Expat Health Insurance: Costs, best plans, and key info before moving abroad

Health insurance is probably one of the top priorities when you move to another country. Whether it’s a straightforward vacation or a longer-term commitment, odds are you’ll need medical insurance.

The longer you intend to stay, the higher the chances you’ll need treatment at some point. Having medical insurance is often a prerequisite when you apply for a long-term visa: your application might simply be turned down if you have none.

In the article below we’ll focus on expat health insurance, i.e. most useful to Americans who plan on living abroad for a while, be it to work or to retire in another country. We’ll cover different insurance types, top insurance providers, costs, and much more. Strap in.

What is expat health insurance?

Expat health insurance is designed for people who wish to live, work, and maybe even retire, in another country, for example, a US citizen who moves to Spain.

The main difference from local health insurance is access to medical professionals who speak your native tongue — a language barrier can be risky when it comes to health issues. Another possible difference is you may not have any/sufficient access to the local healthcare system under the terms of your visa/residence permit.

Finally, as an expat you might be required to produce evidence of health insurance to gain entry to another country. Expat health insurance gives you a way out, potentially better quality healthcare, plus a way to ease the burden on the local healthcare system.

Why do expats need health insurance?

We’ve already outlined one reason above: legal requirements. You might simply lack another option to demonstrate you have an insurer to turn to in case health issues arise while you live in another country.

Expat health insurance might also give you access to higher quality/specific healthcare not readily available through the local healthcare system. We are talking about complex surgeries, dental, vision, and mental health services.

Besides, having no insurance at all in another country can be costly. You can find yourself in a situation where you urgently need help but the costs of such help runs into hundreds or even thousands of dollars. It can be especially burdensome in countries with expensive healthcare systems — such as the US.

Expat health insurance is also a good option for those who travel across different countries. For example, your base of operations can be in one country but you might be required to travel from time to time. Expat health insurance can extend to multiple countries — unlike local health insurance.

Finally, expat health insurance offers you peace of mind. You know you have someone to turn to in case of emergency. So if you don’t speak the language or haven’t had the time to figure out how local health insurance works, you still have a fallback option.

Types of expat health insurance

There are three main types of expat health insurance: travel, local and international. Let’s start with the most straightforward option.

Travel health insurance

It’s a short-term type of medical insurance, which usually stretches to several months. It’s ideal if you are going on vacation or a short business trip. It gives you access to emergency healthcare, should you need it. It’s also a cost-effective solution.

However, it won’t do the trick for foreigners looking to stay in the country for a long period. Firstly, travel insurance covers only emergencies, which rules out preventive care and treating chronic diseases. Secondly, travel insurance might shut off access to more complex healthcare areas, such as surgeries, dental, and mental health care.

Local health insurance

Pretty much “In Rome do as Rome does”. Local health insurance gives you access to the same healthcare system the local population relies on. While it’s certainly more comprehensive than travel insurance, it also comes with limitations — for expats.

You’ll have to deal with the language barrier: local doctors only speak their native tongue. Another important consideration is gaps in the local healthcare system. All the shortcomings locals have to endure and somehow resolve, you’ll have to face too. It might be that specific treatment isn’t available where you live. Or you may have to wait for months until you finally get the help you need.

Finally, your local health insurance might not give you access to private clinics/hospitals — only public ones. And your insurance definitely won’t cover your needs while you are out of the country.

International health insurance

International health insurance is the last on our list for two reasons: it’s the most comprehensive and it’s also the most expensive.

International health insurance will be your saving grace if you are a digital nomad or simply move around a lot during the year. Whichever country you live in, you’ll have access to quality healthcare through your insurer. This healthcare might even extend to your country of origin — and will most likely cover all types of treatment: emergency, preventive, ongoing and everything in-between.

It’ll come with a hefty price tag, but it will give you peace of mind.

What does expat medical insurance cover?

Much will depend on the type of plan you choose — below we’ll outline the areas you should be looking at.

Inpatient and outpatient care

Outpatient care is the more straightforward option. In essence, outpatient care covers situations when you go to a clinic, receive medical services, and are free to leave right after it. Outpatient care can come in the form of medical consultation, getting a prescription, doing bloodworks or other tests, such as X-rays and mammograms.

Inpatient care means you need to be admitted to a clinic/hospital and stay for a while, at least overnight, to receive treatment. It implies you’ll need medical treatment on a schedule and/or be under observation from the medical staff. Inpatient care can be either planned or emergency. The former deals with planned surgeries and childbirth, for example. The latter means you have an acute need to be monitored and treated — in case of a heart attack or a severe illness.

Carefully check which plans insurance providers offer, which situations they cover and which services you can rely on as a result. Start by assessing your current health state and factor in ongoing and potential needs.

Emergency medical treatment

It’s just what the name implies. What happens if you get in a car accident, or your appendicitis flares up, or if you get a panic attack and black out? Does your insurance provider cover such scenarios?

No one likes accidents, especially those which endanger their health. We sincerely hope none of their above never happens to you. But being unprepared when something happens can make an already bad situation worse.

Specialist consultations and diagnostics

You’ll need those in case a specific problem flares up which is not an emergency but can worsen if it goes undiagnosed and untreated — like a persistent cough, for example, or a mild allergic reaction maybe.

In this case you’ll need to consult a doctor who specialises in the area you need treatment in — not a general practitioner. Check whether your plan will cover specialist care.

Prescription medication

You might have a pre-existing condition which requires medication which can only be prescribed. Or an issue might pop and result in you needing one. While you can’t fully account for the latter option, you certainly should be aware of which medications you already take — and will need to continue taking — after moving abroad. Factor that in when choosing an insurance plan — and check whether your prescription meds are available in the country you are going to to begin with.

