The 5 Best Healthcare Systems For Expats in 2025: Quality, Access, and Affordability – International Living
10 min readRetirement isn’t what it used to be.
In the past, most people expected to work diligently until their mid-sixties, get a pension, rely on Social Security and perhaps head for sunnier climes within the borders of their own country.
Life expectancies were shorter, the world seemed much larger and financial futures, while simpler, usually lacked the potential they hold today.
Fast-forward to 2025, and we’re living longer, staying healthier, and reimagining what our later years can look like.
In addition, globalisation and technology have made it easier than ever to live safely and comfortably in countries never experienced before.
These trends have sparked a mini-revolution in retirement possibilities. People nearing retirement today can avail of a wide array of choices that previous generations did not have.
The old path is still there, certainly, but it’s now just one road among many.
You can still move states for better weather and lower taxes, simplify your life by downsizing or even adopt a location-independent lifestyle.
More significantly, you can now move your life overseas.
Unlike the past, Social Security payments can now be sent to you from other countries, and vibrant expat communities make your integration easier than ever.
At the same time, modern challenges are pushing more people to take the expat plunge.
Chief among these, for US citizens at least, is the unique and burdensome system of citizenship-based taxation, which imposes worldwide income reporting obligations and tax liabilities on citizens regardless of where they reside.
However, there are also widespread concerns about the blizzard of controversial actions taken by the Trump administration in the US and the prospect of a real estate market crash there.
Economic worries caused by the rising cost of living, concerns about inflation reducing savings and dissatisfaction with the US healthcare system are all factors.
It’s more than enough to push many retirees and those close to it to consider ‘how to leave the US and where to go next.’
For a growing number, leaving the US is about securing greater financial freedom, preserving wealth and finding a political and social environment more aligned with their personal vision.
At Nomad Capitalist, we call it ‘going where you are treated best’ and, thankfully, there are many countries that align with this principle while addressing common US retirement hurdles.
Yet, comparing residence or retirement visa options, healthcare nuances, tax implications, and living costs can be overwhelming.
That’s why the Nomad Capitalist team created this guide, which identifies the five best countries for Americans to retire in 2025.
Pros and Cons for Americans Retiring Abroad
As with any major life decision, there are practical issues, benefits and downsides to keep in mind.
The Opportunities
A major plus is the potential for a much lower cost of living.
Your money simply goes further in many popular retirement spots, often funding a much better lifestyle than you could afford in the States.
Access to quality, affordable healthcare goes hand in hand with this. Many countries provide excellent medical care through public systems or reasonably priced private insurance.
Furthermore, this financial ease often leads to a better overall quality of life, allowing you to enjoy your retirement more fully.
An added bonus is that many countries actively welcome retirees with special visa options, like the well-known Pensionado programs, making the move easier.
Plus, living somewhere long-term can put you on the path to eventually becoming a citizen there, offering deeper connections and more freedom.
The Challenges
However, making the move overseas does have its downsides.
Top among these is that Medicare generally won’t cover you outside the US, except in very few specific cases. Therefore, you’ll have to arrange good private health insurance or access the local system.
Furthermore, remember that as a US citizen, you still have to deal with US taxes on your worldwide income every year.
Unfortunately, this demands complicated reporting (like FBAR/FATCA) and often makes getting expert tax help valuable, even if treaties prevent actual double taxation.
On a personal note, being far away from family – children, grandchildren or perhaps parents who need support – can be tough emotionally.
Lastly, adjusting to a new culture means dealing with language differences, unfamiliar customs and sometimes tricky local bureaucracy. It truly takes patience and an open mind to settle in smoothly without feeling frustrated or cut off.
5 Best Countries for Americans to Retire in 2025
Sorting through all the global retirement options can be a task, so we’ve narrowed them down.
1. Retire in Portugal
Portugal is always near the top of lists for the world’s best retirement spots, and it’s easy to see why.
Beyond the favourable climate and stunning coastline, it offers a sense of stability and safety (ranking 7th globally for peace in 2024) that resonates deeply in turbulent times.
Portugal also makes it easier for retirees to live there with visas like the D7 passive income visa. This is available if you can show a steady passive monthly income (currently around €870/month minimum for one person) from sources like pensions or investments.
Wealthy foreign retirees looking for residency by investment can use Portugal’s Golden Visa program, which requires either a donation, investment or starting a business.
In addition, healthcare here is excellent, with a respected public system (SNS) for residents and affordable private insurance readily available.
Very importantly, the cost of living is much lower than in the US. In fact, data shows consumer prices are about 34% cheaper, meaning you can retire comfortably without needing a huge income.
Add to that the great food, EU culture, welcoming expat groups, and the fact that English is widely spoken, and you get an attractive way of life in Portugal.
2. Retire in Mexico
Because Mexico is so close to home, it’s often better for Americans who want to be able to fly back home easily.
Yet, it’s distinctly different as a country – with Latin culture and incredibly beautiful beaches, mountains and charming colonial towns. Many retirees are drawn by the slower rhythm of life, the strong sense of community and the fact that their dollars stretch much further.
Getting residency usually starts with a temporary resident visa. You’ll need to show proof of income (around US$4,500 a month) or extensive savings. Once you fulfil the timeline, you can apply for permanent residency and enjoy your life in Mexico indefinitely.
While Mexico has public healthcare, most expats rely on the high-quality private healthcare system, which is very affordable and often staffed by doctors trained in the US.
Life in Latin America costs considerably less than in the United States. A couple can often live well in Mexico for under US$2,500 a month.
