Healthcare and early retirement abroad: what your FIRE number can't tell you

Your FIRE number can hold the cost of healthcare, but not access to it. Check who covers you, what it costs each year, and long-term care before you retire abroad.

Say you plan to stop working at 52 and move from Norway to Portugal. You put a yearly figure for healthcare into your spending, next to rent and groceries, and multiply it like everything else. That covers the price. It does not tell you whether you will be covered in Portugal at all, on what terms, or what your care will cost at 75 instead of 55. Those questions sit outside the maths. Here is how to plan for them, and where fjordFIRE stops.

Price and access are two different things

A FIRE number answers a money question: how big your savings need to be to pay for your life. Healthcare costs fit into that. They are ongoing spending, so they go into the yearly figure you multiply.

Access does not fit. Having the money is not the same as being able to get care where you live. Whether you can use a country’s public system depends on its rules: where you live, whether you work or draw a pension, and what you have paid in. No savings target answers that. And when you move country, both the price and the rules can change.

Healthcare is really three questions

It helps to split healthcare into three questions. The answers vary a lot by country and by your situation.

• Who covers you? A public system, a private insurer, or cover through your work or pension. It is not always the country you live in. In the EU, for example, the country that pays your pension can stay responsible for your healthcare while you live somewhere else. Whether you are covered can depend on where you live, whether you work or get a pension, what you have paid in, and the local rules. Not just your age.
• What will you actually pay? Under whichever system covers you: taxes or social-security payments, insurance premiums (what you pay for the policy each month or year), the fee per visit or prescription, dental and eye care, and anything not covered at all. This is the part that goes into your spending number.
• What happens when you need looking after? Later in life, healthcare can turn into long-term care: help at home, assisted living, or a care home. It can cost a lot, and how much the public system pays varies hugely by country. So give it its own line instead of rounding it into the rest.

Moving can change all three

This is where healthcare gets tricky for a cross-border life. When you move, the price can change. So can the system that covers you, the one that actually treats you, and the rules for getting care. Your cover can even stay tied to your old country while you live in the new one.

A place that is cheaper on rent and groceries can be more expensive for care, or just harder to get it. So check healthcare as part of deciding where to move. A cheap month does not make it a good place to grow old.

What to check before you move

• Which healthcare system would cover you after the move, and what it asks of you: registering, paying in, holding insurance, or living there for a set time.
• What it will cost each year under that system: premiums or payments, the fee per visit or prescription, and what is not covered. That figure goes into your spending number.
• Whether any medicine you take regularly is available there.
• If you are counting on private insurance: the age limits, whether they will accept you, and how they treat health problems you already have. Today’s quote may not survive the move or your retirement.
• What long-term care would cost, how much the public system pays, and how much you would fund yourself. Keep this separate from everyday healthcare.
• A cash safety net for short-term surprises, like an unexpected bill. Do not let it stand in for the yearly healthcare line.
• The current rules, from the health system or insurer. These change, and this post is a rough guide, not medical or insurance advice.

What fjordFIRE covers, and what it doesn’t

fjordFIRE does not model healthcare costs. It does not price insurance, check whether you qualify for a system, or work out how an insurer treats an existing condition.

What it does show is the money around healthcare: the cost of living where you would retire, the currency you will spend in, and an emergency fund for short-term shocks. The yearly healthcare cost you work out belongs in your spending. Who covers you, and on what terms, still has to come from the system, the insurer, and your own situation.

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