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Key Takeaways
- Rising U.S. health care costs are driving more Americans to look abroad for treatment and long-term care options.
- France, Portugal, Spain, Costa Rica, and Panama all offer high-quality health care that expats say rivals U.S. care, but at a fraction of the cost.
- Private health care is affordable and widely available in these countries, while residents can also access low-cost public systems.
Why More Americans Are Looking Outside the U.S. for Health Care
High health care costs, coverage gaps, and long wait times are pushing many Americans to delay care or skip treatment altogether. Nearly half of U.S. adults worry they won’t be able to afford essential health care in 2026, according to a West Health-Gallup poll—and many expect the situation to get worse.
For some, the solution isn’t a new health insurance plan but a new country. In many places abroad, patients can get high-quality care for far less money, with clearer pricing and faster access. That’s driving more Americans to seek treatment overseas or even relocate, especially retirees who need frequent care and have more freedom to choose where they live.
Why This Matters
If you can’t afford healthcare in the U.S., you still have options. Many other countries offer high-quality treatment at far lower costs—and in some cases, you don’t even have to move there to benefit.
How International Living Chose the Best Health Care Systems for Expats in 2026
As interest in affordable health care abroad grows, so do rankings comparing countries on quality, access, and price. One widely followed source is International Living, a magazine and website focused on living and retiring overseas.
What sets International Living apart is that its health care rankings are based on input from expats who actually live in each country. Stringent criteria is another key factor. To make the list, health care systems must be affordable, high quality, easy to access, and welcoming to English-speaking patients.
“These countries don’t just offer cheap health care—they deliver peace of mind,” says Jennifer Stevens, executive editor of International Living. “You can walk into a clean, modern facility and see an English-speaking doctor for less than the cost of a lunch out in the States.”
You Don’t Have to Move Abroad Full-Time
You don’t need to relocate permanently to benefit from health care abroad. In many countries, private care is available to nonresidents, and some public systems are accessible if you maintain legal residency.
5 Countries Where Expats Get World-Class Health Care Without U.S.-Level Costs
France
In France, expats can access world-class health care at a fraction of U.S. costs—and in some cases, pay almost nothing. After three months of residency, you’re eligible for the national Social Security-funded system, which keeps out-of-pocket expenses extremely low. Affordable private care is widely available too, and English-speaking doctors are easy to find using apps like Doctolib.
Portugal
In Portugal, some expats say the biggest difference is how seriously doctors take their concerns, often at far lower costs than in the U.S. Expat Kimberly Anne says providers listened carefully, scheduled tests quickly, and addressed issues she had been requesting for years in the U.S. Affordable prices, short wait times, and English-speaking doctors who communicate clearly are common, especially in larger cities.
Spain
In Spain, expats can get comprehensive private healthcare for surprisingly low monthly costs, often without copays. Expat Cepee Tabibian says private insurance runs about $75 a month and covers nearly everything—plus, there’s reasonable wait times. English-speaking doctors are widely available, particularly in major cities and expat hubs like Madrid, Barcelona, Malaga, and the Costa del Sol.
How Health Care Works in Most of Europe
In many European countries, legal residents can access a tax-funded public health care system at little or no cost. Private health care is also widely available, offering faster appointments, specialist access, and exams without a referral.
Panama
Panama offers modern hospitals and specialist visits at prices far below what many expats paid in the U.S. Jess Ramesch says she no longer feels tied to jobs for health coverage and can access better care without feeling anxious about the cost. She says doctors seem to spend more time with patients and they’re reachable on WhatsApp. Plus, they frequently train abroad and work in highly respected hospitals, some affiliated with institutions like the Cleveland Clinic.
Costa Rica
Costa Rica combines a comprehensive public health care system with affordable private options that give expats fast access to modern care. Public coverage is available for a monthly fee based on income, while private doctor visits typically cost $60 to $100. International Living notes both systems continue to improve while costing about a third of U.S. prices. Medications are often far cheaper, as well.
What Makes These Healthcare Systems Work So Well for Expats
These five countries show that when it comes to health care, cost isn’t directly correlated with quality. Across the board, expats have found affordable care with transparent pricing and modern facilities. What’s more, doctors seem to spend more time with patients and communicate clearly.
Just as important, health care in these countries is accessible to foreigners. English-speaking doctors are widely available. Many systems welcome nonresidents, which is leading expats to visit or even move abroad.
