Expat Health Insurance Plans- Understanding Your Medical Coverage Options Abroad

I understand that choosing an international expat insurance plan can be daunting. Don't worry; I've got you covered. 

This article cuts through the insurance jargon to explain your options in simple English. I'll give an overview of the various types of insurance, the kind of expat they are best for, and breakdown your overseas medical coverage options so you can make an informed decision. 

What Is expat insurance?

This specialized insurance helps cover the costs of medical care if you become sick or injured overseas. Expat health plans provide comprehensive medical benefits, including routine treatments like broken bones and doctor visits to more serious hospitalization and surgery, like a knee replacement operation.

Some plans also provide coverage for prescription drugs, maternity care, mental health services, and catastrophic major medical cases like cancer treatment.  

Other more expensive plans even include medical evacuation services for treatment to a country of your choice. 

Other Guides On Expat Insurance

Why a global expat policy is essential:

No matter where you are in the world, the average healthcare costs are soaring. Getting caught with an uncovered catastrophic major medical emergency like cancer treatment without an international medical plan to protect you can be financially devastating. One insurer paid the following  claims for expats injured overseas. 

Aside from the financial impacts, not having an international policy can be life-threatening. Comprehensive global healthcare coverage is critical in countries with inferior hospitals or when you are not covered by your host country's public health insurance. 

For example, as a retiree in the Philippines you can buy into the country's public plan for less than $350 per year. However, the public plan only provides access to public hospitals. Especially in rural areas, the quality standards of public hospital would make most expats shiver. 

International health insurance for expats provides vital peace of mind and comfort when your family is halfway around the world in a country where you may not speak the language. 

How to get a global policy:

There are a few different ways to get expat health insurance abroad. You can purchase a private plan from an insurance broker, obtain a policy through your employer, or get coverage through government-sponsored public insurance.

What to look for in a global policy:

Choosing an expat health insurance policy is about balancing the level of coverage you need with your health care budget. Your policy's costs are represented in monthly premiums that vary dramatically based on coverage level. 

It's important to consider how your expat policy covers:

1. Your current health - Does the policy cover pre-existing conditions?
2. Your future plans - For example, are you planning on starting a family and needing maternity coverage?
3. Your lifestyle -  Do you participate in high-risk sports? Do you have a lot of international travel planned?

What is the cost of expat health insurance coverage?

Some policies start as low as $100 per month, but the average cost of health insurance for an expat is $3,700 per year and a high-end plans can top $8,000.

Several factors affect the cost of health insurance for expats, including the country you live in, your age, previous medical history, and the type of coverage you need.

• Your location significantly factors into the cost of expat health insurance. Expect to pay more for overseas healthcare moving to a country with a higher cost of living.
• An immutable fact is that you will need more healthcare as you get older. Global insurance companies consider this trend and will charge more for the same policy coverage as you age. 
• Your medical history will impact your costs, as many plans have pre-existing condition exclusions for medical issues you already have. Expat plans that will cover you charge extra to cover these conditions.  
• Most global policies have the same baseline level of coverage. The more you increase your coverage to include additional options like prescription drugs, vision benefits, or other add-ons, the more your monthly premiums increase. 

Read my article on How-To Save On Your Expat Health Insurance Cost for detailed tips on how to save money on your insurance premiums. 

Do I need an expat health insurance plan?

Yes. You may be surprised to learn that your home country's health insurance may not cover you or your family for the treatment of medical conditions while overseas. Expat insurance steps in to save you from crippling medical bills and ensures you get quality medical treatment.

Living outside your home country without comprehensive expatriate medical insurance increases your risks of devastating hospital bills, long wait times, inexperienced doctors, and crowded emergency rooms. 

Read this article on "Choosing An International Health Plan" for my checklist to follow when buying expat medical coverage.

Public Insurance- The Most Affordable Health Insurance For Expats 

When moving to another country, you may have multiple medical coverage choices. Some countries offer public plans to access a government-subsidized public health care system, which can significantly reduce the cost of expat health care.

Will public insurance cover me as an expat?

As public insurance is primarily paid for by taxes, some countries may restrict foreigners' access to public health insurance. However, other countries provide public insurance for expats under specific conditions.

• Suppose you most likely relocate for work in a country with a public insurance system. In that case, you may be automatically registered and pay monthly contributions into the country's public insurance, offering you access to free or low-cost hospital treatment.
• However, expats not employed by a local company, such as retirees or remote workers, will need to "buy in to" the public plan. A buy-in is usually a large one-time payment to access a foreign country's public healthcare system.
• Some countries may also have a waiting period. During the waiting period, foreign expats must pay monthly insurance premiums into the host country's public system but cannot receive any services or access any medical treatments until a pre-determined period has passed.

While these conditions to access a public insurance system cost money, foreigners receive access to low-cost, or in some cases free, expat healthcare coverage.

I've compiled a "Health Insurance Terms and Definitions Explained" list to help you understand the many forms of international medical insurance available and make the best decision. 

What Is The Difference Between Public Insurance And Universal Healthcare?

