How to live in Mexico; Making End-of-Life plans as an expat


Since I started writing the How to live in Mexico series, the most common questions have been about aging and dying in Mexico as an expat. I am 49 years old, so I honestly haven’t given this a lot of thought in my 12-years as an expat, so I decided to research how other expats have thought about end-of-life in a foreign country.

My own personal plans for end-of-life are pretty simple. Throw me in the river, a ditch, landfill. Personally, what happens with my body after death isn’t important to me. My only hope or wish is that my body would not be returned to the United States. I don’t have an interest in living there now, so if there is some kind of afterlife, or spirit that floats out of our bodies, I sure would hate to see my body spending eternity in the USA, that isn’t where I want to be. For me, I feel like Mexico is my home.

Leading up to death, I hope I pass like most other people. Sudden heart attack, dying in my sleep, anything that isn’t diagnosed, such as terminal cancer where I spend weeks or months sick and full knowledge that death is just around the corner. If sudden death is the way I go, there isn’t much planning I need to consider. However, if things turn out differently where I need care in my final months or years, am I prepared? No.

My discussions with other expats while researching how people are dealing with end-of-life choices in a foreign country have overwhelmingly shown most expats haven’t given it much thought either. Many assume they will pass before their spouse and they have told their spouse what they want, but nothing is legally written. About half have said they plan to return to their country of origin for their final time, but none of us have a set date for our death, so if they die tomorrow there is no plan for death in a foreign country.

Everyone’s plans will differ greatly, and like most things, financial status is going to determine most end-of-life plans. I am not wealthy, middle-class at best, I don’t have any expensive assets or investments, and I have no children or spouse. This makes my end-of-life and the legalities a little easier than someone who owns real estate in Mexico, bank accounts and investments in the US (or country of origin), children, or other family members who will challenge any end-of-life choices made. But regardless of your financial means, there are some steps that you need to take as a foreigner to make sure whatever your wishes are will be respected in Mexico.

Plan for aging in Mexico

For many, aging will come with many common illnesses among the elderly population and an aging body becomes less mobile, and normal daily tasks may become harder to manage as we age. As expats, we need to plan for how we want to age in a foreign country and what will be our plan if we need part-time or full-time assistance, or if living independently no longer becomes an option.

Assisted Living in Mexico

There are several assisted living options in Mexico and a handful in Puerto Vallarta. A simple search for ‘assisted living Puerto Vallarta’ will show you a few options, but I won’t mention them specifically in this article because I have not visited any of these facilities and I am not going to make any statements that could be interpreted as a recommendation by me.

Assisted living facilities are popping up everywhere in Mexico, and very popular in cities with large numbers of expats. It’s important to know that these facilities are not government regulated. Some offer private rooms and shared rooms, nurses, daycare services or full-time living, food preparation, and other amenities. Most are small care facilities offering assisted living up to 15-20 people. These facilities range from $1,000 USD – $3,000 USD per month.

In-home care in Mexico

If you are an expat in Mexico and worried about aging and help needed around the house and basic errands and chores, it’s possible you can offer a free room to someone in exchange for help with tasks you can’t perform anymore. If your care is more related to medical attention, there are several services in Mexico (and Puerto Vallarta) that offer in-home care by nurses.

Medial care for aging expats

Unless you have financial means, most expats living in Mexico will find the medical expenses that accompany end-of-life will be the biggest burden in their planning. By the time we near end-of-life, private insurance has already priced most elderly people out of access to healthcare, upwards to $5,000 USD a month for someone 85 years of age or older.

In Mexico, you can apply for IMSS, the public healthcare system, and the rates are extremely low. You do need to pass a physical and preexisting conditions won’t be covered. It is very bureaucratic, but after you spend the time getting enrolled, you will have a safety net in an emergency. As expected, government healthcare is normally overrun and understaffed, so wait times for public healthcare can be extreme.

There is also a system called INSABI that offers free care to people who do not qualify for IMSS or have access to other healthcare. INSABI is a safety net to make sure any citizen or legal resident of Mexico is never denied access to healthcare.

I encourage all expats living in Mexico to consider their options before using Mexico’s free healthcare system. If you have the means to pay for private insurance or pay the minimal yearly fee for IMSS, I recommend that this is the route you choose. But if there is an emergency and you need it as a lifesaving safety net, it’s there. You will need your visa, curp, and copy of your birth certificate. If you are a legal resident in Mexico, you can download your curp here: https://www.gob.mx/curp/

There are two types of hospitals in most cities in Mexico, IMSS and Hospital Generals. IMSS is for people under the IMSS healthcare, people employed in Mexico, and those who buy into the system for a low cost. Hospital General cares for all others who do not qualify for IMSS care. General hospitals use INSABI, the free healthcare plan established in 2020.

