6 Best Countries for Expat Retiree Health Care: 2022

Ranking October 14, 2022 at 10:42 AM

Related: 17 Best Countries for Retirement Abroad: 2022

Retirees looking for a foreign retirement destination want to ensure they have access to the best health care possible, at reasonable prices.

6. Mexico (tied)

Score: 90

The Mexican government runs two health care programs. INSABI is intended for low-income Mexicans who have no health insurance. It's free. It is also available to expats who are temporary or permanent residents.

IMSS is designed primarily for employees of Mexican businesses. Concentrated in the biggest cities, it has the best facilities, with the most specialists and ability to perform the most complicated procedures. The cost to be a part of this program, which is open to expats with temporary or permanent residence, is based on age — a person 70 to 79 pays about $700 per year. Many pre-existing conditions are not covered.

Some Mexican insurance companies offer policies similar to those in the U.S., although costs are generally lower.

Mexico has seven Joint Commission International -accredited facilities, the gold standard for health care in the world, according to International Living. .

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5. Malaysia (tied)

Score: 90

Malaysia has been a popular medical tourist destination for expats for many years now, attracted by low costs, English-speaking staff and high standards.

Out of a total of 88 accredited hospitals in Malaysia, eight are accredited by Joint Commission International. But even the non-JCI accredited hospitals are considered first-rate.

Malaysia is fast on its way to becoming the most preferred medical tourism destination in Asia. In 2019, more than 1 million medical tourists arrived in Malaysia for a variety of ailments. Following a big decrease because of the global pandemic, the country appears to be back on track in 2022 and trending upward.

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4. Colombia

Score: 93

The World Health Organization ranks Colombia's health care system 22nd of the 191 countries it reviews. By comparison, Canada ranks No. 30 and the U.S. No. 37. The larger cities of Bogotá, Medellín and Bucaramanga have hospitals accredited by the Joint Commission International.

Applying for the public health insurance program, EPS, involves a three-step process, with no limitations because of preexisting conditions. Retirees pay a premium equal to 5% of their income. Many expats report monthly premiums in the $70 to $85 range for a couple. A private health insurance supplement to EPS public coverage is an option.

Colombian pharmacists not only fill prescriptions but treat simple ailments. Many medications do not require a prescription and can be bought over the counter for very low prices.

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3. Portugal (tied)

Score: 96

Portugal has some of the finest doctors and medical training in the world, according to International Living. Many, if not most, graduates of top medical programs study and complete residencies in the U.K. and other European countries. In addition, many of their upper-level courses are taught in English, resulting in some level of fluency among most medical professionals.

Sixteen Portuguese health facilities, including nine hospitals, have received Joint Commission International stamps of approval.

Pharmacists generally speak English. Most medications available in the U.S. or an equivalent can be found in Portugal for less money. Medications for chronic conditions, such as diabetes, are provided free to residents. Costs for private health insurance begin around $50 a person, but increase with age, preexisting conditions and how comprehensive the plan is.

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2. Spain (tied)

Score: 96

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.

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1. Costa Rica

Score: 97

Costa Rica's national health care system, the Caja Costarricense de Seguro Social, offers nationalized health care for all of its citizens and legal residents. The World Health Organization places Costa Rica in the top rankings for life expectancy, and the United Nations ranks the country's public health care system in the top 20 worldwide. The Caja operates 30 public hospitals, as well as 250 clinics across the country, plus 1,000 smaller units to cover rural areas.

Once their residency application is approved, expats qualify to join the Caja. They typically pay between 7% and 11% of their reported monthly income. There are no additional copays, no age restrictions and no rejection because of preexisting conditions.

The public system has a couple of downsides. Most of the staff speak only Spanish, and apps and their website do not have an English option. Wait times are long for nonemergency procedures, which prompts many expats to blend both the public and the private health care systems. Many Costa Rican doctors work in both sectors and have studied in North America or Europe, and most in the private field speak English. The country has three Joint Commission International-certified medical centers in San José.

It's possible to purchase health insurance policies from familiar companies such as Blue Cross Blue Shield, CIGNA, BMI/Aetna or the local Costa Rican private insurance, INS, from agents there. As an alternative, the country offers a private health care discount program called Medismart for as little as $14 per person per month.

(Image: Shutterstock)

Michael S. Fischer

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