Rising U.S. health care costs, from asthma medications to emergency care, are driving Americans to countries with universal health care.
How to work abroad with a digital nomad visa
Many countries around the world now offer digital nomad visas that allow employees to work remotely from anywhere. According to travel experts at NerdWaller, a digital nomad visa is essentially a temporary residence permit for remote workers.
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- Some Americans move abroad to access more affordable and comprehensive health care.
- Nearly half of American adults worry about being able to afford medication and health-related expenses.
- Other factors for migration include the desire for stricter food standards and a safer environment.
Hilary Hodge has severe allergic asthma. But in 2012, she found hope in biologics. There was one problem. She was living in the United States at the time and was told that the biologics would cost her $36,000 a year. A few years later, she and her husband moved to Algiers, France. Across the pond, the same treatment cost 12 times less.
Hodge had suffered from asthma since childhood, but was one of the 10% of asthma patients whose breathing condition worsened, rather than getting better. At age 32, her inhaler no longer provided relief. Her chronic illness has been a “huge battle,” she told USA TODAY. She was certified in biologics when she lived in Chicago, but injectable drugs were very expensive at the time.
In 2017, Hodge and her husband decided to temporarily move to France to be closer to friends and family. In her new home, Hodge quickly had access to biologics for $3,000 a year.
“That was kind of one of the first experiences where I realized how different the systems were,” Hodge said.
They only planned to stay for a few years, but then she became pregnant with a son and bought her own home. “It suddenly became more permanent. I think we’re here,” Hodge said. “But to be honest, health care is a big part of the reason.”
Rising health care costs and access to health care are top concerns for many Americans, with nearly half of adults worried they won’t be able to afford medications or health care-related expenses this year, according to a 2025 survey from the West Health Gallup Center for America’s Health Care Centers. This is the highest level of concern recorded since the survey began in 2021.
For some, moving abroad is part of the solution. Other countries, such as Canada, Japan, and European Union member states, offer universal health coverage at lower costs and make it more easily accessible to their citizens and certain visa holders. In a recent Harris Poll survey of U.S. expatriates, 38% of 6,358 respondents cited access to cheaper and better healthcare as a reason for considering an overseas assignment.
Michelle Garabito of luxury moving service The Lux Nomads said she’s seeing a large influx of clients leaving the U.S. for health reasons. “We’re seeing a lot of families with young children coming through this pipeline as well, and we’re seeing a lot of retirees who are ready to have a better retirement with universal health care right by the beach, a beautiful home for half the cost they spend in the U.S.,” she said.
Avoiding high medical costs
For Hodge, the problem wasn’t the quality of care. It was the price.
Americans spend more on health care than any other country in the world. The average family health insurance plan in 2025 was $26,993, an increase of 6% from 2024. Unexpected medical emergencies or expensive diagnoses like cancer can leave people thousands of dollars in debt.
“It would never happen here for a variety of reasons,” Hodge said. “From a purely medical standpoint, thinking about what’s best for my child and me, it’s a better place to be.”
In addition to his asthma, Hodge experiences an adrenal crisis, a life-threatening medical emergency caused by a severe deficiency of cortisol. Although she has had three crises in recent years, she was not worried about whether she would be able to afford hospital treatment.
“You know, in America, we do math,” she explained. “It’s like, ‘Would I pay a $500 deductible to go to the hospital?'” For many people, that can be a very dangerous question, an equation. Like, how sick do I have to be to go pay that $500 deductible? Here, I don’t even think about it. ”
healthy living abroad
Practical medical care is just part of the reason why many Americans find living abroad healthier. Leah Mark, who moved from Indiana to the Spanish island of Mallorca in June, has had her health affected by stricter EU food standards, including bans on many additives, preservatives and other chemicals. Some American foods are prohibited from being imported into Europe.
Mark said he finds food from around Europe to be not only “incredibly delicious” but also much more affordable.
Mark first started thinking about moving from his home state during the harsh winters, considering warmer U.S. destinations like Florida. But it still didn’t feel like a perfect fit. “No matter where you are in the United States today, we face the same issues: toxic culture, food, and growing political instability,” she said.
The move took on added urgency after a mass shooting at a grocery store near her in January 2025 left two people dead. “I no longer felt safe as a single woman in the United States,” she said.
Mark soon found out about The Lux Nomads on social media, run by two expats themselves, Michelle Garabito and Paul Nelson. With their help, she began the process of moving abroad under a digital nomad visa. She is currently based in Mallorca and travels throughout the EU.
“I’m glad I did it,” she said. “It’s been really hard. It’s like saying goodbye to those things emotionally and I’ll miss some things here, but I would say the added quality of life is much more valuable and important to me.”
What you need to know about overseas medical options
Moving abroad is a big endeavor and requires adjustments to your lifestyle. It’s not as simple as packing your bags and buying a plane ticket. There are legal paperwork, logistics, and even the challenges of missing friends and family back home. Trying it out for a month can help you decide if a big move is worth it, especially if you’ve never lived outside the United States.
“I always recommend living in a country around Europe for just a month, especially because of the restrictions,” Garabito said. “Eat out every day, walk around a walkable city, and see how you feel.”
The legal stay process can also be lengthy. Foreign nationals often need a valid visa to access another country’s public healthcare system, a process that can take months.
A good starting point for many people is a digital nomad visa or a non-income visa for non-workers, such as retirees, Garabito said. (However, you will also need to enroll in private health insurance to apply.) Obtaining a residence card can take several months, and once you become a legal temporary resident and enroll in social security, you will be enrolled in the country’s public healthcare system. Overall, the timeline from visa approval to receiving medical care is approximately 3 to 6 months.
In certain countries, such as Portugal, Spain, and Greece, digital nomad visas can serve as a stepping stone to more permanent migration and help people meet residency requirements. In Spain, you can apply for permanent residence after 5 years of residence and citizenship after 10 years.
It’s hard work, but for many Americans, it’s worth it for their health and well-being. “I’m not just saying it to say it. I feel so much happier and so much more at peace,” Mark said.
