The global landscape of millionaire migration is changing in surprising ways, and here’s the twist: soaring private healthcare costs are increasingly influencing where the wealthy choose to settle. And this is the part most people overlook—costly healthcare may soon outweigh even tax benefits or lifestyle perks in determining their moves. But why is this happening now? Let’s explore.
Recent insights from Henley & Partners, a renowned firm specializing in investment migration, reveal that the decision-making process for high-net-worth families is shifting. When considering new residences or citizenships, these affluent individuals are no longer solely driven by tax advantages or luxurious living conditions. Instead, they are placing a rising emphasis on the long-term expenses associated with private healthcare. Their research, which combines client application data with comparisons from a comprehensive global health index, shows that healthcare affordability is becoming a decisive factor.
In fact, in 2025, Henley & Partners reported a 43% increase in applications for global residence and citizenship programs during the first three quarters compared to the same timeframe the previous year. This surge indicates that global mobility is evolving into a vital risk-management strategy for the wealthy—it’s not just about where they want to live, but also about how much it costs to maintain their health and well-being over time.
Christian H. Kaelin, the firm's chairman, emphasizes this shift: “Clients are now analyzing not just accessibility and legal status, but also the true costs of a sustainable lifestyle—particularly the price of dependable private healthcare.” He points out that destinations which seem attractive on paper can become less appealing once the real healthcare costs are understood.
A recent report, the SIP Health Cost Index 2025, provides clear data on which countries are most and least affordable for private healthcare. It examines the premiums paid for international private medical insurance (IPMI) in 50 different nations. The results are striking:
- The United States ranks as the most expensive market worldwide, with an average annual cost of $17,968 per person.
- Hong Kong and Singapore are close behind, with average costs of $16,175 and $14,231, respectively.
- Notably, China, Thailand, and Taiwan have also become costly, driven by increased demand for premium hospital services and higher inpatient care costs.
In Europe, the UK and Greece are on the higher end, with costs approximately $11,726 and $9,654, respectively, while Switzerland sits in the middle at around $8,912. The United Arab Emirates ranks tenth globally, with an average cost of nearly $9,680.
Meanwhile, some middle-tier options like South Africa, Saudi Arabia, and Monaco have healthcare costs ranging from about $7,100 to $7,600.
This rise in healthcare expenses is not uniform across the globe. Kevin Bürchler, CEO of SIP Medical Family Office, points out that while inflation in private healthcare is accelerating worldwide, the pace and pattern vary significantly between regions. He highlights that countries such as Italy, Portugal, and Austria offer more affordable options, boasting lower costs due to their proximity to well-established medical hubs like Switzerland and Germany.
For wealthy families planning their futures, especially those nearing retirement, these cost differences are crucial. For example, paying $30,000 annually for private health insurance versus $10,000 can be a game-changer—affecting their overall financial stability and peace of mind.
The increasing concern over healthcare affordability is also driving Americans and others to consider relocating or securing alternative healthcare options abroad. Basil Mohr-Elzeki, managing partner at Henley & Partners North America, notes a dramatic shift: US clients now make up 40% of their clientele, up from just 5% in 2018. For many, healthcare resilience has become a core part of their migration strategy. They are seeking destinations like Portugal, Italy, Greece, Malta, and Latin American countries such as Panama and Costa Rica, where private medical care is more affordable. Turkey has also attracted many for its cost-effective medical tourism.
Moreover, older clients increasingly look overseas for alternative healthcare solutions—seeking not only to cut costs but also to explore different medical opinions and treatments outside the US system, which, while highly advanced, is often driven by commercial interests.
The overarching takeaway from Henley & Partners’ findings is clear: as healthcare costs continue to climb, savvy movers are proactively planning their lives to avoid hidden financial pitfalls and ensure medical stability. This shift raises a critical question: Are high healthcare costs already outweighing other perceived benefits like tax savings and lifestyle perks when choosing a new country of residence? And how will this trend influence the future of global migration for the wealthy?
We want to hear your thoughts. Do you agree that healthcare affordability will soon dominate relocation decisions among the wealthy? Or do you believe other factors will remain paramount? Share your opinion in the comments—this debate is just getting started.
