IMSS

IMSS (Instituto Mexicano del Seguro Social) is a social security system, offering health care, sponsored by the Government and the States of Mexico, and is required to be provided by all employers.

Who is eligible? It is a Social Security System , allowing non-nationals who hold temporary and permanent resident visas. Those holding Turista visas (up to 180 days permitted in Mexico) or who are in the country illegally are not eligible. For persons and families who are not workers, there is a section within IMSS. Single applicants must declare under oath that there is no family with them.

How does it differ from Seguro Popular? IMSS is a separate department of the Federal Government and is administered by each State. IMSS was established in 1943, and has expanded from health care to include day care and retirement assistance.  Seguro Popular is a relatively new system, and is administered by the Federal Government.  While both systems offer forms of socialized medical care, they each serve different populations and offer different services.

IMSS is administered by each of the States, residents of San Miguel need to go to the IMSS offices in Guanajuato , Sopeña  #1, Centro (473-732-9510) and apply annually. To obtain and maintain IMSS. Needed is a Passport, FM card, CURP verification, a utility bill and possibly a birth certificate that has been an apostiled.  National and naturalized residents are required to submit a birth certificate and voter card.  It is suggested to have available copies of all the documents.  IMSS also requires “infantile photos” which are available at any photographers and some film processing locations.

IMSS is valid for one year, and must be renewed prior to the expiration date.  If the renewal application is after the expiration date, you are required to wait one month for reconsideration. During this period you are not covered.

The IMSS clinic is located at Av. Aurora S/N (without number), near Fabrica Aurora (on the side of the bridge closest to Centro), 415-152-0699.  There are 2 schedules for appointments, one in the morning, 8-2, and in the afternoon 2-6.  This is a treatment center as well as a triage and emergency center. There is an emergency center in the back of the clinic that is open 24 hours.  If it is deemed that your condition needs further treatment or evaluation, you will be sent to a larger IMSS facility or IMSS Hospital within the State of Guanajuato.  You may not go directly to an IMSS hospital without a referral from the clinic.

May one see the same doctor each time? Generally speaking, no. It may be that you will be seen by the same specialist at the larger facility but there is no guarantee.How is the cost determined? Fees for the IMSS program are determined by age. You may also be expected to pay for some medications if they are not available through IMSS.

May I be excluded or restricted from coverage if I have pre-existing conditions?

Yes. There are no pre-screenings for pre-existing conditions. However, it is possible that the examining doctor may determine a pre-existing condition and deny coverage.  There is no recourse and you will not be refunded for fees already paid.

What hospitals are associated with the IMSS program?  IMSS runs all of the hospitals within the system. There are hospitals in many major cities, including Celaya, Leon, and if care isn’t available at either of these, in Quéretaro.  As mentioned above, you cannot simply go to the hospital without referral from your local clinic.

What do I need to know and do when I go to an IMSS facility or hospital? Always bring someone with you, especially someone who speaks Spanish, as it is unlikely that the medical staff will speak  English.  Language is a huge barrier to getting the specific care you may need. If you are to be admitted to an IMSS hospital, again bring someone with you who speaks Spanish.  Also, these hospitals do not provide the same level of nursing services one would expect to find in the US, Canada or many of the larger private hospitals in Mexico. Family and friends are expected to help with general care, such as feeding, bathing and toileting, and may even be expected to provide blankets, bed clothes and grooming supplies. Bring your own medicines with you.  Many but not all medications are covered or available within the hospital.  The person who is with you may need to go outside the facility to purchase your medications. IMSS provides its own ambulance services.

Where do I go if the IMSS Clinic is closed? There is an emergency center located behind the IMSS Clinic that is open 24 hours, located at Av. Aurora S/N (without number), near Fabrica Aurora (on the side of the bridge closest to Centro), 415-152-0699.

What happens if I’m traveling in another part of Mexico and need emergency medical services? If you have your card with you, you should be accepted in any emergency clinic wherever you are within Mexico.

Is coverage valid for visits to private doctors or those not in the system? No.  IMSS coverage applies only those doctors within the IMSS system. You may visit a private doctor at your own cost, and if more involved medical care is warranted you may go to IMSS for another evaluation, diagnosis and treatment.

How do the state/national politics affect IMSS? IMSS is a long established program, and although a part of the governmental structure operates with a great degree of autonomy.  Politics do not have much influence at this time.

For my convenience, can one have both IMSS and Seguro Popular? No. The way the systems are designed restricts a person from obtaining both programs. If you need more information or assistance in obtaining IMSS, contact Silvia Cadena (Home)152-2711 (cell) 044-415-15-7586 (Vonage) 818-660-303, silviadcadena@yahoo.com

Updated 1-12-14