Reliable, affordable, and accessible medical care is a top priority for American retirees moving abroad. These five countries offer the highest-quality healthcare options for expats in 2026, places where it’s not only possible to live well, but also to receive top-tier care without breaking the bank.
As healthcare costs in the U.S. continue to rise, many Americans are finding themselves priced out of basic care. A recent Gallup survey found that nearly half of U.S. adults – 47% – worry they won’t be able to afford necessary healthcare in the coming year. Meanwhile, a parallel NPR report details how insurance premiums and out-of-pocket costs are projected to spike in 2026, leading nearly half the population to expect they’ll skip care altogether.
This paints a grim picture, but it also helps explain why an increasing number of Americans are seeking more affordable, accessible, and higher-quality options overseas.
The editors at “International Living” have named the five countries that offer the best healthcare for expats in 2026—places where retirees can live well and receive top-tier care without going into debt.
“These countries don’t just offer cheap healthcare—they deliver peace of mind,” says Jennifer Stevens, Executive Editor of “International Living.” “We’re talking about countries where 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. That’s a game-changer for retirees.
“Plus in places like Costa Rica and Panama – both of which make this list – a well-established medical tourism industry offers a good-value option for people who may not be ready to move abroad full-time but who are in need of medical care they’re priced out of up north.”
This year’s Top 5 countries for healthcare options for expats
1. France
“Even after 15 years in France, I’m still regularly amazed by the quality, accessibility, and affordability of the healthcare system,” says Tuula Rampont. “That first visit cost €25 (about $29), and with my healthcare card, I was reimbursed 70%—so it only cost me €7, or about $10. That price has remained unchanged for over a decade… One of the most impressive parts of the French system is how it handles chronic illnesses. If you’re diagnosed with conditions like diabetes, cancer, heart disease, Parkinson’s, or dementia, your treatment is covered 100%. There are no age limits or exclusions for pre-existing conditions; everyone is welcome.”
2. Portugal
Portugal offers a public healthcare system complemented by excellent private care options. “I was finally given a colonoscopy – denied to me in the U.S. despite being in my mid-50s – and a DEXA scan that revealed severe osteoporosis,” says Kimberly Anne. “I was prescribed medication that costs €250 every six months without the national healthcare, but just €60 with it… The quality of care is outstanding. On my very first visits, doctors ordered tests I’d never heard of, and others I’d been requesting for years back in the U.S.”
3. Spain
Spain is another standout for accessible and straightforward healthcare, particularly for expats who opt for private insurance. “Here in Spain, it’s the opposite. Healthcare is straightforward, affordable, and transparent,” says Cepee Tabibian. “With private insurance, I can see specialists directly, no referral needed… My private insurance costs about $75 per month. As a healthy 45-year-old, that covers nearly everything with no copay.”
4. Panama
In Panama, expats benefit from modern hospitals and caring, English-speaking doctors at a fraction of U.S. prices. “When I moved to Panama, only then did my worries finally fall away. The cost of healthcare was so low that I knew I would be OK, no matter what,” says Jess Ramesch.
“Though I’ve been in Panama for 20 years, I continue to be amazed by my doctors here… They give me time to talk through any concerns and get all my questions answered. And guess what? They give me their cell phone numbers so I can message them via WhatsApp if I need to.”
5. Costa Rica
Costa Rica rounds out the list with its dual public-private system and growing access in popular expat areas. “Now we live near the beach, where the closest hospital is an hour away. But there are many 24-hour clinics nearby for emergencies,” says Bekah Bottone. “To help manage costs, I use MediSmart, a discount medical service. I pay around $14 a month, which reduces a specialist appointment from about $100 to $50… Even without discounts, healthcare here is highly affordable.”
These countries scored highest in the Healthcare category of International Living’s 2026 Global Retirement Index, a comprehensive annual ranking that evaluates destinations based on cost of living, healthcare, climate, visa ease, and more.
“What sets these countries apart is not just low prices,” says Stevens. “It’s how well the systems work for foreigners. Whether it’s seamless appointment booking, preventative care, or affordable prescriptions, these are places where retirees can feel truly cared for.”
The complete report on healthcare options for expats is now available as part of the “International Living” Annual Global Retirement Index.
Related:
International Retirement on a Budget
Tips for Moving Abroad in Retirement
