There can be a great difference between different countries in terms of health standards, statutory care and emergency treatment. There can also be major differences in waiting times, cost, and access available to expats.
Before you go
Depending on the country that you have chosen for your retirement there are likely to be some health risks that you may have not faced in the past. Indeed these should be part of your research prior to your move in deciding where to retire. The World Health Organization is a good source for information on any health risks associated with your new country.
It is worth having a medical check-up before you move to check whether there are any specific issues that you should consider. This also gives an opportunity to find out if there are mandatory or recommended vaccinations for the country you are moving to and whether there are any specific medical issues you may encounter in that country. You should also ask for a copy of your medical records as one of the first things that your Doctor in the new country will need if something goes wrong is your medical history.
If you are on any prescription medication you should make sure you have a supply to get you through the initial period before you are able to register with a Doctor in your new home. You should take a copy of the prescription with you as it may be needed at Customs or airport security. There are also some prescription drugs that many be illegal in some countries and so you should make sure that you will not be committing an offence by taking the medication with you. Your regular medication may also be marketed under a different brand name in another country, so it is worth finding out about different brand names.
Most people retire in countries where the climate is a factor in the decision. You need to be sure that you learn how to avoid problems from higher temperatures and greater exposure to the sun. Respiratory illnesses are a common problem for those moving to a new country as the body gets used to dealing with new temperatures.
Am I able to use the public healthcare system?
The first issue will be to establish whether as a foreign resident you can access the public healthcare system and on what terms. Spain, Italy, Malta, Canada and New Zealand have comparable healthcare services to the NHS. Other countries often chosen by people planning to retire abroad, including France, Cyprus and Australia, also have an excellent healthcare system, but you may be required to pay a percentage of the costs for any medical care received. In these countries, top-up insurance cover may be required.
Are there any age restrictions to health insurance?
Some health insurance companies have a maximum age limit for new policyholders whereas other companies allow you to take out cover at any age. The maximum age limit, if there is one, is typically set somewhere between 65 and 80 years of age. As life expectancy has improved and with people remaining fit and healthy longer, many companies have removed the upper age limit.
Of course, your private medical insurance is likely to cost you a little bit more if you are older, although you can sometimes find policies where the premium will remain flat if you enrol in the policy before you reach a certain age depending on the coverage you want. Health insurance do not increase premiums based on your claims record as is seen in car insurance. The price does however move to take account of the higher risk that someone who is 70 will develop a serious chronic condition than someone who is 21. If you shop around you should be able to find suitable cover either from an international health insurance company or from a health insurance company in the country you are moving to.
Health insurance premiums do not increase if you have to claim, but if you move to a new insurer you may have problems with pre-existing conditions and so it is well worth trying to find a policy that will be good for you as you get older or if you are likely to move to a different country so that you do not need to change insurer later.
You should also consider what cover will be best for you. If you are retiring to one country and do not expect to change to a different country or travel extensively, a local policy may meet your needs. International plans give you worldwide coverage under a single policy. This gives you the freedom to choose where you receive your healthcare treatment; enabling you to access any doctor or hospital anywhere in the world. This prevents you being reliant on the quality of healthcare locally and will allow you to move to a new location, without having to obtain new coverage, in the event that a new opportunity arises elsewhere abroad.
Care Options Abroad
When retiring abroad it is vital that consideration is given to the likelihood that at some point in the future there will be a need for some form of assistance as your health declines and there is also the likelihood at some stage that long term residential care will be required. Indeed, having moved abroad away from family the likelihood of this being needed will increase.
Since the UK Government does not have any reciprocal arrangements to cover overseas residential care for Brits living abroad – or any residential nursing care – you may not therefore be able to rely on the state in many countries to provide you with options. In France the care options are advanced and if you pass a residence test and fall below an income threshold you may qualify for a payment called the APA to help cover the costs of support and care. In Spain and Portugal there is a tradition of the elderly being cared for by the family and there is a legal obligation on adult offspring to provide care for their parents.
You need to be confident that you will have funds to cover this care when it is needed. As the provision of private care varies significantly from one country to another you should establish what the options are likely to be before making the move.
If you decide to return home to take advantage of the options available in the UK, you will need to recognise that you will have to qualify as ‘ordinarily resident’ in the UK, which requires that you are returning permanently to the UK. During this transitional period before you have proved that you are entitled to state support you will need to be able to cover the costs of any care required. The level of support available from your network of family and friends may also be impacted by a prolonged period living abroad.