retirement · 2026-05-01
Project the all-in cost of retiring abroad — cost of living vs US, healthcare, visa fees, plane tickets home, and tax implications.
| Monthly US cost of living | $5,000 |
| Destination cost % of US | 60% |
| Monthly US healthcare | $700 |
| Monthly destination healthcare | $200 |
| Annual visa + immigration fees | $1,200 |
| Flights home per year | 2 |
| Cost per round-trip flight | $1,400 |
| Monthly cost in destination | $3,200 |
| Annual cost in destination | $42,400 |
| Annual cost staying in US | $68,400 |
The moves to Mexico / Portugal / Costa Rica / Thailand are real, and the cost-of-living delta is real. The two costs that cut into the savings: visa/immigration fees (annual or biannual renewals) and flights home (which compound if you have grandkids).
For routine + most procedures: yes. Mexico private = 30-40% of US. Costa Rica public+private = 25-50% of US. Portugal NHS-equivalent: free for residents post-12-months. The exception: highly specialized cancer / cardiac surgery — many expats fly back to US for major events. Budget for that.
Yes — US is one of two countries (Eritrea is the other) that taxes citizens on worldwide income regardless of residence. Foreign Earned Income Exclusion ($126k 2024) can shield wages, but Social Security + retirement income is fully taxable. Foreign tax credits prevent double-tax.
Easy if you keep US passport + Social Security. Medicare: re-enrolling in Part B after a gap triggers a permanent 10%/yr-gap premium penalty — DON'T cancel Part B if you might return. Healthcare reactivation is the friction point most expat returners hit.