Retiring abroad can be an exciting way to stretch your savings and explore new cultures. But one big question looms for many American expats: What happens to your healthcare overseas? In this conversational guide, we’ll explore everything a middle-income American retiree should consider – from Medicare and Medicaid, to VA benefits, to private and local health insurance options when living abroad. We’ll also compare healthcare in different regions and highlight some of the best countries for affordable, quality care.

Whether you’re dreaming of coastal Europe, a tropical haven in Latin America, or an adventure in Asia, understanding healthcare abroad is crucial. Let’s dive in.

Medicare and Retiring Abroad: What You Should Know

For Americans 65 and older, Medicare is the primary health insurance – but Medicare provides little to no coverage outside the United States. In fact, Original Medicare (Parts A and B) generally won’t pay for medical care you get overseas . There are only a few very narrow exceptions, such as if you have a medical emergency while in the U.S. but a foreign hospital is actually closer than any U.S. hospital (think of an emergency near the Canadian or Mexican border), or if you’re traveling through Canada directly to/from Alaska in an emergency . Outside of rare scenarios like these, Medicare won’t cover you internationally .

What does this mean for you? If you’re planning to live overseas in retirement, you cannot rely on Medicare to foot your medical bills in your new country. Even Medicare Advantage plans typically do not cover regular healthcare outside the U.S., aside from limited emergency coverage in some cases . As NerdWallet bluntly puts it: “If you rely on Medicare…the answer is no, you’re not covered outside of the United States.”

However, you can still have Medicare while living abroad – you don’t automatically lose it by moving. Many expats keep Medicare Part A (hospital insurance), especially since Part A is usually premium-free based on your work history. There’s no cost to keeping Part A, and if you ever return to the U.S. it will be there for inpatient coverage. (If you do pay premiums for Part A due to an insufficient work record, it’s probably not worth paying those hefty premiums while abroad, since you won’t be using it.)

The bigger decision is Medicare Part B, which covers outpatient care and has a monthly premium. In 2025, the standard Part B premium is around $170+ per month, and you must keep paying it every month even if you’re overseas and not using any Part B services. Some retirees choose to drop Part B when moving abroad to save money. After all, why pay ~$170/month for insurance you aren’t using? If you live abroad permanently and don’t frequently return to the U.S., keeping Part B may not be worth the cost . However, think carefully before disenrolling. If you later move back to the U.S. or even visit for extended periods, you might want that Medicare coverage ready. Re-enrolling in Part B later can mean waiting periods and lifelong late enrollment penalties (10% higher premiums for each 12-month period you could have had Part B but didn’t). There are some special enrollment exceptions if you had other health coverage, but living abroad generally doesn’t count as creditable coverage.

Bottom line: Many experts say if you’re pretty sure you’ll stay abroad full-time, you could consider dropping Part B to save money, but only if you’re comfortable with the risks. If you plan to spend part of each year back in the States or you just want the security of being able to return to U.S. healthcare without penalty, you might bite the bullet and keep paying for Part B even while abroad. It’s a personal decision that hinges on your budget and plans.

What about Medicare Supplement (Medigap) plans or Medicare Advantage plans? A few Medigap plans do offer limited foreign travel emergency coverage – typically up to $50,000 lifetime, for emergencies during the first 60 days of a trip, with a $250 deductible and 20% coinsurance. This can help for short vacation travel, but it’s not a solution for someone actually living overseas long-term; it’s meant for occasional travel emergencies. Medicare Advantage plans are mostly HMO/PPO networks based in specific U.S. regions, so they usually do not cover routine care abroad. They must cover emergency or urgent care worldwide in emergencies, but again, that’s only for unexpected issues during a trip. If you live abroad, you’d likely have to disenroll from Medicare Advantage (since you won’t be in the service area) and switch to Original Medicare if you want to keep Medicare at all.

Key Takeaway: Medicare will almost never pay for your healthcare overseas beyond very limited emergency cases . If retiring abroad, you’ll need to plan for other health coverage (more on those options below). You can keep Medicare Parts A/B if you can afford it (for coverage during visits back home or in case you return to the U.S. later), but you’ll still need separate insurance or funds to cover medical needs in your country of residence.

“In most circumstances, there is no coverage through Medicare for health care or supplies you get outside the U.S.” as one U.S. elder law attorney explained . So plan as if you have no Medicare at all when budgeting for retirement abroad.

A note on Medicare and Social Security: You can continue to receive your Social Security retirement benefits while living abroad in most countries, so that income will still be there for you. But Social Security enrollment automatically enrolled you in Part A at 65 in many cases. Part A (if premium-free) you’ll likely keep, as mentioned. Just remember that if you do drop Part B while abroad, your Social Security check will no longer have the Part B premium deducted – so you’ll get a bit more in your pocket each month, which you could redirect toward an international health insurance plan or local medical costs.

Medicaid: Don’t Count on It Abroad

What if you’re a low-income retiree who qualified for Medicaid in the U.S.? Unfortunately, Medicaid won’t travel with you overseas at all. Medicaid is a state-federal program and generally only covers care within your U.S. state of residence. It doesn’t even easily cover you if you go to another state, let alone another country. As one legal guide bluntly states: “Medicaid provides no option for coverage outside of the United States.” If you leave the country for 30 days or more, your Medicaid benefits can be suspended , and reactivating them when you return can be complicated. Essentially, you’d have to resume residency in a U.S. state and reapply/recertify eligibility.

And as NerdWallet notes, Medicaid doesn’t even usually cover outside your state except in some rare emergency cases . So definitely, if you’re on Medicaid, you cannot rely on it once you move overseas.

This means a low-income American retiree abroad will need to look to the local country’s public healthcare (if available to foreign residents) or other resources in that country. The good news is that many countries have inexpensive or even free public hospitals that anyone can use (more on that in a moment), so being of modest means doesn’t mean you’ll be completely out of luck for care. But it does mean you should not expect U.S. Medicaid to cover any of your medical costs abroad. Essentially, once you relocate, you’re outside Medicaid’s domain.

Plan accordingly: If you have Medicaid now and plan to retire overseas, factor in those lost benefits. The healthcare in your new country might still be quite affordable relative to U.S. costs, but you’ll likely be paying out-of-pocket or needing to buy into that country’s insurance system because your U.S. safety net won’t apply abroad.

Veterans’ Healthcare Benefits Overseas (VA and TRICARE)

Are you a U.S. military veteran? If so, you might be accustomed to getting care at VA hospitals or clinics for little to no cost. But when you move overseas, accessing VA healthcare is a different story. The VA (Department of Veterans Affairs) mainly operates within the United States. With one notable exception (the VA clinic in Manila, Philippines), VA medical centers are not available abroad. However, the VA does have a program to help vets overseas: the Foreign Medical Program (FMP).

Under the Foreign Medical Program, the VA will reimburse you for medical treatment related to any service-connected disabilities or conditions while you’re abroad . In other words, if you have a VA-rated disability or an illness/injury officially connected to your military service, you can enroll in FMP and the VA will cover care for those specific issues overseas. For example, if you have a service-connected knee injury and need surgery or therapy for that knee, FMP would pay those costs in your country of residence.

