REtiring to a Country with Affordable Health Care

[ShokWaveRider]

Is this even an option? Myself and my DW are VERY partial to warm climates. As you can tell from a previous rant on this subject I/We are very dissappointed with this countries approach to health care for the masses. (We a pro Socialized Medicine, baed on our experiences with a variety of them)

Bearing this in mind, anf the fact that it will not get addressed any time soon, we are considering the possibilities of moving to another country all together. (Just considering mind you, we love the US and this would be a last resort decision) We do not want to spend our retirement years worrying about what if, scenarios, and what it could potentially do to our nest egg.

I have 3 citizenships, UK (EU), US and Canadian. The EU offers socialized medicine, which we prefer from our previous Canadian experinces, but we are not partial to Europe (I lived there for too long and know better).

Anyway, this leaves us a choice of any European country within reason, Canada that is too cold, and some place like Spain that has a suitable climate. We are just undecided as to where would be suitable, as we have not visited all the suitable (Warm) areas and thus have no idea about them.

My personal preference would be the Caribbean but that does not solve the problem.

I/We are curious about other's opinions on this subject.

SWR

 

[Trek]

Works for me (dual US/EU citizen), but I live where it's very cold much of the year. PM me if you want more info about the route I've gone.

 

[barker]

another option you might want to look at is Massachusetts. While not a "warm" climate, they do have near universal coverage via private insurance companies through an exchange. If your income is low, your insurance is subsidized by the state to varying degrees.

I presume you could always be a Mass resident for the warm time of the year, and snowbird to a warmer climate for the winter. Not quite sure how the health coverage works if you are vacationing, but I would assume it would cover you in an out-of-network fashion at least. Anyone from Mass know this part? I'd be interested in it myself.

 

[Meadbh]

Where is the warmest place in Canada?

Would that be the warmest place, year-round?
If so, says Phillips, the winner is Agassiz, B.C., a town of about 5,000 located not far from Abbotsford in the Fraser Valley, where the average year-round afternoon temperature is 11.1 degrees.
"Oh, it's much better here," remarked Agassiz Mayor Lorne Fisher, who originally hails from Saskatchewan. He described the climate of his home province as "the proverbial nine months of winter and three months of poor sleighing."
Still, what most people probably mean by the warmest place in Canada is the warmest place in Canada in winter.
The holder of that distinction is Ucluelet, B.C. Its average afternoon temperature during the months of December, January and February works out to 8.5C.
"We have fabulous winters," said Marny Saunders, general manager of the Ucluelet Chamber of Commerce. "We say it's rare to get snow, and the snow doesn't stick."
They do, however, get snow. This is Canada, after all, not a camel train across the Sahara.
As for golf, it's a year-round enterprise in Ucluelet, population 5,000, whose motto is "Life on the Edge," a reference to the community's location on the southwest coast of Vancouver Island.
Granted, you might find yourself teeing off in what Saunders described as "sideways rain" or "misty, romantic fog."
But it could be worse. You could be in Eureka.

​

The worst places in Canada for winter - thestar.com

 

[Urchina]

Portugal?

 

[mountaintosea]

Mexico for about 300/year. PBS news hour did a segment on it's health care. Facilities looked modern.

 

[Notmuchlonger]

Mexico for about 300/year. PBS news hour did a segment on it's health care. Facilities looked modern.

Already working on my Spanish!

 

[Ed_The_Gypsy]

My research tells me Mexico or Argentina or Ecuador or Chile.

For Mexico, check out Med To Go:
MedToGo, Medical tourism Company In Mexico, Owned and Operated by US Physicians
They are US doctors who have evaluated many popular Mexican cities for health services.

"Mexico Mike" Nelson also offers evaluations of health care in cities in Mexico, sometimes making note that his observations are at odds with MedToGo. See his book, "Live Better South of the Border": Untitled Document

The Kaderlis have their personal insights, too. I think they used to have a page on foreign health care but they have changed their web site.
The Adventurer's Guide to Chapala Living
I bought their e-book on Lake Chapala and their Adventurer's Guide. Good stuff. Gotta get DW down there.

