Retirement Abroad? Key Costs Aetna Employees Should Consider Before You Go

Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more

'Aetna employees considering retirement abroad should recognize that worldwide taxation, limited Medicare coverage overseas, currency fluctuations, and cross-border estate coordination can materially influence long-term income and legacy planning. Be sure to take a comprehensive view of these factors and consult qualified legal and tax professionals before making an international move.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Aetna employees exploring retirement abroad should carefully weigh how ongoing U.S. tax obligations, health care coverage limitations, currency exposure, and cross-border estate considerations may shape their long-term financial picture. Aim to coordinate with experienced planning, legal, and tax professionals before committing to an international transition.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

1. Key U.S. tax rules that follow retirees overseas.

2. Health care and Medicare considerations for living abroad.

3. Financial planning complexities, such as currency risk and estate planning.

By Brent Wolf, CFP®, Wealth Enhancement

For decades, many Americans have dreamed about retiring abroad—whether for lifestyle reasons, proximity to family, or simply a change of scenery. For many Aetna employees, the idea of enjoying retirement overseas after years of dedication can feel especially rewarding.

For individuals over 55 with substantial invested assets, retiring abroad may be possible. However, it requires careful planning. Moving overseas does not automatically simplify finances and, in some cases, it can increase complexity—particularly when retirement income includes employer-sponsored plans.

Before making a decision, there are several important financial considerations.

1. The U.S. Tax System Follows You

The United States generally taxes U.S. citizens on their worldwide income, regardless of where they live. This remains true even if a Aetna employee establishes residency in another country.

That means:

- Traditional IRA and many employer-sponsored retirement plan withdrawals are generally taxable for U.S. purposes.

- Required Minimum Distribution (RMD) rules apply to most tax-deferred retirement accounts, such as traditional IRAs and many employer plans (though not to Roth IRAs for original owners).

- Social Security benefits may be taxable depending on income levels.

- Capital gains must continue to be reported.

- Depending on thresholds, foreign financial accounts and assets may need to be reported, including potential FBAR (FinCEN Form 114) and/or FATCA Form 8938 filings.

International tax compliance requirements remain in place after moving abroad, and penalties for noncompliance can be significant. U.S. citizens residing overseas typically continue to have federal filing obligations.

2. Medicare and Health Care Outside the United States

Medicare generally does not cover health care services received outside the United States, except in limited circumstances. Some Medigap policies may provide limited emergency coverage abroad, but traditional Medicare coverage is largely restricted to care received within the U.S. ¹

As a result, retirees living overseas often evaluate alternative health care arrangements, which may include purchasing additional coverage. For Aetna employees accustomed to employer-sponsored health care benefits, this transition requires thoughtful comparison of costs and coverage.

Health care planning for retirees—including income-related Medicare premium considerations and broader long-term planning—can become more complex when residency changes.

3. Currency Risk

If retirement income is denominated in U.S. dollars but expenses are paid in another currency, exchange-rate fluctuations can affect purchasing power. This may be particularly relevant for Aetna retirees relying on distributions from U.S.-based retirement accounts.

For example, a significant change in currency exchange rates can increase or decrease the effective cost of living when converting dollars into foreign currency. This exposure introduces additional variability that should be evaluated in long-term income planning.

4. Estate Planning Across Borders

Estate planning can become more complex when assets or beneficiaries span multiple jurisdictions. Aetna employees who accumulate assets across different states or countries during their careers may already have layered estate considerations.

Many countries have forced heirship rules. Some impose inheritance taxes on local assets. Legal treatment of trusts may differ from U.S. law, and foreign real estate may require additional planning to align with U.S. estate documents.

When individuals own property or financial accounts outside the United States, coordination between U.S. estate planning documents and local legal requirements is often necessary.

Evaluating the Decision Carefully

Retiring abroad can be appealing for lifestyle and personal reasons. However, U.S. taxation of worldwide income, limited Medicare coverage outside the country, currency exposure, and cross-border estate planning considerations are important financial factors for Aetna employees to evaluate before making a long-term move.

A thoughtful analysis should consider how relocation may affect income planning, tax obligations, health care arrangements, and legacy goals over the coming decades.

How The Retirement Group Can Help

Relocating internationally in retirement introduces tax, health care, estate, and income planning considerations that deserve careful review. The Retirement Group works with individuals navigating complex retirement decisions, including Aetna employees evaluating international retirement, and can help assess how a move abroad may affect long-term planning.

If you would like guidance tailored to your situation, you can contact The Retirement Group at (800) 900-5867 to discuss your retirement planning questions.

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Sources:

1. Centers for Medicare & Medicaid Services.  Medicare & You 2026 . U.S. Department of Health and Human Services, 2026,  https://www.medicare.gov/publications/10050-medicare-and-you.pdf .

2. Internal Revenue Service.  Tax Guide for U.S. Citizens and Resident Aliens Abroad . Publication 54, Dec. 2025,  https://www.irs.gov/pub/irs-pdf/p54.pdf .

3. Congressional Research Service.  Social Security Benefit Taxation Highlights . IF11397, 23 Sept. 2024,  https://www.congress.gov/crs_external_products/IF/PDF/IF11397/IF11397.4.pdf .