Maternity and family coverage

If you — or your partner — are planning on having a child in the near future, then everything that goes with being pregnant (regular check-ups, tests, childbirth itself, etc.) should be factored in when choosing a health insurance provider and plan.

And if you are moving with your family, your insurance policy should reflect that as well. Will your partner and children be covered under your plan? Which medical services will they be able to get? Do they require specific treatment for pre-existing conditions, or maybe need prescription meds? Think about these questions as well.

Dental and vision options

Much like mental health options, dental and vision are both costly and easily overlooked. Check which services your insurance provider covers under your plan.

In case of dental, for example, routine checkups, hygiene and even treatment and medical procedures (such as crowns, filling and bridgework) can be covered fully or partially. Vision services can include eye tests, prescriptions for new glasses or the costs of lenses’ supplies.

Cost of expat health insurance

There are several factors which affect how much your health insurance will cost, such as your age, medical history, and costly optional extras (e.g. dental, vision, mental health issues). We’ll cover those in a bit more detail soon.

But the most important factor is geographical — which country you need coverage in. Pacific Prime Insurance publishes an annual report on the costs of medical insurance in different countries. Here are some of the most — and least — expensive countries in terms of coverage (all costs are in USD). We rounded off the numbers to hundreds.
 

Best international health insurance providers

The list of companies below is by no means extensive. We have picked some of the biggest players on the market. They have been around the longest, offer the most extensive list of medical services and are easiest to file claims with.

Cigna Global

One of the oldest players on the scene, Cigna Global offers different insurance plans since 1982 — including plans for expats and their families.
Here are some of the features they offer:

• Round-the-clock access to multilingual help centers
• Access to 1.5M hospitals and doctors across 200 countries
• Quote in 2 minutes and buying a plan online will take you 10 minutes

However they are coy on which services they offer — but it’s understandable because a lot will depend on the plan you choose. The most interesting bit we’ve found is that all plans get you access to inpatient treatment.

Allianz Care

Allianz were founded 65 years ago — and they put an emphasis on providing medical care for expats. Their coverage for expats includes:

• Doctor visits
• Hospitalization
• Vaccinations
• Surgeries
• Diagnostic tests
• Prescription drugs
• Cancer treatment

They also offer interesting services included with your cover, such as:

• Telehealth (essentially online consultations)
• Mind coaching
• Fitness coaching
• Nutrition hub

Finally, Allianz are much more upfront with their plans. There are three basic plans: Care, Care Plus, and Care Pro — the services available to you are more and more extensive with each next plan. The max plan limits are $2,500,000, $4,000,000 and $5,000,000 respectively.

AXA Insurance

Established in 1963, AXA covers almost 200 countries. They pride themselves on offering international health insurance. Here are some of the more interesting services they offer:

• Emergency cover for overnight hospital stays and ambulance transport
• Evacuation and repatriation if the needed care isn’t available in your region
• Cancer care and the treatment you might need, such as chemo— and radiotherapy
• Virtual doctor service: online consultations with specialists
• Mind health service: help from a qualified psychologist
• Second medical opinion service — should you wish to hear from another doctor

The sign-up procedure looks a bit less straightforward than with Allianz Care — as do pricing plans. There are a total of five — and the top one maxes out at $8,000,000 a year.

Bupa Insurance

Bupa Insurance was founded in 1947 in the UK. They operate in 190 countries across the globe and have over 43M customers.
Their expat health insurance is relatively straightforward. There are four plans: Select, Premier, Major Medical and Elite. The max coverage limit goes from 1M pounds to 3M pounds.
The services Bupa offer are not dissimilar to other major insurance companies:

• In-hospital private rooms
• 24/7 access to a doctor online
• Global evacuation and repatriation

They cover areas such as:

• Preventive care
• Pre-existing conditions
• Mental health care
• Cancer care

What to consider when choosing expat health insurance

You need to keep in mind several factors when choosing one insurance provider/policy over another. We’ll go over the main ones below.

Your own profile and needs

Your age, medical history and any extras you may need on top of standard plans. As far as age goes, the older you are, the higher your premium will likely be.
Medical history is important because health insurance providers don’t cover pre-existing conditions by default — you’ll have to add that on top of your plan if you need treatment for those.
By “needs” we mean optional (and potentially costly) extras. Coverage in the US is one such example; dental, vision and mental health services are in the mix too.

What your health insurance provider offers

Coverage area should be top of your list. Which regions and countries the provider covers — so you can ensure continuous medical help is available if you travel. Generally, the more countries you pick, the higher your premium will be. Medical help in the US is especially costly.

Coverage limits and exclusions is another consideration. Your plan will only cover your treatment as long as it stays under the annual coverage limit — choose a plan with a higher limit if you expect your medical costs to run high, Exclusions is what your plan doesn’t cover, such as dental and vision options. You should be aware of those.

You also need to keep in mind how strong a network of clinics and hospitals in the area you’ll be living in. Will you be able to get the help you need quickly? After all, that is the main reason you are getting insured in the first place.

Cost-sharing is another important factor. Cost sharing covers the premium (i.e. fixed monthly amount), the deductible (i.e. how much you pay upfront, before your plan kicks in) and copays (how much you pay out of pocket for visits to doctors/treatment, while your insurance provider covers the rest).

Finally, don’t sniff at extras your insurance provider may or may not offer. We’ve already touched on the most relevant ones a couple of times: that’s dental, vision, mental health and maternity services.

Taxes for Expats - Your trusted partner for expats living abroad

As you navigate the complexities of securing health insurance for expats, it’s equally important to manage your tax responsibilities. Taxes for Expats specializes in helping expatriates meet their tax obligations in their host country, ensuring you’re fully compliant. Contact us today to take care of both your health and tax needs, so you can focus on your new adventure abroad.