Ben, this is absolutely amazing information for anyone from abroad. I wish I'd had this when I lived in Japan. Even now, that I found it really helpful for some people living in the UK as it reminds me why I'm on a dual-track programme for healthcare. Thank you for this excellent work.
Thanks Sam, really appreciate this! And for UK, delighted to hear that you’re on the Dual-Track, I think with the NHS in place over there, it’s the most logical solution (for ppl who are younger than 50 at least).
This is genuinely one of the clearest frameworks I’ve seen on this, Ben.
Framing it as a strategy instead of a country ranking is the unlock — especially the eligibility gap and age-related traps that people only discover once it’s too late. The Dual-Track explanation, in particular, feels like required reading for anyone 50+ thinking long-term.
Bookmarking this and sending it to at least three friends who are still stuck on “but France is #1, right?”
Thank you for this well-structured, logical analysis. As a permanent foreign resident visa holder in Japan in my fifties, I now have a greater appreciation for the benefits of publicly funded health insurance. A bout with a severe case of cellulitis solidified my respect for the system. You might be interested in my firsthand account of the experience: https://open.substack.com/pub/realgaijin/p/brush-with-disaster-during-the-tail
Thanks Mark (I mean "Gaijin") 😁 Yes access to public healthcare after a certain age is very beneficial, as private insurers repeadetly try to weasle their way out of obligations. Ideally you have both!
You can enroll in IMSS (public) voluntarily if you have residency, but most expats go private. The public system excludes several pre-existing conditions entirely, wait times favor employed members over voluntary enrollees, and everything operates in Spanish only.
Private care in Mexico runs 50-70% less than the US. Many expats just pay cash for routine and carry private insurance for anything major.
If you're staying long-term with residency, you could do IMSS + private (Dual-Track). But private is really your foundation here, not public.
This is a great analysis. It’s more of a healthcare web than a single solution that one needs to set up. Much like you described for financial matters, the goal being to have options for different scenarios for acute or chronic care.
For us as retirees in Costa Rica, it’s the public + cash option, knowing that cash prices here for healthcare are far less than they would be in the US & the quality of care is high. In addition, at least for now, we have the fallback of Medicare in the US, if the travel expenses of returning there are less than the cash cost for treatment in CR.
Thanks guys! Yep, for Costa Rica the Public + Cash option makes a lot of sense. I use the Private + Cash in Thailand, which (at my age) probably comes out as cheap as other Public + Cash paths.
And for the Medicare part, very important mention from you. I will most likely create a comprehensive guide covering healthcare + Medicare as a whole.
Thank you Ben! The public private combo makes so much sense when you describe it. I've had friends say "the health care system in Europe doesn't work because they all have extra private policies" but now I see why people choose to extend their policy with private care. It's a bit daunting to think about finding a private insurer to fill the gap esp as my husband ages... look forward to hearing about how to do that!! 🤞😉🤞
Very welcome dear! It’s actually less complicated to think in systems (or in this case strategies) than looking at the individual policy in a single country and trying to make sense of it 😎 And for „filling the gap“ I will create a comprehensive healthcare guide at some point!
Ben, this is absolutely amazing information for anyone from abroad. I wish I'd had this when I lived in Japan. Even now, that I found it really helpful for some people living in the UK as it reminds me why I'm on a dual-track programme for healthcare. Thank you for this excellent work.
Thanks Sam, really appreciate this! And for UK, delighted to hear that you’re on the Dual-Track, I think with the NHS in place over there, it’s the most logical solution (for ppl who are younger than 50 at least).
Phew, I just about squeeze in then. 😅
Well, judging from your photo, I was assuming late 30s (like me) 😂
Hah. Not far off TBF! 😅
Ben - I can't thank you enough for this information. We will definitely use this information. Your Retire group is a lifesaver. Thanks again!
You‘re very welcome Rhetta, so glad this helps!
This is genuinely one of the clearest frameworks I’ve seen on this, Ben.
Framing it as a strategy instead of a country ranking is the unlock — especially the eligibility gap and age-related traps that people only discover once it’s too late. The Dual-Track explanation, in particular, feels like required reading for anyone 50+ thinking long-term.
Bookmarking this and sending it to at least three friends who are still stuck on “but France is #1, right?”
Thank you! 😍 Sure, absolutely! Might also want to tell them not to go to France (joking) ;)
Thank you for this well-structured, logical analysis. As a permanent foreign resident visa holder in Japan in my fifties, I now have a greater appreciation for the benefits of publicly funded health insurance. A bout with a severe case of cellulitis solidified my respect for the system. You might be interested in my firsthand account of the experience: https://open.substack.com/pub/realgaijin/p/brush-with-disaster-during-the-tail
Thanks Mark (I mean "Gaijin") 😁 Yes access to public healthcare after a certain age is very beneficial, as private insurers repeadetly try to weasle their way out of obligations. Ideally you have both!
Any advice re Mexico?
Mexico = Strategy 2 (Private-Primary).
You can enroll in IMSS (public) voluntarily if you have residency, but most expats go private. The public system excludes several pre-existing conditions entirely, wait times favor employed members over voluntary enrollees, and everything operates in Spanish only.
Private care in Mexico runs 50-70% less than the US. Many expats just pay cash for routine and carry private insurance for anything major.
If you're staying long-term with residency, you could do IMSS + private (Dual-Track). But private is really your foundation here, not public.
Thank you!!
This is a great analysis. It’s more of a healthcare web than a single solution that one needs to set up. Much like you described for financial matters, the goal being to have options for different scenarios for acute or chronic care.
For us as retirees in Costa Rica, it’s the public + cash option, knowing that cash prices here for healthcare are far less than they would be in the US & the quality of care is high. In addition, at least for now, we have the fallback of Medicare in the US, if the travel expenses of returning there are less than the cash cost for treatment in CR.
Thanks guys! Yep, for Costa Rica the Public + Cash option makes a lot of sense. I use the Private + Cash in Thailand, which (at my age) probably comes out as cheap as other Public + Cash paths.
And for the Medicare part, very important mention from you. I will most likely create a comprehensive guide covering healthcare + Medicare as a whole.
Thank you Ben! The public private combo makes so much sense when you describe it. I've had friends say "the health care system in Europe doesn't work because they all have extra private policies" but now I see why people choose to extend their policy with private care. It's a bit daunting to think about finding a private insurer to fill the gap esp as my husband ages... look forward to hearing about how to do that!! 🤞😉🤞
Very welcome dear! It’s actually less complicated to think in systems (or in this case strategies) than looking at the individual policy in a single country and trying to make sense of it 😎 And for „filling the gap“ I will create a comprehensive healthcare guide at some point!