Out of the hundreds of emails we get from readers every day, at least a dozen are to do with international health care—how do you access it, how much is insurance, what about age limits, etc.?
In fact, our recent survey shows that 6 in 10 Live And Invest Overseas readers are considering going overseas for medical or dental care due to cost.
Health care in Europe (and overseas in general) is typically a fraction of the cost as in America, and access is usually universal—even for foreign residents.
So ask yourself… what would your retirement look like if health care weren’t something you had to worry about…?
When you move to Europe, you’ll discover that a routine doctor’s visit costs less than dinner out, prescriptions are a fraction of U.S. prices, and health insurance no longer dictates your life…
For Americans used to navigating high costs, complicated insurance, and the fear of an unexpected medical bill, Europe can offer a very different experience.
But “European health care” isn’t one homogenous thing, and figuring out any given system takes a little bit of know-how.
This month’s issue of Europe Uncovered is dedicated to giving you just that…
This is an in-depth guide to health care in five of the most popular countries for Americans abroad—France, Spain, Greece, Italy, and Portugal.
But we go beyond the basics of the simple process—that is, how each system works—and dive into the reality of what it’s like to be an expat seeking medical care in a foreign country.
Five sets of expats who have actually used the systems in each country weigh in on their experiences and how they compared to back home—including insider details on access, quality of care, copays, costs, and comparisons.
They share what surprised them, what worked beautifully, where they ran into frustrations, and what they wish they’d known before they needed care.
Because it’s one thing to read about health care overseas (or ask AI for a summary of a foreign health care system)…
It’s another thing entirely to know what it feels like when you actually need it.
Here’s a few snippets of stories expats have shared with me for this report…
What It’s Really Like
Mary’s France Story
Mary Kisinger moved to Montpellier in the South of France in late 2025. Even though she hasn’t even celebrated her one-year anniversary, she’s already had plenty of experience with the local health care system…
“In April I had an unexpected trip to the ER in France.
“I did not yet have my Carte Vitale (French health card), which meant I would pay for this emergency visit from my own pocket. I was very worried about the cost.
“No payment was required that night at the hospital, so I was still dreading that bill.
“Two weeks later I received that dreaded bill… for 257 euros for all the medical services, including the two scans, hospital-administered pain meds, and doctor’s consultation.
“I literally laughed out loud! My previous U.S. hospital procedure was a colonoscopy (granted, not exactly comparable, but the only thing I have to compare), and my bill, with Medicare, was $14,000! I did not add an extra zero to that amount.
“I’ll take the French system any day over the U.S.!”
Micah’s Spain Story
“For our specific visas to live in Spain, we were required to purchase private insurance. Private insurance! Oh no! In the U.S. insurance is crazy expensive, but as it turns out, that is not the case in Spain. For a family of four, for an entire year, the bill was about $2,800, or to put that in terms of American health care, about 2.5 months of what it would cost us through my wife’s employer.
“But there’s more! Or rather, there’s no more! Whereas in the U.S. you are still on the hook for co-pays, deductibles, and the like, in Spain, for the most part, our plan required very little additional out-of-pocket expenses.
“Here’s a specific example—our son needed to have ear surgery. We decided to have this done in Spain, and we spent exactly zero dollars on the procedure, which included pre- and follow-up appointments as well as a one-day hospital stay.
“The fact that we don’t have to pay any out-of-pocket costs to go see a doctor has made decisions to seek medical care much easier—we never have to weigh up whether we need treatment or if we should just try to “tough it out”—an occurrence that takes place far too often in the U.S., often with tragic results. Medicines are reasonably priced as well, most prescriptions we’ve had to fill have rarely if ever cost more than $20 if that.”
Su’s Italy Story
“If there is a fee for a service, it’s usually under 50 euros. You pay a ticket sanitario, which is a bit like a co-pay, but ultimately it is far less than the full price of the service. Many prescription drugs are free; others are heavily subsidized.
“The maximum expats pay is 2,788.87 euros per year currently.
“I have my general practitionerthrough the SSN system, so I don’t pay for visits. She’s also fairly responsive via WhatsApp, which is surprising to me, since no American doctor was ever reachable without an appointment! If I need a prescription without it being necessary to have a visit, I just text her, and she sends me the prescription.
“For appointments that are more urgent than the Italian health system can accommodate, I go to a private facility and pay out of pocket. I’ve done this for various imaging services, and I pay to see my gynecologist; otherwise, I’d end up seeing a different doctor every visit.
“Even paying out of pocket is so much more affordable than the private health care I was paying for in the U.S. as a freelancer.”
Joch’s Portugal Story
“Sleepless nights. Many sleepless nights.
“Anxiety about the costs of quality health care led to sleepless nights as I approached 70. Jeff and I lived in northern California. I feared I could not afford to stop working. If a catastrophic health issue arrived, would escalating costs bankrupt us?
“We did some research and decided a move to Portugal was the answer to our problems.
“Portugal’s health system is ranked the 9th best in Europe and 12th in the world.
Portugal’s hospital network offers modern, well-equipped units, and at least 90% of all doctors are English-speaking. Specialty consultations at a public hospital will cost you about 8 euros and emergencies about 20 euros.
“In 2019 residing in California, Jeff and I paid over $12,000 a year for health insurance (salary deductions plus co-pays). I’m told that figure today can reach $19,000 a year for an individual. Our Portuguese private medical insurance is less than $1,000 a year.
“Yes—we reduced our health care costs by 92%!
“My private health insurance this year is 32 euros per month. Specialty consultations are at least 50% covered by insurance, meaning you pay less than half the total cost of the appointment. For example, an average specialty consultation costs about 80 euros; with insurance you pay only 35 euros.”
Jackie’s Greece Story
“I watched images on the monitor of my husband’s beating heart while the cardiologist completed the exam using modern computerized equipment. It was nearly 7 p.m., evening to our way of thinking, afternoon as it is considered in Greece.
“Back in Washington State, from where we hail, an appointment this late in the day would have constituted an emergency, but here regular office hours can run until 10 p.m.
“And America’s privacy laws would have certainly kept me in the waiting room, unlike here where it is expected that family members who accompany patients to appointments will sit in on them as well.
“There’s no doubt about it; our Greek health care has been different from that which we’ve experienced in the States.
“It is less expensive.
“More thorough.
“More expedient.
“Personalized and caring.
“Joel’s cardiology checkup was a prerequisite for his cataract surgery the following week. Such an exam is generally required prior to medical procedures (cataract surgeries, knee and hip replacements, for example) that might involve an anesthetic.
“This appointment included a dual blood pressure test, EKG, and an ultrasound of the heart, all of which took the better part of an hour. It was all conducted by the doctor and the cost was 70 euros (about $80).
“Joel’s recent cataract surgeries were performed a week apart in a recently opened eye surgery center in Kalamata. The cost of two surgeries was 2,500 euros, and includes three follow up visits—the final one six months from now. My eye exam was 50 euros.”
Bonne route,
