Expat Retirement Location with Health Care Eligibility
Expat Retirement Location with Health Care Eligibility
So, health care in retirement is looking like more of a wild card than planned for, which got me to thinking:
Are there any tropical/warm locations where a US-expat can live, and still be covered for residency healthcare?
I believe that some countries don't allow expats to have property ownership, which is the second element.
Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
Are there any tropical/warm locations where a US-expat can live, and still be covered for residency healthcare?
I believe that some countries don't allow expats to have property ownership, which is the second element.
Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
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Re: Expat Retirement Location with Health Care Eligibility
There are a whole bunch of expat groups on Facebook that discuss this issue nearly every day, with respect to Mexico. Lots of retired Americans and Canadians living the good life there and they answer this question every day - there are public and private options and I believe the public program is for people 60+, and only denies coverage due to history of diabetes, heart disease or cancer - all other conditions accepted, but hustle over there because I don't have all the details memorized.
I got tired of looking at their photos of beautiful homes near lakes and the beach for cheap, lol....
I got tired of looking at their photos of beautiful homes near lakes and the beach for cheap, lol....
- MichaelRpdx
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Re: Expat Retirement Location with Health Care Eligibility
Start with Tim Leffel's A Better Life for Half the Price (If I figure out how to make a Bogleheads Amazon affiliate link I'll put it here. Admins?) and go from there.Sandi_k wrote:So, health care in retirement is looking like more of a wild card than planned for, which got me to thinking:
Are there any tropical/warm locations where a US-expat can live, and still be covered for residency healthcare?
I believe that some countries don't allow expats to have property ownership, which is the second element.
Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
Some countries make retirement visas more available if you buy property. Certainly, you want more than just tropical and warm. clean air, low crime, something interesting to do...
https://www.theearthawaits.com/ provides a database for you to define budget and quality of life metrics to find cities in the world that meet your criteria. It's an excellent companion to other searches.
To directly answer your question:
Panama, Colombia, Mexico, and Costa Rica are starting points.
Be Appropriate && Follow Your Curiosity
Re: Expat Retirement Location with Health Care Eligibility
There are many other considerations. I second the suggestion to look at the Expat sites to start. If you have never lived outside the States for any length of time, you need to make sure it would be the thing for you. In addition to the usual places south of the border already mentioned, cast a wider net. Take some fact-finding trips on your own. Generally speaking, buying in to a foreign healthcare system won't be cheap, plus you will need to forego any Medicare benefits.Sandi_k wrote:So, health care in retirement is looking like more of a wild card than planned for, which got me to thinking:
Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
_D_
Re: Expat Retirement Location with Health Care Eligibility
Thanks for the serious replies. Following the Amazon link posted by MichaelRPDX, I found a couple of similar books, including an author who has a website, internationalliving.com - where there are sorted articles on similar criteria.
One article on medical coverage for expats says that Mexico, Columbia, Costa Rica and Malaysia are the top choices right now that allow residential coverage even if not a citizen.
More reading for me.
One article on medical coverage for expats says that Mexico, Columbia, Costa Rica and Malaysia are the top choices right now that allow residential coverage even if not a citizen.
More reading for me.
Re: Expat Retirement Location with Health Care Eligibility
Not sure what your time frame is, but I'm sure more and more countries will roll out the welcome mat to first-world retirees as that demo increases. And countries already on board will improve their offerings. Nicaragua, the Socialist paradise that has bedeviled American presidents, is moving up the popularity rankings.
You mention property ownership. I wonder if renting might make more sense? You don't have capital tied up, and you can have a landlord who deals with handymen, etc. in their lingo. You can also flee in the middle of the night if it all goes awry.
A couple of people post here from SE Asia, incl. @Kramer, with very favorable comments about hospitals in places like the Philippines and Thailand. Prices are such that you could probably just self-insure. And prescription medications are insanely cheap OTC, as I just discovered in Manila last week.
You mention property ownership. I wonder if renting might make more sense? You don't have capital tied up, and you can have a landlord who deals with handymen, etc. in their lingo. You can also flee in the middle of the night if it all goes awry.
A couple of people post here from SE Asia, incl. @Kramer, with very favorable comments about hospitals in places like the Philippines and Thailand. Prices are such that you could probably just self-insure. And prescription medications are insanely cheap OTC, as I just discovered in Manila last week.
