Five Places to Get Affordable Health Care Overseas

In the following five countries you will pay less for health care than you do at home. And the quality is at least as good…in fact, many expats say it’s better. Affordable health care isn’t the only reason to move overseas—but it makes the move more attractive. You can get great quality health care for less abroad, lowering your monthly expenses.

1. Panama has a Johns Hopkins Medicine International Affiliated Hospital

Panama offers excellent quality health care and modern hospitals in Panama City and other large towns or cities, including David. Many Panamanian doctors are U.S.-trained and speak English. Standards at Panama’s hospitals compare favorably with those in the U.S., Canada and Europe. Smaller towns tend to have clinics or small facilities which offer basic services and are able to coordinate transfers to larger facilities nearby.

Private health insurance is much less expensive than in the U.S. because doctor’s fees and hospital visits are much cheaper. Prices for prescription drugs can be low in Panama, as well, because many manufacturers price them for the market. Some drugs that require a prescription elsewhere are available over the counter in Panama.

Insurance plans run the gamut, offering local and international options which are excellent and affordable. There are many modern hospitals, clinics and laboratories here. If you are retired from the U.S. military, Tricare is accepted in Panama at Hospital Nacional in Bella Vista, Panama City.

Pharmacies in Panama are plentiful. Some are associated with private clinics, located near hospitals and inside supermarkets, which often offer 24-hour service.

If you are under 50, chances are you can get a good local insurance plan for $60 to $100 a month. This may be difficult to obtain if you have a pre-existing condition or are over 65. Maximum coverage tends to be low and local companies are generally free to change rates and coverage over time.

If you are between the ages of 65 and 74, you may need to look at international insurances available in Panama; the most common seems to be Bupa International. If your application is accepted, there is generally no age limit to renew the international policy, which means you can keep it for life.

Terry Coles chose to live in Panama with her husband because of the high-quality, low-cost health care. She says, “I recently had a hysterectomy. This surgery would have cost us $30,000 in the U.S.— but in Panama it cost just $4,500, including a three-day stay in the hospital.”

2. There are Many U.S. Trained Doctors in Mexico

In general, health care in Mexico is very good and in many places it’s excellent. Many doctors and dentists in Mexico receive at least part of their training in the U.S. Nearly every mid-size to large city in Mexico has at least one first-rate hospital. Health care in Mexico is generally half or less of what you might expect to pay in the U.S. The same goes for prescription drugs.

On average, a visit to a doctor will cost $31 to $46. A house call will cost about the same. Lab tests will cost about a third of what they do in the U.S. A CAT scan often costs about 25% of what it does in the U.S.  An overnight stay in a private hospital room generally costs about $80 to $100 and a visit to a dentist for cleaning costs about $24 to $40.

In the major cities of Mexico, you can get good-quality medical care for serious medical conditions, including dialysis, major surgery and even home care for a fraction of what you might pay in the U.S.

Medicare and Medicaid do not travel with you outside the U.S.; neither does Canada’s health care insurance. But you will find that some providers in Mexico accept Blue Cross Blue Shield and other U.S. insurance providers.

Because of the low health care costs in Mexico, many expats choose to pay out of pocket, especially for minor procedures. But many also choose to buy private health insurance. Rates for private insurance coverage vary depending on your age, pre-existing conditions, the deductible you choose, and so on. To give a wide range, if you are in your 50s and generally healthy, you can expect to pay between $800 and $3,500 a year for your premium.

IL’s Mexico Editor, Glynna Prentice, says, “I’ve been to slick, world-class hospitals that rival anything in the U.S. or Europe, and doctor’s offices that are more high-tech than those of my New York specialists. I’ve paid top dollar—for Mexico—in these facilities, naturally. But in Mexico, that ‘top dollar’ usually means prices like $35 to $50 for specialist visits and under $100 for a mammogram or an overnight hospital stay, for instance.”

3. Some of the Best Health Care in Latin America Can be Found in Costa Rica

The best medical facilities in Costa Rica are the private hospitals in the San José area of the Central Valley. The public and private healthcare systems are constantly being upgraded.

Great health care is available at private facilities throughout the country. Costs are low in comparison to those in the U.S., and even some European countries.

Private doctors rarely charge more than $60 a visit, even for house calls, and a specialist will run $80 to $100 per visit. Drugs are also much less expensive and prescriptions are often unnecessary. Pharmacies are allowed to prescribe medicines, including on-the-spot injections.

