Access to quality healthcare is an important consideration for retirees, especially those interested in retiring overseas. The six countries that take top places in the Healthcare category of International Living’s 2019 Annual Global Retirement Index offer retirees first-rate care at affordable prices.
“Medical bills you can afford, doctors who make house calls and healthcare so affordable retirees are simply paying out of pocket—that’s just the reality for those who live in the places that score the highest in the healthcare category of this year’s Annual Global Retirement Index,” says Jennifer Stevens, executive editor.
Healthcare is one of the most important factors potential expats consider before moving abroad. In select locations overseas, it’s possible to access world-class care for a fraction of the cost back home.
“Across the 25 countries we rank and rate in our annual index, we assess the cost, access and quality of care as well as insurance and the cost of medications in the communities where we recommend expats go,” Stevens explains.
“We ask questions like: How much will you have to pay for things like laser eye surgery, a tooth crown or a blood transfusion? Can you get common medications for things like asthma and diabetes? And do you need a prescription to get a reﬁll? When it comes to assessing healthcare, we factor in both quality and price to give a fair and balanced view.”
The six countries that scored the highest marks for best healthcare in the world offer beautiful and adventurous places to retire as well as access to quality healthcare.
Scoring 95 out of 100, Malaysia takes the top spot. Healthcare in this Southeast Asian gem is simply world-class, with an up-to-date and sophisticated infrastructure. There are 13 hospitals accredited by the Joint Commission International (JCI), and almost every doctor is fluent in English. In fact, most Malaysian doctors were trained in the United Kingdom, United States, or Australia—so communication is flawless.
Here, you don’t need an appointment to see a specialist. You don’t need a referral from a general practitioner, either. It’s as simple as registering at a hospital and waiting in line to see your specialist of choice.
Prescriptions in Malaysia cost a fraction of U.S. prices. But it’s not just the cost that’s attractive—it’s the service. Pharmacists, like the rest of Malaysia’s medical staffers, are well-trained and informed. Malaysians are friendly people, but it’s the genuine interest that they take in their patients that makes such an impression.
“Recently, I decided on a whim to have a medical wellness exam,” says Keith Hockton, who lives on the island of Penang. “I’d never had one done before. So, when I had a free morning I decided just to pop in to the Lam Wah Eee Hospital.”
Within an hour, he had been examined by a doctor, had an ECG and blood and urine tests done— and was on his way home.
The total cost of the visit? Just $44. The doctor called Hockton later that afternoon with the results.
“It’s this level of service that makes medical care in Malaysia an attractive option.” He says. “It’s all so easy.”
In second place, with 93 points, is France. The low cost of health insurance and the superb quality of care means that France consistently receives high scores from the World Health Organization as well. Life expectancy now averages 85.7 for women and 80.1 for men, according to the latest WHO data published in 2018. This gives France a world life expectancy ranking of 5th—the United States ranks 34th.
“There’s a reason France is consistently named by the World Health Organization as having the best healthcare in the world,” says Stewart Richmond. “It is accessible to all and affordable. Prescription medicine is heavily subsidized and is among the cheapest in the world. For those with long-term illnesses such as cancer or MS, all healthcare and medicine is provided free of charge.”
Renowned for its excellent healthcare, with a score of 92, Thailand leads the way in medical tourism for Southeast Asia, says Michael Cullen. “That means quality hospitals with well-trained, English-speaking medics in all the major cities and regional towns throughout Thailand,” he adds.
Dental and other health services are also well covered—and all to the same high international standard. “For expats living in Thailand, it’s sensible to have health insurance because there’s no national system within the country they can tap into,” Cullen
notes. “But with healthcare costs averaging from a quarter to less than a half of what they would
cost in the United States, insurance costs won’t break the bank.”
Although there’s no public health insurance available to expats, there are several options to obtain private insurance from a variety of excellent companies, both domestic and international.
Thailand’s private healthcare system consists of many well-equipped, state-of-the-art hospitals. A major benefit is that you’re often able to visit a specialist within a short time of walking through the front door—without booking an appointment beforehand.
One of the great perks for foreign residents living in Ecuador is high-quality, low-cost healthcare. With 89 points, the Land of Eternal Spring comes in at fourth place.
“In February of 2016, Ecuador passed a law that requires all new residents to have some form of healthcare coverage,” says Jim Santos. “However, the same law prevents private insurers from denying coverage because of age or pre-existing conditions.”
This opened the private market, although expats may also choose to sign up for the state-run health plan, which covers all medical, dental, and eye-care expenses—including prescriptions, testing, rehab and more—at IESS (Ecuadorian Social Security Institute) hospitals and clinics with no deductible and no copay. Expats are eligible to use the system after paying into it for the first three months.
In the bigger cities, you’ll find hospitals with state-of-the-art equipment as well as specialists in all fields and physicians with private clinics. But expats don’t need to live in a metropolis to take advantage of good, quality healthcare. Smaller cities also have private clinics and modern hospitals. And in small towns, you’ll often find private doctors who go that extra mile, with some even making house calls if you’re too ill to go out.
Donna Stiteler lives in Ecuador’s third-largest city and the economic center of the Southern Sierra, Cuenca. “My husband, Rowland, who’s a writer and not a carpenter, recently ‘sawed’ his index finger,” she says. “The trip to the emergency room on a Sunday required a five-minute wait. A surgeon stitched his finger for a mere $60. This was walk-up pricing without using any insurance.”
However, Stiteler says, she and her husband do have the government’s IESS plan, which covers them both for under $100 a month. “We do most of our medical treatments out of pocket because healthcare runs about 80 percent cheaper than in the U.S.,” she says. “And you can just walk in and see specialists for $40 a pop.
#5 Costa Rica
By almost any standard, Costa Rica has some of the best healthcare in Latin America. There are two systems, both of which expats can access: The Government-Run Universal Healthcare System, Caja Costarricense De Seguro Social, known as Caja, and The Private System. Both are constantly being upgraded—new hospitals, new equipment and improvements in staff training.
Many doctors, especially in private practice, speak English and have received training in Europe, Canada or the United States. But despite the advancements, costs are low in comparison to those in the United States.
Physician John Michael Arthur, a native Texan who now lives in the Central Valley of Costa Rica, has a lot of praise for the Costa Rican healthcare system. “Having both the public healthcare system and the private healthcare system available to residents gives great options,” he says. “High-quality healthcare —medical, surgical and dental—is easily found and costs about one-third of the prices in the U.S. private system.”
For example, says Arthur, he recently had a new state-of-the-art zirconium crown placed on a tooth for about $275. And he had an echocardiogram for only $145. “I left the office with the complete analysis and report in my hands,” he notes.
A favorite for expats looking for a haven close to The United States and Canada, Mexico Offers an affordable cost of living and great healthcare.
Most doctors and dentists in Mexico received at least part of their training in the United States. Many continue going to the U.S. or Europe for additional education.
Every medium to large city in Mexico has at least one first-rate hospital, with the cost of healthcare generally half or less what you might expect to pay in the United States. The same goes for prescription drugs. Plus, health insurance in Mexico costs much less than it does in the United States.
“Mexico offers two national healthcare plans for residents,” says Don Murray. “The one most used by expats seems to be the Seguro Popular program, where annual costs may be only a few hundred dollars for full coverage.”