However, the VA will not cover routine healthcare or conditions that are not service-connected when you’re overseas. So if you develop a new illness or have a common condition unrelated to your military service, you can’t go to a foreign hospital and send the bill to the VA (unless it’s an emergency tied to a service condition). Only service-connected care is covered abroad . Veterans need to register with the FMP to use this benefit, and it essentially works as a reimbursement program – you might pay the foreign provider and then VA pays you back, or in some cases the provider can bill VA.

One strategy some expat veterans use: handle their service-related medical needs through FMP (for example, getting their VA disability meds or check-ups covered), but secure separate insurance or care for other health needs. If you’re a veteran with substantial service disabilities, FMP can be a valuable benefit to reduce your overseas healthcare costs for those issues.

Now, what if you’re a military retiree with TRICARE? TRICARE is separate from VA and covers military retirees and families. There is a TRICARE Overseas program. If you’re on TRICARE For Life (TFL) – which normally works as a Medicare supplement for 65+ military retirees – note that Medicare won’t cover abroad, but TRICARE will become primary payer overseas. TRICARE has an overseas plan where you can get care and seek reimbursement, but you often have to pay upfront and then file a claim. The rules can depend on which TRICARE plan you have (retirees living abroad often use TRICARE Select Overseas or TRICARE For Life Overseas). Generally, TRICARE can cover care abroad, but you’ll need to find providers and possibly deal with paperwork. This is a complex area, so consult the TRICARE Overseas office for specifics on coverage and any required enrollment steps before you move.

In summary for veterans: If you rely on the VA for healthcare, know that the VA will only cover service-connected conditions overseas via the Foreign Medical Program . Routine care and non-service conditions will be on you (or another insurance). Plan to enroll in FMP and get copies of your service-connection award letters to show foreign providers if needed. If you have TRICARE, check what is covered abroad and be prepared for potentially higher out-of-pocket costs or claim-filing processes. And if you happen to be moving to the Philippines, you’re in luck – that’s the one place outside the U.S. with a VA outpatient clinic, primarily serving the large veteran community there.

Will Your U.S. Health Insurance Cover You Abroad?

Outside of Medicare/Medicaid/VA, maybe you have some other health insurance – say a retiree health plan from your former employer, or an ACA marketplace plan, or private insurance. Can you keep that and use it internationally? Probably not, at least not for routine care.

Most U.S. health insurance plans do not cover non-emergency services outside the country. Employer or private plans often have networks limited to the U.S. (or even a region within the U.S.). They might reimburse emergency or urgent care abroad in some cases, but generally they expect you to get care back home. For example, a Blue Cross or Cigna plan might pay for you to be stabilized in an emergency while traveling overseas, but they’re not going to cover your monthly prescriptions or a hip replacement done in another country (unless it was an emergency and you couldn’t reasonably return to the U.S. for treatment).

As a result, many retirees who move abroad end up dropping their U.S.-based health insurance (except perhaps Medicare as discussed). If you’re moving permanently, paying for a U.S. health plan doesn’t make sense if it won’t cover you where you live. One catch: to buy an Affordable Care Act (ACA) marketplace policy, you must reside in the U.S. – so once you establish residency abroad, you’re generally not eligible for an ACA plan back home. (If you maintain a U.S. address and spend part of the year stateside, some expats do keep an ACA plan for when they’re in America. But if you’ll be abroad 12 months a year, you shouldn’t be on an ACA plan; technically you’d lose eligibility because you’re no longer considered a resident for that purpose.)

Before you move, call your insurance and ask about international coverage. Chances are they’ll tell you it only covers emergencies overseas, if anything. For example, one travel insurer notes: “What About Medicare and Medicaid? Medicaid does not cover you outside the U.S. and most Medicare plans also do not cover you outside the country.” – and the same is true for most private insurers.

If you have a retiree plan or FEHB (for federal retirees), some of those plans do offer some overseas coverage. Federal retirees’ FEHB plans often reimburse overseas care (you might pay upfront and file a claim). But even then, they might not cover 100%, and you’ll need to handle your own logistics.

In general, assume your U.S. health insurance won’t fully cover medical expenses when you’re living abroad. Thus, you’ll need to look at alternatives: either international health insurance that you purchase, or coverage in your new country (through that country’s national health system or local insurers), or simply paying out-of-pocket if feasible.

One scenario to consider: How long and where you live abroad matters. If you’re only going overseas for part of the year (e.g., “snowbird” retirees who live 6 months in Florida and 6 months in Costa Rica), you might keep U.S. insurance for when you’re home and use travel insurance for shorter stints abroad. Many standard travel medical insurance policies cover you for trips up to 30, 60, or 90 days. Some extend to a year. But if you’re moving full-time to another country, you’ll want a more permanent solution like an expat insurance plan or local coverage.

Also, if you plan to split time between two countries (say the U.S. and abroad), check if any policy can cover both. Some global health insurance plans will cover you in multiple countries, including visits back to the U.S., but those are more expensive (since covering care in the U.S. – the world’s most costly healthcare – drives premiums up). Many expats solve this by buying a plan that covers everywhere except the USA, and then they pay cash or use Medicare if they pop back to the States briefly.

To summarize, American health plans generally don’t travel well. You’ll likely need to transition to a different healthcare financing method once you retire overseas, which leads us to…

International Health Insurance for Expats

One popular option for retirees abroad is to purchase international health insurance – private insurance plans specifically designed for expats. These plans (offered by companies like Cigna Global, Aetna International, Allianz, etc., as well as region-specific insurers) can cover you in your new country and often across multiple countries. They function much like regular health insurance: you pay a premium (monthly or annually), and the plan will pay for many of your medical costs per the policy terms, potentially with deductibles or copays.

How expensive are expat health insurance plans? It varies widely based on age, health, and coverage level. For a rough idea, one expat resource notes that in Thailand, “Annual private insurance costs fall in the $1,000 – $2,500 range” for retirees – that’s roughly $100 a month on the low end to about $200 a month on the high end. In Malaysia, private insurance is even cheaper: “Expats can obtain private health care insurance for under $50 a month, the same private plan available to Malaysian nationals,” according to a Kiplinger report . That plan offers coverage at many top hospitals in Malaysia, with English-speaking doctors and short wait times .

Keep in mind, these costs often exclude coverage in the United States. If you want a plan that also covers you during visits back to the U.S., the premium can jump dramatically (since U.S. care is so costly). Many expat retirees forego U.S. coverage in their international plan to keep premiums low – they might rely on Medicare or travel insurance for short U.S. trips instead.

Also, premiums rise with age. A 70-year-old will pay more than a 60-year-old for the same coverage. Some insurers actually have age caps (for example, they may not issue a new policy to someone over 75). If you already have a policy and age up, they usually let you renew, but expect costs to increase as you get into your late 70s and 80s.

