EU Retirement/Healthcare

July 20, 2018 6:16 AM

My wife and I carry passports from different EU countries. We are considering eventually retiring in a third EU country (timeframe >20 years). We have never paid into the social security systems in either of the countries we are citizens of, nor in any material way to any EU country. We are for all intents and purposes Americans who happen to be the children of immigrants. How would healthcare work for us? Is it really as simple as registering with the authorities as legal residents? Is there something we should be doing today? Does property ownership matter for us?

I'm asking because I'm doing some longer-term investment planning and trying to figure out if there is a reason to favor some options over others.

posted by JPD to Work & Money (10 answers total)

How would healthcare work for us? Is it really as simple as registering with the authorities as legal residents?

Broadly, yes. But the specifics depend on the EU country. As EU citizens you have the same right to live, work, retire in that country as a citizen of that country and you have access to the health insurance system.
posted by vacapinta at 6:34 AM on July 20, 2018 [2 favorites]

It should do, yes. But I suggest you check with the relevant regulations. I'm a dual citizen, and as a result I could be denied if I haven't renewed my passport in a timely way. Exceptions may apply.
posted by frumiousb at 6:45 AM on July 20, 2018 [1 favorite]

I believe vacapinta is correct but there are significant differences in healthcare services, expectations and regulations in different EU countries. I would certainly check out the specific regulations in which ever country(s) you would plan on taking up residence and/or receiving health services. Each country is becoming more vigilant at what it considers healthcare "tourism" and "shopping" for specific and expensive services. Not knowing which countries interest you it might also be prudent to look at your need/desire to buy additional health insurance for "private" care in that country. If you are also planning 20 years out I would not plan on the EU having the same configuration or policies it now has. PS--I don't believe home ownership is a factor but demonstrating an intent to establish residence might
posted by rmhsinc at 6:55 AM on July 20, 2018 [2 favorites]

EU Countries have their own quite different health care systems. You'll have to check each specific country (for everything, not just health care). There is no generalization that can be made simply by knowing they are eu countries. Try checking expat websites for each country.
posted by jazh at 7:18 AM on July 20, 2018 [5 favorites]

EU freedom of movement rights cover almost all EU citizens, with the exception of some convicted criminals, but to make use of them on a long term basis you either need to find work in the country where you want to live, or present proof of health cover and enough money for your other living expenses.

See this page:
https://europa.eu/youreurope/citizens/residence/residence-rights/pensioners/index_en.htm

Owning property is not required, but if you don't then you will need to show a stable income that covers your rent.

The way that health cover works varies by country, but in most cases you will need to pay an annual fee for membership of a collective insurance scheme. The fee is likely to vary based on your income and assets (subsidised for the poor, in other words), and be assessed on top of the minimum income requirement. Private health cover would be acceptable too but is likely to cost more. You might still need to go private during your first year or two of residence, if there's a waiting period before you become eligible for the state scheme.

As you say that you are effectively Americans with second passports, you probably don't have the right to a state pension or any other payments from EU governments, because those are based on years worked in each country. So you will need to meet the minimum income threshold based on your own investments. Income from outside the eurozone is acceptable, but the exchange rate risk is on you.

With a 20 year planning horizon, there's a greater-than-zero risk the EU will be smaller, or even have broken up completely before you arrive. There are a number of serious disputes between the member states, and several have governments which make noise about "resisting" Brussels (and Berlin). On the other hand, the UK is already trying to leave the EU, and is widely considered to be making a disastrous mess of it. That will surely be making other prospective separatists think twice... but still, a lot can change in 20 years.

Is there anything you can do in the meantime to both end up with the same EU country's passport? If I understand you right that you are citizens of different places at the moment. Might just need to register your marriage at the other country's consulate.
posted by fireinacrowdedtheatre at 10:33 AM on July 20, 2018 [3 favorites]

fireinacrowdedtheatre’s assertions haven’t been the case in my experience. You can live anywhere in the EU that you like, assuming you don’t need to rely on social benefits... As far as heath care- I’ve lived in 4 EU countries and only one has any concept of health insurance... I’m not sure though, maybe the other 23 are like that?

However, healthcare in the places I’ve lived has been really kind of yuck. Most Americans I know, who enjoy insurance and healthcare in America, would feel..........hmmmmm...... not impressed. Without private insurance you wouldn’t have access (in most cases as far as I can tell) to many kinds of preventive checks or tests unless you pay privately (and I think in some places that being diagnosed privately can mean you must be treated privately- I could be wrong but I do believe I read this can be the case in the Uk) if I were an elder person I am not 100 percent sure I would be happy about that, in the sense that getting checked out regularly might indentify something treatable and help me live longer.
posted by catspajammies at 12:47 PM on July 20, 2018

Technically, as a pensioner asserting your freedom of movement rights within EU countries you're not a citizen of, you do need healthcare cover, and accessing healthcare when you're not a recipient of any EU member state pension may not be as of right.

Given that you haven't said which countries you're citizens of, I can't get more specific than that, but the two pages linked above are official EU pages, and will follow you through to information in English (or any other EU language) which will tell you 90% of what you need.

If you want my opinion on whether it'll be good healthcare, then I'd say it's very likely to be good in all but the poorest EU countries (Greece, Romania, Bulgaria, maybe Croatia), and excellent in many of them.
posted by ambrosen at 2:38 PM on July 20, 2018 [1 favorite]

Sorry, just realised my first link in that last comment is the same as fireinacrowdedtheatre's. But yeah, europa.eu has everything European citizens need to know about interactions with the state.
posted by ambrosen at 2:40 PM on July 20, 2018

So a lot of the time healthcare will cost little or nothing at the point of service but it is financed by contributions out of income. If you are retired this will often include but won’t be limited to your state pension. And a state pension is generally dependent on previous contributions and may be negligible. If you are entitled to live in the country you may be entitled to social security payments I suppose but that is not generally a level of income that makes for a comfortable retirement. So not quite as straight forward as you think.

It is not true that there is no preventative healthcare or screening. But there is no such thing as a recommended annual physical that subjects you to all kinds of tests you don’t need. And you are generally expected to start with your gp and get referrals to specialists and you get the treatment they recommend, not a long battery of things you request. So depending on your views on all of that that may or may not suit you...
posted by koahiatamadl at 10:32 AM on July 21, 2018 [1 favorite]

I guess the type of restrictions I’m describing I’ve experienced have been no smear tests until 27, which only changed when women were dying and no mammograms until 50 unless you were at high risk, my mother died of breast cancer very young and I still didn’t qualify. That was NHS. Your specific care needs are different and care in different countries vary.
posted by catspajammies at 12:02 AM on July 22, 2018