Expenses that many expats and potential expats fail to consider: Travel back home and medical costs

By Kathleen Peddicord

You may be surprised to learn of the two biggest expenses expats often face. Most of us think of rent. Food and entertainment. Taxes maybe.

But, in my experience, many expats spend more on two other expenses. These two costs rarely show up in cost summaries for destinations abroad, and they rarely seem like a big deal when planning to retire overseas.

What expenses am I thinking of? Trips back home, medical care and health insurance.

Travel is one of the biggest expenses faced by expats.

We recently heard from a Seattle couple planning to retire to a tropical climate. They’re on a budget and are thinking of Ecuador, which they know to be a good low-cost choice. They’re interested in Ecuador rather than one of the tropical countries in Southeast Asia (which could, in fact, be more affordable than Ecuador) because they want to be closer to “home.” They plan to make frequent trips back to Seattle.

I told them to forget about saving money. If they make frequent trips to Seattle, their cost of living, all in, after moving to Ecuador will almost certainly exceed what they spend now.

Let’s run some numbers for this couple. A quick check on Expedia shows fares from Guayaquil, Ecuador, to Seattle at about US$1,300, or US$2,600 for two. Those are the deep-discount, advance-purchase, come-hell-or-high-water fares, nonrefundable, nonchangeable. In many cases, the couple will have to pay more.

Of course, if the couple is 65 and legal residents of Ecuador they qualify for the 50% discount on plane tickets, but this is based on full fare prices. The prices would drop but would still not be cheap for people living on a budget.

But airfares are only the beginning. The couple will have to get from their overseas home to Guayaquil, in a bus, car, or taxi, maybe spending a night in a hotel. Once in Seattle they may need a hotel, too, and a rental car. They’ll need presents for the grandchildren, and they’ll want to have dinners out with family, including a few splurges.

We have to make some guesses, about total trip costs and what the word “frequent” means. For the sake of argument, let’s put the trip costs at US$5,000 and figure on three trips a year. That totals US$15,000, easily more than the couple might spend annually on rent, food and entertainment, or any other cost category while living in Ecuador.

Medical expenses are also frequently overlooked.

The couple faces a second major expense, too—health insurance back in the United States. Many expats keep their U.S. insurance just in case, especially if they plan to visit the United States from time to time. Let’s say U.S. health insurance for a couple in their 50s comes to US$500 each per month, or US$1,000 monthly for the two of them. In addition, they’ll have to come up with co-pays, deductibles, and other health-related out-of-pocket costs.

Even expats who have health insurance in their adopted countries often prefer to return home for medical procedures. Paying for these out-of-pocket are expensive.

Again, we’re making assumptions, but it’s easy to imagine this couple’s medical costs associated with their time in the United States exceeding US$15,000 a year.

Note that we’re assuming this couple of retirees is younger than 65. After age 65, most Americans would be covered by Medicare during trips back to the United States. (Medicare doesn’t cover medical costs overseas, but I recommend keeping it even if you do retire overseas as a back-up.)

What’s the bottom line of all this? Every year our Seattle couple might spend US$15,000 or more on travel to the United States, plus US$15,000 or more on U.S. health insurance (at least until they reach Medicare age). They could easily find that these costs, US$30,000 in total, exceed the cost savings of moving to Ecuador in the first place.

So what to do? Expats and retirees overseas can easily get around these two big costs by skipping those trips back home and by opting for medical care abroad, which can be significantly, dramatically less expensive than coverage in the States.

We know retired expats on strict budgets who do exactly that.

Many of us, though, want the freedom to travel back to the United States to see the grandkids, attend a wedding or two, visit the old neighborhood and friends, whatever. In that case we should be realistic about what we’ll spend on travel and, if we’re under age 65, on health insurance. Otherwise, travel to the States and health insurance while in the United States could easily be the two biggest costs in an overseas retirement.

This isn’t a reason not to retire overseas, of course. It’s a reality check to help with your retire overseas budget planning.
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Kathleen Peddicord is publisher of Live and Invest Overseas.