A Step-By-Step Plan For Lowering Your Cost of Expat Health Insurance

The cost of expat health insurance plan can be a huge expense. However, many factors can affect the cost of international health insurance. Understanding how expat medical insurance is priced is key to reducing your costs. This guide details the steps to save over $4,000 per year on health insurance.

  Mins Reading Time

Published On: September 28, 2022

Latest Update: April 10, 2024

About the author

Hi, I'm Marco Sison. I worked in finance for Fortune 50 companies before retiring early at 41 years old. I have been an expat for over 10 years, living in over 50 countries to show you the best ways to save, invest, and live in amazing countries outside the USA. I am a trusted resource on personal finance and overseas retirement for US News & World Reports, HuffPost, MSN Money, USA Today, ABC Network, Yahoo Finance, Association of MBAs, the iTunes documentary Seeking FIRE, and the Amazon Best-Seller- Abroad: Expats That Thrive.

QUICK SUMMARY- How-To Lower Expat Medical Insurance Cost By ~80%

  • $5,000 Average cost of expat health insurance
  • $1,175 Get a competitor quote from another insurer
  • $1,000 Increase deductible
  • $275 Change payment frequency
  • $700 Choose the entry-level 
  • $500 Pay out of pocket for dental coverage
  • $300 Drop optional coverage you don't need

Are you moving abroad? Or maybe you already live overseas and need health insurance coverage? Do you want to save thousands of dollars annually on your expat health insurance?

There are many reasons why expats choose to live abroad. Some do it because they love the culture, others do it for work, and others just do it because they get bored with the same old routine back home. However, more and more Americans are using soaring US healthcare costs as a reason to move abroad. US citizens can find better quality and more affordable healthcare in other countries for thousands less than in the United States.

I will break down the main factors influencing the cost of global health insurance and provide step-by-step examples you can follow to slash your expat health insurance costs while still getting the right amount of benefits you need!

Other Guides On Expat Insurance

A Comprehensive Guide To Philippines Health Insurance For Expats
24 Facts About Healthcare In The Philippines Every Expat Must Know
How To Get Health Insurance In Colombia As A Foreigner
Why Travel Medical Insurance Coverage Isn’t Enough For Expats Abroad
Cigna Expat Insurance- Best Global Health Plans For Living Abroad
Affordable International Health Insurance for US Citizens Living Overseas
10 Common Mistakes Expats Make Buying Health Insurance For Living Abroad
20 Facts About Healthcare In Colombia Every Expat Must Know
Choosing An International Health Plan- Checklist For Buying Expat Insurance Coverage

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What is the average cost of expat health insurance?

The average cost of expat insurance in 2021 for an individual from a recommended insurance partner was $300-$420 USD per month. Prices can vary dramatically based on coverage. Some basic international policies are less than $100 per month, while travel medical plans cost as little as $50 per month.

Here are two real-world examples of expat health insurance costs:

Baseline Insurance Quote #1

Male, American

Early Retiree, 49 years old

Retired in the Philippines but spends 6 months a year living in Colombia. Healthcare costs where he lives are cheap, and he has an HSA account to self-insure for minor issues. Wants a global plan with a high deductible to cover him if any severe medical conditions or major accidents happen.

Baseline Quote #1 Comprehensive Expat Insurance Annual Cost

Baseline Insurance Quote #2

Female , Austrian 

Digital Nomad, 34 years old

Travels the world with no home base. Has a business registered in Austria and continues to pay into their national healthcare system. Mostly travels in Europe. Wants a $0 deductible plan to eliminate pay out-of-pocket if she gets sick. She only needs travel medical coverage, as all wellness or routine check-ups can be done in Austria.

Baseline Quote #2 Deductible Travel Medical Insurance Annual Cost

What Are The Factors That Affect Your Expat Health Insurance Cost?

