Mexico Health Insurance - FAQ

The most important information is the person’s age, height and weight, place of residency and pre-existing medical conditions.
Any illness or surgical procedure declared on the application will be considered a pre-existing condition by the insurance company. In some cases, the insurance company could impose a restriction or require a waiting period.
The age limit with some Mexican Insurance companies is 64. Now in Mexico you can find some Health Insurance companies who accept you up to 74 years old and we work with some of them. Underwriters may require a medical exam before being if they consider it necessary.
Applicants 65 years and older must submit to a medical examination which normally consists of urinalysis, blood chemistry of 6 elements, electrocardiogram at rest, and a medical examination. Applicants who are younger than 65 years of age may be required to submit to a medical examination if certain medical conditions are present.
Cancer, neurological conditions, any medical conditions that occurred less than 90 days from signing the application. Conditions not accepted vary from company to company and Novamar Insurance Mexico’s mission is to find the best policy to suit your individual situation.
Yes, we have a plan with coverage for persons living outside of their country of residence and with a Tourist Visa Only.
Yes, you can purchase a Travel Insurance Policy to cover you from 1 to 180 days.
You can make changes upon renewal and up to 30 days after your renewal date, including changing deductible amounts, provided there have not been any claims.
It's the period of time specified in a health insurance policy which must pass before some or all of your health care coverage can begin. For some illnesses like cancer or HIV you have wait 2 or 4 years before being covered. This is why it is VERY IMPORTANT to have a health insurance in place before a medical condition occurs.
The only way to eliminate waiting periods is by having a current Mexican Insurance policy that has been paid for. That way you can change insurance companies without starting another waiting period.
It is the date on which the policy begins. The policy begins on the exact date which the insurance company accepted the application, not the date the policy is delivered. Waiting periods begin on the inception date.
The Mexican Insurance Companies have a deductible per medical condition. Every time an insured submits a claim for a new medical condition or illness, he or she has to cover the deductible. After the deductible is met, the insurance company will continue paying bills related to that illness or medical condition as long as the policy remains in effect and the policy coverage limit has not been exhausted. With these policies, it is better to choose the lowest deductible. With Foreign insurance companies, just one deductible is applied per person per year. You can accumulate medical bills during the year. Once the policy deductible has been reached, the insurance company will pay the rest.
Coinsurance is a co-participation after you have met your policy deductible, this is common with Mexican Insurance Companies. We offer some plans without coinsurance.
Your age, place of residence, deductible, coinsurance and optional coverages selected.
Renewal is automatic. You will be notified by Novamar about a month before your renewal date.
Premiums are calculated in increments of 5 years of age (from 50 to 55, from 56 to 60, etc.). Insurance Companies review their premiums yearly. Rates depend on the insurer’s loss experience historical, current, and predicted future medical costs. While rates increased about 8% annually industrywide in 2016, premiums are a fraction of what people pay for similar coverage in the U.S.
An insurance policy can only be cancelled by the insurance company for non-payment or by omitting and stating false information on the insurance application. It is very important NOT to let your health insurance policy lapse for any reason.
You would have to submit an official invoice (Factura) to the insurance company for reimbursement. If any laboratory studies are prescribed you also need to submit a medical report, prescription, and laboratory official invoice. The insurance company will apply coinsurance and reimburse the rest.
Yes, some insurance companies offer coverage in case of an accidents with no deductible or coinsurance from the first day of coverage (No waiting period).
A Factura is a receipt. The only difference is that a Factura has an official number that Mexican Insurance companies need in order to pay reimbursements. When you ask for a Factura, you need to provide your RFC.
An RFC is a personal identification code Mexican citizens have for life. When Americans and Canadians (or any other foreigner) don’t have a Mexican residence card, they don’t have an RFC. A general RFC code is used for this group of people recognized by any institution in Mexico. When you need a Factura but you don’t have your own RFC, you can have your Factura issued under this general RFC code.
The Facturas and bills should to be under the insured name.
Some Insurance companies have a network of hospitals and doctors, and if you prefer to be treated at a hospital or with a doctor out of their network, they would cover you through reimbursement up to a certain limit. You can consult with your insurance agent who can tell you what is the amount of coverage included in your policy for out of network treatments. At Novamar Insurance Mexico we have plans that allow you to choose any hospital in Mexico.
The insurance companies have English assistance 24/7.
Seguro Popular is a Mexican government healthcare program. Seguro Popular has many hospitals and hundreds of clinics throughout Mexico. Expats must have a Temporary or Permanent Resident visa to qualify. There are no pre-existing conditions restrictions and there is no age limit. Your insurance starts immediately and is nationwide. You should always present the enrollment approval form and number when needing care.?Coverage is for 3 months to 3 years. This insurance was designed to serve the poorest of the poor.
IMSS is also a government healthcare program mostly for employees, however some expats also join. The annual fee is approximately $400 and is renewed annually. People with pre-existing conditions are normally not accepted in the IMSS Program. The downside of depending on IMSS for all your healthcare is that you have no control over the doctors or specialists that you see for your problems. Sometimes the wait to see a doctor or to receive medication can be uncomfortably long in very crowded hospitals.
Novamar has an in-house claims department ready to assist clients during the claims process. This service Includes providing communicating on your behalf with your health insurance company.
Novamar Insurance Mexico has specialized in providing insurance solutions for the expat community since 2009. We offer communication in English, as well as a courtesy translation of important documentation –including your insurance policy.