One of the main concerns of any person looking to retire overseas is the quality of healthcare. Is it possible to get medical treatment as good as what’s available in the U.S. and Canada? The answer…a resounding yes. Sometimes it’s even better than what’s on offer at home, and at a more affordable price too.
Measuring the quality of healthcare is difficult, and it’s hard to put a number on it. We can, however, put a number on the price of medical procedures. And these costs (as well as quality) helped us score each of the 24 countries in the healthcare category of International Living’s 2018 Global Retirement Index.
Read on to learn more about the top five countries in the world for healthcare. In each of these countries you’ll find clean, excellent hospitals, highly trained doctors, and affordable care.
There are three things that should be considered when assessing the healthcare options in any country; quality, affordability, and accessibility. Mexico ticks all the right boxes in each of these categories, with wonderful individual doctors and specialists, many top-notch hospitals, and cutting-edge technology.
Every medium to large city in Mexico has at least one first-rate hospital. Many doctors speak English as their second language and a large percentage have completed at least some of their medical training in the U.S. That said, Mexico’s medical universities are very good.
National healthcare insurance is available to all residents. Depending on your circumstances and whether you have a pre-existing condition (yes, you’ll be covered anyway), you can apply for one of the two national healthcare programs, IMSS or Seguro Popular.
IMSS provides mandatory coverage for Mexico’s employees. It is also the nation’s social security agency. Funds for the program come from the government, employee contributions, and employers’ contributions. They offer a full range of treatments and care is handled through an appointment system. And if hospitalized, your family is your primary nurse and non-medical caregiver. Expats holding a residency visa may apply for this medical insurance and it costs around $350 to $450 per year, per person.
The second program available to expats is called Seguro Popular. Unlike the IMSS program, participation in Seguro Popular is strictly voluntary. The cost is determined through an interview process that determines your standard of living and assigns a very modest cost, at the end. This program has hundreds of hospitals and thousands of clinics covering millions of people across Mexico. This is the most popular program for expats because there is no age limit to apply and you cannot be denied for pre-existing conditions. There are, however, a few things not covered by this program, such as dialysis. And while not completely inclusive of all ailments, they cover the majority of illnesses and procedures. Seguro Popular is continuing to expand and improve its coverage by building new hospitals and clinics across the country.
Mexico offers a very good system of care, especially when combined with one of the national insurance programs. Prescription costs are silly-cheap and out-of-pocket expenses rarely run more than a few hundred dollars per year, on average. “You’ll find all the common brand-name prescription drugs here, at lower prices,” says IL Mexico Editor Glynna Prentice. “They generally cost 25% to 50% of what you’d pay north of the border. Generics are available for many off-patent drugs, as well.”
Many doctors routinely make house-calls and phone you to inquire about your health, after treatment. In fact, many pharmacy chains provide a free physician whose office is attached to the pharmacy. Simply walk in and pay nothing for a consultation. And most medications do not require a prescription.
As in most of Latin America, healthcare in Panama is affordable, to say the least. The modern, bustling home of the Panama Canal offers high quality, personalized care. There are major facilities in hub towns across the isthmus. No matter where you choose to live, you’ll likely be an hour or two at most from a good hospital. When in need of ultra-specialized or comprehensive care, expats and locals travel to the city of David, near the Costa Rica border, or Panama City, the nation’s capital and medical hub.
Major facilities in Panama City are all affiliated with sister facilities in the U.S., from the likes of Miami Children’s Hospital (now Nicklaus Children’s) to Johns Hopkins International. Hospital Punta Pacifica is known as one of the most technologically advanced hospitals in the entire Latin America region. With participating medical centers in Panama City, Coronado, and David, local provider MS Panama offers easy-access insurance enjoyed by many an expat in Panama.
U.S. expats will tell you their healthcare costs in Panama are 50% to 75% lower than they were back home. Whether you go to a big-name facility or a mid-range clinic, doctors are professional and well-trained.
Thanks to decades of close cooperation between Panama and the U.S., plenty of Panamanian doctors study medicine in the States. It’s easy to find English-speaking doctors, dentists, specialists, and more. However, care in Panama continues to be more personalized than in larger countries. Doctors spend more time with patients, even giving out their cell phone numbers so they can be reached directly.
“That’s one of the big reasons my life in Panama is so comfortable and stress-free,” says IL Panama Editor Jessica Ramesch. “If I leave my dentist’s office and I have a concern, I can call or send a message to her cell phone. After each appointment, she sits and chats with me. The same goes for my dermatologist. I can’t remember the last time I was rushed out of a doctor’s office—oh yeah, it was back in the States. I used to feel anxious. Was I asking the right questions? Getting adequate care? Now that anxiety is gone. I have time to talk to my healthcare providers and explore all my options.”
The World Health Organization (WHO) ranks Colombia´s healthcare system as number 22 out of the 191 countries they review. That is better than Canada who ranks number 30 and the U.S. who ranks number 37.