Medical health insurance costs have increased ~47% in the last 10 years. Some reasons insurance prices rise are out of your control. However, several factors — from your medical history to the extras you want to add to your plan - determine how much you'll pay for medical insurance.

Let's break down the main details affecting the medical health insurance cost.

  • Coverage Level- More expensive comprehensive health insurance coverage could include maternity care, dental treatment, and mental health care. However, most companies also offer a cheaper basic international health insurance plan. This basic or value plan covers medical emergencies and inpatient treatments that could meet the healthcare coverage most expats need.
  • Age – In general, the older you are, the more probable you will require healthcare, particularly for illnesses and ailments connected with old age. As such, you should expect your health insurance premium to rise as you age. See Insider Tip below for more information on how aging affects your expat health insurance premiums. 
  • Medical history – Your current health condition will impact your expat healthcare cost, as some international plans don't cover pre-existing conditions. Some companies may ask you to state any pre-existing medical conditions to assess your overall health status. They will use your medical history to determine if any waiting period should be included in your insurance plan and if you will face additional premiums.
  • Location – As the healthcare systems around the globe vary from one country to another, your geographical location will affect the cost of international health insurance, depending on the expense of the local health system.
  • Claims history – Some international health insurance companies will raise your renewal premiums for each claim. The more claims you make, the higher your chance of paying more for insurance at every renewal.
  • Optional extras: Most entry-level global health insurance plans provide essential medical care and exclude optional extras like vision or adult dental care. The additional benefits you add to a standard plan increase your insurance costs.
  • Life stage: The cost of international health insurance is affected by your unique circumstances. There are methods to cut the cost of health insurance by finding plans appropriate for your stage of life. For example, if you are planning a family, adding maternity coverage to your health insurance plan would raise the costs.
  • Payment Frequency – Most insurance companies will offer you a discount if you pay your insurance premiums annually instead of monthly or quarterly. My real-world example in the section below, shows how I cut my premiums by ~17% by switching to an annual payment.

 INSIDER TIP : Age and Expat Insurance Costs- Most insurance companies determine their costs based on age groups, like 45 to 49, so your medical health insurance cost may only change when you pass a particular age group.

For example, in the quote above, the international medical insurance cost doesn't differ for an expat from 45-49 years old. However, the exact same quote for a 50-year-old jumps by 36%. Getting one year older could increase my global insurance premiums by $276!

How I saved $200 off my annual health insurance costs WITHOUT changing my benefits

In my quote, you can see the initial monthly cost of my expat health policy is $104. This monthly premium is equivalent to $1,251 per year. If I change the payment frequency to pay for entire expat policy upfront, the annual cost is only $1043. I saved over $200 per year without reducing my plan benefits. 

How I saved over $200 off my annual premiums in 3 seconds

How Can You Save on the Cost of International Health Insurance Premiums?

If you want to keep the same coverage but need to reduce your cost of international health insurance, you can look at changing to a cheaper expat medical insurance company. Competition in the global insurance industry can be fierce. 

In my sample quote, the difference in highest prices vs. lowest priced international health insurance plan was $2,608 more per year. Nearly a 450% increase in annual premiums.

Aside from changing companies, there are other ways to reduce expatriate health plan costs. Let's look at what you can do to cut the price of your healthcare coverage.

Prioritize The Benefits That Matter To You

When moving to a foreign country, selecting quality insurance for your worldwide medical needs is critical to ensure that you are safe and secure wherever you go. The truth is that you will almost always obtain better coverage if you pay a higher price. But, there are some details to consider that can lower your expat health insurance cost.

Usually, a health insurance plan is classified into one to four tier levels — bronze, gold, silver, and occasionally platinum with escalating benefit maximums and coverage possibilities, depending on the health insurance policies. Higher coverage levels will also raise the annual maximum amount of money that your medical insurance will cover, so you need to choose carefully the type of plan that fits your needs.

