What’s your primary criteria for choosing a new home base abroad?
The question usually begins with something about beaches, mountains, or both. Or perhaps your preferred climate.
But the reality is that healthcare access becomes increasingly important as we move through our 50s and beyond. That’s especially true for those of us building location-independent businesses rather than hoping for the best in the U.S.
As we’ve discussed, plenty of countries offer quality healthcare at a fraction of the cost — even without insurance. But what’s the overall best option?
According to a recent analysis from International Living, Portugal offers the best healthcare system for expats worldwide in 2025, outranking popular destinations like Costa Rica, France, Spain, and Italy.
The combination of quality, accessibility, and affordability puts it in a category of its own. This is particularly true for Americans accustomed to navigating the complex and expensive healthcare landscape of the United States.
“One of the biggest draws to life in Portugal is the quality and affordability of its healthcare system,” expat Terry Coles says in a recent article from Travel + Leisure:
As an expat, I have access to both public and private health care, along with reasonably priced private insurance. Most expats, like us, choose private insurance because it provides access to top-notch care while avoiding the longer wait times that can sometimes occur in the public system.
This matters for several reasons. First, when you’re running a business remotely, health disruptions can directly impact your income. The peace of mind that comes with reliable, affordable care translates into business stability.
Plus, healthcare costs in Portugal reflect a different reality than what we’ve grown accustomed to in America. A medical visit without insurance typically costs between $65 and $145—about what many Americans pay with insurance. With Portuguese private coverage, that same visit drops to around $20.
U.S. expat in Portugal Stacey Leasca notes in the Travel + Leisure article that insurance averages around $550 monthly, alternatives exist. This flexibility is crucial for location-independent business owners who need seamless healthcare as part of an overall plan to live their best life at midlife.
The Portuguese Healthcare Advantage
Portugal offers dual access to both public and private systems, creating a safety net that’s particularly valuable as we enter our 50s and beyond.
The public system (called Serviço Nacional de Saúde or SNS) covers essential medical services with minimal copays. This provides a baseline of security that simply doesn’t exist for most Americans without employer-sponsored healthcare.
Meanwhile, the private system delivers what digital expats value most: efficiency, choice, and English-speaking providers. When you’re building and running a business, time spent in waiting rooms is income and opportunity lost.
This dual-system approach represents more than just healthcare — it exemplifies why Portugal has become a premier destination for location-independent professionals. The country has effectively removed one of the biggest barriers Americans face when considering starting their own business: healthcare uncertainty.
Beyond Healthcare: The Entrepreneurial Ecosystem
Healthcare alone wouldn’t make Portugal worthwhile if other fundamentals weren’t in place. But they are — and they create a compelling package for digital entrepreneurs.
Portugal’s stunning coastline provides the backdrop that makes working remotely feel less like work. The country’s time zone allows for overlap with both North American and European business hours. Its infrastructure supports digital operations with reliable internet and coworking spaces throughout major cities and coastal towns.
During my time working across the pond, I discovered what many expats and nomads are now realizing: Portugal offers the perfect balance of European charm and practical business support systems. The growing community of international professionals creates natural networking opportunities without forcing you into the insular expat bubbles common in other destinations.
Overcome Inertia and Begin Your Next Chapter
The challenge for most people in their 50s isn’t understanding the benefits of international living. It’s overcoming the inertia of familiar routines and outdated notions about what this phase of life should look like.
Traditional retirement often fails to deliver the fulfillment it promises, even for wealthy Baby Boomers. Building a location-independent business while based in a place like Portugal offers an alternative: continued income, intellectual stimulation, and the lifestyle benefits retirement is supposed to provide.
Healthcare security becomes the foundation that makes everything else possible. As Leasca notes in her article about her own move from Los Angeles to Lisbon:
There are so many things to consider before moving abroad, but if you know you’ll be taken care of during a time of need in your new home, that’s huge.
Are you ready to leverage your experience into a business model that provides both purpose and freedom, backed by healthcare security that most Americans can only dream about? Portugal may be your ideal new home base.
