do they use in Canada? In Latin America, it is the common model, including in Mexico.

Around here, for day-to-day things, like imss, you really need c1 Spanish. You'd really struggle with b2. b2 to c1 is the friggin sargasso sea, that's where people plateau for years. I am a Spanish and English teacher and am certified c2 in Spanish and in English. 

You can google all of this, it is a pretty large industry to be certified. When I was certified c2 in English in the US, all the other students were from Europe, and a lot of it was work-related. Not a single Mexican American, oh well. Cultural differences.


----------



## Takingiteasy (Aug 12, 2021)

I wasn't the one who said you needed C1 for imss. It seems to me that a basic knowledge will get you going and assuming you are constantly learning, you should get by. Of course the better you speak the easier it will be. To me the speaking part is easier but I have to listen closely to catch what they say sometimes due to accents, expressions or a new word. Telling noobs they must be advanced in spanish to do day to day things will be discouraging. If you can do simple conversations in B1, it seems like B2 you should know your tenses and be able to speak freely. But if you speak your spanish rapidly they assume you can understand just as rapidly or even faster, so say "despacio por favor" now and then.

Would a native speaker be an automatic C2 or might they fail the test? A native speaker with phd in the language would only be C2?


----------



## Maxkjo (Sep 6, 2021)

Takingiteasy said:


> I wasn't the one who said you needed C1 for imss. It seems to me that a basic knowledge will get you going and assuming you are constantly learning, you should get by. Of course the better you speak the easier it will be. To me the speaking part is easier but I have to listen closely to catch what they say sometimes due to accents, expressions or a new word. Telling noobs they must be advanced in spanish to do day to day things will be discouraging. If you can do simple conversations in B1, it seems like B2 you should know your tenses and be able to speak freely. But if you speak your spanish rapidly they assume you can understand just as rapidly or even faster, so say "despacio por favor" now and then.
> 
> Would a native speaker be an automatic C2 or might they fail the test? A native speaker with phd in the language would only be C2?


We seem to have hijacked this thread. Apologies. A native speaker can fail the c2 exam, easily. Mexican Spanish is impeccable Spanish, but due to a crappy public school system, they can have real issues with diagrammatic marks, spelling, and even grammar.

You will need c1 Spanish to live where there aren't foreigners and "fit in". Just listen to someone speaking your native tongue at level b2, it's "nefasto".

If you live with foreigners, that sucks, you'll take a lot longer to learn Spanish because so many people will force you to speak English (including Mexicans). In my opinion, that sucks.


----------



## citlali (Mar 4, 2013)

Lots of bs.. I learned Spanish fairly quickly living with an American husband in the chapala area that is full of foreigners. It takes dedicatiin and refusing to speal English.I rarely speak English now .and live part time in another area where i never speak English
It is true it takes mord efgorts and determination to learn if you are not immerse in tbe culture it is peefectly doable.. My plus is that I speak other languages so my brain is wired to speak other languages..Age also adds a difficulty, the short term memory is not as good and the hearing is not as well so it is a double whammer.


----------



## Takingiteasy (Aug 12, 2021)

"Just listen to someone speaking your native tongue at level b2, it's "nefasto". " 

How would I be able to hear someone speaking at that level? Or at other levels of various languages?


----------



## Maxkjo (Sep 6, 2021)

Takingiteasy said:


> "Just listen to someone speaking your native tongue at level b2, it's "nefasto". "
> 
> How would I be able to hear someone speaking at that level? Or at other levels of various languages?


Maybe on youtube? There are millions of people that speak languages at b2 and have been certified at that level. If you're a language instructor, there're just "around".


