Whether you already have international health insurance in Mexico or you’re looking to get coverage, it’s crucial to understand your health insurance coverage to avoid any surprises.
Too many people don’t read their policy documents thoroughly, which can lead to unexpected out-of-pocket expenses.
Keep reading for the most common health insurance gaps in international health insurance plans – and how to bridge those gaps.
Common Coverage Gaps in International Health Insurance Plans
Being aware of common coverage gaps and taking steps to bridge them before an issue arises ensures that you and your family have the health insurance protection you need while living in Mexico.
Remember, a little research and preparation can go a long way in providing peace of mind and avoiding unexpected healthcare expenses.
That said, here are the most common health insurance gaps questions and answers…
Does my international health insurance cover dental work in Mexico?
Most international health insurance plans offer limited or no dental coverage.
Basic procedures like cleanings, which cost around 600 – 800 pesos in Mexico, are often not covered because dental work is relatively inexpensive in Mexico compared to other countries.
Even Mexican insurance plans don’t typically include dental coverage.
International insurers also typically don’t cover general dental work like cleanings, cavities, or root canals.
However, dental work resulting from an accident is usually covered. For example, if you knock out teeth in a bicycle fall, that would be covered.
If you need dental surgery involving your jaw, but not directly related to your teeth, our recommendation is to get pre-certified to make sure the procedure is covered.
Some surgeries may require dental cleaning and tests, but these prerequisites often aren’t covered, even if they’re necessary for the procedure.
Some international insurers now offer dental coverage as a rider or à la carte option.
Talk to your broker about adding dental coverage to your international health insurance plan if needed.
Is vision care included in my expat health insurance in Mexico?
Similar to dental coverage, vision care, including eye exams, glasses, and contact lenses, is often not covered.
However, more serious issues related to your eyeballs, such as glaucoma testing, eye lens repair, and cataract treatment, are generally covered.
It’s important to note that coverage for vision care may vary depending on your specific plan, so it’s always best to review your policy or consult with your broker for clarification.
Will my insurance cover alternative therapies in Mexico?
Alternative therapies like chiropractic care and acupuncture are not typically covered by standard international health insurance plans in Mexico.
This means you’ll likely have to pay out-of-pocket for these services.
If your doctor prescribes chiropractic care, it might be covered, but there are no guarantees.
Chiropractic services fall into a gray area. If a trauma doctor recommends or prescribes a chiropractor, it might be covered, but there will likely be a maximum coverage limit, such as 10 or 30 visits.
It’s important to note that chiropractic care is not considered a form of physical therapy and may be classified as an alternative therapy by insurance providers.
Also, if you visit a naturopath, the consultation might be covered if the naturopath can provide a factura (an official invoice) and is a certified medical specialist. Supplements from a naturopath are typically NOT covered.
It’s best to check with your insurance provider beforehand to confirm whether naturopath consultations are covered under your specific plan.
Does my international health insurance cover mental health?
Unfortunately, most international health insurance plans do not cover mental health consultations or associated medications.
This is an important gap to be aware of, especially if you or a family member requires ongoing mental health support.
Here are some conditions not covered:
- Mental illness
- Behavioral disorders
- Autism
- Apraxia
- Dyspraxia
- Psychiatric or psychological disorders
Also, treatment by a psychologist, psychiatrist, or other mental health specialist is not covered.
Nor are consequences or side effects as a result of treatments for mental, psychological, or psychiatric illnesses.
Our recommendation is to contact the insurance company to find out if there are any exceptions to the policy.
Does my international health insurance cover me for maternity care in Mexico?
Maternity coverage often requires a waiting period of a minimum of 10 months, or a separate rider.
The exact waiting period depends on the insurance carrier, so if you’re planning on getting pregnant, it’s best to review different policies to plan accordingly.
Also, most policies have a deductible minimum before the maternity benefit is eligible.
The maternity benefit is NOT included with deductibles over $2,000 – $2,500 depending on the policy and insurer. A lower deductible means higher premiums but will be a lifesaver if complications arise.
Some policies have a maximum limit of coverage for these complications, so be sure to double-check with your insurer before you go into labor.
NOTE – Maternal and newborn complications are covered 100% as stated in the policy, with the deductible waived, depending on the policy.
The newborn MUST be added to the policy for coverage, which will require some information from your doctor.
Be prepared and discuss all scenarios and needs with your doctor before the baby is born.
[Related Read: Maternity Care for Expats in Mexico]
How to Bridge the Gaps in Your Expat Health Insurance
To bridge the gaps in your primary health insurance policy, such as dental or vision care, you will need supplemental insurance.
One option is GeoBlue.
They allow for a more à la carte approach to add coverage for things like dental, vision, and even mental health therapy.
However, it’s important to note that GeoBlue is only available to US citizens and can be expensive.
When considering supplemental insurance, keep in mind that it typically follows the international insurance reimbursement model.
This means you’ll need to file claims and wait for reimbursement after paying for the services out-of-pocket.
While supplemental insurance can help fill in the gaps, it’s essential to weigh the costs and benefits carefully.
Compare the premiums and coverage options with the potential out-of-pocket expenses you might incur without the additional coverage.
If you’re unsure about whether supplemental insurance is right for you, consult with your insurance broker or a trusted financial advisor to discuss your specific needs and budget.
[Related Read: Expat’s Guide to Health Insurance Reimbursement in Mexico]
Tips for Choosing the Right International Health Insurance Plan
When selecting an international health insurance plan, carefully assess your individual needs and priorities.
Here are our best tips to help you out:
- Ask for recommendations from other expats in your community. Join local social media groups and pages to get a better reach of experiences. Word-of-mouth referrals and opinions from peers is by far the best way to go.
- Research online for “best international health insurance for expats in Mexico.” You might find the local companies are the best for your needs.
- Contact insurance brokers who specialize in international health insurance in Mexico. Don’t just contact one. Talk to multiple brokers.
- Compare policies from multiple insurers. While they might initially look the same, there can be important policy differences that decide for you.
- Read reviews on specific insurance companies. What do people have to say about filing claims and overall support?
