Healthcare in Mexico: a policy instead of the CAK, and the age limit you have to know before departure

The healthcare paragraph is with Mexico not the closing piece but the gate. Not because the healthcare is bad — in the big cities private healthcare is excellent — but because the system is a policy, and a policy has an acceptance. Whoever asks that question too late can have become too old for the plan.

No CAK

Mexico isn't on the list of treaty countries of the scheme for living abroad. So there is no CAK form, no treaty contribution and no right to care at the expense of the Netherlands. Your Dutch basic insurance ends on the day of deregistration, and what applies after that is the policy you have taken out.

That is a substantially different picture than with Spain, Portugal or Morocco, and it is the reason healthcare with Mexico sits in phase 3 of the journey, before deregistering, and not in phase 5, after landing.

Three doors

A Mexican policy. Insurers such as GNP, AXA and Metlife sell a seguro de gastos médicos mayores: cover of major medical costs, with a deductible and a co-payment, at private hospitals. Good and by Dutch standards affordable — but with an entry limit. GNP takes new customers up to 64 years; between 65 and 70 only with a medical file; above that hardly at all. Existing conditions are excluded the first years. Whoever lives in Mexico can take out the policy; nationality doesn't matter, the address does.

An international policy. Wider in age, wider in cover — often also for the visits to the Netherlands — and correspondingly more expensive. For whoever leaves above seventy this is usually the only private door.

The voluntary IMSS package. The Seguro de Salud para la Familia is the public route: whoever has no other system enrols against a fixed annual premium per age, paid in advance, and is insured from the first of the following month — at the clinics and hospitals of the IMSS, not at the private ones. Foreigners with a residence card get in with card, CURP and proof of address.

The IMSS package: the price and the small print

The premium is per person and per year. The official table on gob.mx showed at the time of writing the amounts of 2024 — 19,050 pesos for whoever is between sixty and seventy, 19,850 between seventy and eighty, 20,500 above that. Per 1 March 2026 they have been raised some eight percent: a good twenty thousand pesos a year for someone in their sixties, some thousand euros. That is a fraction of a private policy.

The small print is the list of exclusions. Whoever has one of these isn't enrolled: malignant tumours, diabetes with serious complications, chronic kidney failure, heart valve and heart failure, the sequelae of a heart attack, COPD with respiratory problems, connective tissue diseases, liver diseases, storage diseases, congenital conditions, dementia, psychosis, addictions and HIV. Other conditions have a waiting period. And the IMSS refunds nothing on an incorrect declaration.

For a healthy couple of sixty the package is therefore a real option, as a safety net or as a base with a private policy on top. For whoever already has something it is no option — and you want to know that before departure, not after.

What the healthcare itself is

The private hospitals in Mexico City, Guadalajara, Monterrey and Querétaro reach international level, and many doctors have trained in the United States. On the coast and in the countryside the picture is different: the good clinic is further away, and the IMSS hospital is what there is. So where you're going to live partly decides what your policy is worth to you — and that is an argument in the choice of region, not only in the choice of healthcare.

Dentist, glasses and hearing aid fall outside everywhere. Medicines are cheap and often available without prescription; that is convenience, not a health system.

The order

1. Ask the acceptance question in writing, three months before departure: with a Mexican insurer, with an international one, or both.
2. Read the exclusions of the IMSS package against your own file.
3. Only cancel your Dutch policy once the acceptance is settled, and let the end date coincide with the deregistration.
4. Bridge the gap between the Dutch end date and the first insured day with a travel policy.
5. Activate the policy after landing with your Mexican address and your CURP, and find a GP in the same week.

A gap between two systems is the most expensive thing that can happen to you in this journey. With Mexico the age trap comes on top: whoever postpones the question until after the move can no longer get the policy that was meant to carry the plan.