Long-Term Care Planning for Internationally Mobile Retirees

Long-term care — the ongoing support required when individuals can no longer manage daily living independently due to physical or cognitive decline — is one of the most significant and least-planned financial risks facing retirees worldwide. For internationally mobile individuals who have spent careers across multiple countries, the challenge is compounded: where will you receive care, who will provide it, how will it be funded, and what are the legal and financial implications of care costs in different jurisdictions?

Planning for long-term care is not a comfortable conversation, but the financial consequences of failing to plan are severe. Care costs in the UK, for example, currently average £40,000–£60,000 per year for residential care and considerably more for nursing care with specialist support. Over five to ten years, these costs can consume substantial accumulated wealth. Without planning, care costs can derail otherwise well-constructed retirement income strategies.

This article examines the long-term care landscape for internationally mobile retirees and provides a framework for thinking about and planning for this risk.

Long-term care rules, costs, and funding mechanisms vary significantly by country and are subject to change. This article does not constitute financial advice. Always take regulated advice specific to your circumstances.

The Scale of the Risk

Longevity is increasing globally. A 65-year-old today can expect, on average, to live to 85–87 in most developed countries. One in three people aged 65 will develop dementia at some stage of their life; approximately one in four will require residential care for at least one year; a smaller but significant proportion will require care for five years or more.

The financial impact is asymmetric: most people will require some care, but the extreme cases — those needing specialist dementia care for many years — are the financially catastrophic ones. A decade in a specialist memory care facility in the UK or similar Western country could cost £800,000 or more at current prices, rising with healthcare inflation.

For internationally mobile retirees who may have optimised their financial planning around relatively modest ongoing income needs — perhaps living comfortably on £50,000–£80,000 per year in Spain or Thailand — a sudden large care cost requirement in a high-cost country can fundamentally disrupt the plan.

Where Will You Receive Care?

The first and most fundamental question for internationally mobile retirees is: where? The answer significantly determines the likely cost, quality, and funding mechanisms.

The country of residence: if you are settled in Spain, Portugal, or Thailand, local care systems and private care facilities will be the primary option. Costs vary enormously: residential care in Thailand is a fraction of the cost in the UK or Switzerland, though the availability of specialist dementia or nursing care meeting Western standards varies.

Return to the UK: many British expatriates who face care needs ultimately return to the UK, where family support networks exist and high-quality regulated care is available. However, returning to the UK after years abroad has significant financial implications: any assets you own are potentially subject to UK care cost means-testing if you have UK tax residency at the point of assessment.

Family arrangements: some individuals return to the family home of an adult child and receive informal care, sometimes supplemented by visiting care workers. This requires family coordination and has its own financial and practical implications.

The uncertainty of not knowing where you will receive care — or even where you will be living when care becomes necessary — is itself a planning challenge. A flexible financial plan should accommodate multiple care scenarios.

State Provision: Understanding the Limits

UK State Provision

In England, as of 2026, the means test for residential care has a capital threshold above which individuals are expected to fund their own care. Those with assets above approximately £23,250 in England are expected to fund their own care; the state contributes only for those with assets below a lower threshold. Scotland, Wales, and Northern Ireland have different rules.

Critically:

• The family home is included in the means test unless a spouse or qualifying dependant remains living in it.
• Attempts to give away assets to pass the means test can be investigated as "deliberate deprivation" and reversed.
• Individuals who have been living abroad and then return to the UK for care may face residency eligibility questions — local authorities assess ordinary residency, not just physical presence.

NHS Continuing Healthcare

Some individuals with complex medical needs qualify for fully-funded NHS Continuing Healthcare (CHC), in which the NHS meets the full cost of care. Eligibility is assessed on medical need, not financial means. However, CHC is available only to residents in England (with equivalent but different schemes in devolved nations) and is not straightforward to access — many who qualify initially face delays and disputes.

International State Systems

Most countries provide some level of publicly funded care for elderly residents, but the level, eligibility criteria, and quality vary enormously. France has a well-developed residential care sector with partial state funding; Spain's system operates through regional governments with variable provision; UAE and Thailand have limited state social care systems for foreign residents, meaning private funding is essentially the only option.

Understanding the state provision — or absence thereof — in any country where you might need care is an essential step in planning.