 

[Ed_The_Gypsy]

Would that be the warmest place, year-round?
If so, says Phillips, the winner is Agassiz, B.C., a town of about 5,000 located not far from Abbotsford in the Fraser Valley, where the average year-round afternoon temperature is 11.1 degrees.
"Oh, it's much better here," remarked Agassiz Mayor Lorne Fisher, who originally hails from Saskatchewan. He described the climate of his home province as "the proverbial nine months of winter and three months of poor sleighing."
Still, what most people probably mean by the warmest place in Canada is the warmest place in Canada in winter.
The holder of that distinction is Ucluelet, B.C. Its average afternoon temperature during the months of December, January and February works out to 8.5C.
"We have fabulous winters," said Marny Saunders, general manager of the Ucluelet Chamber of Commerce. "We say it's rare to get snow, and the snow doesn't stick."
They do, however, get snow. This is Canada, after all, not a camel train across the Sahara.
As for golf, it's a year-round enterprise in Ucluelet, population 5,000, whose motto is "Life on the Edge," a reference to the community's location on the southwest coast of Vancouver Island.
Granted, you might find yourself teeing off in what Saunders described as "sideways rain" or "misty, romantic fog."
But it could be worse. You could be in Eureka.

​

The worst places in Canada for winter - thestar.com

Hi, Meadbh,

We went river rafting on the Nelson River in BC. They warned us not to step on the cactuses (!). Sure 'nuf.

There are also scorpions in Alberta.

There are seasonally warm places in Canadistan.

 

[Onward]

Thailand is worth a look too. Warm weather and some very good medical facilities. Here's the lobby of Bumrungrad hospital in Bangkok:

 

[Goonie]

REtiring to a Country with Affordable Health Care

.........The Kaderlis have their personal insights, too. I think they used to have a page on foreign health care but they have changed their web site.
The Adventurer's Guide to Chapala Living
I bought their e-book on Lake Chapala and their Adventurer's Guide. Good stuff. Gotta get DW down there.

I was just pondering this same thing the other day...again. It's a topic that comes to mind every once in a while....especially like this time when a local referendum passed that is going to increase our property taxes yet again...but that's a whole nother ball o' wax. But anyway, I was thinking about it, and was leaning toward somewhere, possibly, in Mexico. Then I too downloaded "The Adventurer's Guide to Chapala Living" and have been perusing it for a couple of days now.

It all sounds interesting, so I'll be keeping my eye on this thread! Thanks for bringing it up, ShokWaveRider!!!

 

[kevink]

We live full-time in the Lake Chapala area of Mexico, driven here in part by the financial crisis (we were coming down for shorter stints in better times, but decided we needed needed to live full-time where we could easily make a lower SWR work in hopes of some recovery in our portfolio).

I've had plenty of experience with medical and dental care here and also talked to lots of other expats and read everything I could. The bottom line is affordable, excellent care is a major reason to be here, and I keep meeting people for whom medical care costs were/are there number one reason for living here.

I would say that Mexico or Thailand would be the best options in answer to this question for most Americans, with the proviso that we're talking about needing to choose an area with a sizable expat population. Not a problem for most gringos, who tend to congregate where there's English-speaking infrastructure, but outside of such enclaves as this area, San Miguel de Allende or the beach resorts (or Bangkok and Chiang Mai if we're talking Thailand) one needs fluent foreign language skills in order to access care - something few of us possess.

For us as U.S. citizens it makes sense to be based down here, pay into the national system for catastrophic coverage, pay out of pocket for routine care (at 10 cents on the dollar or so vs. U.S. prices), then buy travel insurance for the month or two each year we spend in the U.S. during the summer. Canadians, since they have a national health care plan, have a lot more incentive to not be away from home for more than 6 months so as to keep their coverage. My wife and I would like to return to being U.S. based at some point and spend 2-3 months a year down here, but it's out of the question unless there's real reform in the U.S. health insurance system.

