Moving Overseas? How’s the Healthcare? There are many factors that play into helping individuals decide where they wish to retire. For those who are considering living abroad, the decision about the availability and cost of healthcare is a big box on the “to consider” list.
Where does your destination rank?
Since 2000, the World Health Organization (WHO) has ranked the best health systems in the world. The United States comes in at a relatively average 37th, behind Costa Rica and Columbia. Both are considered havens for the millions of retiring Baby Boomers.
Does Medicare cover you abroad?
Since Medicare does not cover healthcare provided in foreign countries, you should understand how healthcare works in any country you are considering for retirement.
Are you eligible for care in all foreign countries?
The WHO weighs many excellent factors in their rankings, but those rankings are based on care given to their citizens, not expats. A good ranking by the WHO is just one of many factors you should consider. Cost and accessibility of the country’s healthcare system are more important than its rank.
For example, Costa Rica has an excellent system called Caja Costarricense de Seguro (CCSS) but expats cannot use the system unless it is an emergency. After the emergency, they are on their own. On the other hand, Singapore, who is ranked sixth best on the planet for healthcare, believes everyone, even foreigners, deserves healthcare and everyone can easily access the system at a reasonable cost.
Are there enough doctors and hospitals for you?
Other factors to consider include how many physicians per 1,000 people are practicing and how many hospital beds are available per 1,000 as well as life expectancy. The World Bank Data compiles such a list and indicates that France, considered to have the best healthcare in the world, has 3.2 physicians per 1,000 individuals and 6.4 hospital beds. Uruguay also ranks well with 3.7 physicians and 2.5 hospital beds per 1,000. The United States has 2.5 physicians and 2.9 hospital beds while Panama has 1.7 physicians and 2.2 hospital beds.
In terms of life expectancy, also according to The World Bank Data, France stands at 81.7 years and British citizens are living to 81.5 years. In the US, that number is 78.7 and Japan is 83.1.
Can you speak the language?
When faced with an emergency or simply routine health care, communication is very important. You should consider whether English is widely spoken unless you are fluent in the language of your retirement home. The official language of Belize is English and doctors there are easy to talk with. But many medical doctors practicing in cosmopolitan Panama City, cannot speak English, and you may need a translator. Medical care is excellent throughout Panama, but communication can be difficult if you do not speak Spanish.
How will you pay?
Regardless of the quality of care, it is important that you consider how the final bill will be paid if you access any system. Most countries expect foreigners to pay, on the spot, with cash or a credit card. While the bill tends to be a fraction of what it would be in the United States, a $20,000 outlay for a hospital stay in France could be a problem. It might take months for your private carrier, to send reimbursement. Have a plan in place.
Even if you have private U.S.-based insurance, most countries expect expats to have local medical insurance or participate in their unique system for payment. In Uruguay you can purchase an insurance policy from Blue Cross & Blue Shield of Uruguay, or you can contribute monthly in a “multialista” which pays for needed healthcare much like private insurance. The cost is reasonable at about $100 per month. Each country is different, but many simply have foreigners contribute to a particular hospital and receive care at that facility.
How will you get home in an emergency?
Knowing that if you are over 65, Medicare will provide you coverage in the United States, you may wish to consider air medical transport insurance, especially if you choose live in a country not known for excellent healthcare. MedjetAssist is just one of many companies offering air ambulance insurance, which provides members with the ability to be taken to a U.S. hospital from any country in the world. There is an annual fee for being covered out of the country for up to 180 days for $430 or for 365 days at $665.
Even if you elect to carry air medical transport insurance, you should take it one step further and consider how long it will take to get you home. Several stops would be required to transport you from Thailand as opposed to a few hours if you start in Mexico.
Is healthcare good in your country?
Healthcare is one of the most important factors when considering retiring abroad. Many believe care provided in the United States is the best in the world, but do your research and you will find that other countries have excellent, easily accessed and affordable care.