The ACA Repeal “Exit Plan”: Expats Save up to 80% on Healthcare Costs Overseas—

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Uncertainty over what, if anything, will replace the Affordable Care Act, should it be repealed, has left many U.S. citizens worried about how they’ll afford insurance premiums, medications, and procedures. A new, detailed report from the editors at, however, reveals what could be a life- and budget-saving “Exit Plan” for retirees—the top 3 healthcare havens overseas where expats can access high-quality healthcare for as much as 80% less than it costs in the U.S.

Panama City, Panama

A retiree in the U.S. who is worried about how to afford insurance and medical-care expenses on top of all the day-to-day costs of living—food, housing, entertainment—would do well to explore the many affordable options that exist overseas today.

Uncertainty over the future of the Affordable Care Act has led Americans around the country to stock up on medications they fear they won’t be able to afford, should they lose their health insurance in a repeal of the ACA. Senior citizens who have paid less for Medicare coverage and for their prescription drugs under the ACA are worried today—with reason—that their costs could go up.

But one group of American retirees is largely unconcerned about the price of prescription drugs, medical treatments, and access to care. In fact, some opt to go without insurance altogether.

That’s because they’ve retired overseas to one of the world's healthcare havens—where costs are low and care is excellent.

“One of the reasons good-value retirement havens abroad offer such good value is because they’re places where the healthcare is both top-notch and extremely affordable, when you compare it to comparable treatment in the United States,” says Jennifer Stevens, executive editor of International Living.

“In places like Costa Rica, Panama, and Mexico, for instance, it’s not unusual for physicians to have trained in the U.S. or in Europe and to speak English. You’ll find in these countries facilities that are every bit as modern and up-to-date as those you find in the States. And so you can access the same level of care you expect at home... but for pennies on the dollar,” Stevens says.

“A retiree in the U.S. who is worried about how to afford insurance and medical-care expenses on top of all the day-to-day costs of living—food, housing, entertainment—would do well to explore the many affordable options that exist overseas today. In the right places, it’s possible to lower your cost of living significantly, while you improve your quality of life—and live a more healthy lifestyle, to boot.”

When expat Jim Santos and his wife Rita decided to move to a sunny beach town in South America, they chose to pay as needed for any healthcare necessities.

“We are in reasonably good health (and getting better thanks to the healthy local food and climate here) and the cost for care even at the best hospitals and clinics is a fraction of what it is in the States,” Santos says. “This gives us complete freedom in our choices of doctors. As well as being pleased with both the doctors and facilities, financially this has worked out very well for us.”

The report from notes, as well, that U.S. citizens don't have to actually live full-time in healthcare havens abroad to take advantage of low-priced, high-quality medical care. They can join the hundreds of thousands of U.S. citizens who take “medical vacations” to these countries each year to save money on treatment.

Here are three of the most popular places in the world for American retirees seeking access to world-class healthcare at a fraction of what it costs in the United States.

Costa Rica

Thanks to the widespread availability of high-quality, but bargain-priced, medical care from well-qualified providers in state-of-the-art facilities, Costa Rica has emerged over the last several years as a premier destination for Americans seeking low-cost medical treatment.

While some U.S. insurance carriers won’t cover costs in Costa Rica unless it’s an emergency, many expats find that private insurance here is very reasonable. John and Lori Jowett have recently gotten their insurance through Blue Cross of Costa Rica. “For a premium of $462 per month, we have better coverage than we had in Florida, and at half the cost,” they say.

And Costa Rica is finding new ways to help lower healthcare costs.

“I recently discovered a program called MediSmart,” says International Living correspondent John Michael Arthur, who lives in Costa Rica’s Central Valley. “It works with Hospital Metropolitano, one of San José’s private hospitals. Essentially, a couple can get deeply discounted medical services at Metropolitano by paying a $17-a-month ‘retainer.’”

While normal office visits may run $40 to $50 (still a bargain, at one-third the U.S. cost), they’re reduced to $14 to $18 by paying the retainer, Arthur explains.