Baseline Quote #1 Changing Plan Levels To Save $700 per year

In quote #1 above, switching from Enhanced to Essential coverage saves me $700 a year. What did I lose by choosing the cheaper plan? Mostly doubling the waiting periods before covering any pre-existing conditions (728 vs. 364 days) and adult wellness (180 vs. 90 days) while adding sub-limits on the ambulance and ICU coverage.


Match Your Insurance With Your Life

Where you are in life needs to factor into your international health insurance policy. But don't focus on just your current situation; since many expat medical insurance policies have waiting periods, you need to look ahead to incorporate your future plans as well.

  • Will you be traveling a lot next year for work? Ensure that your coverage area includes the countries you need to visit.
  • Don't plan on having another baby this year? Go ahead and drop the pregnancy care from your plan.
  • Is your spouse entering the workforce and will have their own employer-subsidized health insurance coverage? Remove them as a dependent from your plan.
  • Finally, decided to drop $5000 on Invisalign to fix your teeth? Time to look for a dental plan with orthodontic care.

Reviewing your health insurance benefits on an annual basis is essential. Matching your benefits coverage with your projected life changes offers you the chance to modify your policy, saving you thousands of dollars on your expat health insurance cost.

Children cost money. I could not purchase the basic coverage if I wanted to include a maternity cover. Upgrading to the enhanced coverage nearly doubles my annual insurance costs! Spouses aren't cheap, either. If my girlfriend and I were married and wanted to add her to my plan, my insurance doubles.

Quote #1 Yearly Cost of Expat Health Insurance For Married Couple

Narrow Your Area Of Coverage Options

Many expat health plans have geographic limits. You might be able to reduce the costs by narrowing down the area of coverage, opting for regional coverage, or excluding specific expensive countries rather than choosing unnecessary worldwide coverage. For example, some global insurers breakdown their areas of coverage as follows:

  • Worldwide coverage, excluding the USA
  • European Countries Only, rest of world optional
  • SE Asia Only, rest of the world optional
  • Full cover in India and Africa, with limited coverage anywhere else

The quote above excludes medical treatments in the United States and Canada. But if you want to add the US to your area of coverage, be prepared for some sticker shock. The price of truly worldwide expat health insurance jumps by over 80%. Simply including the US costs over $600 per year.

 INSIDER TIP : Avoid US Coverage If Possible-  Even if the US is included, most international health insurance companies will limit the time you are allowed in the US. Some limit trips to no more than 60 days per year. The sample quote above requires you to live outside the United States for more than 6 months out of the year.

Remove Optional Benefits, Add-Ons, And Riders

It's also important to remember that most health insurance coverage is modular and offers optional benefits. These additional benefits, sometimes referred to as add-ons or riders, can be dropped to lower the cost of your premiums.

  • Medical care add-ons- Vision, Wellness, Adult Dental Care, Maternity Coverage, Psychiatric, Gynecology, Pediatric Care, or prescription medication are among the add-ons you can add to your base plan.
  • Optional features- high-risk sports, repatriation of remains, hospice care, and access to digital services like telemedicine, medical evacuation, and repatriation plans are also additional services you can choose from.

Customizing your insurance plan offers you the flexibility to tailor your needs and reduce medical costs.

Quote #1 does not include vision care but dental coverage ($490 per year), and an adventure sports rider ($290 per year) can be purchased at an additional cost. 

Even "normal" activities like skiing and surfing require additional insurance

Reduce Outpatient Medical Coverage Levels

Expat life abroad is full of unexpected surprises. Think of recovering from major surgery, a trip to the ICU, or needing inpatient hospital admission for cancer treatment or heart attack. Inpatient treatment is when you need hospital stays over 24 hours.

Did you know a one-night stay in a hospital can cost nearly $5000 per night in some countries? Given that just a few days in the hospital can crush your savings, paying for an international medical insurance policy that covers inpatient hospital admission is worth the peace of mind. Thankfully, I've avoided the hefty medical bills associated with inpatient care.

