How to Pay for Healthcare as an Expat Retiree

vitucci-medical-cost-planning-expat-retirement-header-imageOne of the biggest issues facing those in retirement is healthcare. From navigating Medicare enrollment to considering the possibility of long-term care down the line, there’s simply a lot to think about.

For those moving abroad, healthcare planning is even more complex – and arguably even more important. So what do you need to do to make the most of your expat retirement?

In this article we’ll cover some of the basics of medical budgeting for expats, but that’s not the only thing you’ll need to think about as an expat retiree. Keep an eye out for more articles with tips and advice on financial planning for retirement abroad.

First thing’s first: Understand the limits of Medicare

 Medicare is the first order of business for most retired Americans.

If you aren’t automatically enrolled, you’ll be eligible to sign up in the 7-month period around your 65th birthday. Remember that date, because forgetting to sign up can cost you. In fact, for every year you don’t sign up after you become eligible, your Part B premiums will rise 10%!

But there’s another big problem with Medicare for those who don’t live stateside: Medicare won’t cover your medical expenses in another country.

This presents a kind of Catch-22: don’t sign up, and risk a higher premium if you move back to the US and need care. Do sign up, and pay extra for care that you won’t be using. Unfortunately, there’s no right answer. Only you can decide whether the gamble is worth it.

Consider the following factors:

  • What quality of care can you receive in your new country, and at what price? (more on this in a moment)
  • How likely are you to come back to the US for specialized treatment or permanently later in retirement?
  • How much are you willing to pay in higher premiums by delaying signing up for Medicare?

Again, it’s a decision that’s highly personal, but it should be made with an understanding of the costs and limitations of Medicare and the alternative coverage you might be able to get abroad.

Planning for care abroad: What are the options? 1

Foreign medical expenses, especially in the developing world, can seem breathtakingly low for many Americans – but keep in mind that those low costs can come at a price.

In some cases, certain specialized procedures might not be as readily available. You may need to wait longer for appointments or have less flexibility in choosing specific treatment options.

In other words, it’s important to get familiarized with local care options and potential issues.


All in, expat retirees generally have four options for health coverage.

  • Move to a country that allows you to sign up for the national health plan
  • Pay for private insurance in your new home country
  • Pay out-of-pocket for all foreign medical expenses, and budget accordingly to take emergency costs into account
  • Purchase a high-deductible American plan that allows for foreign medical expense coverage

The options in detail

 Some countries allow foreign residents to join the local national plan.

  • Pros: Can be very convenient and low-cost.
  • Cons: May require local language ability and involve patience, wait-times, and bureaucracy.

Similarly, you may also be able to purchase local private insurance coverage.

  • Pros: Possibly more personal service and a greater range of treatment options
  • Cons: Again, you might need to be able to speak the language, at least a little.

Of course, in some countries medical expenses are extremely low by American standards – in these cases, it could make sense to just pay out-of-pocket.

  • Pros: No insurance wait-times or other hassles, and you could even save money. Some places still have a more traditional approach, such as in-home doctor’s visits and a truly involved family doctor.
  • Cons: Emergencies and specialized treatments might be neither readily available nor cheap – you may need to fly home for those, or shoulder a high cost in an emergency.

Finally, depending on your health and where you go, you might be able to purchase a private plan with an American insurer that covers extraordinary expenses abroad.

  • Pros: Could give you the best of both worlds when combined with another option.
  • Cons: May be expensive or quite limited in terms of coverage.

Whatever you do: Don’t ignore it!

 While it’s not as fun as planning a real estate purchase or weekend trips from your new home base, planning for medical care is an absolute must prior to retiring abroad.

Knowing that you have the coverage you need won’t only make the experience more enjoyable, it will save you the stress of scrambling for answers in the wake of an emergency or illness.

Research the options both here and in your potential new home country, and make the very best of your experience as an expat retiree.

Let Us Help!

We can discuss this topic and more at a complimentary appointment. As a bay area retirement planning coaches, we can give you a review and make suggestions based on your retirement objectives.

1 There are numerous online resources that can help you investigate local insurance options and plan for medical expenses as an expat retiree. For more information, please take a look at the following resources: and

Important disclosures:

The opinions voiced in this article are for general information only. They are not intended to provide specific advice or recommendations for any individual and do not constitute an endorsement by United Planners.

BD disclosure, including Vitucci & Associates and United Planners are separate and unrelated companies.

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