Hundreds of thousands of US citizens move abroad every year and become expats or expatriates. They are realizing their dream of living abroad for various reasons. They could be young students who are spending a year abroad, or working person that would like to get the job in a foreign country or start some new business or elderly person who would like to retire abroad for various reasons such as weather or cost of living.
While moving to another country, Americans have a lot of adjust in terms of accommodation, transportation, food, day to day living, shopping and more. Healthcare may not be the first thing on their mind. However, it is important to consider the health care options carefully in case you were to get sick or injured while living abroad.
Many countries offer socialized healthcare. Some people call them "free" healthcare or government healthcare. It is not really free but it is usually paid by the payroll deductions and goods and services taxes (VAT, GST, etc.)
Depending upon the country you will be living, this may vary. Some countries allow only the citizens of their country to participate in socialized healthcare. However, many countries allow all residents to participate as long as they are paying through payroll deductions and/or taxes. In a few countries, even though there is no payroll deduction or special tax, everyone is paying for that through higher income taxes.
The problem with socialized healthcare is that many of the government facilities may be poorly run, with not adequate equipment or doctors and nurses. In some countries, such healthcare quality is so bad that most people, even with reasonable means, would not want to use it and there is no question of expats even thinking of using them.
Even in the countries where socialized healthcare is good, there are often delays for appointments and surgeries, which may sometimes be months or even years.
Therefore, a lot of US expats who live in such country still prefer to purchase expatriate health insurance anyway to allow them the freedom of choosing healthcare facilities, quality and prompt attention.
Additionally, some countries that have universal healthcare system allow only the working expats to enroll in it. They still have to purchase private health insurance for non-working spouse and dependent children.
Inadequate Care and/or Remoteness
Some US expats choose to live in a foreign country due to their relatively lower cost of living or warmer weather throughout the year. However, many of such countries have inadequate healthcare and are usually remotely located. Therefore, in case you run into serious health issues, you may not get quality healthcare locally or the treatment may not even be available. Therefore, it is very important to purchase expat health insurance that provides emergency medical evacuation, which is a transportation to the nearest place where adequate care can be given. Please keep in mind that the remote area that attracted you in the first place, whether it is a beach on the island or mountain, can work against you in such emergencies.
Local Health Insurance
Many US expats may be tempted to purchase a local health insurance from the country where they choose to live in. That can work out to be convenient in some cases. However, they usually have lower policy maximum limits and don't provide important coverages such as emergency medical evacuation and repatriation of remains.
Apart from that, such local health insurance plans don't provide the portability, in case you choose to live in another country or transferred elsewhere. Therefore, you would have to apply for a new health insurance plan all over again and you may run into pre-existing conditions exclusions or waiting period.
Individual Private Medical Insurance
In general, it is advantageous to purchase individual private medical insurance (iPMI) or expatriate health insurance if you are going to live in a foreign country. Several countries, including UAE, Qatar and Turkey require all expats to have private health insurance.