 

[Onward]

pay into the national system for catastrophic coverage

kevink, do you qualify for the national system & rates immediately on moving to Mexico, or is there some waiting period?

 

[kumquat]

Would that be the warmest place, year-round?
If so, says Phillips, the winner is Agassiz, B.C., a town of about 5,000 located not far from Abbotsford in the Fraser Valley, where the average year-round afternoon temperature is 11.1 degrees.
"Oh, it's much better here," remarked Agassiz Mayor Lorne Fisher, who originally hails from Saskatchewan. He described the climate of his home province as "the proverbial nine months of winter and three months of poor sleighing."
Still, what most people probably mean by the warmest place in Canada is the warmest place in Canada in winter.
The holder of that distinction is Ucluelet, B.C. Its average afternoon temperature during the months of December, January and February works out to 8.5C.
"We have fabulous winters," said Marny Saunders, general manager of the Ucluelet Chamber of Commerce. "We say it's rare to get snow, and the snow doesn't stick."
They do, however, get snow. This is Canada, after all, not a camel train across the Sahara.
As for golf, it's a year-round enterprise in Ucluelet, population 5,000, whose motto is "Life on the Edge," a reference to the community's location on the southwest coast of Vancouver Island.
Granted, you might find yourself teeing off in what Saunders described as "sideways rain" or "misty, romantic fog."
But it could be worse. You could be in Eureka.

​

The worst places in Canada for winter - thestar.com

Alternatively, one could live in the worst parts:

Welcome to Kenaston, Sask., located midway between Regina and Saskatoon, a community that takes a perverse pride in appalling weather.
For more than 20 years, the town of 300 hardy souls proclaimed itself "The Blizzard Capital of Saskatchewan" and emblazoned the words on a great big sign right beside the huge artificial snowman that still grins out at its surroundings from a loftier height than almost anything else in or around Kenaston, apart from the grain elevators.

or

And don't forget Winnipeg, which continues to hold sway as the world's coldest city with more than 600,000 inhabitants.

Wonder why anyone would live in or near those places?

 

[Calgary_Girl]

Alternatively, one could live in the worst parts:
or
Wonder why anyone would live in or near those places?

Us Canucks refer to Winnipeg as "Winterpeg" for a reason . Visited there once and that was enough for me

 

[kevink]

Onward asked:

kevink, do you qualify for the national system & rates immediately on moving to Mexico, or is there some waiting period?

The answer is that pre-existing conditions are excluded and there is a three year waiting period for full benefits. You get emergency and accident coverage immediately upon enrollment, quite a bit of preventive care coverage in year two, and full coverage after three years.

Most gringos here use IMSS (the national system) strictly as catastrophic coverage and pay out-of-pocket for routine care. At about $300 per year per person for a year's premiums you're paying less than what many up north pay every month for a full year of coverage.

Routine care is excellent (house calls are still common here, with many U.S. trained doctors and excellent facilities) and affording it is hardly a hardship when doctor visits run 150-200 pesos (13 peso to the dollar, at the moment), dental cleaning using state-of-the-art equipment about the same, etc. One of the most refreshing things is you walk into a doctor's office or clinic and the prices for common procedures are on the board right over the receptionist's desk (vs. the U.S. where finding out the real price of anything is essentially impossible and/or likely to result in a heart attack when you do find out).

More impressive is I know of many people here who have dealt with really major medical events, paid out-of-pocket, and while they've taken a financial hit they're still whole, whereas in the U.S. they'd likely be bankrupt. Things like triple-bypass surgery (11K all in), breast cancer treatment over a year (less than 30K) and much else.

