Places abroad to retire, claimed to be affordable.

[Squirrel]

No intention of moving country, but that article just expanded my overseas vacation list.

[sengsational]

Quote:

Originally Posted by gattara With long-term care so expensive in the USA, this idea has crossed my mind, but I didn't know if it was a real possibility. Reading what you wrote, apparently it isn't just an idea - Americans actually do this? I'll have to do some google searches to learn more.

Let us know what you find out. On the surface, it seems like a reasonable idea, but I think the problem may turn out to be that you don't get Medicare benefits or VA benefits.

So you pay, say, the same or less for your nursing home, but you get a high quality rather than sub-standard environment that you might get for a "cheap" US nursing home. But when you go to the doctor as an expat, you actually pay for it, vs Medicare in the US you don't pay? (or what...I'm not schooled in HC after 65 stuff)?

[JakeinChina]

I have no idea, but for an older American on Medicare, how much would assisted living cost? Are the facilities if one had to move in nice?


I would assume the overseas facilities, even if you pay out of pocket, are nicer then what's in the U.S no?

[kevink]

We've visited a few of these facilities at Lake Chapala ourselves and they compare very favorably with the grim ones we visited my stepdad and other relatives in in the U.S.

I'll post a link to one recent overview of facilities below.

Medicare as we all know isn't free. Co-pays and add-ons for Parts B-D add up - especially considering that one can pay out-of-pocket to see an excellent English-speaking doctor down there for $20-25 and many drugs that would be prescription-only in the U.S, are OTC and much cheaper there. Plenty of exceptions though and one size doesn't fit all.

The most typical scenario we've seen is a couple where one person needs care and the other is either exhausted from being their caretaker or incapable of it. In the U.S. they'd quickly spend down their assets to nothing leaving no options but a grim Medicaid-eligible nursing home (and of course no inheritance for their kids), while in Mexico the cost for care can be paid for completely using social security alone.

https://www.focusonmexico.com/assisted-living-lakeside/

[Teacher Terry]

Both my grandma’s were in the same nice nursing home and one self paid and one was on Medicaid.

[sengsational]

Quote:

Originally Posted by JakeinChina I would assume the overseas facilities, even if you pay out of pocket, are nicer then what's in the U.S no?

I'd make that same assumption. I'd presume higher staffing level and probably workers willing to provide a bit of TLC occasionally. My impression, totally based on zero facts, is that those employed at lower rung US facilities are there because many of the positions require no previous experience, training or certifications. In the US, people who fill those positions are looking to move up and out, and might not be very dedicated. That same position in other countries might be quite relished and so generate some pride in doing the job well. All speculation, though.

[kcowan]

We are considering moving full-time to Mexico. Not for a couple of years. Just evaluating possibilities. One of our concerns is that septicemia seems to claim many hospitalized patients. OTOH a friend just had his wife succumb in Seattle.

But we are trading off the higher quality of life with the risks. The home bias is very much at work.

[brett]

That is exactly where we have been in the past and where we are now.

I suspect our future will hopefully look like a place in winter for six months and a place where we live for six months. Undecided as to whether we own or buy, sell or current home at some place.

One thing for certain, we do not want to own two properties. Perhaps not even one. We owned for many years then rented for four. Now we own. Renting opened our eyes to the financial and the lifestyle benefits. Now we view renting primarily as a financial and flexibility decision.

[ShokWaveRider]

Quote:

Originally Posted by kcowan We are considering moving full-time to Mexico. Not for a couple of years. Just evaluating possibilities. One of our concerns is that septicemia seems to claim many hospitalized patients. OTOH a friend just had his wife succumb in Seattle. But we are trading off the higher quality of life with the risks. The home bias is very much at work.

What will you do for healthcare? Very difficult for over 65s I hear.

[sengsational]

Quote:

Originally Posted by kcowan One of our concerns is that septicemia seems to claim many hospitalized patients.

I wonder what the rates are between the best hospitals in each country. I can't imagine the rates are much different, but who knows. I bet without big pharma breathing down their necks, the Mexican hospitals will employ Marik's regimen more often.

[kevink]

Quote:

Originally Posted by ShokWaveRider What will you do for healthcare? Very difficult for over 65s I hear.

On the contrary access to care is far easier in expat enclaves in Mexico than it is in the U.S. The issue isn't health care, it's health insurance. Gringos can join the Mexican national insurance system (IMSS and/or Seguro Popular) but many pre-existing conditions aren't covered and without fluent Spanish such coverage is really only useful for emergencies in a few instances.

Private insurance is available but becomes prohibitively expensive after age 70 or so. The majority of older retirees we know down there self-insure while in Mexico while maintaining basic Medicare coverage in the U.S. as a hedge against expensive treatment for, say, cancer or heart disease.

Routine and preventive care are easy to pay for out-of-pocket. And we've known numerous people who've "gone naked" insurance-wise and had to pay for serious illnesses such as triple/quintuple bypass surgery or breast cancer treatment and in all cases complete courses of treatment including surgery, drugs and stays in the best private hospitals haven't exceeded 30-40K total. Not pocket change, but add a few zeroes to get to U.S. costs, obviously.