It’s difficult to find an expat who doesn’t think that Costa Rica’s private hospitals are as good as those back home. The three general hospitals with a full range of services typical of those you’ll find at home are CIMA Hospital, in Escazú, and Clinica Biblica and Hospital La Catolica, both in San José.

It’s not difficult to find a competent doctor in Costa Rica either. Most of them have been trained in North America or Europe. A high percentage of doctors at the private hospitals and in private practice have a knowledge of English, but that’s not always true of those who practice in the public system, known as Caja. The American Embassy in San José has compiled a list of physicians to help expats locate English-speaking doctors.

Laurel and Charles Carpenter used to pay $1,200 a month for health insurance in Florida. Now living in Atenas, in the Central Valley, they pay just $88 a month to be in the Caja. Charles has multiple sclerosis and with the money they don’t spend on insurance, they can afford to have a private, full-time nurse, which would cost $9,000 or more per month in the States.

4. The Patient is “Put First” in Ecuador

Foreign residents in Ecuador will get high-quality, low-cost health care. Ecuador’s best medical services are offered in the cities of Quito, Cuenca and Guayaquil. It is common for doctors in other parts of Ecuador to refer seriously ill patients to hospitals in one of these cities.

You will receive personal attention from medical practitioners, not seen in the U.S. since the 1960s. In general, you can expect to pay 10% to 25% of what you would back home.

First-rate medical care can be found in Ecuador, and many doctors are educated in the U.S. and Europe. Most doctors do not have nurses and the average office visit is 30 to 45 minutes. Some doctors still make house calls (remember those?).

A visit to a general practitioner costs $25 to $35, while a visit to a specialist runs at $30 to $40, and this is the entire bill, not an insurance co-pay. There is no charge for follow-up visits. A psychiatrist will charge $30 to $50 for a half-hour session.

Health insurance is a bargain in Ecuador. In the U.S., a 60-year-old man could pay a monthly premium of $1,200; in Ecuador he pays $70. The policy cited is offered by Salud, S.A., Latin America’s largest health insurance company, which pays 80% of doctor’s visits, 60% of medications costs and 100% of hospitalization. It also offers extra coverage for walk-in procedures and accidents.

The policies of major insurers consider pre-existing conditions and require that you sign-up for coverage before you reach the age of 70.

Patty and Mike Grimm have lived in Ecuador for three years. They have had a range of health services over the years and Mike says, “In each and every case, our care has been first class, with very caring and skilled medical practitioners. And it’s been a fraction of the cost of the U.S.”

5. The Mutualista Plan Doesn’t Take Pre-Existing Conditions Into Account in Uruguay

Uruguay has a range of health care options that includes a free public health care system for people who cannot afford to pay for private care and private health insurance.

There are several private health insurance companies that offer different policy options in Uruguay. They are Blue Cross and Blue Shield Uruguay; Medicina Personalizada,  which includes a 24-hour call center as well as online consultation; Summum, which includes emergency care; and Seguro Americano, which includes care at a modern and well-equipped hospital in Montevideo, Uruguay’s capital.

The most popular health care option is a hospital plan called a mutualista. Health care is considered a social security benefit in Uruguay. The health care portion of a person’s social security benefit is paid to the mutualista of their choosing.

Retired expats who haven’t paid into Uruguay’s social security system, can also apply to become members of a hospital plan. In this case monthly payments are paid directly by the member to the hospital. Each member also makes a small co-payment when they see a doctor or have a medical test

A mutualista is different from health insurance. There is no middleman between the hospital providing service and the member, no deductible, no lifetime cap and no complicated terms to decipher.

Lisa Marie Mercer moved from Colorado to Atlántida, Uruguay, just over a year ago. She and her husband have a mutualista plan. She says, “My monthly insurance in the U.S. was $650, with a $1,500 deductible. My medications started at about $200 a month. Now we each pay the equivalent of $80 a month. My prescriptions come to about $60 a month.”

Lisa says, “Contrary to what you might have heard, mutualistas do not discriminate against people with pre-existing conditions, overweight people or people of a certain age.”

Another popular choice is the British Hospital in Montevideo. It is not a true mutualista, but has a similar hospital plan they call the “Hospital Scheme.” The membership fee is higher and the waiting times are usually less.

As an alternative to insurance companies and mutualistas offering services in Uruguay, there are some international private insurance carriers who do provide coverage to older people living abroad.

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