Moving abroad changes how you live, how you work… and very often, how you deal with healthcare.

And here’s the part nobody tells you when they’re romanticizing life overseas: you won’t use healthcare abroad the same way you did at home. Not even close.

Some expats end up using more healthcare than they ever did back in the U.S. (because suddenly a dentist cleaning doesn’t require a small loan). Others basically avoid the system entirely unless it’s an emergency—because the paperwork feels like a side quest, the language feels intimidating, or the local “normal” is just… different.

So what do expats actually use in real life?

Let’s open the Healthcare Passport and look at the services people lean on everywhere—from Colombia to Thailand to Spain—and the ones they often skip until the next trip “back home.”

The Big Pattern: Expats Don’t Choose “Best Healthcare.” They Choose “Best Access.”

Back home, healthcare is often a system you tolerate:

  • You delay appointments because they’re expensive

  • You avoid checkups because insurance is confusing

  • You “wait it out” because you don’t want a surprise bill

Abroad, especially in major expat hubs, healthcare becomes something else:

  • If it’s affordable and fast, expats use it.

  • If it’s slow, bureaucratic, or confusing, they route around it.

That’s the whole story in one sentence.

Now let’s break down where that plays out—service by service.

1) Primary Care: Used Often… When It’s Simple

Primary care is the most “normal” category—because everybody gets sick sometimes, and everybody needs a prescription eventually.

In the big expat hubs—think Spain, Portugal, Thailand, Colombia—primary care is often used a lot, especially when:

  • appointments are easy to book

  • the clinic feels familiar

  • you can pay $20–$50 out of pocket and move on with your life

Where expats use primary care the most

  • Minor illnesses (cold/flu, stomach bugs, sinus infections)

  • Check-ups when they’re affordable

  • Follow-ups that used to feel “too expensive to bother with” back home

Where expats start skipping or avoiding

Even in countries with strong public systems, expats often avoid the “official” pathway when it feels like:

  • confusing sign-up processes for local GP registration

  • long waitlists

  • forms that require local knowledge (or five office visits)

So they do what humans always do: they go private, even in countries with great public care—because convenience wins.

Used often:

  • Annual check-ups

  • Antibiotic prescriptions

  • Cold/flu care

  • Vaccinations

Commonly skipped:

  • Signing up for a local GP when the process is slow/confusing

  • State clinics with long wait times

2) Dental Care: The “Everyone Suddenly Becomes Responsible” Category

Dental care might be the most universally used expat healthcare service on Earth.

Because in places like the U.S., Canada, and Australia, dental costs can feel like:

❝

“Sure, we can do that crown. That’ll be $2,800. Would you like to finance it over 48 months?”

And then expats land in countries like Mexico, Colombia, Hungary, Turkey and realize:

  • the clinic is modern

  • the dentist is highly trained

  • and the price is… reasonable

So people don’t just get cleanings. They go full glow-up.

Used a lot:

  • Regular cleanings

  • Whitening and cosmetic work

  • Emergency fillings

  • Crowns, implants, orthodontics

Often skipped:

  • Dental insurance (because many just pay out of pocket anyway)

Dental becomes the expat “life admin” win: one of the first things people catch up on when they move abroad—because they finally can.

3) Specialist Care: Used Frequently… Privately When Possible

Specialists are where the “country personality” shows up.

In some places—Thailand, Malaysia—specialists can feel shockingly accessible:

  • minimal gatekeeping

  • private hospitals set up for foreigners

  • English-speaking departments

  • fast appointment scheduling

In much of Europe, the public system may be excellent… but slower:

  • referrals required

  • waiting periods for non-urgent issues

  • bureaucracy that makes people feel like they need a PhD in paperwork

So expats do what they always do:

  • public system for serious long-term needs

  • private consults for speed

And because specialist visits can be affordable abroad, many expats use specialists more than they did at home.

