These 5 Countries Provide The Best Health Care In The World

International Living's annual Global Retirement Index reports that France, Uruguay and Malaysia provide the best and most affordable health care in the world. And Mexico!

#5 Mexico

Given the galloping rise in health care costs in the U.S. and elsewhere, Mexico’s affordable and top-notch health care is a huge benefit to living there. Pretty much across the board, health care in Mexico costs a quarter to a half of what you would pay in the U.S. Mexico comes in fifth in the health care category of the InternationalLiving.com annual Global Retirement Index 2014. Medical insurance with Mexico’s national health care service costs less than $300 a year; private insurance will cost more, depending on age and pre-existing conditions—but still a fraction of what you’d pay in the U.S. for similar coverage. Photo: Glynna Prentice,InternationalLiving.com

International Living Presents This Explanation of the Affordable Care Act for Expats

A Doctor Explains: What the Affordable Care Act Means for Expats
By Timothy J. Garrett, MD, MBA

October 1, 2013 saw the beginning of the enrollment period for health coverage under the Affordable Care Act (ACA). Along with the news about glitches with the health care website came lots of questions for expats: Do expats have to enroll? Will there be penalties for expats who do not enroll? Even if expats are not required to enroll, is there a benefit to enrolling?

Here are three things that every expat should know in regards to the ACA:

1. U.S. citizens who are bona fide residents of a foreign country are notrequired to have health insurance as mandated by the ACA.In general, U.S. citizens living outside of the United States for at least 330 days in a given year and who meet the IRS requirements to be a bona fide resident of another country are exempt from the ACA. (You’ll find the full list of requirements for bona fide residence in Form 2555 on the IRS website.)
2. U.S. citizens living outside of the United States but who are not bona fide residents of a foreign country are required to have health insurance or face fines.
   If you:
   a) have told your country of residence that you are not a resident of that country
   and
   b) are not required to pay income tax in your country of residence,
   then you are not a bona fide resident of that country.
   If you don’t meet these stipulations—or any of the other listed IRS requirements—and you do not purchase health insurance, then you could face fines in 2014 of $285 per family (US$95 for individuals)—or 1% of your income, whichever is the greater amount... That amount will rise to a whopping $2,085 per family (US$695 for individuals) or 2.5% of your income by 2016.
   To avoid these fines, it’s in your best interest to purchase at least minimum essential coverage.
   Good news if you are entitled to Medicare, however: Medicare qualifies as minimum essential coverage. If you’re eligible for Medicare, you won’t be at risk of fines.
3. It could make sense for you to have minimum essential coverage under the ACA even if you are a bona fide resident of another country.
   Many expats are fortunate to live in an area with high-quality, affordable, and easily accessible health care. Those who are bona fide residents don’t have to pay for health coverage in the U.S. But even if you are a bona fide resident of a foreign country, having extra cover in the U.S. could help you to secure your own peace of mind.
   If, for any reason, you think that you or your family might have health issues that will require treatment in the United States, it’s worth thinking about purchasing a low-premium/high-deductible U.S. plan that’s coupled with a medical evacuation policy. There are several medical evacuation companies that will provide evacuation from almost any location in the world to the U.S. hospital of your choice for a reasonable membership fee.

Next steps:

The most important things you can do next are to determine whether or not you are a bona fide resident of a foreign country...and then to carefully consider your personal needs and requirements for health care.

Then, if you find you’re required under the ACA to obtain health insurance or that your circumstances make U.S. health insurance a wise choice, the next step is to shop around for the insurance plan or medical evacuation membership that best fits your needs and budget. A trusted insurance advisor who is well versed in the intricacies of the ACA can help you find the exact U.S. coverage you need.

Editor’s note: Now that you know what coverage you require in the USA...it’s time to get your overseas health plan sorted. You’ll have all the tools you need to devise that plan when you discover one comprehensive resource. It’s called the Health Care Roadmap...and it could enable you to save hundreds, thousands or even tens of thousands of dollars on health care every year.

