Healthcare is an important factor to consider when choosing a country to live in, especially if you have a family, – and we know that 38% of global remote workers have kids. So before deciding where to invest to benefit from the Golden Visa of Citizenship by investment program, investors often ask our experts questions about the healthcare systems in the countries they are considering.
Here is the list of five countries with attractive Golden Visa or Citizenship by investment programs and easy-accessible, well-organized, and efficient healthcare services.
According to the 2021 global healthcare report, Spain is the only county from the list popular with investors that made it to the top 10. Its healthcare system ranks 8th and offers a great choice of affordable public and private services.
Public clinics and hospitals are well-equipped. Spanish citizens and residence permit holders can benefit from their professional specialists free of charge, except for dental care, which public insurance does not include. Public healthcare insurance also covers treatment at home, which can be used by those who have difficulties attending hospital, such as the elderly and disabled.
However, the waiting time to consult specialists for regular check-ups can take up to several months. For this reason, expats usually choose to use private insurance. Depending on the insurance company and the range of services, private insurance can cost from €50 to €200 a month for a single middle-aged person and €200 a month for a family with two children. If you prefer more high-end services, the costs can get up to €500 for a family of four. Note that the insurance cost also depends on the client’s age and can be higher for older people.
Public insurance does partially cover the price of prescription drugs. The coverable base depends on your income and is usually between 40–60%. For retired people, it covers up to 90%.
Like Spain, Portugal offers free healthcare for its citizens and residence permit holders. The Portuguese healthcare system was ranked 13th on the 2018 Euro Health Consumer Index.
Public healthcare covers a wide range of medical services, including medical visits, different kinds of tests, childbirth, and medical emergencies. However, like in Spain, it doesn’t cover dental health unless you are part of a vulnerable group. While you can have a day-to-day appointment with the specialist if you have a problem that needs immediate attention (usually through the emergency room), getting an appointment for an ordinary check-up can take up to several months.
In general, the public healthcare system in Portugal is of great quality. The only difference compared to private healthcare is the long waiting time to see specialists if you don’t have a problem requiring immediate attention. To schedule visits on short notice, expats usually go to private clinics where consultations with specialists typically cost about €60-90 without insurance or pay for the insurance plan. The insurance cost varies depending on the company and the region, but you usually have to pay from €1,200 to €1,400 per year for a person of 50 years and slightly lower for younger clients. Family insurance can cost up to €3 000 a year, with an average monthly cost of €200-250. In Portugal and Spain, you can have excellent private healthcare for a fracture of what private healthcare insurance costs in the USA.
Portugal vs Spain: what to choose?
Turkey offers citizenship for investors ready to purchase real estate property for at least $400,000. This country has a public healthcare system that fully covers most of the medical services, but there are some medications and consultations that you will still have to pay for. The monthly fee for access to public healthcare is about €40. Emergencies, pregnancy, and childbirth are also covered.
You can get private healthcare insurance for an average of €75-85 for a single person, and the yearly payment starts from as low as €300. There are also multiple discount packages for kids, which makes family insurance not a lot more pricy than insurance for single people. Like in other countries, the price depends on the client’s age and medical history. Private insurance covers some services that the state plan doesn’t cover, such as teeth and nose cosmetic surgeries after injuries caused by accidents. Also, private medical facilities are usually less crowded.
Turkey is a medical tourism destination for different kinds of surgeries, including various cosmetic surgeries, and you don’t need to worry about the local surgeons’ level of quality and professionalism.
Unlike Caribbean countries, Costa Rica has a Residency by investment program instead of a Citizenship by investment program. However, if you are interested in immigrating to the Caribbean islands, it’s great to know that this country has the best healthcare system in the region.
Costa Rican free healthcare is available only for citizens who struggle financially. Others, including expats, must pay to benefit from public healthcare, and registering in the system is obligatory for all residents. The payment amount depends on your income or on the amount of savings you declared in your visa application if you aren’t working. On average, public healthcare may cost about 7-11% of your monthly earnings.
Public insurance covers general, specialist, and emergency healthcare, including major surgeries. However, the waiting times for non-urgent appointments can be pretty long.
As mentioned above, having public healthcare insurance is obligatory in Costa Rica, meaning you can buy private insurance only in addition to public insurance but not as a substitute. The Costa Rican government monopolizes private insurance plans in the country. You will pay $60-250 monthly for private insurance, depending on your age, gender, and underlying conditions. The difference between the two systems is that the waiting times are significantly less, and it is easier to find English-speaking specialists in private clinics and hospitals. You can also get a private health insurance plan from other international providers, which will be more expensive.
The state-owned private insurance covers about 80% of medical costs. And to see a specialist without insurance costs no more than $100.
Antigua and Barbuda
Antigua and Barbuda, Dominica, Grenada, Saint Kitts and Nevis, and Saint Lucia are the famous "Caribbean Five" that grants citizenship to wealthy investors. Among them, Antigua and Barbuda has the most prominent healthcare system.
Citizens of Antigua and Barbuda can use the public healthcare system by paying 4% of their salaries in healthcare taxes. You must pay this contribution for six months before benefiting from the system. Residents are entitled to public healthcare for four years after getting their residency permit. The national insurance scheme covers various medical services, including basic dental treatment, childbirth, and major surgeries.
Private insurance costs about $5,000 a year for a single middle-aged person, and unlike public healthcare, it covers cosmetic and dental surgery, which are the main reasons expats buy it.
It is important to remember that Antigua and Barbuda are small islands and don’t have a lot of medical facilities. For this reason, many expats opt for private health insurance with a medical evacuation clause, which includes treatment in the Cayman Islands for complicated surgeries and complex conditions.
Summing up, Antigua and Barbuda has a good public healthcare system. Still, due to the country’s small size and limited capacities, you should consider other options if you have major health concerns.