Liz Weston

Dear Liz: My husband is 55 and we are hoping to retire in five years. That gives us time to clean up our outstanding debt (the house, car and credit card debt from medical bills). We have a little over $1 million saved. He was recently offered early retirement but didn’t take it because of our debt and my health problems. I have end-stage liver disease and recovered from liver cancer. I have been collecting disability for a while.

I’m doing relatively well for my condition. However, at any time my health can take a bad turn. So I was interested in what you said about living in other countries to get affordable healthcare. If we were to do that, how long would we need to live there to qualify for healthcare? Should we talk to a tax preparer and financial advisor?

Answer: Residency requirements to qualify for public healthcare vary by country, said Kathleen Peddicord, founder of the international living site Live and Invest Overseas. “In some cases it’s instant, in others it could take years,” she says.

In most countries, anyone who is employed or self-employed can instantly access the public system. Some countries allow non-workers to opt into this system by volunteering to pay into it, but there may be restrictions for those with pre-existing conditions. If you’re collecting Social Security disability, you probably have Medicare, but that coverage typically doesn’t extend abroad.

Expatriates in good health can use an international medical plan to bridge any gaps in coverage, but those policies also typically exclude preexisting conditions. You might have to settle for a more limited travel medical plan that would expire after six months and need to be renewed, she said. Given your serious health issues, that could be problematic.

Then there’s the potentially enormous stress of moving to a foreign country, adapting to a different culture and possibly learning a new language. Even in countries with excellent healthcare, finding specialists who can help you manage your condition, and who can communicate clearly with you, can be a hassle.

If you can find advisors familiar with life in the country of your choice, that could be helpful, but you’ll probably be doing a lot of research on your own. Before you decide to move, you should make at least one and preferably a few trips to the country to get a better idea of the challenges.