Another approach is local health insurance in the country you retire to. Many countries have private insurance companies that offer plans to residents (including foreigners). These can be significantly cheaper than U.S. insurance too, though they might have lower maximum coverage limits or exclude some pre-existing conditions. In Panama, for instance, local private insurance premiums can range from ~$50 to $125 per month depending on age and coverage level . In Mexico, you could purchase a private plan or simply pay cash since costs are low (more on Mexico soon). In Portugal, as one expat couple shared, basic private plans start around $50 a month, and comprehensive plans for older couples might be roughly $550 per month for two people in their 60s/70s – and that’s for very robust coverage (their plan covered a pacemaker and even allowed elective cataract surgery with minimal cost) .

A mix-and-match strategy: Many expats use a combination of resources. For example, you might join the local national health system for basic care (sometimes it’s free or very cheap), and carry a private insurance policy to cover private hospitals or care in another country if needed. Or you might pay out-of-pocket for routine things and only carry a high-deductible international plan for big emergencies (kind of like catastrophic coverage).

One important tip: pre-existing conditions can be a sticking point. Some international or local private insurers exclude pre-existing conditions or impose waiting periods. However, if the country’s public system accepts you as a resident, they usually treat pre-existing conditions (national healthcare typically doesn’t turn people away, though there might be a waiting period for non-urgent treatment). For instance, Mexico’s public IMSS insurance has some exclusion for pre-existing conditions in the first year , but an alternative program (INSABI) was created to cover anyone including those with chronic conditions . Costa Rica’s public system (Caja) covers you fully after you join, pre-existing conditions and all . So, it may be easier to get your pre-existing conditions managed in public systems or by paying cash, while using private insurance for new issues or major events.

Lastly, some retirees decide to self-insure for smaller costs and only insure against big risks. If you have sufficient savings, you might pay out-of-pocket for doctor visits, meds, and even mid-range procedures in your new country (since they might be relatively cheap), and only use insurance for a catastrophic event like a major surgery or serious illness. For example, routine doctor’s visits in many countries can be $20-$50, a course of physical therapy might be a few hundred dollars – amounts one could budget for without insurance. But a heart surgery or cancer treatment could still run into the tens of thousands. So you could choose a plan with a high deductible to lower the premium, essentially covering only those nightmare scenarios.

In short: Yes, you can get medical insurance as an expat – either through international companies or local insurers – and premiums are often much lower than in the U.S. for comparable coverage. A middle-income retiree will find that even paying out-of-pocket in many countries can cost less than the annual deductible on a U.S. insurance plan! Still, carrying some form of insurance is wise for peace of mind. Shop around and compare expat insurance options; consider your health needs and how they match the country’s offerings.

Now, let’s talk about how healthcare actually works in some popular retirement destinations, and which countries are known for making healthcare easy and affordable for foreign retirees.

Healthcare in Latin America: Affordable Care Close to Home

Latin America is a magnet for American retirees seeking good weather, lower costs, and proximity to the U.S. It also offers significantly more affordable healthcare in many countries, without sacrificing too much quality. Let’s look at a few key countries:

Mexico: Our neighbor to the south not only offers a familiar culture and short flight home, but also excellent healthcare options in major cities. Many Mexican doctors are U.S.-trained or speak English, and private hospitals in places like Mexico City, Guadalajara, Monterrey, and expat hubs (Puerto Vallarta, Lake Chapala, Cancun, etc.) are modern and well-equipped. Costs in Mexico are often 50-70% less than in the U.S. on average. According to International Living, healthcare costs are at least 50% lower in Mexico compared to the U.S., and the system is easier to navigate, with rare long waits and many medications available over the counter . An American expat can literally fly to Mexico, get a dental crown or knee surgery, enjoy a recovery by the beach, and fly home, all for less than just the procedure would cost in the States – that’s why Mexico is a top destination for medical tourism . Mexico has both public and private insurance options for residents. The public system is two-fold: IMSS, which is a social security healthcare program that working residents pay into – but retirees can also voluntarily enroll by paying a yearly premium; and INSABI, a newer program intended to cover uninsured people (including those with pre-existing conditions) for free or minimal cost . To give you an idea, the IMSS premiums in 2024 for foreigners were around $63 per month at age 50-59, $89/month for age 60-69, and $93/month for age 70-79 . Those premiums cover virtually all your care (doctor visits, surgeries, medications) at IMSS hospitals – effectively it’s like a Medicare-for-all within Mexico. There are exclusions for some pre-existing issues initially , but many expats still join IMSS for the security. If you can’t get into IMSS (say you have an excluded condition), INSABI allows legal residents to use public hospitals essentially for free by showing your resident ID . Yes, you read that right – Mexico’s constitution views healthcare as a right, so they aim to provide free care to those who need it. Quality in public facilities can be hit or miss (great in some, mediocre in others, often with crowds), so many expats use IMSS or pay out-of-pocket at private clinics. Private healthcare in Mexico is still far cheaper than in the U.S. For example, a specialist consultation might cost $50-$75 (and often you can just call and get an appointment in a few days). An MRI that costs $1,500 in the U.S. might be $300 in Mexico. A routine doctor visit could be $20-$30 at a private office. With costs so low, some American retirees simply pay out-of-pocket and forego insurance. Others buy local private insurance or an international plan for major incidents. Either way, Mexico makes it pretty easy and affordable for expats – plus it’s close enough that you could even return to the U.S. for some care if you really wanted (though many find they don’t need to).

Costa Rica

Often touted as one of the best retirement destinations, Costa Rica also has a strong reputation for healthcare. The country has a universal public health system known as the Caja Costarricense de Seguro Social (CCSS), commonly called “Caja.” All residents (including foreign retirees with residency) are required to enroll in and pay into the Caja . The cost is income-based: typically 9–11% of your reported monthly income . For a pensionado retiree visa, you need at least $1,000/month income, and you’ll pay roughly $90 (if 9%) to $110 (if 11%) on that amount – many report paying around $75-$150 per month for a couple to be covered by Costa Rica’s public healthcare. In return, you get access to free at the point of service care in the public hospitals and clinics . That includes doctor visits, tests, surgeries, prescription drugs – everything, even for pre-existing conditions. It’s an incredible value. One expat described it succinctly: “Expats must pay 9-11% of their reported income for public healthcare but often supplement with private insurance for shorter wait times.” In other words, the public system is comprehensive but can have waits for non-emergency procedures, so some retirees also maintain a private plan or pay private doctors for speedy service when desired. Private healthcare in Costa Rica is also available and much cheaper than in the U.S. There are excellent private hospitals in San José and other areas. You can see a private doctor for $50 or so, a specialist for maybe $80, and many doctors there speak English (especially those serving expats). Some medications that require a prescription in the U.S. can be bought over the counter there. A number of retirees use both systems: they’ll use their Caja membership for big things (e.g. a surgery or chronic condition management), and pay out-of-pocket for an occasional private consultation to avoid wait times. There are also private insurance plans you can buy (INS, a national insurer, offers policies, and international insurers cover CR too). But since the public system covers you fully once you’re a resident, many just stick with the Caja and are quite happy with it – Costa Rica’s health outcomes are excellent (people there enjoy longevity on par with the U.S., at a fraction of the cost).

