Sick Abroad–Now What?

What Will It Cost?

Accessing and paying for quality healthcare is a major concern for most people in the United States because the U.S. system is, by far, the most expensive in the world. In the United States, 18% of the Gross Domestic Product (GDP) is spent on healthcare, far greater than any other country. Outside the U.S., paying for healthcare is not viewed as something that could result in bankruptcy, but accessing it and finding appropriate insurance can be daunting.

What About Retirees?

As U.S. Baby Boomers begin to retire and consider settling in another country, they must find an alternative way to pay for healthcare because Medicare, the government provided insurance for US citizens aged 65 and older, is not portable. You cannot use Medicare in a foreign country.

Is Insurance Available?

Good healthcare is available and affordable in most industrialized countries, but paying out-of-pocket should not be readily considered. Private insurance, even American-based insurance, is available for coverage in most countries. If residency is established, individuals should then be able to access a foreign system which allows for greater flexibility in choice and cost, eliminating the need for private insurance.

Where Do They Have the Best Health Care?

It is widely recognized that France has the best healthcare, followed by countries such as Italy, Singapore, Spain and Austria. France has a fully integrated network of public hospitals, private hospitals, doctors and other medical service providers. It costs about 23 euros to see a French specialist. Healthcare is provided to all French citizens and it is also available to expats and retirees living in France through supplemental and private insurance.

Spain also has a system which allows expats to pay a monthly premium and is covered for all health related care. In countries such as Uruguay, foreigners simply pay about $100 a month into a “hospital plan” and then they are allowed to access care through that hospital.

Each country is different so once you have established where treatment might be needed, further research should be used to figure the cost, accessibility and options for healthcare in those countries.

Many countries have mandatory coverage, so pre-existing conditions are not factored into acceptance. If you have chronic diseases such as diabetes, COPD, arthritis, hepatitis or need dialysis, finding a country with good healthcare without exclusions is very important.

What About Prescriptions?

Drugs and supplies are generally much less expensive outside the United States but not all medications are available. You might want to consider having your Medicare covered drugs and supplies received in the United States and then shipped to your foreign address. But of course, countries such as Panama have no postal service, so shipping and receiving through a service like Mail Boxes Etc. can become expensive.

Remember These Points.

When considering a new country for retirement, in terms of healthcare.

  • Medicare is not accepted outside the United States.
  • you will need private insurance initially.
  • if you have a chronic condition look for a country that does not consider pre-existing conditions when providing healthcare.
  • research how healthcare is handled in the countries you are considering and become knowledgeable on how to access state-supported facilities, after establishing residency.
  • if you think you will want to come back to the United States for treatment in complex situations, consider air medical transport insurance.

Individuals who have lived most of their lives in the United States, tend to be most comfortable with a system they have always known. It is important to keep an open mind to alternatives because many countries have developed systems that routinely deliver highly effective and specialized healthcare in a cost-effective model.

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