Seguro Popular

What is Seguro Popular?

Seguro Popular provides health service coverage, through voluntary, public insurance for persons that are not affiliated to any social security institution.  It is operated by the National Ministry of Health, and is independent of State or local operations.

 

Who is eligible?

It is an open 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.

 

How does it differ from IMSS?

Seguro Popular is governed and administered by the National Secretary of Health.  Seguro Popular is a fully voluntary program available to all who do not have other insurance coverage in Mexico, in particular IMSS.

 

Where does one go to obtain Seguro Popular?

The Seguro Popular office is located in the Parking Lot of Hospital General.  After you make your application you will be directed to the Clinic in LaLajona for a brief physical and health evaluation. In the past there was an open enrollment period, but that has now been eliminated and one may apply at any time.

What documents are needed to be shown to obtain coverage?

Passport, Residency card, CURP verification  a utility bill and 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. Photos are not necessary.

How long is it valid?

After application Seguro Popular is valid for 6 months or until one has had the physical.  After the physical it is valid for 3 years. After this period one must reapply.

Where does one go for service/treatment?

La Lajona Clinic at the corner of Vicente Araiza and Arco Iris, Colonia La Lajona 2.  Clinic hours are 9 am to 5 pm..  The doctor in attendance will refer you for follow-up treatment and care at one of the Hospitales Generales which will best serve your condition.

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 facilities but there is no guarantee.

How is the cost determined?

Fees for Seguro Popular are determined by income.  You may also be expected to pay for some medications .

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

No.  It must be noted, however, that Seguro Popular does not cover dialysis but will cover many of the medications associated with dialysis and renal failure.

What hospitals are associated with the Seguro Popular program?

Seguro Popular is administered through the Hospitales Generales by the National Ministry of Health.  There are hospitals in many major cities, including Celaya, Leon, Quéretaro, all of which offer a higher level of services than the Hospital General in San Miguel. 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 a Seguro Popular facility or hospital?

You are expected to 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 a Hospital General, again you are expected to 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.  Most medications available through the Seguro Popular system are generics. Seguro Popular provides its own ambulance services.

Where do I go if the La Lajona Clinic is closed?

Go to the Emergency Room at Hospital General

What happens if I’m traveling in another part of Mexico and need emergency medical services?

With Seguro Popular you simply need to present yourself with your number of affiliation at any Hospital General or Ministry of Health clinic where you are.  You are not restricted by city or state of residence.

Is coverage valid for visits to private doctors or those not in the system?

No.  Seguro Popular coverage applies only to Seguro Popular system and the physicians operating within them.  You may visit a private doctor at your own cost, and if more involved medical care is warranted you may go to Seguro Popular for another evaluation, diagnosis and treatment.

 

How do the state/national politics affect Seguro Popular?

Seguro Popular, being governed by an appointed National governmental official is more vulnerable to political actions than IMSS.

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 818-660-2303

silviadcadena@yahoo.com


Updated 1-12-14