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IMSS Medical
Insurance |
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IMSS Medical Insurance is available to foreigners holding a visa card (not a Visitante). The cost is quite low. To apply you will need copies of your passport, FM#, proof of residency (utility bill, etc), birth certificate, marriage license, and two passport-type pictures. The birth certificate and marriage license will probably be required to have an apostille and to be translated into Spanish by an approved translator. A physical exam is sometimes required, depending on the answers to the questionnaire. Coverage of per-existing conditions is complicated. Some may be covered after two years; others are never covered; and some will disallow your enrollment. The criteria for disallowing enrolment seems to be quite subjective and often varies among offices. IMSS fees for 2015 (pesos per person):
0 to 19 years old $1,900
Fees usually go up in February of each
year Benefits are phased in over a three year period. In the first year only minor things such as colds, Moctezuma's revenge, etc. are covered. These are basically out-patient services for which you will probably want to see a private doctor rather than wasting half a day or more waiting in the IMSS out-patient clinic. The first year will cover automobile and other accidents and emergencies such as heart attacks. The second year adds everything except broken bones and orthopedics. The third year offers full coverage including medications so long as you get them from IMSS, You will not be reimbursed for drugs bought from other pharmacies. This drug benefit is often pretty hollow as IMSS is chronically short of medications. The schedule of benefits and annual cost are subject to change, so get the latest word from your local office. The following is a typical application questionnaire. |
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IMSS Application Questions Name as it appears on your migratory document? 1. Father’s full name? /Apellido paterno? 2. Mother’s full maiden name? /Apellido materno? 3. How old are you? /Edad? 4. How tall are you? (cm) /Estatura? 5. How much do you weigh? (kg) /Peso? 6. What is your highest level of education? /Profesion o escolaridad maxima? 7. Are you active in any sports? /Practica algun deporte? 8. What is your occupation? /Ocupacion principal? 9. Do you drink? /Toma bebidas alcoholicas? 10. How many drinks per week? /Cuantas copas por semana? 11. How long have you been drinking? /Desde cuando empezo a tomar? 12. Do you smoke? /Fuma? 13. How many cigarettes per day? /Cuantos cigarros por dia? 14. How long have you been smoking? /Desde cuando empezo a fumar? 15. Do you take any over the counter medication? /Acostumbra automedicarse?
Do you have any of the following – Yes or No
16. Allergies or asthma? /Alergia o asma 17. Chronic blood diseases? /Enfermedades cronicas de la sangre 18. Cancer or tumors? /Cancer o tumores 19. Diabetes Mellitus with /Diabetes mellitus con · Kidney insufficiency /Insuficiencia renal · Retinopathy /Retinopatia · Neuropathy /Neuropatia · Peripheral circulatory insufficiency /Insuficiencia circulatoria periferica 20. Heart disease? /Enfermedades del corazon 21. Liver diseases? /Enfermedades del higado 22. Chronic nervousness or psychiatric diseases? /Enf nerviosas o psiquiatricas cronicas 23. High blood pressure? /Presion arterial alta 24. Rheumatism or arthritis? /Reumatismo o artritis 25. Tuberculosis? /Tuberculosis 26. Stomach ulcers? /Ulcera del estomago 27. A.I.D.S.? /S.I.D.A. 28. H.I.V. positive? /V.I.H. positivo 29. Genetic diseases (from birth)? /Enfermedades congenitas (desde elnacimiento) 30. Chronic bronchitis? /Bronquitis cronica 31. Vascular accident or embolism? /Accidente vascular o embolia 32. Deformations or movement impairments due to accidents or illness?/Deformaciones o limitaciones de movimiento por accidents o enfermedades 33. Addictive alcoholism (frequent)? /Alcoholismo adictivo (frecuente) 34. Addiction to toxic substances? /Adiccion por sustancias toxicas
Exclusions and Limitations A foreigner will not be covered for these pre-existing conditions. Malignant tumors (cancer) Chronic degenerative diseases such as: complications from long-standing diabetes, and diseases of the liver, kidney, heart, lung, neurologic, cerebrovascular, peripheral vascular, and many others. Drug or alcohol dependency Psychiatric illness HIV positive status or history of AIDS History of traumatic or muscular injury that continues to require treatment These conditions are not covered at first: Benign breast tumors in the first six months after acceptance Births in the first ten months after acceptance In the first year, the following surgical procedures are not covered: Lithotripsy for kidney stones Surgery for gynecologic conditions except for cancer Surgery for vein disorders Surgical procedures for the sinuses, nose, hemorrhoids, rectal fistulas, tonsils and adenoids, hernias (except for herniated spinal discs), and other operations that are also considered “elective,” or voluntary, rather than required In the first two years after acceptance you cannot receive surgery for orthopedic conditions. IMSS insurance will not cover the following: Aesthetic or plastic surgery, eyeglasses, contact lenses, hearing aids, the surgical correction of astigmatism, Lasik surgery or the equivalent, treatment of self-inflicted injury, preventive care, treatments for behavioral or psychiatric disturbances, dental care (except for extractions), or infertility treatments. |