Immigrants and family members in the home and host societies experience inequalities in access to social protection. Focusing on healthcare, we demonstrate that immigrant families today respond to healthcare needs of family members here and there through four cross-border strategies. We show that immigrants select and articulate these different strategies to assemble transnational health care arrangements. Using an intersectional approach, we argue that heterogeneity markers such as gender, race, class, and levels of transnational engagement determine the choice between different types of arrangements. We support our argument with ethnographic data collected with 48 members of 10 Andean transnational family members during fieldwork in Belgium, Colombia, and Peru.