Besides being an issue of cost savings for the Medicare Program, there is an issue of fairness. Eligible seniors living in Mexico have paid into the Medicare program through payroll deductions for their entire working lives. Yet, due to their decision to retire in Mexico, they are unable to access the services for which they have paid.

One might argue that moving to Mexico was a choice, and a consequence of that choice is foregoing benefits paid by a U.S. government program. But in many cases, that "choice" is almost an economic necessity. In a survey conducted by a team led by Dr. David Warner, Professor of Public Health Policy at the University of Texas, Lyndon B. Johnson School of Public Policy, it was found that the lower cost of living is the primary reason seniors choose to move to Mexico. The median income for a retired couple living full time in Mexico is $35,000 per year. There are few places in the U.S. where $35,000 is sufficient for a comfortable lifestyle, while in Mexico that sum is quite adequate.

Further to the fairness issue, the University of Texas survey found that 63% of seniors living in Mexico had worked in the U.S. for 31 years or more. These people have paid a lot of money into the Medicare system!

Most seniors living in Mexico continue to maintain their Medicare coverage. 60% are enrolled in Medicare Part A, the traditional coverage for inpatient hospital care, and 50% pay monthly premiums for Medicare Part B, which covers outpatient medical care expenses including doctor's fees. Smaller numbers of seniors have Medicare Parts C and D. Yet, in order to access the benefits for which they have paid, and in many cases continue to pay, they must travel back to the U.S.