Re: Expat Retirement Location with Health Care Eligibility
I'm not sure what you mean by "health care eligibility"? Do you mean access to public healthcare subsidised by the tax payers of another country?
You can also move to any country you want and buy private health insurance. Though there you might need to factor in pre-existing conditions -- I'm not sure how that works, honestly. Have you tried pricing private insurance in places like Thailand, Malaysia, Vietnam, Indonesia, Cambodia, and Laos? You can get online quotes and see what things are like.
Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
You can also move to any country you want and buy private health insurance. Though there you might need to factor in pre-existing conditions -- I'm not sure how that works, honestly. Have you tried pricing private insurance in places like Thailand, Malaysia, Vietnam, Indonesia, Cambodia, and Laos? You can get online quotes and see what things are like.
Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
Re: Expat Retirement Location with Health Care Eligibility
Medicare would cover you in any US territory so that would include Puerto Rico US Virgin Islands and several others. See link below
https://www.medicare.gov/Pubs/pdf/11037 ... d-Stat.pdf
https://www.medicare.gov/Pubs/pdf/11037 ... d-Stat.pdf
Re: Expat Retirement Location with Health Care Eligibility
Only once you're of Medicare-eligible age.3feetpete wrote:Medicare would cover you in any US territory so that would include Puerto Rico US Virgin Islands and several others. See link below
https://www.medicare.gov/Pubs/pdf/11037 ... d-Stat.pdf
If I retire at 60, there's a 7 year period of no Medicare, should my employer-based retiree health care be revoked. Thus the question....
Re: Expat Retirement Location with Health Care Eligibility
No - just whether it's affordable and whether you can self-insure affordably.AlohaJoe wrote:I'm not sure what you mean by "health care eligibility"? Do you mean access to public healthcare subsidised by the tax payers of another country?
No, I foresee a lot of international changes in the coming years, and I'm still ~ 10 years from retirement. So I don't see the need to do detailed research until we're a little closer - just wanted to throw the thought out there.AlohaJoe wrote:You can also move to any country you want and buy private health insurance. Though there you might need to factor in pre-existing conditions -- I'm not sure how that works, honestly. Have you tried pricing private insurance in places like Thailand, Malaysia, Vietnam, Indonesia, Cambodia, and Laos? You can get online quotes and see what things are like.
No, but I'm good with languages. And ~6 weeks.AlohaJoe wrote:Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
Re: Expat Retirement Location with Health Care Eligibility
I don't recall if it was here or some other board but some expatriates posted that the way that they handled it was that they just paid cash for their healthcare because it was so inexpensive in some countries. They may have also had a policy for catastrophic expenses.
Many countries have a dual public and private system and even if you could qualify for their public system the much higher quality private system is still very affordable compared to the US so many expatriates pay for private healthcare.
Many countries have a dual public and private system and even if you could qualify for their public system the much higher quality private system is still very affordable compared to the US so many expatriates pay for private healthcare.
Florida on Medicare.Sandi_k wrote:Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
Re: Expat Retirement Location with Health Care Eligibility
Thank you! Yes, renting for the first year or so (at a minimum) would make total sense, and what we plan to do. Having moved multiple times, I'm aware of how your choices are different once you've lived in a town for awhile, instead of basing it on the "tourist" views of a place.
SrGrumpy wrote:Not sure what your time frame is, but I'm sure more and more countries will roll out the welcome mat to first-world retirees as that demo increases. And countries already on board will improve their offerings. Nicaragua, the Socialist paradise that has bedeviled American presidents, is moving up the popularity rankings.
You mention property ownership. I wonder if renting might make more sense? You don't have capital tied up, and you can have a landlord who deals with handymen, etc. in their lingo. You can also flee in the middle of the night if it all goes awry.
A couple of people post here from SE Asia, incl. @Kramer, with very favorable comments about hospitals in places like the Philippines and Thailand. Prices are such that you could probably just self-insure. And prescription medications are insanely cheap OTC, as I just discovered in Manila last week.
