2. Spain (tied)
Expats settling in Spain can look forward to better health care than that available in the U.S. In 2021, World Population Review ranked Spain’s public health care system No. 7, 30 places ahead of the U.S.
Spain’s public health care system, the Seguridad Social, covers general medicine, family practice, pediatrics, nursing and physical therapy. The Seguridad Social normally pays most or all the cost of medical treatment and hospitalization and up to 40% of the cost of prescriptions. The patient pays the remainder or buys supplemental insurance to cover the difference.
Spain also has excellent, affordable private health care, with the same doctors often working in both systems. Joint Commission International has accredited 24 Spanish facilities. The private system allows expats to request English-speaking doctors when making an appointment, while the public system offers the option of booking a translator when booking a doctor’s visit.
Those applying for a retirement visa in Spain are required to buy private Spanish health insurance. Complete coverage, with no copays and including basic dental care, may cost less than Medicare A and B, Medigap and Plan D in the U.S. Private insurance is required for at least the first year of residence. Some municipalities allow expats to buy into the public system after one year. If accepted, the monthly fee is $70 for those under 65, $157 for 65 and older. After five years, all expats are welcomed into the public system.