RankCountryCost of a night in a hospital bed
6San Marino$1,169
9United Arab Emirates$1,005
17United States of America$888
23United Kingdom$781
30New Zealand$508
32Equatorial Guinea$494
38Czech Republic$346
40Trinidad and Tobago$328
41Republic of Korea$325
42Saudi Arabia$310
50Libyan Arab Jamahirya$233
52Antigua and Barbuda$225
54Russian Federation$189
56Saint Kitts and Nevis$169
57Venezuela (Bolivarian Republic of)$162
69Cook Islands$115
76Costa Rica$94
79Saint Lucia$81
80South Africa$78
85Saint Vincent and the Grenadines$73
87The former Yugoslav Republic of Macedonia$68
93Dominican Republic$61
107El Salvador$47
111Cape Verde$41
123Syrian Arab Republic$27
125Micronesia (Federated States of)$26
126Marshall Islands$25
128Sri Lanka$24
135Republic of Moldova$19
140Solomon Islands$14
143Papua New Guinea$13
146Sao Tome and Principe$12
150Cote d’Ivoire$11
155Lao People’s Democratic Republic$9
169Democratic People’s Republic of Korea$5
174United Republic of Tanzania$5
178Central African Republic$4
183Sierra Leone$3
189Democratic Republic of the Congo$1

Global Cost of One Night In A Hospital Room

However, outpatient medical care is a different story. Outpatient care means no overnight hospital cover. Outpatient can include non-emergency treatment, lab tests, diagnostic scans, treatment of chronic conditions, and even minor surgery that doesn't require an overnight stay to recover is considered outpatient.

I've needed emergency services in Thailand ($12), urgent care to treat an ear infection in Vietnam ($30), and an MRI to diagnose unexpected pain in my knee in the Philippines ($100). No cases required me to stay overnight in the hospital; they were outpatient medical treatments and cheap. 

Many outpatient procedures in countries outside the US are very cheap. I pay for them out-of-pocket and don't bother submitting a medical insurance claim.

Many medical procedures and tests (like an MRI ) are cheap enough to treat as an out-of-pocket expense outside the USA 

An outpatient and inpatient treatment plan is great but ineffective at lowering your international health insurance cost. Reducing the maximum limit options of your outpatient care can significantly save your medical insurance costs.

The Risks Of Removing Optional Benefits

Dropping benefits you feel are unnecessary, such as accidental death and dismemberment (AD&D), preventative care benefits, or terrorism & war risks from your policy, will help you save money on expat health insurance costs. But removing benefits or lower dollar limits from your international health insurance policy also comes with risks.

Even reducing the dollar limits on your outpatient maximum can be financially devastating. Dialysis required for chronic conditions is still considered an outpatient procedure but can still cost over $10,000 per month.

Dropping add-ons like dental coverage means no protection for your teeth. You become financially responsible for non-emergency treatments, such as cleanings, implants, cavity fillings, root canals, or crowns.

Another risk is dropping repatriation plans and medical evacuation options. If you need to leave the country for a national emergency, you may have very few options available. Transportation and repatriation costs are very high, especially during a global crisis, like emergency evacuation for the pandemic lockdowns of 2020 or the start of the Ukraine war in 2022.

There is no right answer to balancing risks. Risk tolerance and personal circumstances vary based on the insured person. Don't reduce your coverage more than you feel comfortable with; You can always change the deductible options to lower your cost of expat health insurance.

Increase Your Deductible To Reduce Your Expatriate Health Plan Costs

Simply put, a deductible is the annual out-of-pocket medical expenses you agree to pay before your expat insurance plan kicks. To phrase it another way, a deductible is the initial amount of money you are responsible for before an international health insurance company will pay a claim.

The more responsible you are for your initial health care spending costs, the less risk for the health insurance provider. Health care plans base everything on risk. Insurance companies basically assign dollar amounts to the probability you might need access to health care.