Panama

Another popular expat retirement spot, Panama offers a mix of public and private care. Panama’s public hospitals are very inexpensive – so much so that even visitors are treated for low cost. (In fact, Panama at one point had a policy that tourists/visitors got a month of free emergency insurance – they really want to promote medical tourism and expat living!) As a resident, you can use the public clinics and hospitals almost for free or very little cost . However, many expats in Panama choose private healthcare because it’s still affordable and generally higher comfort. Private insurance in Panama is relatively cheap: basic local plans can be $30-$50 a month for a 60-something , though more comprehensive ones for older ages might be a bit more. One interesting option in Panama (and also in some other Latin countries like Uruguay) is hospital membership plans. For example, a network of private clinics might offer an “expat plan” where you pay, say, $20 a month for membership , which then entitles you to very low fixed prices for services or just free primary care at their clinics. A Panama Relocation guide cites a clinic network offering expat membership at $220 a year (about ~$18/month) that covers basic healthcare needs, with discounts on other services . Essentially it’s like joining a health co-op or HMO directly. Overall, Panama’s healthcare is high-quality in Panama City (Johns Hopkins International has an affiliated hospital there), and generally good in larger towns. Costs are much lower than the U.S. – a doctor visit might be $25. Prescription meds often cost 30-50% of U.S. prices. Many American retirees find they can afford procedures out-of-pocket in Panama that would have been impossible to pay for in the States. Panama makes it fairly easy for foreign retirees to get residency (the “Pensionado” visa) and does not require you to buy insurance – but of course it’s wise to have something. Because of the combination of decent care and lower costs, a lot of expats feel secure there medically.

Colombia

While not as classic a retiree draw as Costa Rica or Panama, Colombia is gaining popularity for its excellent, modern healthcare. In fact, in rankings of hospital quality, several Colombian hospitals (in Bogotá, Medellín) rank among the best in Latin America. Colombia has a public-private system where even foreigners who become residents can join the national health insurance (EPS) by paying into it. The cost can be very low – reports often cite ~$70 per month for a comprehensive plan that covers you at good facilities. And that’s not just cheap; the quality of care is high. Surgeries in Colombia can cost a quarter of U.S. prices. The city of Medellín is even known as a medical tourism hotspot for procedures like hip replacements or dental work at top hospitals. So Colombia is an option for those who want city amenities and top-tier care at a low price. (Bonus: many doctors in private system speak English, and the country’s culture is very warm and patient-centric in healthcare).

Ecuador

Ecuador used to be famous for having extremely cheap healthcare for expats – a few years ago, retirees could join the public IESS health system for around $70/month per couple (!). That plan covered everything with no copay, even pre-existing conditions (after a waiting period). It was an incredible deal and many expats took advantage. Ecuador adjusted the rates more recently, but it’s still affordable. The public hospitals are not fancy, but they get the job done. Private healthcare in cities like Quito, Cuenca, or Guayaquil is affordable too (doctor visits $30-$40). Some retirees keep a private insurance that might be a few hundred a month at most for older ages, but plenty also go without and pay cash because it’s workable. For instance, one might pay $20 for a lab test or $200 for an MRI – things that are manageable on a fixed income.

Brazil & Argentina

These larger South American countries have universal healthcare on paper. Notably, Brazil’s constitution guarantees free healthcare to everyone in the country – even visitors. Brazil’s SUS system is free at point of use for any person who needs care . This means an American retiree in Brazil could walk into a public hospital and be treated without paying. The catch is that the public system is under strain and quality varies widely. In big cities like São Paulo, you’ll find world-class private hospitals (and you’d likely want private insurance to use those). In smaller towns, the public clinics are basic but functional. Many expats in Brazil might use a mix – free public care for minor or preventive needs and pay private for anything complex. Argentina similarly has a public system that offers free hospital care to all residents (and even non-residents can access it). Argentina’s public hospitals in Buenos Aires are generally good (some are teaching hospitals affiliated with universities). Again, many who can afford it opt for private care which is very affordable – for example, a high-end health insurance plan might be $100-$150 a month, and that gets you access to excellent private hospitals and English-speaking doctors. For a middle-income expat on a tight budget, knowing that if all else fails you can go to a public hospital and it won’t cost anything is a big relief.

Regional summary – Latin America

Healthcare in Latin America is generally accessible and budget-friendly for expat retirees. Most countries have some form of universal healthcare that legal residents can access at low or no cost . Quality in private facilities often rivals the U.S., especially in big cities, while public facilities ensure no one is completely without care. You’ll likely want to learn some Spanish (or Portuguese in Brazil) to communicate, although in areas with many American retirees, you’ll find doctors who speak English. Many retirees in Latin America are happy to report that they get excellent care and pay a fraction of what they used to.

For example, an American couple who moved to Italy (not Latin America, but illustrating the contrast) noted: “In 2022, despite the fact that neither of us had anything terribly wrong with us, we spent over $6,000 on premiums and medical bills [in the U.S.],” and they felt “this is insanity.” In their new country, they spend about $1,500 to $1,600 yearly on healthcare . Similarly, many expats in Latin America find their out-of-pocket costs plus any local insurance total in the low thousands per year or less, whereas in the States they were paying that much per month in premiums or copays.

Now, let’s turn to another region: Europe.

Healthcare in Europe: World-Class Systems for Residents

If your retirement dream leans more towards sipping wine in Tuscany or exploring the villages of Spain, you’ll be pleased to know that Europe has some of the best healthcare in the world, and as a resident you can access those systems – often very affordably. European countries typically have universal healthcare, funded by taxes or social insurance. The challenge for American retirees is usually obtaining residency, since many European Union countries require non-EU citizens to purchase private insurance for a visa. But once you’ve settled in, you can often join the national health plan.

A number of European countries consistently rank at the top for healthcare quality, outcomes, and accessibility – France, Spain, Italy, Portugal, Germany, and the Nordics are all renowned for their medical systems . Let’s highlight a few common expat destinations:

Portugal

Portugal is not only popular for its sunny climate and low cost of living, but also for its healthcare. It has a national health service (SNS) that provides low-cost care to residents, and private healthcare that’s also relatively cheap. Many expats rave about the care they receive. For instance, one American expat had a hip replacement done through Portugal’s public system and said “Total cost to me? Zero. Literally priceless.” – she went through some waits and bureaucracy, but ultimately did not pay a cent for a surgery that would have cost tens of thousands in the U.S. Another expat couple in Portugal opt to carry private insurance for flexibility, paying $550 per month for comprehensive coverage for two people aged 64 and 70, with modest copays (around $17 per doctor visit) . They love that prescriptions are cheap (sometimes only a few cents or dollars) and that even pre-existing conditions like a pacemaker implant were covered . For residency, Portugal requires you to have private health insurance initially (unless you’re over 65, in which case they sometimes accept just proof of ability to pay for care). Once you are a resident, you can use the public SNS by getting a user number. There’s typically a small copayment in the public system (a few euros per visit). Overall, Portugal’s healthcare is high-quality (ranking #12 globally in one expat health index) and very affordable. As a bonus, many doctors speak some English, especially in Lisbon and the Algarve where there are international communities.

