What is Expat Health Insurance and How Does it Work?

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It may come as a surprise, but did you know that when you live or work abroad as an expatriate or diplomat, your domestic health insurance plan does not come with you?

Healthcare systems around the world generally fall into three broad categories: single-payer healthcare systems, insurance mandate systems, and hybrid healthcare systems. However, there are only two countries with true single-payer healthcare systems that cover their entire populations (including expats): Canada and Taiwan.

If you are working and living abroad, it’s important to familiarize yourself with the country’s healthcare system and your options. Most countries’ health care systems are like Mexico’s – they have a hybrid, three-tier system that consists of a public, government-subsidized option, a social program, and private health insurance.  

Expats who want Health Insurance in Mexico have three options available to them within Mexico’s three-tier healthcare system: INSABI, IMSS, and private health insurance.

The Three Tiers of Healthcare in Mexico

Unfortunately, the three tiers of healthcare in Mexico are not all created equal. Let’s examine INSABI, IMSS, private health insurance, and the advantages and disadvantages of each.


The lowest and cheapest healthcare tier is INSABI (Instituo de Salud para el Bienestar). This is a universal healthcare system that is subsidized by the government – which means that it is free to the public.

The Instituto de Salud para el Bienestar, which means “The Institute of Health for Well-Being” in English, is directly funded by taxes. INSABI allows all individuals to access public medical facilities for preventative healthcare treatment, outpatient care for common illnesses, and disease prevention.

While the INSABI system is an admirable effort on the Mexican government’s part, it is still experiencing teething problems, such as shortages of critical medication for cancer patients.

Other issues are long waiting lists for treatment – in some cases; patients have to wait for weeks or months just to book a doctor’s appointment.

The Bottom Line

Although treatment and medications under INSABI are free, the system is far from perfect. Many patients are still forced to pay out-of-pocket for their medications due to shortages and because of the lengthy waiting time for treatment in a public hospital.


The medium tier is IMSS (Instituto Mexicano del Seguro Social). IMSS allows individuals to make small monthly contributions to the healthcare system to get access to public healthcare – it is a social security program.

If you are employed by a private Mexican citizen, social security from IMSS is mandatory. The monthly contributions are deducted by your employer and paid on your behalf. In addition to healthcare, IMSS also provides compensation when you are unable to work due to an accident or illness.

Health cover under the IMSS system includes hospital expenses, doctor’s fees, surgery, and medications – however, the expenses are only paid in full with confirmation from a doctor who decided if treatment is necessary.

Under IMSS, you cannot choose which doctor or hospital you want to go to, which means the quality of your treatment can vary greatly from doctor to doctor or from hospital to hospital. The waiting time is also lengthy for IMSS – it can take three months for emergency surgeries, and even longer for non-emergency surgeries.

The Bottom Line

The cost of IMSS largely depends on your age – it can be from around $218 to $590 per year. If you are an expat, this option is not ideal unless you can speak fluent Spanish, are prepared and able to wait for treatment, and have gone through the lengthy process of applying (and have been approved) for IMSS.

Bear in mind that some pre-existing conditions are not covered by IMSS.

Private Health Insurance

The highest tier in Mexico’s health care system is private health insurance, which gives individuals access to private healthcare facilities.

Private health insurance is the most popular option among expatriates because it allows you to get treatment much faster and choose your own hospital and doctor. Another benefit of private health insurance is that most of the staff members at private hospitals can speak English.

There are two private health insurance options available to expats: local insurance and international insurance.

Local Insurance

You can get health insurance locally in Mexico if you plan to stay long-term, which is provided by local health insurance companies. This option will provide access to private hospitals and facilities and will cover treatments specified in your health insurance plan.

You can choose to have state-wide or country-wide cover, choose your preferred hospitals and doctors, and decide which plan is right for you. Plans costs work on a tabulator or sliding scale–higher coverage equates to higher premiums.   

International Insurance

Also known as expat health insurance, international insurance is provided by international health insurance companies and provides coverage worldwide.

The benefits of international health insurance are that it is available to you wherever you are in the world. Because international insurance plans offer global coverage, these plans are the most popular among expats – however, international health insurance is also the most expensive health care option.