As a medical tourist, even factoring in travel costs, treatment in Costa Rica is usually much cheaper than it would be in the U.S.

It’s estimated that patients save between 25% and 80% on care, depending on the procedure. For example, an angioplasty that would cost close to $60,000 in the U.S. is $9,000 in Costa Rica.


Panama is the most sophisticated and technologically advanced country in Central America—and quality healthcare facilities are a function of that. Panama’s hospitals, clinics, and laboratories are clean and modern and compare favorably with their counterparts in just about every country in the world. In particular, Panama City’s major hospitals have garnered excellent reputations.

Private health insurance in Panama is much less expensive than in the U.S., in large part because doctor’s fees and hospital visits are much cheaper.

“Prices for prescription drugs can be low, too, because many manufacturers price them for the local market,” says International Living Panama editor, Jessica Ramesch. “Plus, some drugs that require a prescription elsewhere are available over the counter in Panama…which means you don’t need to pay to see a doctor and get a new prescription every time you want to buy them.

“If you do take medication regularly, check to make sure it is available in Panama. A great deal of U.S. and European medications are available here, from Lipitor to Claritin to their generic counterparts,” Ramesch says.

At Punta Pacífica—known as Panama’s most expensive facility—a consult with a general M.D. costs approximately $50, while a specialist consult is around $70. (With insurance, co-pays can be as low as $10 and $17, respectively). There are local clinics all over Panama, where treatments cost much less.

When expats Clyde and Terry Coles decided to retire early and move overseas, they chose Panama. “With low medical costs top of our list, Panama had just what we were looking for,” Terry says.

While the couple pay out of pocket for medical expenses, they do have a local health insurance plan. “We pay $270 per month for the two of us and the policy has a yearly $250 deductible. Prices vary by policy, coverage, and age just as they would anywhere else. Since we never meet our deductible the policy serves as a safety net just in case we needed hospitalization,” Terry says.


In general, healthcare in Mexico is very good—and in many places it is excellent. Most doctors and dentists in Mexico receive at least part of their training in the U.S. (And many U.S. doctors have trained in Mexico, notably in Guadalajara.) Many of them continue to go to the U.S. or Europe for on-going training.

Every mid-size to large city in Mexico has at least one first-rate hospital. And a big plus is that the cost of healthcare in Mexico is generally half or less than what it is in the U.S. The same goes for prescription drugs.

On average, a visit to a doctor—specialists included—will cost $17.50 to $30. A house call will cost about the same.

Lab tests will cost about a third of what they cost 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 costs around $100. A visit to a dentist for cleaning costs about $17.50 to $25.

“In Mexico, you’ll have two routes for healthcare: private and public,” says International Living Mexico editor, Glynna Prentice. “And you don’t have to choose just one: Just as many Mexicans do, expats can mix and match these services, depending on your healthcare needs at the time.”

Most medications in Mexico are available over the counter and cost less than back home. “You’ll find all the common brand-name prescription drugs here, at lower prices,” Prentice says. “They generally cost 25% to 50% of what you’d pay north of the border. Generics are available for many off-patent drugs, as well.”

The complete story on the top three healthcare havens abroad can be found at: Seeking Access To World Class Healthcare? Check Out These Three Countries.

Editor’s Note: Members of the media have permission to reproduce the article linked above once credit is given to

To learn more, please contact Associate Editor, Carol Barron, (772) 678 – 0287, CBarron(at)internationalliving(dot)com.

For 36 years, has been the leading authority for anyone looking for global retirement or relocation opportunities. Through its monthly magazine and related e-letters, extensive website, podcasts, online bookstore, and events held around the world, provides information and services to help its readers live better, travel farther, have more fun, save more money, and find better business opportunities when they expand their world beyond their own shores. has more than 200 correspondents traveling the globe, investigating the best opportunities for travel, retirement, real estate, and investment.

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