Lake Chapala Ajijic Mexico Information

Medicare and Medicaid in Mexico

History/Background

The number of U.S. citizens and permanent residents moving to Mexico upon retirement has increased substantially over the past decade. These individuals choose Mexico for its low cost of living, sunny climate, culture, family, and close proximity to the United States, among other reasons. Numerous communities of American retirees are developing throughout Mexico. Most communities are comprised of U.S. and Canadian retirees who live part of the year in Mexico, and have organizations or clubs, to which many of the retirees belong, that provide information about real estate, expenses, health care and social events. Many individuals who chose to retire to Mexico find that coverage has become severely attenuated and they must arrange to be in the U.S. to receive care to which they are entitled. In only extremely rare cases will Medicare cover care outside of the United States. Without Medicare, Americans retiring in Mexico are more vulnerable to the potentially devastating financial consequences of inadequate health coverage. As the demography in the United States changes, and more Americans decide to retire in Mexico, government-sponsored health care coverage for U.S. retirees should examine options to adapt to the needs of its beneficiaries.

Dr. David C. Warner, Professor at the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin has been actively involved in researching possibilities for extending coverage to Medicare eligible individuals residing in Mexico for many years. In 1993, the fourth policy report of the U.S.-Mexican Policy Studies Program Series, Health Care Across the Border: The Experience of U.S. Citizens in Mexico, was published. This report was followed by numerous other publications pertaining to U.S.-Mexico health care issues, including the 1998 report Getting What You Paid For: Extending Medicare to Eligible Beneficiaries in Mexico. This project included the administration of a survey to a non-random sample of U.S. retirees in the Mexican states of Jalisco, Guanajuato, and Baja California Norte. In February 1999, a conference was held at the LBJ School of Public Affairs to air and discuss a proposal to develop a research and demonstration project to analyze the feasibility of extending Medicare benefits to eligible retirees in Mexico.

In recent years, the Mexican government has been working towards further standardizing health professionals’ qualifications and regulating medical facilities. Also, private health insurance carriers in the U.S. have created products targeted to transnational populations that cover care on both sides of the U.S.-Mexico border. These trends indicate that the infrastructure is developing to support the portability of Medicare benefits to Mexico.
Objective

In order for Medicare benefits to be offered to all Medicare enrollees residing in Mexico, a series of incremental steps would have to be taken. The Center for Medicare and Medicaid Services (CMS), a Federal agency within the U.S. Department of Health and Human Services administers Medicare as well as Medicaid. CMS is authorized to conduct and sponsor demonstration projects to test and measure the effect of potential program changes, but is not authorized to do so internationally. Thus, Congressional approval will be needed in order to conduct such a demonstration. The project plans to help draft a Medicare research and demonstration project to evaluate the effect of program coverage in Mexico.

This web site provides information on current Medicare policy pertaining to receiving care abroad. It also explains the structure of our proposed research and demonstration project, and provides additional resources for information on health care in Mexico, Medicare and cross border health insurance. Visit website