Re: Expat Retirement Location with Health Care Eligibility
Did you see this Wall Street Journal article about a couple who moved all the way to Uruguay for the healthcare? It seemed a bit extreme, but each to their own, I guess.
https://www.wsj.com/articles/why-this-u ... 1458525875
https://www.wsj.com/articles/why-this-u ... 1458525875
Re: Expat Retirement Location with Health Care Eligibility
The foreignness of a foreign country is MUCH more than language.Sandi_k wrote:No, but I'm good with languages. And ~6 weeks.AlohaJoe wrote:Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
- Artful Dodger
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Re: Expat Retirement Location with Health Care Eligibility
Costa Rica is an option. We did a seminar a few years back and a retirement tour. The organization who put on the seminar was the ARCR (the Association of Residents of Costa Rica) and cost $70. It covered residency, insurance, buying property, etc. There is a public healthcare system as well as private insurance coverage.
http://www.arcr.net/services1/insurance-in-costa-rica/
http://www.arcr.net/services1/insurance-in-costa-rica/
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Re: Expat Retirement Location with Health Care Eligibility
I'd be willing to bet that she knows that. Her comment though rings true with nearly every expat I know...they were much more content once they'd made a few inroads to enjoy the culture - mostly the language, etc.The foreignness of a foreign country is MUCH more than language.
Over time, it appears the case for retiring abroad seems to become more compellng, particularly the healthcare angle.
How many retired people does it take to screw in a lightbulb? Only one, but he takes all day.
Re: Expat Retirement Location with Health Care Eligibility
Oh, that is the truth! Lived in England and Australia for 3 years. While we loved it, when we finally returned to the US we were really ready. There were so many things about US culture we noticed with fresh eyes. And that was all with fairly familiar English. Not to say Sandi_k should not go for it. I would love to do it for a few years again, this time with language challenge!GerryL wrote:The foreignness of a foreign country is MUCH more than language.Sandi_k wrote:No, but I'm good with languages. And ~6 weeks.AlohaJoe wrote:Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
More on point, my impression is that many European countries make it fairly easy, allow ownership, and health care. The visa requirements are country specific and of course very particular. Portugal and Spain come up a lot as expat retiree friendly on some of the sites mentioned above.
Re: Expat Retirement Location with Health Care Eligibility
I agree. But I was answering the questions that were asked...GerryL wrote:The foreignness of a foreign country is MUCH more than language.Sandi_k wrote:No, but I'm good with languages. And ~6 weeks.AlohaJoe wrote:Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
Re: Expat Retirement Location with Health Care Eligibility
Yes, many expats in Mexico buy into their national health plan (IMSS, iirc) which serves essentially as catastrophic coverage.
And either buy private insurance or pay out of pocket for routine medical care.
(those 65+ usually keep paying their Medicare Part B premium so they can return to the U.S. for more involved care, e.g. transplants)
IMSS is priced by the decade. e.g. I'm in my 40s, so given the peso's recent weakness IMSS would cost me around $200 annually.
As noted, there are exclusions for pre-existing conditions.
We had a relative who lived in Guadalajara until their death and we were very pleased with their living/healthcare situation (paid out of pocket.)
And either buy private insurance or pay out of pocket for routine medical care.
(those 65+ usually keep paying their Medicare Part B premium so they can return to the U.S. for more involved care, e.g. transplants)
IMSS is priced by the decade. e.g. I'm in my 40s, so given the peso's recent weakness IMSS would cost me around $200 annually.
As noted, there are exclusions for pre-existing conditions.
We had a relative who lived in Guadalajara until their death and we were very pleased with their living/healthcare situation (paid out of pocket.)
LuigiLikesPizza wrote:There are a whole bunch of expat groups on Facebook that discuss this issue nearly every day, with respect to Mexico. Lots of retired Americans and Canadians living the good life there and they answer this question every day - there are public and private options and I believe the public program is for people 60+, and only denies coverage due to history of diabetes, heart disease or cancer - all other conditions accepted, but hustle over there because I don't have all the details memorized.
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Re: Expat Retirement Location with Health Care Eligibility
I've been an ex-pat for one 5 year stint (Italy) and one two-year stint (Brazil) and I would add one more factor to your search, which is which culture could you live inside. Quality low cost health care outside the US DEMANDS a precision of language. Doctors don't have as much fancy diagnostic stuff so you absolutely need to be able to speak precisely to them.
Cost of living sidebar: The Americans I knew/know in Italy and Brazil that move there and try to continue living the same way they did in the US find the cost of living is far higher. For instance, we currently live in the most modern part of Sao Paulo and to have the level of internet necessary to stream programs is twice as costly as the US. Add in that Netflix only has a fraction of the content that it does in the US (a certain percentage has to be local or something... I know that is an EU thing, not sure about Brazil), and you cannot VPN into the US Netflix, which means that we end up paying a lot to have ties to home. Another example is that peanut butter is ungodly expensive and steak is cheap. So if you live somewhere with a high level of friction between yourself and the lower cost culture, it could wipe out any financial advantages of lower-cost health care.
