Healthcare for Expats

A lot of people want to travel the world when they retire. A lot of people also want to move away from their current homes and live a differently lifestyle now that they no longer need to go into work every day. So, it’s only natural that many retirees decide to pick up and move to a different country.

If you decide to do this, there are a lot of factors to take into consideration. The cost of living, the lifestyle, the weather, and much more. However, one aspect that you might be overlooking is healthcare.

As we age, we naturally require more healthcare and different healthcare. When you retire, you may also lose your employer-sponsored health benefits. This means you will likely need to rely on private healthcare plans or cover costs yourself, alongside federal Medicare benefits. 

Of course, that’s only the case if you remain in the United States. Many retirees take healthcare considerations into account when they’re thinking of moving and, for a lot of people, it’s one of the main factors. You can find a lot of affordable healthcare options by looking abroad. In many countries, you can receive both public or private healthcare and get quality care for much less than you would in the United States. You’ll also get the experience of living in a different country and a different culture without the need to worry about your health and well-being. That’s huge for peace of mind. 

Many seniors worry that traveling to a different country means giving up access to high quality healthcare, but that doesn’t have to be the case. There are many locations where you can get the care you need along with the experiences you crave.

Costa Rica

Costa Rica has very strong public and private healthcare systems. Most doctors’ visits are less expensive than they would be in the United States, and medication is both considerably less costly and also more easily available. In fact, many drugs that are available by prescription only in the United States are easily available in Costa Rican pharmacies. 

Legal residents can join the country’s public healthcare system (known as the Caja Costarricense de Seguro Social or CCSS) and be covered by the system for a small monthly fee. The fee is based on your income. It is mandatory for all permanent residents to join the government plan. The residency process takes about 18 months. 

Portugal

Private insurance is available and relatively affordable in Portugal. There are also no deductibles or copays. In addition, full-time residents can access the state-run National Health Service (SNS). 

To obtain permanent residency, you need to have lived in the country for five continuous years. However, you can also obtain a temporary residence permit in the meantime. To receive this, you must show that you have sufficient financial resources. The length of the permit will depend on the purpose of your stay, but it can be renewed. 

To apply for a visa and residency in Portugal, you must have private health insurance. 

Panama

Panama has a two-tier health system, but residents can receive coverage in any hospital in the country. The public system is only available to employers and employees who have valid deductions taken from their pay. 

However, paying for your own care is quite affordable, with costs being considerably lower than in the USA.  In Panama, you’ll find many English-speaking staff members, and generally fast access to specialists. 

Spain

Much like many of the other countries mentioned, Spain has a public healthcare system (known as the Sistema Nacional de Salud or SNS) as well as a private system. 

To secure a visa, you must have private health insurance. Many plans in the area have no copays or deductibles and provide full coverage. To access the private system, you much be a permanent resident, which you can apply to become after five years of residency. 

Mexico

In general, healthcare costs in Mexico are considerably less than those in the United States. For most services, expats can expect to pay about half (or less) than they would in the USA. There are also private health insurance plans available.

Similar to many of the other countries mentioned, there is also public healthcare options. Legal residents can enrol in this healthcare system.

In regions that are home to large numbers of expats, there are often medical concierge services available. These services help you arrange for medical care and give you access to vetted healthcare professionals. You’re typically able to use your American health insurance plan to pay for these services. 

Greece

Expats must show proof of private health insurance to apply for a visa. There are many established insurance providers in Greece, and you can receive English-speaking support from most of them. 

Healthcare in Greece is generally quite good and private healthcare options typically have short wait times and many specialists and staff speak English. Having insurance is important, as not only is it required to obtain a visa, but healthcare costs can be quite expensive if paid upfront. Note that your insurance options may change once you are over 65. You may need to work with a specific provider to receive coverage at this point.

While Greece offers a Golden Visa Program that grants those who have significant real estate investments in the country with a residence permit, these visa holders are not able to contribute to the Greek public social security system (EFKA) and do not receive free public healthcare.

France

When applying for a visa in France, you must have private insurance. However, once you have lived in the country for three consecutive months, you’re able to join the public healthcare system. 

It is known as Protection Universelle Maladie (or PUMA) and it covers medical care, hospital care, and prescriptions. However, you will likely still have some out-of-pocket costs as the system usually covers between 70-80% of the costs. The rest can be paid either with your own funds, or you can purchase a top-up health insurance policy. Costs of these plans are based on your income. 

Italy

Italy has a national public healthcare system: the Servizio Sanitario Nazionale (SSN). Official residents can choose to pay into the system on an annual basis, with costs being determined by income. To become a permanent resident, you much have continuously lived in the country for at least 5 years under a valid temporary permit. 

However, much like with many other countries, obtaining a visa requires you to prove that you have comprehensive private medical coverage. 

Choosing The Right Option

When it comes to deciding where to retire, expats have a lot of things to think about. It isn’t just about healthcare costs. It’s also where you would like to spend your time. Your retirement is about enjoying yourself and feeling comfortable. Moving to a different country is a big move and it’s one that you don’t want to take lightly. 

In addition to the lifestyle you’re going to have while you’re there, consider the overall cost of living in addition to healthcare. If you can get affordable quality healthcare, but your monthly rent and living expenses are very high, saving the money in healthcare costs may not help your budget. 

Your priorities will be different from anyone else’s priorities, as well. Some people want to relax on the beach in retirement while others want to go on adventures. Some want to visit museums and historical sites while other want to focus on having great meals. For a lot of people, budget is their primary concern while other expats care more about experiences. Healthcare should definitely be a consideration, however. You’ll need it as you age and you don’t want to end up with a costly bill or confusing, substandard care when you need it most. Researching the healthcare situation in different retirement destinations can help you make the right choice for you. There are many that offer comparable (if not even better) health services than the United States, and often for less money as well.