Private Long-Term Care Insurance

Long-term care insurance (LTCI) provides a regular income or lump sum benefit upon meeting a definition of care need — typically being unable to perform a certain number of "Activities of Daily Living" (ADLs) such as washing, dressing, eating, and mobility.

UK Long-Term Care Insurance

The UK LTCI market has contracted significantly over the past decade — many insurers have withdrawn — but products remain available. Options include:

• Pre-funded LTCI: regular premium policies that pay out when care is needed. Premiums are significant for older applicants and increase further if you have existing health conditions.
• Immediate needs annuities: purchased at the point care is required, these convert a lump sum into a guaranteed income paid directly to the care provider. They are available at any age and remove the risk of outliving care fee provision. Premiums reflect health status at purchase.

International Private Medical Insurance

For those living abroad, a comprehensive international health insurance policy may cover some care costs — particularly in the early stages of care need. However, standard medical insurance typically does not cover long-term residential care. Specialist international long-term care policies exist but are available from a limited number of providers and involve careful assessment of where care will be received.

Asset-Based LTCI Hybrids

Some offshore investment bonds and life assurance products incorporate care benefit riders — effectively combining investment growth with a care insurance element. These products have their own complexity and must be carefully assessed against standalone options.

Funding Care from Assets

Given the limited insurance options and the uncertainty of state provision, most internationally mobile retirees will need to fund at least some care costs from their own accumulated assets. Key considerations:

Liquidity Planning

Care costs must be met regularly and reliably — they cannot be deferred while you wait for a property to sell or an investment to mature. Any care cost planning must include sufficient liquid assets to meet care fees on an ongoing basis.

Property — often the largest asset for many retirees — is illiquid. A retiree who has most of their wealth tied up in overseas property faces a mismatch: care costs arrive as a regular liability, while the asset is illiquid. Planning ahead may mean retaining more liquid assets (bonds, cash, investment funds) than pure income optimisation would suggest.

Ring-Fencing Care Reserves

One practical approach is to identify a portion of your portfolio as a "care reserve" — funds that are not spent on income or inheritance but are preserved specifically for care costs. This could be held in a separate investment account with a conservative asset allocation to preserve capital.

The care reserve should be sized based on a realistic assessment of potential care costs in the likely care location, inflated forward for healthcare inflation (which typically runs 2–4% above general CPI).

Means-Test Planning (UK Return)

For those who may return to the UK, understanding the means test and planning asset ownership accordingly is important — but must be done well in advance of any foreseeable need. Importantly, there is no fixed "seven-year rule" for care means-testing (the seven-year period applies to inheritance tax on lifetime gifts, not to local-authority care assessments). A local authority can treat assets disposed of at any time as still belonging to you if it decides the disposal was a "deliberate deprivation" undertaken to avoid care charges — there is no time limit. These rules are complex and must be navigated with specialist legal advice.

Married couples and civil partners have additional planning opportunities through asset ownership structures.

Care Planning Beyond Finance

Long-term care planning is not only financial. Equally important:

Lasting Power of Attorney (LPA): as of 2026, a UK Lasting Power of Attorney for both property/financial affairs and health/welfare is essential. If you lose mental capacity without one in place, the Court of Protection process is slow, expensive, and stressful for family members. For those living abroad, a local equivalent document may also be required.

Advance care directives: a living will or advance directive specifying your care preferences in the event of incapacity is important in many jurisdictions. Requirements and recognition vary by country.

Family communication: the biggest practical challenge in care planning is often the reluctance to discuss preferences with family members until it is too late. Early family conversations about preferences — type of care, location, who will be involved in decisions — dramatically ease the practical challenges when care needs arise.

How Global Investments Can Help

Long-term care planning for internationally mobile retirees is a specialist area that sits at the intersection of financial planning, insurance, tax, and legal advice. Global Investments works with clients and their wider professional teams to build care cost projections into retirement income plans, assess insurance options, and identify appropriate asset structures to meet potential future care needs.

With over 32 years of experience across multiple jurisdictions, we understand the varied care landscapes our clients may navigate. We help you plan for this risk before it becomes a crisis. Contact us to include long-term care planning in your retirement review.

Long-term care rules, costs, and state provision vary by jurisdiction and are subject to change. Tax treatment depends on individual circumstances. This article does not constitute financial advice. Always seek regulated advice tailored to your personal circumstances.