As an expat in Mexico, knowing your preventive care benefits helps you make informed decisions – and avoid costly surprises.
While the specific preventive care benefits covered by your international health insurance may vary depending on your policy and provider, they typically cover similar procedures and tests.
Keep reading for what you need to know about preventative care coverage and costs.
What Is a Preventative Care Benefit?
Preventative care benefits – also known as wellness benefits – are designed to encourage you to take charge of your health with annual checkups, bloodwork, labs, and other general health consultations.
The goal is to help you stay on top of your health and catch any treatable issues in their early stages.
Typically, for preventative care, the deductible is waived for reimbursement of anywhere from $100 to $200 USD.
What’s Covered under Preventive Care in Mexico for Expats?
It’s important to understand that preventative care benefits found in global insurance plans are different from what’s covered by a US health insurance policy.
And only cover the basics.
Preventive care covers a basic physical checkup with your doctor.
Most lab tests and images are covered, but always check with your insurer if you’re unsure about specific tests.
Another thing that’s different is that preventative care benefits in global healthcare policies are ONLY applicable to the policyholder and the spouse.
That’s right: No kids are covered.
Dependents’ claims that fall under preventative care benefits are NOT reimbursable nor do they go toward the deductible. Instead, they will be an out-of-pocket expense.
However, required adolescent vaccinations are covered as a standard claim.
What’s NOT Covered under Preventive Care?
The following diagnostic tests are not covered:
- MRIs
- Cat scans
- PET scans
- Genetic genome tests
Adult vaccines are not covered:
- Flu shots
- Shingles
- Pneumococcal
- TDap
- Hepatitis
- Measles
- Covid
Also, anything related to mental health, reproductive health, smoking cessation, and sleep disorders are not covered as preventative care – or under the policy in general.
While some diagnostic testing like mammograms and colonoscopies are considered preventative, if they’re being done to further diagnose symptoms or if the results come back abnormal, they will be considered “normal” claims and will be processed toward the deductible.
Does My Expat Insurance Cover Annual Checkups?
Annual checkups for men and women are covered AFTER a waiting period of 10 – 13 months, depending on the insurer.
Any medical claim that falls under the insurance company’s parameters of a preventative benefit will always be processed as a preventative benefit – even during the waiting period.
This means that there will be an out-of-pocket expense until the benefit goes into effect.
NOTE – If you are still in the waiting period for the preventative care benefit to kick in, your claim will be denied outright and will not be applied toward the deductible.
What Screenings and Tests Are Covered?
For Men:
- Comprehensive Hemogram
- Lipids profile
- Renal profile
- Liver profile
- HIV, VDRL tests
- Urinalysis
- Prostatic Antigen profile – PSA
- Prostate ultrasound
- Electrocardiogram
- Chest X-ray
- Bone density tests – confirm with your insurer
- Skin biopsies
For Women:
- Comprehensive Hemogram
- Lipids profile
- Renal profile
- Liver profile
- HIV, VDRL tests
- Urinalysis
- Papanicolau Monolayer – pap smear
- Mammogram
- Breast ultrasound
- Electrocardiogram
- Chest X-ray
- Bone density tests – confirm with your insurer
- Skin biopsies
What Vaccinations Are Covered Under My Expat Health Insurance?
For adults, vaccines are NOT covered.
For kids under 18, vaccinations are covered. But as mentioned above, dependents’ claims that fall under preventative care benefits are NOT reimbursable. They will be an out-of-pocket expense.
Preventive Care Coverage for Pre-Existing Conditions in Mexico
Anything that is excluded on your policy as a pre-existing condition is not covered by the insurer – including preventative care.
For example, if you have a history of breast cancer and it’s excluded as a pre-existing condition, breast screenings and mammograms typically won’t be covered.
Check with your broker or the insurer so you know what’s covered and what isn’t.
[Related Read: Can I Get Health Insurance in Mexico If I Have a Pre-Existing Condition?]
Cost of Preventive Care for Expats in Mexico
The cost of preventive care benefits varies depending on where you live in Mexico – and some places are more expensive than others.
These days a standard consultation with your doctor costs anywhere from 800 – 1,500 pesos.
But the $100 to $200 USD benefit covers a big chunk of the costs.
Shop around and talk to your expat community to find the best prices.
Some clinics also offer package deals and specials, like discounted mammograms in October for Breast Cancer Awareness month.