Spain

Spain’s single-payer health system is frequently praised for its quality and efficiency. The World Health Organization once ranked Spain among the top healthcare systems globally. If you become a legal resident in Spain (for example, on a non-lucrative retirement visa), you aren’t automatically covered by public healthcare unless you eventually get permanent residency or citizenship. But Spain created a program called Convenio Especial that lets non-working residents (including foreign retirees) buy into the national health system by paying a monthly fee. This fee is around €60/month for adults under 65 and €157/month for those 65+. It covers virtually everything, with no exclusions for pre-existing conditions, though you pay full price for prescriptions (which in Spain are pretty cheap anyway). Many expats take advantage of this after they’ve lived in Spain for a year (you become eligible for Convenio after 12 months residency in some regions). €157 ($170) per month for an older person is not nothing, but it’s still far less than U.S. insurance premiums and gives access to Spain’s outstanding network of doctors and hospitals. Alternatively, some retirees just keep a private insurance plan. Spain’s private insurance for a 70-year-old will likely run a couple hundred dollars a month for a good plan – and that’s with zero deductible and wide coverage. People often do this to skip waiting lists. But if you’re content with the public system, you’ll find that as a resident, Spain offers near-free healthcare beyond that modest monthly contribution . Spanish healthcare is so good that it’s cited among the reasons people retire there. According to one international index, Spain and Italy offer near-universal coverage to residents (including expats) once you meet residency requirements .

Italy

Italy has a tax-funded National Health Service (Servizio Sanitario Nazionale, SSN) which provides universal care. Italian healthcare is excellent (particularly in the north and major cities – some southern areas are a bit less resourced). For Italian citizens and residents with work permits, it’s essentially free except small copays. For foreign retirees, Italy recently changed the rules: now non-employed residency permit holders (like retirees on an elective residence visa) are required to get private health insurance for their visa or voluntarily enroll in the SSN by paying an annual fee. That fee was recently standardized – reports in 2024 indicate Italy set a flat cost between €2,000 and €2,700 per year for a retiree to buy into the national health plan . That sounds high (about $2,300-$3,100), but that covers an entire year of full public healthcare coverage, with no additional costs, which is still way cheaper than an average health insurance annual cost in the U.S. (which for an older couple could be well over $10,000). Some Americans in Italy choose to just pay out-of-pocket for care instead, as many services are inexpensive by U.S. standards (an office visit might be $50-$100). But it can be comforting to have unlimited access to the system by paying that enrollment fee. As the Business Insider story we saw illustrates, Americans moving to Italy often cite healthcare as a big motivator. One couple from Florida who retired to Italy reported that even paying out-of-pocket in Italy, their medical spending dropped dramatically. Micki Dukinfield, 72, said, “In 2022, despite the fact that neither of us had anything terribly wrong with us, we spent over $6,000 on premiums and medical bills [in the U.S.]. We’re like, ‘this is insanity.’” Now, in Italy, she and her husband spend between $1,500 and $1,600 yearly on healthcare costs . Another expat couple in Italy (the Schwendemans) said their annual health expenses are about $2,800 a year for both of them . These figures include private insurance and any out-of-pocket spend they have in Italy – still dramatically lower than what they paid in the States. Italy, therefore, can be considered one of the best countries to retire for affordable quality healthcare, given the sheer difference it made for these Americans’ budgets. (Italy’s lifestyle and environment were the icing on the cake – “It’s the way they approach life,” one expat said of why they love it there, noting less stress and a healthier pace .)

France

France’s healthcare system is often held up as a gold standard. It’s a mix of public insurance (covering about 70% of costs on average) and optional private top-up insurance. As a resident of France, you can join the public system via the PUMa (universal health protection) after 3 months of residency. You’ll pay a fee based on your income (around 8% of income above a certain exempt amount – if you’re living on just Social Security, you might end up paying very little). Once in the system, you get a carte vitale and pay small copays – like €25 for a GP visit (reimbursed 70% by insurance), etc. Many expats also buy a “mutuelle” (private supplement) for a few tens of euros a month to cover the copays and any extras. The end result is near-free care at some of the best hospitals in the world. France routinely ranks in the top 5 globally for healthcare. So if you can manage the visa (France’s visitor visa requires private insurance for the first year), you’ll be very well taken care of. There’s a reason so many American retirees adore France despite the higher cost of living – not worrying about medical bankruptcy is part of it.

United Kingdom

The UK’s National Health Service (NHS) is famous for being free at point of use and comprehensive. However, retiring to the UK as an American is not straightforward (unless you have British family or an obscene amount of money for an investor visa). But if one does manage to live in the UK legally, note that the NHS generally covers all residents (if on a visa over 6 months, you pay an “Immigration Health Surcharge” up front – currently around £624 per year – and then you get full NHS access). The NHS has its issues (long waits for some things), but no one can beat “free.” We mention this mostly because the NHS is an example of a system where expats are included (provided they legally reside in the country). Other European countries have similar inclusion for legal residents (for example, Germany requires everyone to have health insurance; most people are in the public system and expats can join in many cases if retiring there or might need private insurance if not). Norway has automatic universal healthcare for all legal residents (financed by high taxes) – though retiring there is hard due to visa rules. Sweden and Denmark enroll all residents into their taxpayer-funded systems as well . In other words, across Europe, once you surmount the residency hurdle, you generally gain access to excellent healthcare with minimal cost.

A note on private vs public in Europe

Even in countries with national health systems, there are private clinics and hospitals. Some expats opt to use more private care to ensure English-speaking providers or faster appointments. For example, in Sweden, the healthcare is top-notch but to avoid any waits, expats might pay out of pocket for a private doctor (which could be a few hundred dollars). In Germany, most people have statutory health insurance, but high-earning individuals and self-employed can choose private insurance – some expats go that route. Germany’s public system is not free – workers and pensioners pay about 14% of income (capped at a certain level) into health insurance funds. As a retiree, if you transfer a German pension you might get in; otherwise, retirees often have to buy private insurance in Germany which can be pricey if you’re older. So Germany might be less accessible for an American retiree unless you have an employer pension connection.

Regional summary – Europe

European healthcare is generally excellent and far more affordable for individuals than U.S. healthcare (because a lot of it is tax-funded). Countries like Spain, Italy, Portugal, and France offer near-universal coverage to expat residents , meaning once you’re in the system your out-of-pocket costs are minimal. Northern European countries (Nordics, etc.) have great systems too, though cost of living is higher and weather harsher – which is why they’re less common among American retirees. But quality-wise, you can’t go wrong in Europe: you’ll find modern hospitals, highly trained doctors, and a philosophy that healthcare is a right, not a privilege. After navigating the paperwork, many U.S. retirees are amazed to get world-class treatment without the big bills.