With information on everything you need to know to get top health care overseas, like the types of coverage available in the best retirement destinations worldwide...where to make your health care dollar go further...where to find the best health care in the world—at the lowest prices...and much more, it’s an essential part of your "retire overseas" checklist. You can get it—with a discount—here...until tomorrow at midnight.

Six Lies About Living Abroad

Joanna Rolston at AbroadDreams.com has compiled a list of Six Lies About Living Abroad that include:

Lie #1 Cost of Living: It’s dirt cheap – you will live like a King on almost nothing.

Lie #2 Real-Estate: It’s best to invest in real-estate right away, while it’s cheap.

Take a look at her article and learn about all six.

Will I be safe in Mexico?

Compare Portland's Cost Of Living to Mazatlan

Numbeo has a nice little chart that you can use to compare the city you currently live in to a city in Mexico. I compared Portland, OR to Mazatlan. It's pretty eye-opening for someone not familiar with Mexican prices.

Housing is one of our biggest expenses. Rent Prices in Mazatlan are 72.26% lower than in Portland, OR.

From reading the two previous articles, you can surmise that healthcare is cheaper. Right now Bev is paying $620 a month for healthcare, and she's healthy, or almost $7,500 a year. (We just received a bill for January that reflects a 6% increase over 2011.) In Mexico the cost for Bev's health insurance would be no higher than $300!

Mexico is calling!

Have You Been To Gringo MD?

Gringo MD is a useful service I just came across. GringoMD.com is your community-created resource for healthcare support in Mexico. The recommendations are for gringos, by gringos.

I learned quickly from the Medical in Mexico website that doctors and dentists in Mexico do not enjoy the same income levels that doctors and dentists do in the USA do. Therefore health care is more reasonable for Mexican residents and for foreigners who use medical services in Mexico. To supplement their income, it is not unusual for a doctor to own a pharmacy (Farmacia) as well as practicing medicine. The quality of doctors and dentists in Mexico, as well as most anywhere else, varies considerably. so it is best to consult other expats for their recommendations.

Farmacias in Mexico are everywhere. A downtown area will have one every couple of blocks or so. In some cases, if you don't have a prescription the doctor can write one for you, for a small fee. The pharmacist can often be helpful if you just explain what your situation is.

Now this seems like great advice for travelers to Mexico with pre-existing conditions:

•  Before you go, write up a brief description and history of your condition. Begin with your name, birthdate, your doctor and his contact information, and who to notify in case of emergency. Include a list of medications and dosages that you are taking. Include a list of anything that you are allergic to. Unless your Spanish is very good, I would just write this in English. Get this onto one sheet of paper or less and carry it with you. Give your travelling companions copies. That way, if you do have an emergency, someone can just hand this to the doctor and you don't have to worry so much about communicating all this information during the emergency.
• Also before you go, find out where you might find treatment and how to make contact.
• Find out how to say your condition in Spanish

Here's a good site: Public Health Care System in Mexico (IMSS)

Now go and have fun!

Medicare Pre-Planning For Expats In Mexico

Mexperience has an article in their Mexico Living Blog about an expat named Phil who experienced chest pains and went to a Mexican hospital. He received excellent care, but his plan to go back to the U.S. with his wife Gloria and have Medicare cover the expenses went awry. He was put in intensive care, then a standard room "...but it was clear that between the heart monitor, the IV solutions and the oxygen therapy, Phil was not moving anywhere for a while. He certainly wasn’t in any shape to jump on an international flight back to the USA to use his Medicare benefits."

If they had thought things through more carefully and had the information about the various types of insurance available to expats in Mexico, including various “blended solutions,” Gloria and Phil might have actually been able to take advantage of Medicare while still getting the emergency care that Phil needed in Mexico, and to have had quality, affordable coverage for all of it.

What was missing was information, the kind of information they would have found in The English Speaker’s Guide to Medical Care in Mexico. This helpful book suggests a number of strategies for people like Gloria and Phil.

With some pre-planning, Gloria and Phil might have actually been able to take advantage of Medicare while still getting the emergency care that Phil needed in Mexico, and to have had quality, affordable coverage for all of it.