I got news from the hospital today about my biggest fear.  

My Biggest Fear

So what was I so afraid of?  The number one killer of men my age is heart disease.  Some people drop dead with no advanced warning or symptoms.  Now, Fear does not consume me. I don’t walk around in fear every day.    

I eat right, I work out 5 days a week, and I monitor my blood chemistry every year.  But I have always wondered about my heart because I can’t see inside my body.  I have wondered how much, if any, plaque I have built up in my arteries.

I got news from the hospital today about that.  

But first, what sent me to the hospital to find out about my heart and arteries?  When we were in Dalat, Vietnam, we met with one of our friends who lives there.  

He told us about a test he had done that showed 60% plaque buildup in his arteries.  So the doctors put him on meds to reduce heart attack or stroke risks.  

What blew me away was how little it cost him. He was able to see inside his arteries for so little money. The cardiologist and the imaging cost him only $250 USD.   This could easily have cost him five times as much in the US.

My Journey Begins

So, it was his story that sent me on this journey.  I didn’t want to worry about how much plaque I had in my arteries.   I wanted the peace of mind of knowing how advanced my plaque buildup was.  

That knowledge would give me the power to manage a long, healthy life.  After I tell you my results, I want to explain why I may be able to take better care of myself outside the US.

And I am not just talking about the cost savings, though that is significant.   So I booked an appointment with a cardiologist when we arrived here in Danang, Vietnam.  

Now, I am 64 years old and I am not old enough to have Medicare in the US.  First, I will explain what happened here in Vietnam.  Then I will explain why I would not have flown to the US to do this even if I were on Medicare.  

So, we are in Danang, Vietnam.  And I don’t speak Vietnamese.   So I booked the appointment online.  But I didn’t know if the cardiologist speaks English.  So I wrote a series of questions in English and used Google Translate to get the Vietnamese translation.

Here are the questions.  

The hospital had full-time translators for various languages.  The translator read my questions to the cardiologist.   Then the cardiologist answered each question in Vietnamese, and the translator spoke English with us.  

They had all of the modern equipment, and the cardiologist recommended two tests to determine the level of plaque in my arteries.  

Scan 1:  A coronary calcium scan is a computerized tomography (CT) scan of the heart. It looks for calcium deposits in the heart arteries that reduce blood flow to the heart.  This CT scan shows coronary artery disease before you have symptoms.

Scan 2: The second test is called a carotid ultrasound, which determines if the carotid arteries are blocked or narrowed. Narrowed arteries increase the risk of stroke.

With these two scans, the cardiologist would be able to see my plaque levels and suggest treatments that lower stroke risks or heart attack risks. 

The costs of the two tests, plus the pre- and post-imaging consultations with the cardiologist, cost $174.  I consented to the two tests, and they were both performed within a two-hour period.  The doctor was in surgery when the tests were complete, so they set a 9:30 AM appointment the next day.

I decided to shop for prices in the US.  The cardiologist alone would have cost $200 or more in the US.   A coronary calcium scan in the US would range from about $100 to $400 USD.  A carotid ultrasound in the US would range from about $150 to $400.  

So if I were in the US, this would have cost me anywhere from about $450 to $1000.  But the problem is, because of the way medicine is practiced in the US, I would need to go see a General Practitioner and get a referral to a cardiologist.  That could push up the cost by another few hundred dollars. 

But, since I have no symptoms, I may not be able to get a referral to a cardiologist in the US.  Many general practitioners suggest doing blood work and prescribing meds without asking for an image of the present status of your arteries if you have no symptoms.

Requiring a referral to a cardiologist is often called a gatekeeper.  In some parts of the world, like Vietnam, Thailand, Malaysia, and others, there is no gatekeeper.  You just find the doctor you want, book an appointment online, and go see the specialist first.  

After I tell you the results from the scans of my arteries, I will share two very important things.  First, why would I not fly to the US for testing even if I were 65 or older on Medicare?

Second, I will explain why I feel I can take better care of myself outside the US.  

Image Results

So, I showed up at the hospital to find out the results of my two scans.  The translator was also there.   The cardiologist read the report while we all waited.  

Then he turned to the translator and spoke in Vietnamese.  The translator smiled and said.  Both scans are clear.  You do not have plaque in your arteries.  

I said, “Wait, you mean my arteries are blocked less than 5%?”

The translator spoke to the cardiologist and then replied, “No, you have zero plaque showing in these scans.  

I sat back in my chair and thought, Wow. 

All those years I had wondered if my exercise and diet was worth all the trouble.  And now I knew.  I was treating my body right, and it was returning the favor.  

Just 24 hours before, I didn’t know what my heart looked like in the inside.   Was it struggling to keep me alive?

You won’t believe the peace of mind it has given me to know the plaque is not slowly taking life out of me.   Having images of your own beating heart, knowing it is not having to fight, 20, 40, or 60% blockage, feels really good.  

But there is more to this story.   If I had another fear about my body, like cancer, or other serious ailments that only an image can reveal?  They have full body imaging you can do, blood work, EKGs, everything you can get in your home country.

You just book an appointment with a specialist in that specialty, and your fears are often gone within 24 hours.   So, why live in fear?  Just come, get rid of your concern for 50 to 90% off in some cases.  

I got rid of my biggest fear for $174.  Here is the cardiologist’s information:

Why I would Not Fly to the US even if Medicare

The flight alone could cost me $1500 round-trip.   Then, when I arrived, the doctor would ask if it was an emergency.  Since it is not an emergency, my appointment might be in 2 to 4 weeks.  

And that first appointment might be with a gatekeeper instead of the specialist.  So now I am stuck paying for life in the US for a month, waiting to see a gatekeeper.

Even if I get to see the specialist, can they order the test, or do they need to get insurance approval?

Even if I stayed with family and friends, it could cost me $2 to $3,000 US living in the US for a month or two, plus another $1500 round-trip flights, so $3500 to $4500 US before considering any medical expenses.  Hopefully, Medicare would cover most of that.  

If I have no symptoms, they may just want to do a few tests and then put me on Meds.  I may not get the peace of mind of knowing how much plaque I have in my arteries.

Why go through all that when I get the results in 24 hours for $174 USD?

Can I take better care of myself outside the US?

My experience living overseas for the last 18 years tells me that I can take better care of myself overseas.

In 2025, I can get full body images, bloodwork, and access to a specialist for less than $1500 US in Malaysia, Thailand, and Vietnam.  And the equipment is all top-notch in the various hospitals I have been in.

That allows me to act proactively at the first sign of trouble.  Even before symptoms start.  And I am in charge of my care in SE Asia.  I am not trying to convince my doctor to order an image.  I am not trying to convince my insurance company to pay for an image or a test.  

Being in charge of my health care, and using access I have to trained specialists for a reasonable price, empowers me to learn more about how to solve problems proactively instead of waiting until I have symptoms.  When I add the cost of living savings in SE Asia, it means I may be able to live a longer, healthier life here with less fear about money.  

Now, I am not recommending what you should do with your life or health care.  I am just sharing what I have learned about my life and my healthcare after living overseas for the last 18 years.  

Before you make any permanent changes in your life, you need to do an exploratory visit, see what it would cost you to live here, and visit some of the hospitals and doctors in the countries you are interested in.  You may not feel the same about living overseas as I do.  So don’t make any permanent changes in your life until you have completed your exploratory visit and verified with your feet on the ground whether or not this life is right for you.  

Make sure to grab my free eBook, How I fired my boss and traveled the world for 18 years.  Also, watch the playlist in the upper right-hand corner of your screen right now, if you would like to hear 150 other people share what their life has been like retiring overseas.