I think you would also need to take a real look at the local health care systems. Both Brazil and Italy are very inconsistent so an "average quality of health care" metric won't capture how different the options would be in Sao Paulo or Rome vs the beautiful, cheap remote parts of those countries. This is probably true in the US too, but I haven't experienced it first hand. Here in Brazil a friend broke an arm in a vacation town in the north and it was a 5-hour bus ride to get an x-ray. Just about every major city I have been to in Europe/South America has health care equivalent/better than the US (I experienced better doctoring in Brazil and Italy than in the US, but I never needed anything exotic, lived in big cities and am a small sample size. Examples would be an apples-apples cataract surgery in the US and Brazil...)
So if I were you I would ask:
1. Which culture could I live in most completely without needing to add in expensive extra-cultural amendments (technology, entertainment, diet) and a language I would love learning enough to learn it well enough to be able to communicate specific issues. (I have learned Portuguese and Italian and the kind of language you use in a hospital is different than in restaurants and stores...) Also remember that the tourist clinics in nice vacation areas you visit won't necessarily be the one that those with national health care go to.
That probably leaves a smaller list
2. Then you apply a sliding scale of the level of health care you need and decide the size place you will need to live in to have health care that meets your minimum level of expectation. Go look at some of the clinics in the beautiful places in those countries and try to get a sense of what the closest hospital there looks like. Beautiful villages in Northern Italy will have great access, southern Italy, less.
For me this would mean a small city or larger in a Spanish, French or Italian speaking country and now I can start on my list.
Cost of living sidebar: The Americans I knew/know in Italy and Brazil that move there and try to continue living the same way they did in the US find the cost of living is far higher. For instance, we currently live in the most modern part of Sao Paulo and to have the level of internet necessary to stream programs is twice as costly as the US. Add in that Netflix only has a fraction of the content that it does in the US (a certain percentage has to be local or something... I know that is an EU thing, not sure about Brazil), and you cannot VPN into the US Netflix, which means that we end up paying a lot to have ties to home. Another example is that peanut butter is ungodly expensive and steak is cheap. So if you live somewhere with a high level of friction between yourself and the lower cost culture, it could wipe out any financial advantages of lower-cost health care.
I think you would also need to take a real look at the local health care systems. Both Brazil and Italy are very inconsistent so an "average quality of health care" metric won't capture how different the options would be in Sao Paulo or Rome vs the beautiful, cheap remote parts of those countries. This is probably true in the US too, but I haven't experienced it first hand. Here in Brazil a friend broke an arm in a vacation town in the north and it was a 5-hour bus ride to get an x-ray. Just about every major city I have been to in Europe/South America has health care equivalent/better than the US (I experienced better doctoring in Brazil and Italy than in the US, but I never needed anything exotic, lived in big cities and am a small sample size. Examples would be an apples-apples cataract surgery in the US and Brazil...)
So if I were you I would ask:
1. Which culture could I live in most completely without needing to add in expensive extra-cultural amendments (technology, entertainment, diet) and a language I would love learning enough to learn it well enough to be able to communicate specific issues. (I have learned Portuguese and Italian and the kind of language you use in a hospital is different than in restaurants and stores...) Also remember that the tourist clinics in nice vacation areas you visit won't necessarily be the one that those with national health care go to.
That probably leaves a smaller list
2. Then you apply a sliding scale of the level of health care you need and decide the size place you will need to live in to have health care that meets your minimum level of expectation. Go look at some of the clinics in the beautiful places in those countries and try to get a sense of what the closest hospital there looks like. Beautiful villages in Northern Italy will have great access, southern Italy, less.
For me this would mean a small city or larger in a Spanish, French or Italian speaking country and now I can start on my list.
Re: Expat Retirement Location with Health Care Eligibility
Moving overseas strictly for healthcare reasons is a prescription for disappointment. That's a guarantee if you have significant health issues upfront. Healthcare is only one factor in the quality of life comparison. Many other factors could easily outweigh that for most. If you venture out to actually live overseas, versus visit as a tourist, you will slowly learn which of those things are most important to you. Give it a year or so after you arrive to start learning. Until then, InternationalLiving magazine/website is not a great source as it is very commercialized, and in my view glossy and superficial. Go directly to the expat sites within the Country you are considering, long before you leave.