The Kaderli's, mentioned earlier in this thread (of retireearlylifestyle.com fame) are friends of ours and our mentors in this area, and they report that as good as Mexico is, Thailand is far better and cheaper. For us the proximity to the U.S. (Thailand is FAR) and much shallower language learning curve make Mexico a better choice, but if you were strictly looking at retirement places on the basis of affordable medical care I think you'd be buying a ticket to Bangkok.

 

[Onward]

Thanks for the info. There's nothing like a first-hand account.

 

[simple girl]

My wife and I would like to return to being U.S. based at some point and spend 2-3 months a year down here, but it's out of the question unless there's real reform in the U.S. health insurance system.

Do you get homesick? I often think about us retiring abroad to save on expenses, but I worry that I would get homesick...we spent one month in Thailand, and while it was absolutely the best travel experience I have ever had, I missed home and was happy to return.

 

[Goonie]

Thanks kevink for all of that info!!! It's definitely appreciated!

 

[kevink]

Sure we get homesick. In the long run, having deep friendships seems to be the biggest factor in determining whether people make it in retirement, regardless of where they live. Clearly that's why most people prefer to "age in place" right where they are.

IMHO this is also the reason why nearly all of the tiny percentage of Americans who do decide to retire overseas usually end up in gringo enclaves where there's a common language and history. In our case for financial reasons we had to choose between small, low-cost and pretty darn boring and conservative small towns in the U.S. and their equivalent in Mexico and have found good friends here with easy access to the U.S. So few people have the gumption to just pick up and move to another country, so those that do tend to be very encouraging of others, outgoing and have much more of a spirit of adventure. We find that refreshing, but also appreciate the great things about the U.S. we used to take for granted.

You can't know how it will work for you until you take the leap and live rather than visit a place, which to me means renting for at least six months. In that amount of time you can start to access true local costs, go through the culture shock, meet some new friends, and see life back home through the eyes of an expat.

Okay this is far removed from the OP's questions. Sorry for hijacking the thread.

 

[Ed_The_Gypsy]

kevink,

As I recall, IMSS has an upper age limit for joining, as do most health insurance companies who offer coverage in Mexico (and elsewhere). I remember 60 or 65 as the top age. Is that correct?

Thanks.

Ed

 

[kevink]

Hi Ed,

No, no age limit for IMSS. Private insurance - to supplement or in lieu of IMSS- is readily available in Mexico as well. I've looked into it and it isn't cheap, but is much cheaper than the U.S. as long as you exclude or limit coverage for the U.S. when traveling (one starts to see just how scary the U.S. system is when shopping for travel insurance - one rate, very high, if you include U.S. cover, another for "worldwide excluding U.S." that's reasonable).

If you're old enough to be eligible for Medicare you do have to make the decision as to whether to continue paying in while living down here just in case you return.

Another big advantage of being here is it is a very family-oriented society where elders are respected. We know any number of people who as they age hire a part-time caretaker from the family of their maid or gardener to either come in each day or even live in a spare room in their house and provide assistance. At 30-40 pesos an hour (~around $3.50) it beats the hell out of a nursing home.

 

[simple girl]

The answer is that pre-existing conditions are excluded and there is a three year waiting period for full benefits. You get emergency and accident coverage immediately upon enrollment, quite a bit of preventive care coverage in year two, and full coverage after three years.

Do you have to live full-time or a certain # of months in Mexico per year to purchase the insurance?

 

[barker]

are the pre-existing conditions covered after the 3 years?

 

[kcowan]

Also in Mexico, the doctors carry cell phones and give you their numbers.

For a USians experience with IMSS, here is an account of two former Californian's: freeeye and his wife rabi (Rick and Sarah)
The Puerto Vallarta Scene Forum • View topic - IMSS info

This might save Kevin some typing.

MRIs and Cat Scans cost $300 and can be had the same day.

Doctors appointments can be had next day if not urgent and cost $30.