How much can a 60-year-old American save on healthcare by moving to Spain?

A 60-year-old American couple earning $90,000 pays approximately $22,000–$31,800/year in US healthcare costs (ACA premiums + out-of-pocket). In Spain, the same couple pays $2,400–$3,600/year for private insurance or $1,440/year through Convenio Especial (public system buy-in at €60/month per person). Over 10 years, the savings range from $180,000 to $300,000 depending on health status and coverage choice.

What factors affect healthcare savings when moving from the US to Spain?

Key variables: age (ACA premiums rise 3x from 21 to 64), household income (determines ACA subsidy eligibility at 400% FPL threshold), health status (affects US out-of-pocket costs but not Spain's Convenio Especial pricing), plan tier (Bronze/Silver/Gold), and time horizon. Spain costs are flat: €60/month per person under 65 regardless of health. US costs inflate at ~6%/year vs Spain's ~2.5%/year, so the gap widens every year.

Healthcare savings calculator — US vs Spain cost comparison

Your age

Household

Annual household income (pre-tax)

$90,000

$40k

$250k+

Health status

Current US plan tier

Sample 10-year projections

Enter your details above for a personalized calculation. Here are three common scenarios:

Scenario	US (10yr)	Spain (10yr)	Savings
Single, 60, $75K income, Silver	$210,000	$14,500	$195,500
Couple, 60, $90K income, Silver	$413,000	$27,800	$385,200
Couple, 55, $120K income, Gold	$478,000	$26,200	$451,800

Your 10-year projection

estimated savings over 10 years in Spain

🇺🇸 Stay in the US

Annual premiums

Deductible + copays

ACA subsidy

🇪🇸 Move to Spain

Year 1: Private insurance

Years 2-10: Convenio Especial

Supplemental private (optional)

10-year total comparison

🇺🇸 United States

🇪🇸 Spain

Year	Age	US cost	Spain cost	Annual savings	Cumulative

Methodology and assumptions

US premiums based on 2026 ACA marketplace benchmark rates by age band, adjusted for plan tier (Bronze 0.78x, Silver 1.0x, Gold 1.22x).
ACA subsidies calculated using 2026 Federal Poverty Level ($15,650 single, $21,150 couple). Subsidy cliff applies above 400% FPL.
US out-of-pocket: Bronze $6,500 deductible + $2,000 copays; Silver $4,000 + $1,500; Gold $1,500 + $800 per person. Scaled by health status.
Spain Year 1: Private insurance at market rates (age-adjusted, $100-180/month per person). No Convenio Especial eligibility until 12 months residency.
Spain Years 2-10: Convenio Especial at $60/month per person (€60). Optional supplemental private at $40/month per person.
Annual healthcare cost inflation: US 6% (CMS National Health Expenditure projection), Spain 2.5% (EU average).
Does not include: travel costs, cost of living differences, visa fees, tax implications, or currency fluctuation.
All figures in USD. EUR/USD assumed at 1.08.

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Sample 10-year projections

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10-year total comparison

Methodology and assumptions

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