You should also pickup a good Medevac policy (MedJetAssist is the best, in my opinion) when you plan to live outside the States. Good to have until you are very, very sure of medical care quality, cost, and access in your country of choice. Access is not the same as quality. Care and access in the USA is very good by global standards, if admittedly expensive.
You should also pickup a good Medevac policy (MedJetAssist is the best, in my opinion) when you plan to live outside the States. Good to have until you are very, very sure of medical care quality, cost, and access in your country of choice. Access is not the same as quality. Care and access in the USA is very good by global standards, if admittedly expensive.
Truth and clarity are important in all things...
Re: Expat Retirement Location with Health Care Eligibility
Hello Sandi K
Good afternoon Diogenes,
I agree with your assessment Diogenes.
I will assume that Sandi K has put more thought and insight into this.
If warm and tropical is what you want, and not too far away from the U.S., with lots of expats in the area, I would recommend Puerto Vallarta Mexico.
I do not know if living in Mexico is a non starter for you, but if it is a place you might consider, I would take a very serious look at it. Very many Americans and Canadians live there and seem to be very happy there.
I own property down there, and live there part time.
I love the place, and I will likely spend my retirement years both here in San Diego, and in Puerto Vallarta.
There is an abundance of activities, including some you might not have thought of like scuba/snorkle tours, zip lines through many parts of the jungle, para sail along the coast, sport fishing, food and wine tours, etc. And boy are there cultural activities here!!!
It is a very safe city. I would feel safer in Puerto Vallarta than in many places in the U.S..
Cost of living. Far below most any city in the U.S., you would be living like kings.
Great weather. Humid in the summer though. The hot months start around May and go through September, but the months of July and August start the rainy season, and since this is a tropical area you will get very significant tropical storms. It is very refreshing though, and as soon as the rain storm ends, you can go out and enjoy the cooler air for several hours. It is quite enjoyable actually.
Americans will find excellent healthcare here. Most pay for private healthcare. Doctors do house visits and such.
I believe residents can get health coverage in Mexico, but this is not an area I am familiar with. As mentioned earlier, most Americans will chose to pay for private healthcare.
Taxes in Mexico are very very low. My property tax for my + $ 150K condo that I own down there was less than two hundred dollars last year. WOW!!!! My TV cable bill each month is about $19. My cable bill in San Diego is + $120 each month, and the Mexico cable programing is FAR superior. My condo has WIFI so no bill for internet.
The Puerto Vallarta airport has daily service to most all the major U.S. cities and Mexico cities through both U.S. airlines and Mexican airlines. You did not list this as important, but others did on another thread, so I added this too.
I should also add that if you don't speak the language, you would not have any issues down there. Just about all the Mexicans that work down there interact with the Americans and Canadians, and their english is usually quite good.
I hope this helps.
Good afternoon Diogenes,
Diogenes wrote:Moving overseas strictly for healthcare reasons is a prescription for disappointment. That's a guarantee if you have significant health issues upfront. Healthcare is only one factor in the quality of life comparison. Many other factors could easily outweigh that for most. If you venture out to actually live overseas, versus visit as a tourist, you will slowly learn which of those things are most important to you. Give it a year or so after you arrive to start learning. Until then, InternationalLiving magazine/website is not a great source as it is very commercialized, and in my view glossy and superficial. Go directly to the expat sites within the Country you are considering, long before you leave.
You should also pickup a good Medevac policy (MedJetAssist is the best, in my opinion) when you plan to live outside the States. Good to have until you are very, very sure of medical care quality, cost, and access in your country of choice. Access is not the same as quality. Care and access in the USA is very good by global standards, if admittedly expensive.
I agree with your assessment Diogenes.
I will assume that Sandi K has put more thought and insight into this.
If warm and tropical is what you want, and not too far away from the U.S., with lots of expats in the area, I would recommend Puerto Vallarta Mexico.
I do not know if living in Mexico is a non starter for you, but if it is a place you might consider, I would take a very serious look at it. Very many Americans and Canadians live there and seem to be very happy there.
I own property down there, and live there part time.
I love the place, and I will likely spend my retirement years both here in San Diego, and in Puerto Vallarta.
There is an abundance of activities, including some you might not have thought of like scuba/snorkle tours, zip lines through many parts of the jungle, para sail along the coast, sport fishing, food and wine tours, etc. And boy are there cultural activities here!!!
