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Ask HN: What country is easiest to go from USA and have insurance without job?

19 points by techsin101 ↗ HN
I feel burnt out but i also don't want spend a year without an insurance, and the more i think about how you need a job to have medical insurance the more I feel like the whole system is inhumane. I just want to be in place where if I break my ribs then I can get them fixed without going into debt.

24 comments

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gotorazor
Canada? But TBH, healthcare is either regulated to a very affordable rate or government provided anywhere outside of USA.
UmYeahNo
Following...I'd be curious how to emigrate to another country and get insurance without a job. I was under the (misguided?) understanding that to emigrate you need to show that you have value to the new country (i.e. a job) and won't just be a resource suck (i.e. using up medical resources).
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gregjor
Pretty much correct. You will need to show either sufficient money in the bank or from external sources (pension, retirement funds, income derived from another country), or arrange a job. Generally if you can land a job with a foreign employer they get a work permit/work visa for you. You can’t just show up and start looking for a job. How expensive and difficult this can get depends on the destination country, your citizenship, your assets and income, and sometimes your education and skills. Some visas have age requirements, either 55+ (or older) for retirement, or much younger for student or skilled worker.

The other common path is marrying a foreign national.

The USA has these same rules. When someone comes into the US on a tourist or student visa, or no visa, then tries to get a job, or works under the table, they are breaking the law and can get jailed and deported if caught.

Source: US citizen, lived overseas for 5+ years working for US companies remotely.

gregjor
Health care and insurance vary widely around the world. Many countries have socialized or subsidized health care for citizens and permanent residents. Some have employer-paid plans. If you don't have a job and don't pay taxes and don't have a visa that allows you to participate in the local health care plan you will have to pay for your own care, or insurance.

Several companies offer traveler/nomad and expat insurance policies that give global coverage. I used CIGNA, I also know about BUPA. You can find others. Premiums depend on your age, health, and where you plan to live/visit. Generally expat policies don't apply to US medical care, or have restrictions on care received in the US.

Some places offer health care at such low cost that you can essentially self-insure by saving money and paying out of pocket.

prirun
If you switch to a job where you make $18K-$50K/yr, maybe part time, you can get subsidized health insurance in the US through Obamacare/ACA/healthcare.gov. If you are on the lower end it will not cost much and could even be free with low deductibles and/or copays.
tigerlily
Probably New Zealand, but for certain afflictions e.g. gall bladder operations, there are waiting lists on the public healthcare system. You can always access the private medical system via an insurer, which is reasonably priced. Jobs pay less.

BTW breaking ribs is something that might not get diagnosed right away 100% of the time. Maybe plan to not break ribs.

drstewart
None. Why would a country take you in for you just to leech off their system?
jolmg
They never said free nor even public health care.
Leftium
It's actually feasible to live outside the USA without medical insurance. In the USA, medical fees are crazy expensive, especially without insurance. But this is not the case in other countries.

For example: Korean medical fees are controlled by the government, to the point some doctors may struggle to make a living. And Korea offers pretty high quality healthcare.

I thought I broke a rib so I got two x-rays. This only cost $15 including consultation with the doctor. Without insurance.

Later when I got insurance, I had 5 x-rays of my knee taken. Only cost $5. The non-insurance rate would have been about $20. (Korean public health insurance generally covers 70% of covered fees.)

Another example: I can get a 6-month supply of generic Accutane for about $50 (not covered by Korean health insurance). This would likely cost thousands of dollars in the US.

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Finally, if you plan to be abroad for only about a year, traveler's health insurance for non-US countries is usually very reasonably priced.

