She moved to France and her $36,000 asthma drug dropped to $3,000

• Some Americans are moving abroad to access more affordable and comprehensive health care.
• Nearly half of American adults worry about affording medication or health-related expenses.
• Other factors for moving include stricter food standards and a desire for a safer environment.

Hilary Hodge suffers from severe allergic asthma. But in 2012, she saw hope in biologic medication. There was one catch: She was living in the United States at the time, and biologics would cost her $36,000 a year. A few years later, she moved to Angers, France, with her husband. Across the pond, that same medical treatment was 12 times cheaper.

Hodge has had asthma since childhood, but instead of improving, as many asthmatics do, she was part of the 10% whose respiratory condition worsens. By age 32, her inhaler no longer provided relief. Her chronic condition became "a big struggle," she told USA TODAY. Although she qualified for a biologic when living in Chicago, the injectable medication was highly expensive at the time.

In 2017, Hodge and her husband decided to make a temporary move to France to be closer to his friends and family. In her new home, Hodge was instantly able to get her biologic for $3,000 a year.

"That was sort of one of the very first experiences I had with realizing how different the systems were," Hodge said.

They had planned to stay only for a few years, but they got pregnant with their son and bought their own house. "It just sort of all of a sudden turned a lot more permanent. I guess we're here," Hodge said. "But honestly, health care is a big part of why."

Rising costs and access to health care are top of mind for many Americans: Nearly half of adults worried they couldn't afford medication or health-related expenses this year, according to a survey in 2025 by West Health-Gallup Center for Healthcare in America. It's the highest level of concern recorded since the survey's inception in 2021.

For some, moving abroad can be part of the solution. Other countries, such as Canada, Japan and those in the European Union, offer lower costs, universal health care and easier access to citizens and certain visa holders. In a recent American Expats Survey by The Harris Poll, 38% of the 6,358 respondents cited cheaper, better health care as a reason for considering expatriation.

Michelle Garabito of the luxury relocation service The Lux Nomads said many of her clients are leaving the United States for health reasons. "We're seeing a lot of families with small children also coming through the pipeline, and then we're seeing a lot of retirees who are just ready to go and live a better retired life with universal health care right by the beach and having a beautiful home for half the cost and what they're spending in the U.S."

Avoiding the steep price of health care

It wasn't the quality of health care that was the issue for Hodge; it was the price.

Americans spend the most on health care of any country in the world. In 2025, a family health insurance plan averaged at $26,993 – a 6% increase from 2024. An unexpected medical emergency or costly diagnosis, such as cancer, can leave people thousands of dollars in debt.

"It's just not something that would ever happen here for a lot of different reasons," Hodge said. "When I just think about what's best for my child and me, just purely from the point of view of health care, it's a better place."

Along with her asthma, Hodge experiences adrenal crises, a life-threatening medical emergency caused by a severe deficiency of cortisol. She has had three crises in the past few years and didn't feel worried about affording treatment at the hospital.

"In the States, as you know, you kind of do the math," she said. "You're like, 'Do I want to pay a $500 deductible to go to the hospital?' For a lot of people, that can be a really dangerous question, an equation. Like, how sick do I have to get to go pay that $500 deductible? Here, I just never even think about it."

A healthier life abroad

The actual medical care is just one part of why many Americans find their lives abroad healthier. For Leah Mark, who moved to Mallorca, Spain, from Indiana in June, her well-being is influenced in part by the European Union's stricter food standards, including bans on many additives, preservatives and other chemicals. Even some American food products are banned from being imported into Europe.

Mark said she finds the food across Europe not only "incredible" but also much more affordable.

Mark first started thinking about moving from her home state during a harsh winter and was considering warmer U.S. destinations like Florida. But it still didn't feel like quite the right fit. "Everywhere in the United States right now, I'm bumping up against the same issues – the toxic culture, the food, the increasing political unrest," she said.

The move became more urgent in January 2025 after a shooting at a grocery store not far from her that killed two people. "I stopped feeling safe as a single woman in the United States," she said.

Mark soon came across The Lux Nomads on social media, which is run by two expatriates themselves, Michelle Garabito and Paul Nelson. With their help, she began the process of moving abroad under a digital nomad visa. Now she travels throughout the E.U. with Mallorca as her home base.

"I'm so glad that I did it," she said. "It was really hard, like just emotionally saying goodbye to that stuff, and I do miss some things over here, but I will say, the quality of life that was added is so much more valuable and important to me."

What to know about health care options abroad

Moving abroad is a major endeavor and life adjustment; it's not as easy as packing up and buying a plane ticket. There is legal paperwork, logistics and missing friends and family back home. A monthlong trial run can be valuable in deciding whether a big move is worth it, especially if you've never lived outside the United States.

"I always advise to just do one month of living in countries around Europe, specifically because of the regulations," Garabito said. "Go eat out every single day and go walk in walkable cities and just see how you feel."

The process of legal residency can also be slow. Foreigners often need a valid visa to access the public health care systems in other countries, and the process can take months.

A good starting point for many people is obtaining digital nomad visas or nonlucrative visas, which are for nonworking people like retirees, Garabito said. (To apply, however, you also have to get private health insurance.) Getting your residency card can take a few months, and once you're a legal temporary resident, paying into Social Security, you are enrolled in the country's public health care system. Overall, the timeline from visa approval to accessing health care takes three to six months.

In certain countries, including Portugal, Spain and Greece, digital nomad visas are a stepping stone into a more permanent relocation, helping people meet the residency requirements. In Spain, people can apply for permanent residency after five years of living there, and for citizenship after 10 years.

It's a lot of work, but for many Americans, it's worth it for their health and happiness. Said Mark: "I'm not just saying it to say it. ... I am so much happier, so much more at peace."