FAQs: From Health Care to Crime

Can I live comfortably on Social Security?

In much of Latin America, the answer is yes, especially for couples receiving two Social Security checks. Monthly costs in the region’s less expensive countries, such as Nicaragua and Belize, are typically about $1,500. A smart idea: rent a home before buying one—be sure you like where you live before making a major financial commitment.

In the more developed countries of Europe—and even the pricier parts of Latin America—you may need an additional source of income. You can find low-cost living in the regions we’ve reported on, especially in Spain and Portugal, but you’ll need a minimum of $2,000 a month for frugal comfort in Europe. Some expats insist they live on far less—or far more—but $2,000 is a reasonable figure for people of average means. Books and websites touting a new life abroad for $900 a month aren’t always realistic.

How good is the health care?

Better than you might think. In Latin America you’ll find good-to-excellent private, low-cost care in and around big cities. Mexico has a progressive health care policy, with clinics established in even the smallest villages and first-rate care in cities such as Guadalajara and Mexico City. Panama City has very good health care; in fact, many Americans fly from Miami to Panama City to get inexpensive medical treatment. Even in poor countries such as Nicaragua, competent private care is available in the capital city, Managua, at a fraction of the U.S. cost. Doctors’ visits in these countries can be $30 and drugs are inexpensive, many available without prescription.

In Europe, French medical care is considered the best in the world. You must be a legal resident to be eligible for nonemergency care. If you pay into France’s "social security" and pay French taxes, you get great care for the rest of your life. Italy, Spain, and Portugal also have excellent care and strong national systems. The chief complaint about nationalized health care everywhere is long waits for nonemergency treatment. Private care—common among expats everywhere—is prompt.

Some key things to know about health care abroad:

1) You can't use Medicare.  That can be a deal breaker for some. Expat organizations are lobbying for the use of Medicare in Mexico, though it’s not expected to happen anytime soon. A good percentage of expats in Mexico make regular "Medicare runs" back to the States, so bear that in mind when you choose a locale. (And keep up those Part B payments, folks!)

2) You can join most national health care systems.  They’re subsidized and sophisticated in Europe, basic in Latin America. And while you can’t always find a U.S. insurance policy that covers you abroad, you can get reasonably priced international insurance that will cover you for serious problems. (BUPA, a European-based insurance company, is the most common.)

3) Many doctors speak English.  They are generally available at private hospitals, and many of them have trained in the United States.

4) The hospitals are good.  In Europe, they range from good to superb. In Latin America, as medical tourism increases and more retirees migrate from North America, hospital care is slowly improving. Costa Rica is a major destination for medical tourism, for example, and its hospitals are good. You can check with Joint Commission International, the hospital accreditation agency (www.jointcommissioninternational.org/) for hospitals abroad that meet high standards. (Mexico currently has eight.)