One thing to adjust to is the culture: socialized systems may have more waiting and less hand-holding than high-end U.S. private care. And you might have to adapt to local language (though medical terminology is often Latin-based, and many European doctors speak some English, especially younger ones). Nonetheless, knowing that a medical event won’t ruin your finances is a huge relief that expats appreciate. As International Living put it, “Expats with valid residence visas can typically access public healthcare at a fraction of U.S. costs – or even for free.” That holds true throughout much of Europe.

Healthcare in Asia: High Quality at Low Cost

Shifting to Asia, we find another attractive region for expat retirees, especially those seeking an even lower cost of living or a different cultural adventure. Asia is a big place, so let’s focus on a few countries known for being expat-retiree friendly and offering great healthcare value: Thailand, Malaysia, Vietnam, and others like Taiwan or the Philippines.

Thailand

Thailand has long been a hotspot for expats and medical tourists. It offers an appealing combination of excellent private hospitals and clinics (particularly in Bangkok, Chiang Mai, and other major cities) at relatively low prices. Hospitals like Bumrungrad International in Bangkok or Bangkok Hospital (which has branches in many cities) are internationally accredited and cater to foreigners. Doctors often speak English; many were trained in the West. You’ll see patients from all over the world flying in for surgeries that cost 20-30% of what they would at home. For example, an annual comprehensive check-up package (blood tests, scans, etc.) might cost $300 in Thailand – something that could be $3,000 in the U.S. A consultation with a specialist can be $30-$60. Even major operations are much cheaper: a knee replacement that’s $40,000 in the U.S. could be $10,000 in Thailand at a top hospital; a heart bypass that might be $120,000 in the U.S. could be $25,000 in Thailand. These are still significant sums, but it shows the scale of savings. Insurance in Thailand: If you get a long-term retirement visa (the popular “O-A” or “O-X” visas), Thailand actually requires health insurance with certain minimum coverage (as of recent years). They want you to have at least ฿400,000 (about $12,000) inpatient coverage and ฿40,000 ($1,200) outpatient coverage on a Thai-approved insurance plan to get the visa . There are Thai companies and international ones that provide these. The cost, as noted earlier, can be around $1,200 to $2,500 per year for older retirees , depending on age and health. That works out to roughly $100-$200 a month – far below Medicare’s total costs or U.S. insurance for that age bracket. Some retirees in Thailand report paying about $1,500 a year for pretty good coverage (that’s $125 a month). Some older expats note that after a certain age (mid-70s), private insurance in Thailand can be hard to get or keep – premiums rise or some companies won’t insure beyond 75 or 80. In those cases, a number of expats go uninsured in Thailand and pay cash. It’s risky, but they reason that even a big procedure is affordable relative to U.S. costs. There are also local Thai government hospitals that are extremely cheap (almost free) for anyone, but the catch is you might face language barriers and long waits there since they prioritize Thai citizens. Still, in an emergency, a public hospital will patch you up, and the bill might be laughably small. (One expat recounted a trip to a public ER for an injury cost him $50 total.) Overall, Thailand offers high-quality healthcare at a low cost. It’s a top choice if medical care is a priority and you’re okay with being far from the U.S. Culturally, showing respect and a smile goes a long way; Thai healthcare staff are generally very kind.

Malaysia

Malaysia is often cited as having one of the best healthcare systems for expats. The country’s private hospitals are excellent – some even better equipped than hospitals in the U.S., with internationally trained doctors. English is widely spoken (Malaysia was a British colony and English is still a common second language). On international rankings, Malaysia frequently scores high in terms of healthcare quality and expat satisfaction. Prices are very low. For example, one source notes: “The most basic [insurance] coverage will cost you just $400 per year and cover things like a colonoscopy to most operations.” And Kiplinger’s report that we mentioned says expats can get the same private insurance locals have for under $50 a month . Indeed, private health insurance under $600 a year is feasible for a healthy retiree in Malaysia – that’s incredible. This gives access to world-class facilities like Gleneagles Hospital in Kuala Lumpur (which the article highlighted as a top-notch hospital) . Many medical tourists go to Penang or Kuala Lumpur for affordable treatment. Malaysia’s government hospitals are also very good and ultra-cheap (but foreigners generally use private since it’s still cheap and easier to navigate). The country actively promotes itself as a retirement destination (with programs like “Malaysia My Second Home” visa), so they have an interest in ensuring expats have good healthcare options. The short wait times and presence of English-speaking providers are big pluses . It’s not an exaggeration to say Malaysia offers “affordable, highly rated private health care” and even “luxurious” options for those who want them, at costs that “largely offset” the initial hassle of getting the visa . Middle-income retirees can feel quite pampered here medically without breaking the bank.

Vietnam

Vietnam’s healthcare has been improving rapidly. While its public system isn’t up to Western standards yet, the private healthcare in cities like Ho Chi Minh City (Saigon) and Hanoi can be very good. There are international clinics and hospitals (some with ties to French or American providers). Costs are very low – a doctor visit might be $20. Many medications can be bought cheaply at pharmacies (sometimes without prescription). Expats in Vietnam often just pay out-of-pocket because the costs are so low it hardly warrants insurance for day-to-day things. For bigger coverage, international insurance can be used or some regional insurers. Vietnam doesn’t yet have a comprehensive expat healthcare integration like Thailand or Malaysia, but it’s still quite manageable. It’s an emerging retiree destination known for low living costs, and decent healthcare is part of that equation.

Taiwan and South Korea

These two are a bit different profile (not typical retirement havens due to language and residency issues), but they deserve mention because they arguably have two of the best healthcare systems in the world. Taiwan has a famed National Health Insurance (NHI) that covers everyone – it often ranks #1 globally for efficiency and satisfaction . It’s a single-payer system with smartcard access, minimal wait times, and very low cost. Expats who become residents can enroll after six months and pay the same low premiums (often $30-$50 per month for full coverage) . Taiwan’s quality of care is superb (modern hospitals, very high doctor-to-patient ratio). If it were easier to retire there (they now have a Gold Card visa that some retirees might qualify for if they have certain professional backgrounds or income), it would be a top choice healthcare-wise. Similarly, South Korea has universal health insurance (mixed public-private) and extremely high-quality care. Expats must enroll after getting an alien registration. Premiums average maybe $50-$80 a month for an individual – and that gives you access to advanced hospitals and specialists (South Korea is known for cutting-edge medicine and short wait times). It’s no surprise that in global health indices, South Korea and Taiwan rank at or near the top. For an American used to high costs, the affordability is shocking. For instance, South Korea has a co-pay system but the total bills are low – an MRI might cost $300, a surgery a few thousand. Many Americans probably wouldn’t consider Korea or Taiwan simply due to language and distance, but purely on healthcare merits, they are among the best in the world for expats .

