International Health Insurance: Do You Need It?

Go Naked? (Not Having Health Insurance)

Health insurance to cover you in your new country of residence is one of the most important issues you must address as you plan for your retirement overseas. Bottom line, you have three options: an international policy, a local policy, or no policy at all.

This third option can be more reasonable than it may seem, depending on where you intend to spend your retirement years. In some countries, medical care is so affordable that it can make sense to pay for it as you need it, rather than to insure against it. Most people, though, most places in the world, feel more comfortable knowing that they’re covered in case of medical emergency or, certainly, calamity.

Not everyone is comfortable going naked, as it were.

This means you’ve got to decide whether you want an international policy…or a local, in-country one.

One of the main advantages of an international health insurance policy is that it can cover you under all circumstances anywhere in the world, making it a good option if you intend to travel regularly beyond your chosen overseas retirement haven; if your retire-overseas plan is to move around among two or three countries; or if you, like our Intrepid Correspondents Paul and Vicki Terhorst, intend never to retire anywhere but to roam the world perpetually, discovering and exploring as your wanderlust dictates.

An international policy also can be a good option if you’re an American and intend to divide your time between your chosen overseas haven and the United States, because it can be possible to purchase an international health policy that will also cover you when you return or pass through Stateside.

This is the coverage Lief and I have opted for. Our Bupa policy, based now in Panama, covers us anywhere in the world, including the United States. We’re paying extra for this, as the U.S. is the most expensive place in the world to obtain medical care. Given our lifestyles and travel schedules, though, we decided recently to make this additional investment.

All that said, an international health insurance policy has an important downside: It’s more expensive than a local one. Local medical insurance can cost less than US$100 a month. In some countries, depending on your age, less than US$50 a month.

It’s important, though, that you understand what you’re buying. Policy options, details of coverage, deductibles, and premium costs vary dramatically both country to country and agency to agency within a country.

In addition, local insurance providers accept new policyholders only through a certain age that is typically younger than the cut-off age for an international policy. In other words, depending on the country and your age, a local policy may not be an option. You may have no choice but to invest in a (more expensive) international policy if you want formal health coverage. And, once insured, some companies allow you to renew your policy only until a certain age. Others offer lifetime coverage.

Bottom line, though, if you qualify, in-country insurance options in some of the world’s top overseas retirement havens can be remarkably affordable. In the Dominican Republic, for example, a 60-year-old man could arrange decent health coverage for as little as US$277 per year. That’s US$23 per month. A more comprehensive policy could be had for US$1,062 per year (or US$88.50 per month).

Meantime, Uruguay boasts one of the world’s most affordable in-country options for obtaining medical treatment as a resident here. For around US$50 per month, you can obtain hospital-based coverage through two programs, La Asistencial and Sanatorio Mautone. As a member of either of these programs, you are covered for all in-patient treatment, surgery, emergencies, tests, even after-care in your home.

It’s tremendous coverage and an amazing bargain, especially considering the standard of the care. However, you must understand that this is not health insurance, per se, but a hospital-based program, meaning the coverage does not follow you to any other hospital or medical facility within Uruguay and provides no coverage outside the country.

Kathleen Peddicord

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