CUERNAVACA, Mexico — What kind of person sells all her possessions, hops in a car with a fistful of cash and drives south of the border to make a new life?
Meet Barbara Swartz: She's done it twice.
"It takes a sense of adventure," said the 78-year-old, whose roots are in California. "I've come here twice, once 25 years ago, and once five years ago after my husband died, and each time I sold everything I owned and left."
Or meet Gordon White, a retired software executive who left the snow and ice of Michigan 12 years ago and has never looked back.
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"The transition was nice," White said. "No more cold, no more snow, no more ice. The only ice I see is in my drinks now. I love it."
Swartz and White are among the estimated million American expatriates living in Mexico, the largest community of American expatriates anywhere in the world. They come to Mexico for its sunshine and warm weather, its proximity to home and a cost of living that's far lower than in the United States.
All these factors brought Swartz to Cuernavaca, a city of about 800,000 a little more than an hour's drive south of Mexico City, where she can live comfortably on about $1,000 a month, she said.
"The weather is fantastic here. It's about 75 to 85 degrees year-round and it only rains at night," Swartz said, pointing to a sun-drenched yard punctuated with bird of paradise plants.
Along with the culture and warm weather, however, the expats face a tradeoff: Some must go without any type of health care coverage while they're living in Mexico.
"We have friends that are 65 and older that fly back to the states to take care of these things because it's not in their budgets to have health insurance here," said Andrea Grater, the president of a local group of American expats known as the Newcomers Club.
Indeed, for some the availability of health insurance as they age becomes a larger and larger factor in determining whether retiring to Mexico makes financial sense.
Swartz moved to Mexico for the first time in the early 1980s, when she settled in Cuernavaca with her husband, a retired naval officer. They stayed for about 20 years, but in 2004, her husband's battle with Parkinson's disease took a turn for the worse.
In the U.S., he could take advantage of the excellent medical benefits available to veterans, benefits he couldn't use in Mexico.
"I made the decision to sell our house and drive back up," Swartz said.
The couple's daughter found them a small house outside Houston, where they lived for a few months while her husband received his treatment.
"He went downhill rather quickly. He was 86 years old," Swartz said. "He had excellent medical care at the VA and a hospice situation, and all of that went exactly the way my family and I wanted it to go."
After her husband died, however, Swartz said, she just didn't feel right. Her friends told her repeatedly to come back to Cuernavaca.
In Mexico, she spends her days on what most would call a vacation: playing cards with her friends, painting and tending to her garden.
"Now I wouldn't go back" to the United States, she said. "I was there alone in this cute little house wondering, 'What's it like to be a widow?' "
Like most widows of veterans, she still collects her husband's pension, which helps to supplement her income. She said she lived very well, but she acknowledged that she's "living on the edge" by not having health insurance.
Health insurance is an issue that arises often, according to U.S. diplomats in Mexico who deal with the American expatriate community.
For some expatriates, paying out of pocket isn't a big deal: The cost of health care in Mexico is a fraction of what it would be in the United States. For others, however, who often live on fixed incomes composed of pensions and 401(k) savings, health insurance is a luxury that's out of reach.
While the expatriates still receive their pensions and other benefits, such as retiree or supplemental security income, they can't use health plans that are covered under Medicare and Medicaid.
Don McLeod, a public affairs specialist for Medicare and Medicaid, said that his office got frequent calls from people wondering whether they could use their benefits outside the U.S.
"Medicare — by law — does not pay for services outside of the country. People think they can retire and take their Medicare with them, but they can't," he said.
Not every expatriate lives without medical benefits, however.
White buys health insurance through the Mexican government. "It's like an HMO; it's government health care," he said. "But it's not a lot of money — about $50 a month — and that gives me some coverage."
White has needed it. The 67-year-old Detroit native recently underwent surgery to repair his knee and said he thought that he was in excellent hands.
"The rich Mexicans go to the United States for medical care, but I think the doctors down here are good. A lot of them go to the United States for their advanced degrees anyway," White said.
Another adjustment that expatriates must make is how they communicate with and see loved ones back home.
White said he hadn't been back to the U.S. for more than five years. His parents are deceased, but he has sisters, although said he didn't "have any real ties or desire to go back."
Some expatriates, such as Swartz, have families in Cuernavaca. Her son recently moved back to the city with his family.
For holidays, Swartz said, other family members often travel to be with her in Mexico.
"I don't care to go back to the United States that much. I'm really convinced that if they come here, I can show them the wonders of Mexico and they'll love it," she said.
However, she said, her sister in Laguna Beach, Calif., doesn't like to come.
"She's afraid to come to Mexico. She believes the press; she's assured that she'll be either murdered in her bed or her car," Swartz said.
(Reinbold is a student at Penn State University. This story was reported from Mexico for a class in international journalism.)
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