From a tax perspective, while US obligations persist, the US-Mexico tax treaty generally means US Social Security and pensions are not taxed, though this depends on residency and other factors. Mexican-sourced income is taxable.
3. Retire in Panama
Panama stands out as a top retirement choice as it offers the opportunity to live a modern life in a tropical setting.
Being a major travel hub also makes getting around the Americas easy, plus it uses the US dollar, so there’s no need to switch or use other currencies.
Beyond the modern capital city and the famous canal, the country is packed with wildlife and natural beauty.
Panama openly welcomes retirees with its outstanding Pensionado Visa.
It’s quite possibly the best retiree visa on the planet. All you have to do is show a lifetime pension of just US$1,000 a month (US$1,250 for a couple), and you get permanent residency plus big discounts on healthcare, travel, restaurants and more.
On top of all this, any income earned outside Panama isn’t taxed locally due to Panama’s territorial tax system.
While Panama isn’t the cheapest country in Latin America, living costs are still well below the US (rent is around 44% lower), allowing retirees to live comfortably for under US$3,000 monthly.
Add the warm climate, overall safety and the fact that English is widely understood, and Panama shapes up as a smart place to retire.
4. Retire in Costa Rica
Costa Rica is number four on our list. It’s a politically stable country and a world leader in environmental protection.
For retirees, this means a lifestyle that combines adventure with peace, surrounded by amazing wildlife, rainforests and beaches. It also has a ‘Blue Zone’ where people tend to live longer, healthier lives.
Getting residency is possible through routes like the Pensionado Visa (with proof of US$1,000/month pension income) or the Rentista Visa (stable income of US$2,500/month).
A huge plus is Costa Rica’s territorial tax system, which doesn’t tax foreign income, like your US Social Security or pension.
With living costs that can be up to 50% lower than in the US and very good healthcare (both public and private), Costa Rica is a healthy and affordable retirement choice.
5. Retire in Spain
Choosing Spain for your retirement means a life surrounded by European history and culture every day. It’s a passionate country with lively festivals, amazing food and wine and strong social traditions.
Spain also offers retirees a huge variety. From the sunny Mediterranean coast to the green hills of the north or busy cities like Madrid and Barcelona, there’s a region to suit almost anyone.
The main way for non-working retirees to get residency is the Non-Lucrative Visa. For this visa, you need to show that you earn around €3,000 a month.
Keep in mind that buying property no longer qualifies for Spain’s Golden Visa, but other pathways still exist.
Tax-wise, Spain taxes residents on their worldwide income. While the US-Spain treaty stops you from paying tax twice on the same income, your US pension and other retirement income will generally be taxed in Spain, with progressive rates based on income level.
Still, living costs are lower than in major US cities, offering good European value alongside top-notch healthcare and a much better lifestyle.
Best Countries for Americans to Retire in 2025: FAQs
Portugal often tops lists as the best retirement destination for American retirees, thanks to its safety, tax incentives, affordability and great lifestyle. Of course, the perfect spot always depends on your personal needs, like budget and healthcare preferences.
Countries like Panama, Costa Rica and Portugal are often mentioned as having easier visa paths for retirees. They tend to have clear ‘pensioner’ visas with income levels (sometimes around US$1,000 monthly) that are achievable for many.
Portugal generally has more affordable living costs than the US. A single person’s basic monthly costs, not including rent, might be about €680. It naturally costs more to live in Lisbon or the busy Algarve coast.
Panama can be quite affordable, especially away from Panama City. A single person’s basic monthly spend, without rent, is usually somewhere between US$800 and US$1,200.
Yes, almost always. US citizens typically need to file a US tax return each year, reporting income from anywhere in the world. However, special rules often mean you won’t end up paying tax twice on the same income.
While it can cost more than some nearby countries, Costa Rica is generally cheaper than the US and better ‘equipped’ than many neighbouring countries in Central America. A single person’s average monthly expenses, without rent factored in, are usually about US$850 (around 448,000 Colones).
Mexico generally costs much less to live in than the US, though prices change a lot depending on the area. Away from the big tourist spots, a single person might cover basic monthly costs (excluding rent) for around US$800 to US$1,000.
Spain is usually cheaper than other European countries, the US or the UK, but often a bit more expensive than nearby Portugal. A single person’s average monthly expenses, not counting rent, are often about €670. Madrid and Barcelona cost more.
When choosing where to enjoy your golden years, factors like affordable housing, climate, healthcare facilities, tax advantages, welcoming communities and safety should be at the top of the list. Many jurisdictions now offer residence and citizenship options to attract foreign retirees at a relatively low cost. Countries in Central and South America, Southeast Asia and Europe are particularly appealing for those looking to retire overseas.
Go Where You’re Treated Best
The traditional concept of US retirement has been updated and is changing rapidly.
Today, you have the power to design a retirement plan that truly reflects your personal wants and financial realities. You truly have the power to choose a location because it treats you best.
The benefits, like lower living costs that make your savings last longer, access to quality healthcare, dedicated residency visas for retirees and sometimes very helpful tax advantages, are all real and waiting for you.
Being ‘treated best’ in retirement means finding a place where you feel secure and valued, where your savings work harder and where life suits you.
It means looking for places that offer greater personal freedom and align with your priorities. We encourage you, therefore, to think seriously about what retiring abroad could offer – the financial, healthcare and lifestyle freedoms that matter most to you.
If you’re ready to design a bespoke international retirement plan focused on maximising your freedom and finances, get in touch with the Nomad Capitalist team.