Philippines

The Philippines is a unique case. It’s one of the few countries in Asia where a lot of locals speak fluent English (one of the official languages). It’s also notably popular with U.S. military veterans and ex-military retirees. Why? For one, the cost of living is very low, and healthcare is cheap – and the Philippines hosts the only U.S. VA outpatient clinic outside the U.S. (in Manila). Veterans with service connections can actually get some care at that VA clinic or have referrals to local hospitals paid for by the VA’s Foreign Medical Program. Even if you’re not a vet, the Philippines offers affordable private hospitals in big cities (e.g., St. Luke’s in Manila is well regarded). Routine medical costs are low. However, the quality can vary outside major urban centers. Some retirees pay for an international insurance that covers a broader network including maybe nearby Thailand or Singapore for major procedures, while handling minor stuff locally. The Philippines does have a national health insurance (PhilHealth) that foreigners can join for a small fee, but it only covers a portion of costs and mostly in public hospitals (which are basic). Many expats find it’s worth joining PhilHealth just to get some discounts at hospitals, then pay the rest out-of-pocket. The advantage is definitely the language (English) and a culture that’s very friendly to Americans. If you have a limited budget, the Philippines can be a place where you won’t be turned away for lack of money – costs are low and people find solutions.

Others Asian Countries

There are certainly other countries in Asia where you could retire and have good healthcare: Japan has outstanding healthcare (but getting residency is tough unless you have family ties or some employment sponsor; also not cheap cost of living). Indonesia (e.g., Bali) is a growing retiree spot – there are some international clinics there but complex care might require a trip to Singapore or Australia. India has world-class private hospitals at rock-bottom prices, but living there long-term might be challenging for some, and things like pollution and distance from home factor in. Each country has pros and cons, but generally Asia offers a lot of value for money in healthcare.

Regional summary – Asia

High quality care at low cost is the norm in much of Asia. Countries like Thailand and Malaysia make it very easy and affordable for expats to get health services, with thriving medical tourism industries and English-speaking providers . Some countries (Thailand, Philippines) require or encourage expats to have insurance, but those policies are reasonably priced by U.S. standards . If you are open to living far from the U.S., you can reap huge savings – often enough to travel home once or twice a year and still come out ahead.

One retired American in Thailand noted on a forum that even without U.S. Medicare, he felt secure because “in the US with deductibles running $10k… it is worth it to stay in Thailand” – he mentioned he has both Thai and US citizenship, but chooses to get care in Thailand since out-of-pocket it’s cheaper than dealing with U.S. insurance deductibles . That sentiment is increasingly common. The combination of quality and price in parts of Asia is hard to beat.

Countries That Make Healthcare Easy and Affordable for Expats

From the above, it’s clear there are many countries where an American expat can feel safe and well-cared-for. To answer directly: Yes, you can get medical insurance in foreign countries, and quite a few nations make this easy and affordable for resident expats. In fact, by becoming a legal resident in many countries, you automatically gain access to their national health programs (often by contributing via taxes or fees).

Let’s list a few standout examples:

• Mexico: Easy enrollment in public insurance (IMSS) for retirees, with premiums under $100/month for seniors . Alternatively, completely free care through INSABI for those who can’t get IMSS . Private insurance also available, but many don’t need it due to low costs. Mexico’s combination of quality and proximity to the U.S. makes it a top choice.
• Costa Rica: Mandatory coverage through Caja at ~7-11% of income , which is often well under $100/month for a retiree – a fantastic deal for comprehensive coverage (including pre-existing conditions) . Private insurance is optional; some choose to add a private plan or pay occasional private expenses for convenience.
• Panama: Very accessible healthcare – public system covers everyone (even visitors) at low cost , and private options are inexpensive too (local plans $50-$100/month) . Some innovative options like $20/month clinic memberships for expats .
• Malaysia: Extremely expat-friendly. Though foreigners aren’t in the public system (which is free for citizens), the private system is so affordable it fills the gap. A retiree can get good private insurance for <$600 a year and enjoy cutting-edge care at modern hospitals where English is spoken. Malaysia actively courts retirees with its MM2H visa, and healthcare is one of the big perks.
• Thailand: Requires insurance for retirees, but the cost is modest (a couple thousand dollars a year or less) , considering the top-notch hospitals available. Also, if you choose not to carry full insurance, paying as you go is manageable for many things. The government hospitals provide a safety net at negligible cost if needed.
• Portugal and Spain: After establishing residency, both offer ways to join the national system for a relatively low fee . Or you can maintain private insurance which, compared to U.S., is very cheap (as noted, a couple in Portugal pays $550/month for top-tier private coverage ; in the U.S. a 70-year-old could easily pay that each, and with higher copays). The ease of getting treatment and the high standard of care make these countries favorites among expats who prioritize health security.
• Taiwan and South Korea: Perhaps more niche for American retirees, but undeniably they have virtually free/universal healthcare for residents with superb quality . If you happen to be able to live there, you’ll be very well taken care of for very little cost.
• Brazil & Argentina: Both effectively offer free public healthcare to legal residents – Argentina explicitly allows all residents (and even anyone on Argentine soil) access to public hospitals at no charge . Brazil does the same by law . The “ease” part is that you don’t even need insurance – you just show up and get treated. The caveat is that public system quality can vary. But an expat with limited income would not be denied care in those countries. Many expats still opt for some private care for better comfort, but knowing the public option is there is huge.
• Uruguay: Worth mentioning because it has a unique model of private “membership” hospitals (Mutuales). Expats can join these cooperative hospitals for a low monthly fee (often under $100/month, sometimes much less) and that covers all their care. One expat in Uruguay detailed how his monthly hospital plan premium is far lower than what he paid for insurance in the U.S., and it covered his entire knee surgery except a $400 in copays . His total out-of-pocket for the surgery was $568 , whereas in the U.S. he would have faced a $5,000 deductible plus more in coinsurance . Uruguay makes it easy: you can sign up for these plans with just your residency or even temporary residency in many cases. This kind of system is quite welcoming to expats.

In summary, many countries around the world extend their healthcare systems to expat retirees in one way or another – often with minimal bureaucracy once you’re a legal resident. And outside the U.S., healthcare is generally seen as a service for all, not a luxury, so the costs are kept reasonable by design.