There are many excellent hospitals and clinics located throughout Colombia that provide both general and specialized medical services. Half of the top 43 hospitals in Latin America are in Colombia (22 out of 43).
IL Colombia Correspondent Nancy Kiernan reports that one U.S. expat recently underwent five surgeries and three months of home healthcare after facing a life-threatening experience. “He pays $300 per month for a premium policy that covers him and his wife,” explains Nancy. “After spending six weeks in intensive care he received a bill for about $25 when he checked out of the hospital. For three months, a home healthcare nurse attended to his needs, at a cost of $25 per month.”
While speaking Spanish certainly helps, it will not prevent you from receiving excellent care. Many hospitals in the large and medium-sized cities have either English speaking staff, or a certified translation department.
Any expat with a resident cédula (national ID card) can apply for the government health insurance EPS (Entidades Promotoras de Salud). Even if you have pre-existing conditions, you can be accepted into the plan. These conditions may be excluded for a short period of time, 6 months or so, but then will be covered in full.
Co-pays for the public health plan are based on a three-tiered system with the mid-range price costing about $3. These co-pays apply to laboratory tests, x-rays, and prescription medications.
Private health insurance is an option for people under the age of 60 as a supplemental plan to your EPS public coverage. Premiums will be significantly lower than what a couple would pay in the U.S. Of course, they vary depending on the carrier you choose and the level of coverage you want.
If you decide to pay-as-you-go and not obtain health insurance, it is not a scary decision. Prices for procedures, office visits, and medications are much lower than in the U.S. For example, a one-hour consultation with a specialist costs about $50.
“In Malaysia, almost all the doctors are trained in the UK, U.S., or Australia,” says IL Malaysia Correspondent Keith Hockton. “The caliber of care is up to Western standards. Most of the doctors speak English so communicating, even the most intricate of details, will not be a problem.”
Top retirement spots like Kuala Lumpur and Penang have numerous JCI accredited hospitals, so you are in good hands. The Joint Commission International (JCI) is considered the gold standard in healthcare around the globe.
There are specialists in every hospital, but unlike other countries, you don’t have to wait for months to get in for a visit. Just show up to the hospital and register in the lobby, then take a number and wait your turn. If you need to see another doctor or get further testing, that also happens on the same day, in the same place—it is a very efficient system.
Many of the hospitals offer health screening packages which include a physical, chest x-ray, ECG, full blood work, abdomen ultrasound, and a vision test. More specific tests can be added on, but the basic package starts at less than $120.
A first-time doctor or specialist visit is usually between $15 and $65 with follow-up visits around $11 to $28. If you are admitted, the overnight stay will cost roughly $55 to $200 for a private room per night.
There are private and public hospitals and expats can choose whichever one suits their needs. The private hospitals tend to be a bit more expensive but are more up to Western standards than the public hospitals. Even at the private hospitals, the treatment is so affordable that for minor visits some people pay out of pocket.
The United Nations has ranked Costa Rica’s public health system within the top 20 worldwide and the number one in Latin America. The country provides universal healthcare to its citizens and all legal residents—that means you, if you’re an expat.
Costa Rica also has a private healthcare system that is available to anyone—and at a fraction of the cost you’d pay in the States. It wouldn’t be unheard of that you could pay in full for private services for less than the cost that your copays and deductibles would be.
Both the private and public healthcare systems are always being upgraded. New hospitals, new clinics, new machines, and improvement in staff and training are always underway.
“An angioplasty that would cost close to $60,000 in the U.S. is $9,000 in Costa Rica,” explains IL Roving Latin America Correspondent Jason Holland. “A hip replacement is more than $40,000 in the U.S. but just over $10,000 in Costa Rica. A knee replacement is $40,000 versus $11,000. And a facelift is $9,000 versus $5,000.”
Dental and vision care are not to be forgotten, either. Prescription eyeglasses run about one third of the U.S. cost and include a one-year guarantee. Likewise, up-to-date dentistry is available everywhere. A state of the art zirconia crown costs around $1,800 in the State, but only about $300 in Costa Rica.
Pharmacies are well-stocked. And, expats quickly learn that the regulations covering prescription medicines are not as restrictive as they are in North America, Australia, or Europe. The only drugs that require a prescription are psychotropic drugs, narcotics, and antibiotics. Therefore, most locals tend to have a great relationship with their local pharmacist and they head there first rather than the clinic or doctor’s office.
You can see why Costa Rica is such a popular destination for medical tourism. Over 55,000 medical travelers from around the world sought care in Costa Rica last year. With its stunningly beautiful surroundings, low costs, excellent medical reputation, and plenty of bilingual medical personnel, Costa Rica provides world class care to its population. And the small, inviting nation does it better than its North American counterparts. Maybe that’s why Costa Rica has an average life expectancy that is higher than that of the U.S..