The paper examines social protection for older people in three middle-income countries: Argentina, Thailand and South Africa. It focuses on income support, health services and the provision of care, as well as considering the effects of these policies on social exclusion. The paper locates each country's different social protection programmes within a broader welfare regime model. It finds an interesting variety of approaches to pension and health provision, which range from generous universalism to minimal means-testing. However, it finds much less innovation in areas such as long-term care and intermediary services. The paper challenges generalisations about old age social protection in developing countries, and argues that the different experiences of these three countries could provide useful lessons for social protection in many parts of the world.