Ask the Expert: Public or Private Health Care Overseas?

Many budding expats are excited at the thought of moving to a country with good, cheap health care—especially when it’s one of their biggest expenses back home. Often one of the least expensive options is a country’s nationalized health plan. But is it right for you? And when might you want to use it? Here are the answers.

Q. How do I even qualify for a country’s public (nationalized) health plan?

A. In general, expats can join the public system in Latin America and in some European countries (like France and Italy). But you won’t be able to join the public system in all countries (i.e. Asia).

In countries where you can join the system, you usually need to have a valid residence visa, rather than a tourist visa, to qualify for the country’s national health plan.

Q. So what are the pros and cons of each system?

A. Let’s think of them instead as trade-offs, because that’s really what they are.

Public Care

Public systems tend to be very inexpensive—in Latin America, for instance, roughly $300 to $600 a year. They often provide medications as well as doctor and hospital care. And in some countries you can join regardless of your age or pre-existing conditions. So they are a very affordable health safety net.

Public systems serve vast populations, so wait times for an appointment may be longer, and there may be waiting lists for non-urgent procedures. They may have slightly older medical equipment, or no-frills hospitals. And if you’re in a country that’s not English-speaking, you may find that fewer doctors in the public system speak fluent English—after all, their patients don’t.

Private Care

In contrast, doctors and hospitals in the private sector serve a smaller customer base. They often have fancier facilities and may be able to give you an appointment more quickly. The doctors are more likely to have studied abroad and to speak English.

You’ll pay more for their services (though usually 25% to 50% of what you’d pay in the U.S.). And if you must rely on insurance to foot part of the bill, remember that it doesn’t tend to cover pre-existing conditions. In addition, relatively few insurance companies will issue new health policies to those over the age of 64.

Q. So will the medical care be equally good in either system?

A. It’s hard to generalize across so many countries. Fancy facilities don’t make good doctors. And “English-speaking” is no guarantee of competence. On the other hand, it’s just common sense that top doctors do often gravitate to the private sector.

The bottom line is that you can find good doctors and hospitals in both systems, and it simply depends on what you feel comfortable with.

One tip: Check out the health care facilities—in both the public and private systems—in the city or region where you plan to live. Do you like what you see? Would you feel comfortable using these facilities? Also, ask local expats what they do for health care, and why. Their decisions can inform yours.

And remember, this isn’t an either/or situation. Many expats—and locals, too—use both public and private systems, depending on what their health needs are at a given time. I’ll help you to explore your options in greater detail here.

The choice is yours. And even better…in many countries out there, both options are affordable.

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