What You Should Know About Overseas Medical Care

Wednesday, February 03, 2010

Dear Reader,

My husband had a heart attack at the age of 47. A surprise. He was (and is) in good shape and eats a healthy diet.

So I know about health surprises…the unexpected crisis. Needless to say, top-quality health care was a major factor in my own choice of an overseas destination.

In our continuing series on critical factors for choosing an overseas home, this week’s look is at health care.

Many expats move abroad specifically to obtain affordable health care. But many others don’t consider medical care a priority when deciding on a second-home destination. I’ve spoken with many readers at conferences who had considered everything else, from living costs to climate, but not medical care. In some cases, these people had already had strokes or heart attacks, or even needed regular specialized medical care.

Country to country, medical care varies widely. You need to investigate the quality of care in the country you are interested in, and pay particular attention to the facilities in the area where you propose to live, and how accessible they are. If there is a hospital close by, check that there is good road access…what looks like a 15-minute drive could take more than an hour if the road surface is poor, and it may be impassable if the road floods in rainy season.

Medical care abroad, in some senses, is similar to what you’ll find back home. In large cities, you find the bigger, better hospitals, the specialty clinics, and the highly trained surgeons and diagnosticians. Outside large cities, medical care is on a smaller scale, less specialized, and frequently without emergency or ambulance service.

Most countries offer both public and private medical care, with private health care the better of the two…better quality, with shorter wait times. Private coverage is generally much more affordable than back home.

In Costa Rica, a new immigration law comes into force on March 1, stipulating that all residents must register with, and pay into, the Costa Rica Social Security Health Insurance scheme. It’s a government scheme. It covers pre-existing conditions, doctor and hospital visits, and medications. Of course, like most public health systems, there are queues. The cost, however, is only around $50 monthly per resident. To hear more on healthcare in Costa Rica, click here.

Sometimes it’s possible to find a modern hospital outside a country’s capital city. Costa Rica’s Southern Zone has a new, modern 85,000 square foot hospital, opened in April 2008. The hospital has a state-of-the-art emergency room, a pediatrics wing, a neurology center and an obstetrics center. The hospital is out of proportion to the area right now…this part of Costa Rica is not densely populated. Plans are afoot for a new international airport here. The government has already chosen the site and allocated funds. Eventually, the plan is to have a runway capable of accommodating even the world’s largest passenger planes. An airport of this scale needs to be close to a modern hospital…which is why they built one. If you’d like to explore this region, with someone else picking up some of the tab, click here.

For first-rate, affordable medical care, my choice is Panama City. Panama City has modern hospitals and numerous clinics. Many doctors trained in the US, and can speak English. What sets Panama apart is the Johns Hopkins affiliated hospital in Punta Pacifica. It’s the only Johns Hopkins hospital in the region. Medical care here is excellent. The hospital currently offers treatments unavailable in the US (as they are not FDA approved).

Medical treatment costs less here, too. A specialist visit will set you back around $35, a doctor’s visit $25. Prescription medication is priced for the local market, so it usually costs less than back home—and many “prescription-only” medications can be bought over the counter in Panama.

And the cost of complex treatments is also low.

A gastric bypass that can cost $25,000 in the US will set you back around $15,000 in Panama. You can save on lens implants for your eyes—$5000 for both eyes in Panama, rather than the $10,000 you’ll pay in the US. For that reason, a medical tourism industry is springing up, servicing Americans and Canadians who can’t afford treatment back home.

There are a couple of important points regarding medical insurance abroad. One is that medical insurers will often have an upper age limit for acceptance, which can be between 60 and 65. The other is that many countries (and international policies) do not cover pre-existing conditions. Notable exceptions are Costa Rica (mentioned above) and Uruguay. This pre-existing condition exclusion may even apply to common, treatable conditions such as diabetes.

So before making the final choice of your new home abroad, be sure to check into your home-country’s insurance coverage and your new country’s insurance availability…especially with respect to pre-existing conditions and age limits. Also check the quality of nearby facilities, and how long it takes to get there.

But once you land overseas, it’s likely that you’ll enjoy top-quality health care at affordable prices.

Margaret Summerfield

PS: Medicare is not valid outside the US. However, there is an ongoing lobby trying to make it valid in Mexico. This would be a huge benefit to anyone spending significant amounts of time in Mexico, saving many journeys back home for medical care.