It is a very safe city. I would feel safer in Puerto Vallarta than in many places in the U.S..
Cost of living. Far below most any city in the U.S., you would be living like kings.
Great weather. Humid in the summer though. The hot months start around May and go through September, but the months of July and August start the rainy season, and since this is a tropical area you will get very significant tropical storms. It is very refreshing though, and as soon as the rain storm ends, you can go out and enjoy the cooler air for several hours. It is quite enjoyable actually.
Americans will find excellent healthcare here. Most pay for private healthcare. Doctors do house visits and such.
I believe residents can get health coverage in Mexico, but this is not an area I am familiar with. As mentioned earlier, most Americans will chose to pay for private healthcare.
Taxes in Mexico are very very low. My property tax for my + $ 150K condo that I own down there was less than two hundred dollars last year. WOW!!!! My TV cable bill each month is about $19. My cable bill in San Diego is + $120 each month, and the Mexico cable programing is FAR superior. My condo has WIFI so no bill for internet.
The Puerto Vallarta airport has daily service to most all the major U.S. cities and Mexico cities through both U.S. airlines and Mexican airlines. You did not list this as important, but others did on another thread, so I added this too.
I should also add that if you don't speak the language, you would not have any issues down there. Just about all the Mexicans that work down there interact with the Americans and Canadians, and their english is usually quite good.
I hope this helps.
Re: Expat Retirement Location with Health Care Eligibility
I never said it was strictly for healthcare reasons. But I want to retire at age 60, and if I cannot have retiree health care (which looks *possible*, if not *plausible* 10 years out) it's smart to be assessing options now.Diogenes wrote:Moving overseas strictly for healthcare reasons is a prescription for disappointment. That's a guarantee if you have significant health issues upfront. Healthcare is only one factor in the quality of life comparison. Many other factors could easily outweigh that for most. If you venture out to actually live overseas, versus visit as a tourist, you will slowly learn which of those things are most important to you. Give it a year or so after you arrive to start learning. Until then, InternationalLiving magazine/website is not a great source as it is very commercialized, and in my view glossy and superficial. Go directly to the expat sites within the Country you are considering, long before you leave.
You should also pickup a good Medevac policy (MedJetAssist is the best, in my opinion) when you plan to live outside the States. Good to have until you are very, very sure of medical care quality, cost, and access in your country of choice. Access is not the same as quality. Care and access in the USA is very good by global standards, if admittedly expensive.
Re: Expat Retirement Location with Health Care Eligibility
Thank you, Coato - very useful. My mom was a CCU nurse, and my dad was a dentist, so I understand entirely what you say about precision of language.
I am considering dabbling in language lessons as I prepare for retirement, and your perspective certainly encourages that path.
I am considering dabbling in language lessons as I prepare for retirement, and your perspective certainly encourages that path.
Coato wrote:I've been an ex-pat for one 5 year stint (Italy) and one two-year stint (Brazil) and I would add one more factor to your search, which is which culture could you live inside. Quality low cost health care outside the US DEMANDS a precision of language. Doctors don't have as much fancy diagnostic stuff so you absolutely need to be able to speak precisely to them.
Cost of living sidebar: The Americans I knew/know in Italy and Brazil that move there and try to continue living the same way they did in the US find the cost of living is far higher. For instance, we currently live in the most modern part of Sao Paulo and to have the level of internet necessary to stream programs is twice as costly as the US. Add in that Netflix only has a fraction of the content that it does in the US (a certain percentage has to be local or something... I know that is an EU thing, not sure about Brazil), and you cannot VPN into the US Netflix, which means that we end up paying a lot to have ties to home. Another example is that peanut butter is ungodly expensive and steak is cheap. So if you live somewhere with a high level of friction between yourself and the lower cost culture, it could wipe out any financial advantages of lower-cost health care.
I think you would also need to take a real look at the local health care systems. Both Brazil and Italy are very inconsistent so an "average quality of health care" metric won't capture how different the options would be in Sao Paulo or Rome vs the beautiful, cheap remote parts of those countries. This is probably true in the US too, but I haven't experienced it first hand. Here in Brazil a friend broke an arm in a vacation town in the north and it was a 5-hour bus ride to get an x-ray. Just about every major city I have been to in Europe/South America has health care equivalent/better than the US (I experienced better doctoring in Brazil and Italy than in the US, but I never needed anything exotic, lived in big cities and am a small sample size. Examples would be an apples-apples cataract surgery in the US and Brazil...)