In exchange for reducing the likelihood they need to pay any claims, your health insurance issuer agrees to reduce the cost of your expatriate plan.

A high deductible health care plan will drastically reduce your premium. The bigger the deductible, the lower the cost of your international health plan. The more upfront risk you are willing to take, the more money you save.

For example, let's say you have $900 in medical bills from a foreign hospital where you needed emergency medical treatment for food poisoning from questionable shrimp. Yet, your expat health insurance has a $1000 annual deductible. You are responsible for the $900 hospital bill because you must pay the first $1,000 in yearly medical expenses before the insurance company settles a claim. However, any additional health care costs you incur this year greater than $100 will be paid for by the insurance company.

If you are young, relatively healthy, and don't anticipate any major medical operations for the year, choosing a high deductible plan reduces your health insurance premiums. 

Here I am saving $1500 per year in health insurance costs

In the sample quote above, I raised my deductible from $250 to $10,000 cutting nearly 60% off my cost of expat health insurance.

 INSIDER TIP : Emergency Funds and Self-Insurance-  By raising your deductible, you are, in effect, insuring yourself up to the deductible amount. Before taking on that risk, you must pay attention to your location and financial situation.

Depending on the average cost of medical procedures in your location, plans with high deductibles may be more advantageous in some areas than others.

Carefully consider your financial stability. Insurance is supposed to provide protection and peace of mind. Are you going to feel safe knowing that you may need to pay a massive sum of money before your insurance company starts helping you?

And absolutely don't raise your deductibles unless you have at least the same amount saved in your emergency fund.

Covering the Pros and Cons of Increasing Your Expat Insurance Deductible

If you want to increase your deductible, take a look at some advantages and disadvantages that come with the process!

Pros For Increasing Your Deductible:

  • A plan with a high deductible is more efficient in several locations than others, depending on the country you want to travel to.
  • It lowers your premium costs significantly.
  • It is more efficient and beneficial in terms of healthcare costs for someone in good health.

Cons Of Increasing Your Deductible:

  • When not managed well, your medical procedures can lead to exorbitant out-of-pocket expenses for you.
  • Even though it reduces costs on your annual premium, it's still worth considering whether this option is worth the risk.
  • A high deductible can cause financial instability in case of emergencies

Key Takeaway- Lowering Your Expat Health Insurance Costs

Expats living abroad often face numerous challenges when it comes to their healthcare. They may find it difficult to find qualified English-speaking doctors and staff or struggle to navigate a foreign hospital's bureaucracy. A competent international insurance provider can guide expats and eliminate these hassles.

But a trustworthy international health insurer isn't cheap. The average cost of global health plans tops $3,700 per year, while platinum or gold level plans can top $8,000 or more. 

However, there are several steps that you can take to reduce your insurance costs while still getting the treatment you need and the service you deserve.

The first step is to shop around for the best international health insurance provider. There are plenty of insurance companies out there offering low rates for expats. Switching insurance companies can save you thousands immediately. And you shouldn't hesitate to ask your current provider for a discount when it's time to renew your policy, especially if you have not had any claims. Insurance providers know to keep their best clients close to home.

Once you've found a company that offers competitive pricing, you can use this guide to compare plans and choose the plan options that fit your lifestyle, needs, and budget. Use your deductibles, coverage area, optional add-ons, and maximum limits as levers to only spend money on benefits and insurance that matter to you.

Following the steps in this guide can easily save thousands of dollars on your expat health insurance costs. Several factors affect the cost of health insurance, but you can get the best possible rate by understanding how the system works.

Click here to get free quotes from reputable international insurance companies today and start saving!


If you liked this story, you will enjoy these other posts on Expat Insurance

Expat Health Insurance Plans- Understanding Your Medical Coverage Options Abroad
Why Travel Medical Insurance Coverage Isn’t Enough For Expats Abroad
Cigna Expat Insurance- Best Global Health Plans For Living Abroad

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FAQs: International Health Insurance Costs

How much does expat medical health insurance cost per month?

