Traditionally, one of the most significant concerns about moving abroad, especially for retirees, is the quality of healthcare. To answer this question, Best Places in the World to Retire surveyed 389 expats, primarily from the U.S. and Canada and mostly residing in Panama, Belize and Nicaragua.

The survey, Expat Report: How is Healthcare Abroad?, found that healthcare is less expensive abroad, with 38.2% of expats reporting that their healthcare cost from half to a quarter of what it did in their home country, and almost as many (36.5%) stating that their healthcare cost less than .25 cents for every dollar they might have previously spent.

With average healthcare costs per capita in the U.S., according to World Bank for 2014, equal to $9,403, a 75% reduction in cost for an average U.S. couple would equal about $1,175 per month in savings. The costs and savings would probably be higher as people age.

The survey had a margin of error of +/- 4.9%.

"Complete medical care here frequently costs less than what our deductible would have been back home," said David R. Smith, a middle-aged American living in Panama. 

A Comparable Quality of Healthcare

Most respondents reported that the quality of healthcare was roughly comparable to what they had experienced before. More than three in four expats (76.1%) reported that the quality of their healthcare abroad was either "somewhat better," "about the same", or "somewhat worse." Only 11.4% reported that the healthcare quality in their home abroad was "much worse" and only 7.8% reported that it was "much better."

Charlotte Lintz, a retired nurse practitioner from the U.S. living in Panama reported that when her father fell and had to have surgery in Panama, he received outstanding care at low cost. "The medical care was excellent and up to date, even though they do things a little differently," Lintz said, adding, "The cost was about one tenth of what it would have been in the U.S."

The quality of care also depended on where the expat lived. Most of the complaints were from expats who lived in remote areas, especially in popular expat destinations on islands or away from major population centers. However, there was close to uniform agreement on how much more caring those providing healthcare services abroad were. "Not sure if the quality is better," wrote a 25-44 year old American man living in Nicaragua, "but I feel much more like a patient than a person with a dollar sign over my head, like in the States."

Many comments said that healthcare abroad was more like it used to be in the U.S. "Practitioners can practice actual healthcare instead of paperwork and bureaucracy!" wrote Kris Cunningham, a middle-aged American woman who moved to Panama.

Health-Related Lifestyle Issues

Of course, the best way to deal with health-related issues is not to need care in the first place, and in this category, there were surprises. A whopping 43.3% of expats reported that their lifestyle was "much healthier," and an impressive 31.2% reported that their new lifestyle was "a little healthier." Only 5.9% reported that they were "much less healthy" or "a little less healthy."

These impressive results appeared to stem from a combination of less stress, healthier food, more time (perhaps because the overall cost of living is lower, so they had to work less) and more exercise. "Access to the fresh food market and the warm climate mean I eat much healthier and get more exercise in Belize," wrote Leon Hooker, a middle-aged Canadian.

American Robert Raymer, who has lived in Panama for 10 years, wrote that he was also able to exercise regularly. "I am in excellent shape because of regular daily exercise in a climate that easily permits it."

Another American expat, a woman living in Panama, wrote that she had lost 20 pounds over three years "due to lifestyle changes only."

Overall Level of Satisfaction with Healthcare Abroad

More than two in five respondents (42.3%) said that they were "very satisfied" with the healthcare they'd received, while another 28% said they were "somewhat satisfied." Most respondents said that they were satisfied with the the healthcare they received abroad. Only 9.7% were either "somewhat dissatisfied", or "very dissatisfied."

The country with the highest percentage of expats reporting they were "very satisfied" with their healthcare was Panama, at 50%, followed by Nicaragua, at 36%, and then Belize, at 26%. However, even in Belize, 59.4% of expats reported that they were either "very satisfied" or "somewhat satisfied", and only 6.2% reported they were "somewhat dissatisfied" or "very dissatisfied."

"I worked in a hospital for 30 years," reported Carol Hurst, a middle-aged American living in Panama, "so I can honestly say that the care is really quite good." Hurst added, though, that it's important for individuals to "be proactive" and research their decisions. "Ask the right questions, seek out the best doctors, and make the right informed decisions," she said.

Healthcare professionals often provide an extra level of service that underscores their concern for patients. T. Rob Brown, a Canadian living in Panama, wrote that an hour after he drove home from a doctor's appointment in which he had a blood test, the doctor was at his gate with the results, "freaking me out."

"How bad was my test result?" he said that he wondered at the time. 

The result was fine, and the doctor was simply delivering the results because Brown was supposed to wait for the analysis at the hospital. "When is the last time your doctor did a house call?" Brown asked.