Should you move abroad for health care?

The notion that health care outside the United States could be good as well as cheap is a foreign concept to many Americans.

Kathleen Peddicord frequently hears from such skeptics as founder of Live and Invest Overseas, a site for people curious about living abroad. Actual expats, however, tell of quality care at a fraction of U.S. prices. For instance, treatment for a motorbike accident in Panama cost her $20. Emergency dental surgery that might cost $10,000 or more in the United States was $4,500 in Paris.

"The health care in a lot of places around the world is very good, as good as in the United States," said Peddicord, who currently divides her time between Paris and Panama. "Some places, it is better."

RETIREE CONCERNS

Health care is a particular concern for Americans who want to retire before age 65, when Medicare kicks in. Currently, early retirees can buy coverage through the Affordable Care Act, but it's not always truly affordable and its future is uncertain.

Some who would otherwise retire keep working rather than risk being uninsured. But a move abroad could be an option.

Cheaper health care also may appeal to gig-economy workers who aren't tied to stateside jobs. Freelance science writer Erica Rex, for example, recently wrote an opinion column for The New York Times about moving to the United Kingdom and then France after her 2009 cancer diagnosis. "Moving to Europe was a choice weighed against other, grimmer options for health care, which included the strong possibility of being bankrupted by cancer treatment and winding up at the mercy of New York State's welfare system," she wrote.

HEALTH CARE QUALITY VARIES BY DESTINATION

Not all expat havens have great health care systems. Belize, for example, encourages immigration by exempting retirees from most income taxes — but many expats there cross the border to Mexico for health care, Peddicord says.

France, on the other hand, is known for its excellent health care system. International Living and Live and Invest Overseas give the country top marks, along with Mexico, Ecuador and Malaysia. International Living praises Thailand and Costa Rica as well, while Live and Invest Overseas says Portugal, Italy and Malta have admirable health care.

With any country, quality can vary — especially in sparsely populated areas. Murray and his wife, Diane, left their first retirement destination, a small town in Ecuador, after encountering broken equipment and few doctors. They're much happier with the care near their Yucatán Peninsula home, where next-day appointments are the norm and doctors typically trained in the United States or Europe, he says.

"It's like in the U.S. — if you live in Possum Belly, Alabama, and they don't have a hospital and the nearest one is an hour and a half away, the health care isn't going to be the same" as in a major city, Murray says.