You can enroll in INSABI at any General Hospital and with the IMSS healthcare plan at any IMSS Hospital or clinic.

My current setup for healthcare in Mexico as an expat is that I use a primary care physician and pay out of pocket. I am healthy and see my doctor once a year for a physical, but have not needed my physician for a medical emergency or care of an illness. A visit to my primary care physician is $500 pesos ($25-$30 USD), the same as a co-pay with US insurance.

The only medication I take is Escitalopram for anxiety, I pay out of pocket for the daily medication and it costs me $5 USD at a pharmacy for a month’s supply, no prescription required. In the USA, I was paying $25 at the pharmacy with insurance 15-years ago, not to mention the co-pay to the doctor to get my prescription written every couple of months.

My overall healthcare plan is out-of-pocket funded with private doctor care, however, I am also enrolled in IMSS as a safety net in the event of an emergency that required hospitalization. I am not in a financial situation where I could pay for a major medical emergency and hospitalization out-of-pocket, so IMSS offers me peace of mind. I would never use IMSS for basic care, like stomach flu or cold. It’s only added protection for a major emergency.

Plan for death in Mexico

Even if you have a will and have expressed your wishes for your death in your country of origin, you need to make sure you make plans in the event that your death takes place in Mexico. Like many other countries, your next-of-kin (spouse or children) will have a lot of power to make choices and see that your last wishes are carried out, but there are a lot of things you can do now so that your family isn’t burdened with the arrangements of your death while they are still grieving. That’s the point of end-of-life planning.

Plan for burial or cremation

Many funeral homes in Mexico will allow pre-arranged burials and cremations for those who want to plan ahead and not leave it to friends and family. You can make arrangements and be issued a letter of intent to keep with your important documents that will inform authorities of which funeral home you have authorized to have your body or remains transferred to after your death.

Burials: most burials in Mexico are rented burial plots, typically on six-year contracts. Someone will need to renew your contract or your body will be removed at the end of the terms.

Cremations: the cremation process is standard in Mexico. Just make sure you have left instructions on your decision for cremation, who gets the remains, should they be returned to your country of origin.

Many funeral homes in places with a large expat population will have the experience needed to help you arrange for burial, cremation, or repatriation of your remains.

Returning your remains to country of origin

Any expat living in Mexico should plan on how to handle their remains after death. Even if your hopes are to return to your country of origin before death, we can’t always plan for that to be the case.

Upon your death, or the death of a loved one in Mexico, there will be many legal processes to complete if you plan on returning the body of a loved one back to their country of origin. The Embassy of the country of origin of the deceased will play a major role in helping you return remains to another country, so contacting the Embassy will be one of the first calls you should make.

In order for a body to be successfully exported, these are the documents that are required:

  1. Official Death Certificate
  2. Health Permit issued by the local health authorities in Mexico
  3. Embalming Certificate (all bodies must be embalmed by Mexican law)
  4. Transportation information (example: flight itinerary)
  5. Information on the final destination of the remains (receiving funeral home)

Documents 1-3 will be obtained by a local funeral home, and hopefully, you have already made arrangements with a funeral home prior to your death. Even if you don’t plan on a burial in Mexico, a funeral home can provide services to expedite the return of your remains. Many funeral homes located in areas popular with expats will have experience in returning bodies to a country of origin.

After you have all five documents, the Embassy or Consulate from your country will issue a Consular Mortuary Certificate, which will be the passport document needed for a deceased body to return home on a final flight. Without this document, the remains cannot be returned to the country of origin.

Transportation of the body can be arranged through commercial airlines and the delivery of the body to and from the airport will be handled by the chosen funeral homes that will deal with the body in Mexico and the country of origin. The funeral homes in both countries will need copies of all five documents and your Consular Mortuary Certificate.

Tip: Make arrangements with a local funeral home now so you won’t leave the burden with your loved ones.

Legal issues for expats who die in Mexico

It doesn’t matter if you plan on dying in Mexico or hope to return to your country of origin as you age, death can happen any time, so if you live in Mexico at any age, make sure you have a declaración jurada, basically, a living will. This document needs to be notarized in Mexico, about $1,000 pesos, and it MUST be written in Spanish. This document will ensure your wishes after death is followed, including burial or cremation preferences, and remains to stay in Mexico or returned to your country of origin.