So if I were you I would ask:
1. Which culture could I live in most completely without needing to add in expensive extra-cultural amendments (technology, entertainment, diet) and a language I would love learning enough to learn it well enough to be able to communicate specific issues. (I have learned Portuguese and Italian and the kind of language you use in a hospital is different than in restaurants and stores...) Also remember that the tourist clinics in nice vacation areas you visit won't necessarily be the one that those with national health care go to.
That probably leaves a smaller list
2. Then you apply a sliding scale of the level of health care you need and decide the size place you will need to live in to have health care that meets your minimum level of expectation. Go look at some of the clinics in the beautiful places in those countries and try to get a sense of what the closest hospital there looks like. Beautiful villages in Northern Italy will have great access, southern Italy, less.
For me this would mean a small city or larger in a Spanish, French or Italian speaking country and now I can start on my list.
Re: Expat Retirement Location with Health Care Eligibility
I was in Malaysia earlier this year -- cost of living in Georgetown is cheap -- $1.50 on average for dinner at a hawker stall. Kuala Lumpur is more modern and double the price of Georgetown. You can get away with mostly English in the major cities in Malaysia. English is often used as the secondary language for ethnic groups to communicate with each other and to communicate with tourists from other SE Asian nations.
They don't have national insurance coverage so you'd have to get insurance companies from private carriers but it appears to be relatively simple. (Google up "Malaysia MM2H medical insurance".)
Requirements for a retirement visa:
https://en.wikipedia.org/wiki/Malaysia_ ... ligibility
At today's exchange rates, the above numbers come out to $115K in liquid assets and $2300/mo in income (whether pensions, dividends or online contract work). If you're under age 50, you have to deposit $69K into a Malaysian bank.
They don't have national insurance coverage so you'd have to get insurance companies from private carriers but it appears to be relatively simple. (Google up "Malaysia MM2H medical insurance".)
Requirements for a retirement visa:
https://en.wikipedia.org/wiki/Malaysia_ ... ligibility
At today's exchange rates, the above numbers come out to $115K in liquid assets and $2300/mo in income (whether pensions, dividends or online contract work). If you're under age 50, you have to deposit $69K into a Malaysian bank.
Re: Expat Retirement Location with Health Care Eligibility
My health insurance costs me $1,308 a year. I'm 42 and live in Vietnam. It is "Ultra Care Select" offered by Aetna/Interglobal.Sandi_k wrote:No, I foresee a lot of international changes in the coming years, and I'm still ~ 10 years from retirement. So I don't see the need to do detailed research until we're a little closer - just wanted to throw the thought out there.
The current premium matrix they sent me is
So if you're at a more normal retirement age, the premium would be more like $3,600 a year.
You can see the full benefits here https://interglobal.aetnainternational. ... 010115.pdf on page 9. $2.5 million lifetime limit, valid anywhere in Asia and Pacific other than Singapore. No deductible for most things. If you go to an affiliated hospital/clinic then you just swipe you card & pay nothing. I can go anywhere else, pay myself, and get reimbursed.
The full table of benefits is https://interglobal.aetnainternational. ... 010115.pdf
That's good. It wasn't clear from your original post...some people have never been outside the US but think a retirement overseas will solve all their problems somehowNo, but I'm good with languages. And ~6 weeks.AlohaJoe wrote:Have you ever lived outside of the US? What's the longest vacation outside of the US you've ever taken?
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Re: Expat Retirement Location with Health Care Eligibility
Medicare age-eligibilty is different than SS FRA. Medicare starts at age 65.Sandi_k wrote: Only once you're of Medicare-eligible age.
If I retire at 60, there's a 7 year period of no Medicare, should my employer-based retiree health care be revoked. Thus the question....
I met an ex-pat living in Panama - she liked her healthcare system a lot.
Re: Expat Retirement Location with Health Care Eligibility
Good morning Sandi K and BH community,
I looked at the healthcare issues down in Mexico, and it appears that there is very good access to the Mexican heatlhcare system for residents.
As well there is very good private healthcare.
Not sure how important this is to you, but there you go.
I hope this helps.