----------



## Takingiteasy (Aug 12, 2021)

This is what the british council says about b2

*B2 level competencies*


Can understand the main ideas of complex text on both concrete and abstract topics, including technical discussions in their field of specialization.
Can interact with a degree of fluency and spontaneity that makes regular interaction with native speakers quite possible without strain for either party.
Can produce clear, detailed text on a wide range of subjects and explain a viewpoint on a topical issue giving the advantages and disadvantages of various options.
That does not sound like b2 is a terrible speaker, it sounds like they could get by just fine in a spanish speaking country


----------



## MangoTango (Feb 8, 2020)

I've been living in Mexico right around 10 years and I would grade myself (based on internet searching) somewhere bewtween A2 / B1 - it really depends on the context / situation and to a large extent the (intelligence of the) individual I am speaking with. I really have developed my own hybrid language - which for the most part works. I know quite a few nouns and when needed I either throw out the infinitive OR I recite a good part of the (possible) verb conjugations until I get my point across. 

In my own defense let me say that I live (virtually) in the middle of nowhere. I don't interact with a ton of people (at least not a lot of different people) - and for the 10 years I've been in Mexico I used my wife's Spanish fluency as a crutch. 

I have no issues dealing with the people at IMSS (which was the orignal topic of interest, no ?). Most 'doctors' are bilingual (somewhat). Outside of IMSS you would be amazed at how many times people nearby, when I speak to someone else, will join in the conversation (they are silently bilingual). For example - this week I visited CFE to hand over my constancia (a transaction which was handled in pure Spanish - no English spoken). But when I arrived the security guard told me I needed to wait for the room to empty a little before entering (she spoke purely Spanish). I got the message - but the guy I was standing next to translated her message to English for me anyway - probably to practice his English (he spent some time in Clearwater Florida)... 

And when I am really in a conversation which is going nowhere - more and more often - we break out our cellphones and let the translation programs help us along.


----------



## citlali (Mar 4, 2013)

I have no idea what my level of proficiency is , in any of the languages I speak-- How do you guys know what is your level? Did you get tested? 

I have been here 20 years and came with no Spanish understanding whatsoever. I now can follow the ganbangers without much problem, not sure if that is part of the proficiency test. I still have problems with some of the puns and jokes, no problems with the speed whatsoever and I speak pretty fast myself. What is my level no clue..
I never use the help of translators.

When the person from Social Security called me the other day she had a Spanish accent in English and I asked her to speak Spanish. I have more problems understanding people who speak English with a Spanish accent than understanding someone who speaks Spanish no matter how fast on the telephone.


----------



## MangoTango (Feb 8, 2020)

citlali said:


> I have no idea what my level of proficiency is , in any of the languages I speak-- How do you guys know what is your level? Did you get tested?
> 
> I have been here 20 years and came with no Spanish understanding whatsoever. I now can follow the ganbangers without much problem, not sure if that is part of the proficiency test. I still have problems with some of the puns and jokes, no problems with the speed whatsoever and I speak pretty fast myself. What is my level no clue..
> I never use the help of translators.
> ...


I've no idea but I used this site :
Levels of Language Proficiency Explained, Finally! Infographic

But I believe there are tests (with a cost associated). I think some schools will guarentee you will pass a certain level. (I'm on very thin ice here).


----------



## Maxkjo (Sep 6, 2021)

ok, kudos to todos. Congratulations on your ability to survive in Spanish. Around here, the doctors and imss personnel do not speak Spanish and my topic was that language, or maybe isla verde started it, or helped? It is a religious topic amongst foreigners. jeje. As they say, ¡obvio! All I can say is that I am credentialed to teach the subject. (I have a degree in the subject and can grade peoples' proficiency.) Good luck to all. edit: I know some of you are quite fluent, I didn't mean to say otherwise.


----------



## Sojourner2 (8 mo ago)

Maxkjo said:


> . . . To have imss, you need at least c1 Spanish.


I didn't realize there were various classifications for proficiency levels in Spanish. I'm definitely at the beginning of the A1 level. Of course, if we wind up spending much time in Mexico, I will work on obtaining greater proficiency. Otherwise, there is no opportunity for its use in my home area of rural eastern NC.


----------