Some funeral homes also offer Letters of Intent that make clear your plans for end-of-life if arrangements were made prior to death. You will receive a card that you must keep in your wallet so at the time of death authorities will know your wishes for handling your body and the funeral home you have chosen to take possession of your body. However, this letter of intent should not be used as a replacement for the declaración jurada. The letter of intent is additional security that your wishes are honored, but the declaración jurada is the legal document that cannot be disputed.

Make sure that you choose three people to act on your behalf in the declaración jurada. Many people only choose their spouse or partner without a plan if both were to die together in an accident. It is very important that you have three people located in Mexico who you trust will honor your last wishes. It will be absolutely necessary for all three of your trusted individuals to speak fluent Spanish and are able to handle business in Spanish, preferably choose Mexican nationals.

Make sure you have several copies (at least 5) of all your important documents; passport, visa, curp, declaración jurada, funeral home letter of intent. Make sure the three people you have trusted to act on your behalf know where the originals and copies can be found, or give them copies now. Instruct your three trusted people to never give the originals to anyone, only allow copies to be given to bureaucrats.

Something to consider: The cost of documents and transporting and handling the body of a deceased in Mexico can range between $15,000 pesos and $20,000 pesos. Is there someone locally who will pay these fees in the event of your death? Or is there a way for you to have money set aside for these costs so your loved ones or neighbors aren’t strapped with these costs? Maybe a separate bank account with a debit card with savings to be used in the event of your death, and instructions and the card left with your important documents? Just some ideas, these decisions are personal.

Get an attorney

You can create and gather all the documents above without an attorney, but if your situation is complicated by real estate and assets in Mexico, you should get an attorney (in Mexico) to work with you and close any loopholes that may prevent your wishes from being fulfilled after you have passed. I cannot offer legal advice or advice on what will happen to your real estate or other assets in Mexico. However, even if you have a will written in your country of origin, I recommend having a separate will written in Mexico that deals with any assets you have in Mexico and make sure that a will in Mexico doesn’t contradict any will you have in place in your country of origin. Don’t leave the burden on loved ones or a situation where your family and loved ones are torn apart with arguing over your assets because you didn’t make your wishes clear and legal. Most of us have seen this happen in our own families when someone passes.

What happens if you die in Mexico without a spouse or legal documents?

If you die in Mexico without a spouse or any prepared legal documents on your wishes after death, your body will likely be removed by SEMEFO (Servicio Médico Forense – Medical Forensic Service). They will contact the local consulate from your country of origin to register your death, an autopsy will be performed, and you will be buried in a communal grave if your body isn’t claimed.

Conclusion

End-of-life planning is a way for you to have your last wishes honored if you are unable to make choices for yourself or in the event of your passing. It’s a way to not burden family and loved ones with making these choices at a time when they are grieving.

In any event, if you are an expat living in Mexico without any end-of-life planning, your next-of-kin will be able to make decisions on your behalf. That is first your legal spouse, and secondly any living children. If none of those exist (such as my case), then the Mexican government will make decisions for you. If incapacitated, medical staff will be in charge of your medical decisions. Personally, I am comfortable with all these scenarios, but if you are not, make sure you have your wishes written in Spanish and notarized, and make sure you appoint individuals to oversee your wishes are honored.

If you leave this blog with any recommendation from me, it’s PUT IT IN WRITING (IN SPANISH). That is the biggest takeaway if you have specific wishes about how to handle affairs if you are incapacitated or in the event that you die in Mexico.

I can only give advice from my own perspective and life experiences. Your death may be less, or more, complicated than mine and require different approaches. I have only provided the basic navigation of where to start and what to consider as you age, and ultimately, your end-of-life decisions as an expat. The sooner you start planning, the more you will offer peace of mind to your loved ones and yourself. Death is a very complicated topic to cover in a blog and to cover all the possibilities of everyone and their unique situations, and I haven’t tried to do that here.

This blog should not be used as legal advice. I am not an attorney or medical professional. You should consult with a legal advisor and medical professionals on planning for your death as an expat in Mexico, this blog isn’t a substitution for professional advice.

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Ian Hayden Parker is the founder of PVDN and has been living as an expat in Mexico for the past 12 years. You can contact Ian Hayden Parker to suggest a topic for the next issue of How to Live in Mexico by submitting your feedback here. You can also join the PVDN Newsletter to receive daily news and more articles like this, join the newsletter here.

How to live in Mexico is a new series of posts dealing with life as an expat in Mexico and lessons that have been learned over the last 12 years as an expat. This series is opinions based on my own experiences as an expat in Mexico and each individual should expect different experiences through their own personal journey.


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