552BB wrote:Hello Sandi K
Good afternoon Diogenes,
Diogenes wrote:Moving overseas strictly for healthcare reasons is a prescription for disappointment. That's a guarantee if you have significant health issues upfront. Healthcare is only one factor in the quality of life comparison. Many other factors could easily outweigh that for most. If you venture out to actually live overseas, versus visit as a tourist, you will slowly learn which of those things are most important to you. Give it a year or so after you arrive to start learning. Until then, InternationalLiving magazine/website is not a great source as it is very commercialized, and in my view glossy and superficial. Go directly to the expat sites within the Country you are considering, long before you leave.
You should also pickup a good Medevac policy (MedJetAssist is the best, in my opinion) when you plan to live outside the States. Good to have until you are very, very sure of medical care quality, cost, and access in your country of choice. Access is not the same as quality. Care and access in the USA is very good by global standards, if admittedly expensive.
I agree with your assessment Diogenes.
I will assume that Sandi K has put more thought and insight into this.
If warm and tropical is what you want, and not too far away from the U.S., with lots of expats in the area, I would recommend Puerto Vallarta Mexico.
I do not know if living in Mexico is a non starter for you, but if it is a place you might consider, I would take a very serious look at it. Very many Americans and Canadians live there and seem to be very happy there.
I own property down there, and live there part time.
I love the place, and I will likely spend my retirement years both here in San Diego, and in Puerto Vallarta.
There is an abundance of activities, including some you might not have thought of like scuba/snorkle tours, zip lines through many parts of the jungle, para sail along the coast, sport fishing, food and wine tours, etc. And boy are there cultural activities here!!!
It is a very safe city. I would feel safer in Puerto Vallarta than in many places in the U.S..
Cost of living. Far below most any city in the U.S., you would be living like kings.
Great weather. Humid in the summer though. The hot months start around May and go through September, but the months of July and August start the rainy season, and since this is a tropical area you will get very significant tropical storms. It is very refreshing though, and as soon as the rain storm ends, you can go out and enjoy the cooler air for several hours. It is quite enjoyable actually.
Americans will find excellent healthcare here. Most pay for private healthcare. Doctors do house visits and such.
I believe residents can get health coverage in Mexico, but this is not an area I am familiar with. As mentioned earlier, most Americans will chose to pay for private healthcare.
Taxes in Mexico are very very low. My property tax for my + $ 150K condo that I own down there was less than two hundred dollars last year. WOW!!!! My TV cable bill each month is about $19. My cable bill in San Diego is + $120 each month, and the Mexico cable programing is FAR superior. My condo has WIFI so no bill for internet.
The Puerto Vallarta airport has daily service to most all the major U.S. cities and Mexico cities through both U.S. airlines and Mexican airlines. You did not list this as important, but others did on another thread, so I added this too.
I should also add that if you don't speak the language, you would not have any issues down there. Just about all the Mexicans that work down there interact with the Americans and Canadians, and their english is usually quite good.
I hope this helps.
I looked at the healthcare issues down in Mexico, and it appears that there is very good access to the Mexican heatlhcare system for residents.
As well there is very good private healthcare.
Not sure how important this is to you, but there you go.
I hope this helps.
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Re: Expat Retirement Location with Health Care Eligibility
As a first step in that direction I strongly encourage Duolingo. https://www.duolingo.com/ It is free, very easy to use, and very reasonable for putting a foundation in place for further learning. They also encourage a little bit each day. That's a way to go.Sandi_k wrote: I am considering dabbling in language lessons as I prepare for retirement, and your perspective certainly encourages that path.
Be Appropriate && Follow Your Curiosity
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Re: Expat Retirement Location with Health Care Eligibility
Here's an option yet to be mentioned: Malta. Mediterranean island, close to southern Europe (e.g., Italy) and North Africa (e.g., Morocco). English as official language, former British territory with a really cool blend of European and North African cultures. Universal, high-quality healthcare, plus an EU passport that gives you freedom of movement throughout the EU and Schengen countries. They have a High-Net Worth immigration programme that requires property ownership (or rental) but it's not exhorbitant. Not everyone's cup of tea (British style drive-on-the-left, super-slow beaurocracy, passive aggresive locals mixed with self-entitled uber-rich Euro's) but the weather is great.Sandi_k wrote: Are there any tropical/warm locations where a US-expat can live, and still be covered for residency healthcare?
I believe that some countries don't allow expats to have property ownership, which is the second element.
Any suggestions for countries that meet all three criteria? - Warm, medical coverage, and property ownership allowed?
https://economy.gov.mt/en/globalresiden ... /home.aspx