Investing for Survival

Health Insurance: The Options

By Glynna Prentice

If you plan to use private health care, it’s always a good idea to have health insurance. Even when health-care costs are low, as they are in the countries we cover here, a major illness or surgery can quickly run to thousands of dollars. Health-insurance companies everywhere share a few things in common: They tend to exclude pre-existing conditions, and they tend to have an age limit (usually 65) for issuing new policies.

A few companies issue new policies up to age 75. And any company that accepts pre-existing conditions builds that risk into the premium you pay. For these reasons, always first check whether your existing U.S. insurance plan covers treatment abroad. If it does, consider maintaining it. And remember that neither U.S. Medicare nor Canadian national health insurance covers you abroad.

Here Are Your Other Options:

International health insurance: These plans are truly global, covering you any place in the world. Some companies also offer a semi-global option, excluding certain high-priced countries in exchange for a lower premium. When this option is offered, the U.S. and Canada are always on the excluded list. You may want an international plan if you travel for long periods to several different countries, or if you live in a small country with limited health-care options and will need to go elsewhere for care. Premiums vary, but for a healthy, 60-ish individual, expect to pay roughly $3,000 to $5,000 a year.

National, in-country health insurance: These plans, offered by national or regional insurance companies, provide in-depth coverage in a given country. If you plan to spend most of your time abroad in a single country, a national plan can be a good option. Ask whether the plan includes a travel-insurance component to cover health emergencies when visiting other countries— such as vacations back in the U.S. or Canada. Premiums in Latin America generally run 10% to 35% less than international plans, while in Asia they can cost $1,000 a year or less.

Hospital membership plans: Top hospitals in some countries—notably Costa Rica, Panama, and Uruguay—offer membership plans that provide steep discounts on services at their facilities, including hospitals stays, doctors’ visits, and prescriptions. While not strictly insurance, these plans serve many of the same purposes. Monthly fees generally run $25 to $75 per month per person.