Basic private healthcare insurance costs start at $100 per month for global coverage, excluding the USA. However, if you want more than just essential coverage, worldwide medical health insurance with inpatient hospital admission and preventative care benefits average $300 - $400 a month per person.

You can read my previous article to find the best international insurance company with the additional services you need at a monthly cost you can afford. 

Which countries are the most expensive to add to my expatriate health insurance plan?

The US is nearly always the most expensive country to get emergency medical care. Expat health insurance issuers typically charge if you require staying in the United States for extended periods. Expect your premiums to rise 50-80% higher by adding the United States to your policy coverage zone.

Even if your health insurance issuer includes the USA, there will be a limit on how many days you can stay in the country and still have your eligible expenses covered. The maximum limit can range from 15 days to 9 months, depending on your plan.

What influences the cost of my international health insurance plan?

The cost of medical insurance for expats is impacted by several factors. Some are macroeconomic factors out of your control, such as global rising costs of expatriate healthcare or increasing government regulation of health care providers.

Some personal factors such as age, country of residence, or previous medical history also influence your policy costs but are out of your control.

However, there are aspects of expatriate health plans you can control. Your choice in the type of coverage you need and the deductible amount you choose is typically the easiest way to save on your plan costs.

What is the cheapest international health insurance for expats?

IMG, the expat insurance company with the highest customer service rating, also offers the cheapest overseas medical coverage. IMG offers affordable expat health insurance options with their Global Medical bronze plans and cheap travel health insurance under their Patriot Travel plans.

IMG's Global Medical bronze plans start at $56 per month per person for a 49-year-old male

Their Patriot Trave Lite plans start at $37 per month per person for a 49-year-old male.

You can read my previous article to find the other low-cost global health providers with comprehensive benefits, including repatriation plans, access to private hospitals, and specialist care.

Can I use travel insurance to reduce my expat health insurance costs abroad?

Travel medical insurance cuts your annual premiums by 30% or more compared to an overseas health insurance plan. However, ensure you purchase travel medical insurance, not ordinary travel insurance that only covers lost baggage, delayed flights, and other trip-related expenses, not medical expenses.

While a travel medical policy is cheaper, it does come with significant limitations:

  1. Travel medical insurer requires you to maintain home health insurance.
  2. Travel medical limits your access to health insurance, primarily for medical emergencies or illness. Travel medical does not provide any preventative care benefits. If your spouse gets the f u and needs to see the doctor, their medical expenses are covered. However, if you want a flu shot to avoid catching her sickness, travel medical will not reimburse your doctor bill because vaccines are considered preventative care.

We moved the comments to the New Expat Forums

  • Giagitsis Nicolaos says:

    I would like to thank you for providing all these informations fot the expat community. Nico Giagitsis, Zurich

  • Hi, Marco. It would be very useful for seniors considering retirement in Colombia to include information for them. Most international medical insurers are entirely “For Profit" and may not issue new policies beyond an age; even then, the premium level would easily be in the $15k rance.
    Are there not Colombia-only medical prepaid service plans or health care insurance supplemental plans? Thanks.

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    About the author

    Hi, That's me. I'm Marco Sison. I am a survivor of the corporate rat race. I started Nomad FIRE to show you an alternative to the stress and grind of 70-hour weeks to pay off a mortgage, student loans, and countless bills. After getting laid off in 2015, I said screw it all and retired early at 41 years old. I have traveled the last eight years to over 50 countries to show you the best ways to save, invest, and live in amazing countries for 70% less cost than the US. I have been featured in: US News & World Reports, HuffPost, MSN Money, USA Today, ABC Network, Yahoo Finance, the iTunes documentary Seeking FIRE, and the Amazon Best-Seller, Abroad: Expats That Thrive. [view press...]