What is major medical insurance and how does it work?


This article was translated from our Spanish edition using AI technologies. Errors may exist due to this process.

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What is major medical insurance and how does it work?

If we’ve learned anything from COVID-19, it’s that an unforeseen event can completely change our lives and it’s important to be as prepared as possible. With the global health emergency we have experienced, we can see that we are all at risk of needing medical attention at any time. This is why it is important to have health insurance.


Insurance is a financial protection plan by which people protect themselves from unexpected risks. There are different types, including major medical expenses. This covers expenses generated by medical care that is required due to an accident or illness.

How does health insurance work?

When insurance is taken out, the customer pays an amount within a period of his choice to an insurer. So, in the event of the unexpected, you won’t have to pay with your own money. With the investment you made, the company has covered it.

What is included will depend on the plan you hire , it’s important to ask yourself what your needs are and choose the plan that’s right for you. The basic blankets are those that any insurance generally covers without having to pay extra, such as preventive medicine, consultations with first-contact physicians (general, pediatrics and gynecology), consultations with specialist physicians and laboratory, office and imaging.

How do I get one?

  1. If you are an employee, first check what type of insurance your contract offers you and decide if you need to take out a separate one.

  2. Find out which insurer you want to contact. For more information on the options, read the BEF analysis here.

  3. Make an appointment and talk to an agent about the different offers he offers: how much does it cost, what does it include, how are they paid, etc.

  4. When the plan and the estimate have already been drawn up, an applicant’s file will be drawn up with the following documents:

  • Plan contract request
  • Copy of a valid official ID
  • Proof of address
  • RFC copy

In Mexico there are 32 companies where you can purchase insurance for major medical expenses. There are nine that represent 90% of the market, including GNP, AXA, Metlife and Seguros Monterrey New York Life. In addition to researching the insurer, there are several terms that you should understand before signing a contract, you can find them here.

You must take into account the type of insurance you want, with or without quota or reimbursement insurance. Find out about the medical file, it tells you about the services and centers that the insurer covers you. Remember that to prevent people from purchasing insurance for a specific treatment and then stopping paying, insurers set a grace period, which is a period during which you cannot use your insurance at any time. from the moment you subscribe to it. Check what the gap is in your insurance before you hire him. Also consider previous illness coverage and age limits, as these can be important in your decision making.

Like all bureaucratic processes, this can be tedious. For this reason, you should be as prepared and informed as possible, but if you know what you want and the steps to take, it shouldn’t be a complicated process.

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