Much harder choice for Canadians like Keith since Canada does have excellent universal health care. Most Canadians we know in Mexico limit their stays there to less than 6 months in order to maintain coverage back home.

[brett]

Maintaining our Canadian healthcare coverage is one of the key reasons why we view a six month horizon as being optimum.

[JakeinChina]

Quote:

Originally Posted by sengsational I'd make that same assumption. I'd presume higher staffing level and probably workers willing to provide a bit of TLC occasionally. My impression, totally based on zero facts, is that those employed at lower rung US facilities are there because many of the positions require no previous experience, training or certifications. In the US, people who fill those positions are looking to move up and out, and might not be very dedicated. That same position in other countries might be quite relished and so generate some pride in doing the job well. All speculation, though.

Yeah I would totally agree with you on this.

Plus, in many of these countries, a lot of the infastructure like buildings and such may tend to be new, where in the U.S. they might be old and a bit run down.

[kcowan]

Quote:

Originally Posted by kevink Much harder choice for Canadians like Keith since Canada does have excellent universal health care. Most Canadians we know in Mexico limit their stays there to less than 6 months in order to maintain coverage back home.

Quote:

Originally Posted by brett Maintaining our Canadian healthcare coverage is one of the key reasons why we view a six month horizon as being optimum.

Yes we are covered with up to 212 days absent (Ontario and BC) so the trade-off is maintaining a residence in a LCOL area versus heading to the mountains in Mexico summers. Self-insurance is certainly feasible. I did it this year as a trial. So far only 1300 pesos with 2 weeks to go.

[sengsational]

Quote:

Originally Posted by kevink The majority of older retirees we know down there self-insure while in Mexico while maintaining basic Medicare coverage in the U.S. as a hedge against expensive treatment for, say, cancer or heart disease. Routine and preventive care are easy to pay for out-of-pocket. And we've known numerous people who've "gone naked" insurance-wise and had to pay for serious illnesses such as triple/quintuple bypass surgery or breast cancer treatment and in all cases complete courses of treatment including surgery, drugs and stays in the best private hospitals haven't exceeded 30-40K total. Not pocket change, but add a few zeroes to get to U.S. costs, obviously.

That's some really good information there, thanks for sharing it. Doing the expat thing is more of a plan B for me because DW is just not interested (doesn't even want to move unless it's to be near the grandkids that we don't even have). But it's nice to know that getting caught out on health insurance can be so "cheap".

[sengsational]

Quote:

Originally Posted by kcowan Yes we are covered with up to 212 days absent (Ontario and BC) so the trade-off is maintaining a residence in a LCOL area versus heading to the mountains in Mexico summers. Self-insurance is certainly feasible. I did it this year as a trial. So far only 1300 pesos with 2 weeks to go.

Out of curiosity, you need to keep a residence in Canada and be in- country a couple of months or so? They use border crossing records? I thought those only had arrivals.

[brett]

To compound matters, each Province in Canada has slightly different medicare rules as it pertains to maximum number of days one can spend outside the country. It is typically six months give or take some days.

I do not know the residence requirements. For some I suppose it might be what province they pay their income tax. Some provinces collect medicare premiums direct, others do it through tax returns, still other base the premium in part on income. Where we live there are no premiums as such. Health care is funded from general revenues and is included in the provincial tax rate. Every Province that we have lived in requires 3 month residency in order to get service. Until that time you are covered by your previous plan.

Some provinces also have a cap on how much seniors pay for prescriptions. Where we live, on turning 65, we only pay a maximum of 30 percent (sometimes much less in our experience) on many prescription drugs but not all. Blue Cross administers it. Covers both married couples as long as one is over 65, the other also gets the benefit of the plan.

[youbet]

Quote:

Originally Posted by kevink In the U.S. they'd quickly spend down their assets to nothing leaving no options but a grim Medicaid-eligible nursing home (and of course no inheritance for their kids), while in Mexico the cost for care can be paid for completely using social security alone. https://www.focusonmexico.com/assisted-living-lakeside/

I've also heard that the price of LTC is cheaper in Mexico and some other countries. But your description of the typical USA based couple "quickly spending down their assets to nothing" might not be all that true for the FIRE types here. For example, like DW and I, many have planned to self-insure or have LTCI to cover these issues without having to move far away from family and friends to secure a less expensive situation.

[UnrealizedPotential]

I have read that Ukraine, Belarus, Poland, and Moldova are rather cheap places to retire to. I'm not sure about that. I know Ukraine is rather cheap, although Kiev itself can be expensive if you wanted the best, it can be that way. The rest of the country, is cheaper. But in Ukraine there is the war and the language barrier for those who don't speak Russian in the eastern part of Ukraine and Ukrainian in the western part.
I would think the language would be a huge barrier for most of the English speaking World to move to those countries. But it is still an option for some I suppose willing to go that path. I know some are talented in languages and for those who would have an income stream and could adjust to the culture, some might be able to make a go of it.

[Teacher Terry]

Poland is cheap if you stay out of Warsaw and Kraków. However, outside of the big cities no one speaks English. It’s a beautiful country but long dreary winter with short days. They heat with coal so air quality not good in winter.