NLPlatypus
I just checked Accutane’s price using GoodRx which compares many US pharmacies side-by-side and gives a free discount. It looks like a six month supply of generic Accutane is about $492-$610. The upper range includes shipping, otherwise you have to drive to the pharmacy. No quote on name-brand Accutane, though.
isbvhodnvemrwvn
Traveler's insurance likely won't cover any serious long-term diseases, if you get cancer in that time period, you are screwed.
tothrowaway
You have to read the fine print, but generally they do. The coverage is limited to the time period you purchased it for, and they are unlikely to renew it if you get cancer. To work the system, you need to ensure you're covered until Jan 1 of the following year. Then in November (during open enrollment), either get a USA policy (if you have cancer), or at the end of open enrollment, extend your travel insurance for another year.
rnk
Buy in to one of the 3 euro countries with "golden visas", Portugal, Greece, Spain are reasonable - Portugal is a 300k investment to get a visa, but I think it takes 3 years. Then you can live there, have health insurance.
nemesis1637
This is one option. You can also get a Non-Lucrative Visa if you don't plan on working in the country. You have to demonstrate a certain financial capacity (to prove you won't be a drain on the system). It's valid for one year and renewable two times for two years each time. After five years you're granted permanent residency. You can join the public healthcare system after the first year. In addition, private healthcare is incredibly good and very reasonable compared to rates in the United States and not linked to employment. (Source: I live in Spain on a Non-Lucrative Visa)
rnk
Interesting, I never heard of the non-lucrative visa! So is the only real cost (1) you can't work and (2) you are subject to Spanish income and wealth taxes?

I see from an ad, you have to have 28k euros in your bank account for a year, which seems shockingly low, but it looks like you have to pay spanish income tax, so that must be how they see this as a benefit. I wonder if you are subject to the Spanish wealth tax. As Trump still looks likely to run and could definitely win the presidency (uncertain chance but possible), I think a lot of wealthy Americans will do it. I'm a software engineer and almost everyone I know well enough to ask says they or their friends are investigating. All the immigrants I asked can usually go to their original country, unless maybe they are from a non-free country. This last group all seem to want to go to one of the 3 cheaper Euro countries.

nemesis1637
You can't have a Spanish job. My wife and I both have remote jobs in the U.S. This is a highly debated topic in expat forums. Some people argue until they're blue in the face that you can't work at all on a NLV but we consulted many Spanish attorneys before applying and they all agreed that you can have remote income. We just didn't mention it on any of our application paperwork.

Yes, you do have to pay Spanish income and wealth taxes (though the wealth tax varies greatly depending on where you live in Spain, for example it's zero in Madrid). However, you don't get 'double-taxed' on income. You only have to pay either U.S. or Spanish income taxes, whichever is higher (almost always Spanish).

I am telling everyone who asks me, which is a lot right now as you mention, to wait for a bit if they can because Spain is 'any time now' supposed to be approving a digital nomad visa will will make the process MUCH more simple for people who are working remotely. The details haven't all be ironed out yet but: https://www.thehomelike.com/blog/spains-digital-nomad-visa/

Healthcare here really is wild. Our first month here my wife got extreme food poisoning and had to take an ambulance to the ER. The ambulance took her to the public hospital because it was much closer to our house compared to the hospital of our private insurer. She spent a few hours in the ER, including the ambulance ride, it cost €138 out of pocket (since we aren't on the public system). And, get this, our private insurance company reimbursed us for the cost. It's a completely different world.

nemesis1637
It's €500,000 in Spain. I don't know about Portugal but it doesn't take 3 years in Spain. Its 'immediate' upon the investment.
zenbryo
As some already have said, the best option is to get a (backpacker) travel insurance. Its usually not that expensive, around 1-2k for a year I think.

But usually you need to be able to show immigration that you have enough money to support yourself for the duration of the trip or visit.

The best would be to get a fulltime job in a European country for a few years and then get a permanent residency, resign your job and scratch your butt all day and still enjoy more or less free healthcare for life =)

gniv
Maybe also ask/research on r/expatfire. Lots of knowledgeable folks there.
rozenmd
Find a french startup and come over on the tech talent passport.

Most remote friendly tech jobs I've seen offer a 90k euro base, at which point you live like royalty in most cities.

obiefernandez
Surprised nobody has mentioned Mexico yet. Great private medical providers and insurance options
GoldenMonkey
You can get private insurance. Have you looked into costs. I pay <$500/mo.