INSABI – The Institute of Health for Well-being (to use its acronym in English), has been a common topic of discussion amongst the Expat community from its inception, and social media has been a source of reliable information but also a lot of inaccuracies regarding this system.
INSABI has been described as a free healthcare system by some, whereas others believe it provides coverage through private hospitals and doctors. Of course, some people also choose to believe it is a program for every single condition and circumstance. And while INSABI is in fact free, it’s important to know the scope of its coverage and its conditions. Users of the system should be clear about its remit in advance of needing assistance.
Before we talk about INSABI in more detail, we need to go back in time to 2003 when Seguro Popular was born. In 2003 the president of Mexico Vicente Fox Quesada created Seguro Popular. This healthcare system was designed originally to provide healthcare to the Mexican community living in extreme poverty, or with such limited resources that even a 40 USD doctors visit would be a financial challenge.
Seguro Popular had such an affordable enrollment fee that it was practically free. In 2019 the government began a review of that system and after modifications it was renamed INSABI in January of 2020.
We have received hundreds of questions about this system such as how to enroll and what it offers. This article provides a summary of everything you should consider about INSABI, and we hope it will give you the information you need if you’re planning on applying for it.
1. There is no cost to enroll in INSABI. That’s right, enrollment is completely free
2. It is funded by government resources. Unlike IMSS or ISSSTE, INSABI is not funded by the taxes of Mexican employees and corporations whereby a portion of the taxes of every employee and company in Mexico go towards those healthcare systems. INSABI is a system partially funded by government resources, NPO’s, and private companies from different industries and individuals that donate all kinds of things, i.e. toilet paper, sheets, towels, soap, clothes, pillows, diapers, water, food, etc.*
3. No underwriting process. It is the only healthcare system in Mexico where the underwriting process is not required. Of course there is a reason for this which brings us to our next point.
4. Not everything is covered. This is one of the most common misconceptions people have. INSABI does NOT cover all conditions and the more serious medical conditions are not 100% covered. Cancer, heart attacks, cardiovascular failure, diabetes, Hepatitis-C, major surgeries and long-term treatments are among the things that INSABI does not fully cover. There is no complete list of conditions that INSABI will not cover because the judgement is determined based on the individual’s medical condition and the severity of it.
It is well known that users of this system have to cover between 40-60% of the cost for major conditions, and that expensive medication is not provided by INSABI.
5. No age limit to enroll. So far, no age limit has been established to apply for INSABI though that may change in the future as it’s still a program under evaluation.
6. Location of residence is a factor in qualifying. In some areas of Mexico, the neighborhood where you live would be a determining factor to qualify. Why? The reason is INSABI is still meant for the poorer communities in Mexico. If you live in a middle class, upper middle- or high-class area you may not be considered as someone that is in need of this system since you could afford IMSS or private insurance.
7. Expat qualification– You need to be a resident of Mexico to qualify, and need to bring your CURP and ID to the INSABI facilities for enrollment.
8. You are assigned to a specific clinic. Unlike private healthcare, with INSABI you cannot choose the facility where you would like to be treated. They will assign a clinic where you will be seen by your GP, and it’s usually only one clinic or small hospital per city.
Private hospitals are NOT covered by INSABI.
9. Not all medicines are available. As stated at the beginning of our article, most medicines for major conditions are not provided by INSABI.
10. If hospitalized, a friend or family member must be with you. INSABI does not provide 24/7 nurse care nor a nurse per patient but rather one nurse for a group of people. Therefore, if you require hospitalization, you’ll need people to be with you at all times to change your clothes, bath you, feed you and take you to the bathroom.
11. INSABI does not have private rooms. Usually large rooms with space for 6 patients is available under this system, each bed divided by a slide curtain. Service providers do try to have separate rooms for male patients and female patients, although during crisis such as the current pandemic that may not be the case.
12. Toilet paper, soap, towels, etc. are NOT provided at the facilities. In addition, you will be responsible for washing your clothes with the support of whoever is accompanying you during your illness/treatment.
13. No services are provided in English. If you need to enroll or will receive treatment of any kind please know that all applications, reports and feedback will be provided in Spanish so you will need to bring a translator with you unless you are bi-lingual.
14. Consultations with specialists must be approved by a GP first. This is the rule of thumb with all public healthcare sectors of Mexico. You cannot see a specialist unless approved by a general physician first.
15. INSABI does not own hospitals. Most INSABI hospitals are rented from private owners or other government divisions, and later equipped by INSABI.
16. There are no waiting periods for minor treatments. The INSABI system does not have waiting periods as do private health care policies or the IMSS, so in theory assistance even for more serious conditions can be attended to immediately. However due to it being a public health system, (having usually only one hospital per city) even if needing emergency attention, you could encounter long delays. In addition, if it’s a major health challenge there will be a long waiting list for treatment. For example, if you needed treatment for a heart condition, stroke, cancer, etc. depending on the city and type of treatment required that waiting list could be days, weeks or months.
17. Major procedures/treatments are handled in larger cities. Local clinics are designed to treat basic conditions, but when you need treatment for major health problems or long-term treatments you will be sent to a large city. That will likely be GDL, Mexico City, Monterrey, or Tijuana among others.