Used often:

  • Dermatology

  • Gynecology

  • Orthopedics

  • Physical therapy

Skipped often:

  • long referral chains in public systems

4) Mental Health: Growing Use… Still Underutilized

This is the category that’s rising fast—especially among:

  • remote workers

  • long-term expats

  • people dealing with culture shock, loneliness, burnout, identity shifts

  • anyone who realized moving abroad doesn’t automatically fix everything

But mental health care is still underused abroad because of two friction points:

  1. Language barriers (therapy is hard enough in your native language)

  2. Cultural mismatch (you want someone who “gets” your background)

That’s why online therapy platforms have become the bridge for a lot of expats—especially nomads who move often and want continuity.

Used more than before:

  • Online counseling

  • English-speaking therapists in major cities

  • Wellness retreats / coaching

Still commonly skipped:

  • local therapists when language/culture feels mismatched

  • public mental health systems (often underfunded, limited access)

The pattern is simple: expats will seek support when it’s accessible and comfortable. Otherwise, they “push through.” Sometimes for too long.

5) Emergency Care: Used When Needed… But With Strategy

Emergency care is the wild card.

In some countries (like Spain or Portugal) the public hospital system is reliable and widely used.

In others, expats learn quickly:

❝

“If it’s serious, go private.”

In places like Thailand, Malaysia, Colombia, many expats head straight to private hospitals:

  • excellent care

  • faster triage

  • more predictable experience

  • but often upfront payment is expected

Ambulance services also vary wildly:

  • sometimes included in public plans

  • sometimes expensive

  • sometimes slow

  • sometimes avoided in favor of Uber unless it’s truly urgent

Used:

  • Private ERs

  • Urgent care walk-ins

  • Tourist-zone trauma hospitals

Skipped or avoided:

  • public ambulances if slow/pricey

  • public ERs when language gaps create stress

6) Preventive Care & Screenings: The “I’ll Do That When I’m Home” Trap

This is the most skipped category for expats.

A lot of people delay:

  • mammograms

  • colonoscopies

  • comprehensive blood work

  • long preventive screening schedules

Not because they don’t care—but because:

  • the system is unfamiliar

  • it’s hard to know where to go

  • there’s fear of miscommunication

  • and life abroad feels busy and distracting

So they postpone until a home visit, where they feel confident navigating the process—even if it costs more.

There’s an exception: expats living in wellness-forward places (think Costa Rica, parts of Italy, “Blue Zone” culture areas) sometimes lean into prevention more—especially if private plans bundle screenings.

Used sometimes:

  • Basic blood panels

  • STD testing (especially younger/single expats)

  • Wellness programs in health-focused regions

Skipped often:

  • comprehensive preventive checkups unless prompted

  • country-specific preventive programs (mostly due to lack of awareness)

This is one of the biggest “quiet risks” of expat life: feeling healthier day-to-day, but falling behind on the boring preventive stuff.

7) Pharmacies: The Expat’s Universal Best Friend

Pharmacies might be the most consistently used healthcare “service” abroad.

In many countries, pharmacists are:

  • accessible

  • helpful

  • cheap

  • and willing to guide you through minor issues

In places like Mexico, Vietnam, Spain, pharmacies are fast and practical—even if you’re literally miming symptoms like a confused tourist in a silent film.

And in some countries, meds that require a prescription back home can be obtained more easily—sometimes with pharmacist guidance.

Used constantly:

  • OTC meds

  • refills without drama

  • advice for minor issues

Skipped:

  • insurance reimbursement paperwork unless absolutely necessary

Pack Smart… But Also Adapt

Living abroad reshapes your healthcare habits. You might:

  • finally get dental work you’ve avoided for years

  • see a dermatologist like it’s normal

  • rely on pharmacies for 80% of minor issues

  • and postpone preventive screenings longer than you should

The key is flexibility.

Know the basics of your new system. Keep private options in your back pocket. And don’t be afraid to build a hybrid plan—some local, some digital, some “I’ll do it next time I’m home.”

Because your Healthcare Passport isn’t static.

It evolves as you do.

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