Best Countries for Retirees Concerned About Healthcare

Finally, you may wonder: Which country is the best to retire to if affordable, quality healthcare is my top concern? It’s hard to crown a single “best” country, as it depends on personal preferences (climate, language, distance from family, etc.). But based on healthcare alone, here are a few that consistently get top marks:

• Portugal and Spain – These Iberian neighbors offer a mix of excellent public healthcare and affordable private options. They rank highly in expat surveys for healthcare. As noted, private insurance can be quite reasonable , and both countries’ public systems are accessible to expats (either free with residency or via an affordable buy-in scheme) . The quality of hospitals and doctors is first-rate. For overall retirement, Portugal often comes out #1 in magazines (for climate, cost, safety and healthcare). Spain, with its great healthcare system, is also top-tier.
• Malaysia – Frequently listed by experts (like International Living) as having some of the best healthcare for retirees. The combination of low cost, ease (English widely spoken, no wait times), and advanced facilities is hard to beat . If you don’t mind the long flight from the U.S., Malaysia can be a paradise for someone concerned about medical care. Plus, you can easily travel to other nearby countries for leisure and even more specialized care (Singapore is next door, though it’s pricier).
• Costa Rica – Often touted as the “Switzerland of Central America,” Costa Rica offers political stability and a healthcare system that’s among Latin America’s best. For an American worried about affordability, Costa Rica provides peace of mind: you know exactly what you’ll pay (a fixed percentage of your income) and you get care for everything under the sun. The presence of many other expats and some English-speaking doctors in expat hubs is a bonus. It’s no surprise Costa Rica regularly ranks among the top retirement destinations in the Western Hemisphere – healthcare is a big reason. Costa Rica’s healthcare is high quality and very affordable for expats , making it a safe choice.
• Thailand – If you want a vibrant culture and don’t mind being far afield, Thailand’s healthcare is a strong attractor. You can live very inexpensively and still have access to international-standard medical care. For those who maybe can’t afford Europe but want high quality, Thailand (and Malaysia) are compelling.
• France – We shouldn’t forget France for healthcare. Many would argue France has the best healthcare in the world for its citizens. For an expat, once you’re in the system, you’ll likely agree it’s fantastic (and low-cost). The challenge is the front-end (visa, language). But if you speak a bit of French and value top-notch care, France could be your ideal retirement spot – where a huge chunk of your medical costs will be covered by the state, and supplemental insurance is cheap.

Other honorable mentions: Panama (solid healthcare and close to U.S.), Mexico (especially for those who want proximity and a large U.S. expat community – healthcare in places like Guadalajara or Mexico City is excellent and inexpensive), and Taiwan (if one can qualify to live there, the healthcare is arguably the best value on Earth). Australia and New Zealand also have great healthcare systems, but they are hard for foreign retirees to access (strict immigration unless you have family or a lot of money to invest).

Ultimately, “affordable quality healthcare” as an American expat is achievable in dozens of countries. The “best” country for you will balance healthcare with other factors you care about. But rest assured, if healthcare is the only concern, you have plenty of choices better than the U.S. in terms of cost-to-quality ratio.

To quote International Living’s report: “Numerous expat-friendly countries offer both public and private healthcare. Expats with valid residence visas can typically access public healthcare at a fraction of U.S. costs — or even for free.” This means you can focus on enjoying retirement rather than stressing over medical bills.

Conclusion: Planning for a Healthy, Worry-Free Retirement Overseas

Moving abroad in retirement requires planning, especially when it comes to healthcare. As we’ve discussed, Medicare won’t cover you overseas, so you must arrange alternative coverage . Medicaid and VA benefits have very limited applicability abroad (Medicaid not at all; VA only for service-related issues) . The good news is that outside the U.S., you’ll often find excellent healthcare at a much lower cost, whether through national health services, private insurance, or paying out-of-pocket.

Be sure to research the specific country you’re interested in:

• What are the requirements for expat health coverage? (Do you need to buy insurance for a visa? Can you join the national system? What do other expats there do?)
• How much do typical medical services cost there, and how accessible are they in your town of choice?
• Are there reputable hospitals or clinics nearby? Do they speak English or will you need a translator?
• If you have a chronic condition, can it be managed effectively in that country (availability of specialists or medications)?

Budget for health insurance or contributions in your new country just as you would budget for housing or other expenses. The amounts, as we’ve shown, are usually quite reasonable. For instance, maybe you’ll pay $100/month into a public system, or $200/month for a private plan – vastly less than many Americans pay in Medicare supplements or ACA premiums.

Also, consider evacuation insurance if you’re going somewhere remote or with limited local facilities. Companies offer emergency medical evacuation coverage that will airlift you to a nearby country or back to the U.S. in a dire situation. This is relatively cheap (a few hundred dollars a year) and can be a smart safety net if, say, you’ll be on a small island or far from a major hospital.

One more thing: take care of your Medicare enrollment if you ever plan to return. Some expats keep paying for Part B even abroad as a backup. Others drop it and later re-enroll with a penalty if they come back. There’s also the option of Medicare Part A (free) + a travel policy when visiting the U.S. Each person’s scenario is different, so get personalized advice if needed from a Medicare consultant or use resources like the Medicare Interactive guides.

Perhaps the most reassuring takeaway is hearing the experiences of fellow expat retirees: many report that after moving overseas, their healthcare became less of a financial burden and sometimes even improved in quality. “We saved thousands while getting top care overseas,” as one expat said . And Micki, the 72-year-old who moved to Italy, summed up her feelings after seeing the drastic reduction in her medical spending: “I knew that as we got older, healthcare would always become an issue.” That concern led her abroad, and now her healthcare costs are a fraction of what they were – an issue no more.

Retiring abroad, you’ll still have to deal with doctors, prescriptions, and maybe an illness or two as you age – some things are universal. But with a bit of planning, you can position yourself in a country where those inevitable healthcare needs are met with quality care you can afford. Do your homework, talk to expats on the ground in those countries (many online forums and Facebook groups exist for expat retirees and are goldmines of firsthand info), and consult official sources for up-to-date rules on insurance and residency.

In the end, if you choose well, you might find you’re like those expats who laugh in delight when they leave a pharmacy with a bag full of medications that cost them $20 instead of $200. Or you might find you actually visit the doctor more – because you can afford to and the experience is stress-free – and your health improves as a result.

Retiring overseas can indeed offer not just adventure and lower living costs, but a healthier, less stressful life – both physically and financially. With medical worries eased, you’re free to enjoy your new home, whether that’s walking the cobblestone streets of a European village, relaxing on a Latin American beach, or exploring an Asian market.

Healthcare abroad does not have to be scary for American retirees. On the contrary, it can be one of the best perks of expat life. As long as you educate yourself and secure coverage, you can step on that plane with confidence that your health needs will be met, and often met more affordably than back home. Here’s to your health and happiness in your overseas retirement journey!

Sources:

• U.S. Medicare & Medicaid official guidelines on coverage outside the U.S.
• Medicare Interactive – considerations for Medicare when living abroad
• Philipps & Graham law firm – explanation of Medicare/Medicaid limits abroad
• U.S. Veterans Affairs – Foreign Medical Program info for service-connected care overseas
• Business Insider – experiences of American retirees in Italy highlighting cost differences
• NerdWallet – confirmation of no Medicare/Medicaid coverage abroad
• International Living – reports on expat healthcare savings and country comparisons
• International Insurance & other expat resources – country-specific healthcare details (e.g. Mexico’s IMSS/INSABI costs , Costa Rica’s 9-11% Caja rule , Malaysia insurance costs , Thailand insurance range , etc.)
• Bright!Tax and expat blogs – additional insights on Costa Rica, Spain, etc.