Navigating Mexico: What’s Not to Love about the IMSS?

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 If you’re living in Mexico, coming from Europe, it will all seem familiar.

From Canada, somewhat familiar.

From the United States, it will be pretty foreign.

It is Mexico’s socialized medicine program, the National Social Security Institute (IMSS), started in 1943 to guarantee workers and their families health care.

All formal workers pay into coverage with about 3 percent of their base salary, with 70 percent of the total cost paid by the business and about 30 percent paid by the employee.

The worker, plus immediate family members, including parents, are covered for doctor visits, medicine, hospitalization, childbirth, surgery and even free nurseries for preschoolers.

When a worker is sick or on maternity leave, the IMSS also will pay 60 percent of the employee’s salary, depending on how many sick days the doctor authorizes.

Based on a person’s address, they are assigned a clinic. Each clinic will have from one to 50 primary-care physician offices inside, each with a doctor and a receptionist.

The offices run on a morning and afternoon shift, with a complete changing of the guard at 1 p.m.

Almost every IMSS doctor has a practice in private hospitals as well, since they work either the morning or afternoon shift at the IMSS and the opposite shift in private practice. They are very well networked.

The clinics share “preventative” nurses, who are very old school: They read the patient the riot act, make sure kids’ immunizations are up to date, do screenings for things like diabetes and high-blood pressure and check on nutrition and weight.

Clinics have their own pharmacies as well, and all medicines dispensed there are free.

Larger clinics have labs and X-ray services. Some even have emergency rooms.

Beyond the clinic level, there are specialist-level care at regional facilities for more complicated illnesses and psychiatric care.

Retired seniors receive lifetime care at no cost.

Sounds pretty good, but now the downside.

Many Mexicans complain about the IMSS for being overly bureaucratic, though I personally have never had a bad experience.

Appointments can be obtained online, but it is not the most efficient approach for simple illnesses, although it does make sense for patients who have something chronic and need lifelong treatment or medication.

The IMSS staff are rule-oriented about shifts and the order of when things are done, but once you figure it out, they tend to run like clockwork.

If you are a foreigner, it might be wise to take a friend on your first few trips since IMSS bureaucracy can be somewhat of a labyrinth without the clearest of signage. Like many things in Mexico, people seem to be expected to know innately how things work.

People who are self-employed or digital nomads can self-pay for medical coverage for as little as 9,000 pesos a year for someone up to 29 years old. The annual fee goes up by age bracket.

While IMSS health care may not be for everyone, it could be something worth exploring.

And if you are a payroll worker, you may have already paid for a service you are not using.

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