While easily confused, there are big differences. Universal healthcare covers every citizen or resident. Public insurance may limit coverage by age or income. For example, Medicare and Medicaid are considered public insurance. Still, they are only available if you are low-income, disabled, a child, or over 65.

Universal health coverage refers to a government-funded health care system that provides basic medical care to every citizen or resident of a country without regard to the ability to pay.

Public health insurance is government-subsidized medical coverage paid for by taxes. In some instances, public insurance limits eligibility by income or age. ACA coverage ("Obama-care") is an example of public health insurance that is limited by income. 

All universal healthcare is considered public insurance. However, since public plans can restrict access, not all public insurance is considered universal healthcare. 

Countries With Universal Healthcare Where Eligible Expats Get Low Cost Or Free Healthcare

Private Insurance- Comprehensive Health Insurance For Expats- 

On the other hand, private insurance is a for-profit health care system managed by private insurance companies, with treatment administered at private hospitals. Private health insurance is typically funded by individuals or their employers. Expat health insurance is a type of private insurance. 

Working expats may negotiate private insurance coverage as part of their expat compensation package. Expat retirees or remote freelancers pay the entire cost of a private plan out-of-pocket. 

Luckily, most international private insurance have 3-5 plan levels (bronze, silver, gold, platinum) to fit different budgets. A bronze or value plan could be ideal for younger expats who don't have many health concerns and just need coverage for major medical emergencies. A platinum of comprehensive plan would be better suited to expat families or older retirees with more extensive healthcare needs.  

Is an international private insurance plan worth the cost?

The additional cost of international private insurance comes with the benefit of access to better private hospitals and clinics, private rooms, and more attentive and potentially English-speaking staff and doctors. You'll also find less waiting time for appointments, especially for minor sicknesses or routine procedures. 

In addition to a wider section of doctors and hospitals, private insurance provides substantial benefits not available with public healthcare. Depending on your expatriate health plan coverage, you may optionally obtain medical treatment in another country where specialists are better trained or equipped. Some expatriate health coverage even allows you to fly back to your come coverage for medical care and still be covered by the medical insurance policy.

Travel Medical Plans- A Limited Type Of Health Insurance For Expats 

Sprain your ankle while trekking to Machu Pichu or get a case of Bangkok Belly from suspicious street food? As mentioned, your home country's insurance will not cover you overseas. A travel medical policy takes care of you.

Similar to expatriate health plans, travel medical plans are specifically designed to cover you outside your home country. However, there are significant differences.

• Duration- Travel health insurance is usually meant for short-term, limited-duration trips. Some travel health issuers cover long-term travel for up to 24 months. However, many policies limit your coverage to no longer than 60-days. 
• Home Health Insurance Requirement- Most notably, travel health insurance only supplements your home country's insurance. Maintaining your national health insurance or purchasing additional, comprehensive private insurance are conditions for travel insurance. Many medical insurance providers will not even sell you a travel insurance policy unless you provide proof of insurance in your country of residence.
• Trip Insurance Features - Some travel plans are bundled with trip insurance to reimburse expenses due to missed flights, lost luggage coverage, canceled tours, or delayed connecting flights. 

What is the difference between expat medical insurance and travel medical insurance?

Both qualify as an international health insurance policy. However, travel medical has significantly less coverage, is primarily used for emergency treatment, may only cover short-term trips abroad, may exclude pre-existing conditions, and does not cover routine examinations or preventative medicine. 

Travel medical is a more affordable option because it requires you to have insurance in your country of residence. This requirement is an essential distinction because travel medical insurers can make a life-altering decision if you need serious medical care.

1. Pay for your medical treatment in your current country. Or, if it is cheaper for the insurer, they can
2. Pay for a medical evacuation flight back home and have you and your home insurance pay for any medical treatment required. 

Travel medical insurers will always take the cheaper option regardless of what is better for you.

Additionally, travel medical coverage typically includes sickness and emergency treatment but not routine examination or preventive medicine. If you catch yellow fever from a mosquito bite, your travel medical policy covers you. But if you want a vaccine to prevent catching yellow fever in the first place, then you are not covered. Insurance logic is not always logical. 

In contrast, a comprehensive expatriate health insurance plan is similar to the "normal" medical insurance coverage you are familiar with at home. Medical insurance for expats covers inpatient hospital service and emergency medical costs, routine doctor visits, vaccinations, annual preventative exams, pregnancy, and cancer treatments. It can even include prescription medications, vision and dental care.

Expat health plans do not require you to maintain insurance at home, and in some cases, expat health plans cover you for short trips back home to visit. 

Why I don't recommend international trip insurance for expats moving abroad?

Most trip insurance does not cover you for health issues or medical emergencies while abroad. Trip insurance is only a limited form of travel insurance policy for reimbursing non-refundable deposits or travel expenses if a trip cancellation or interruption occurs. 

Trip insurance protects you if the airlines lose your bags, your flight is delayed, or you must cancel your trip because of illness. In these cases, trip insurance may reimburse your pre-payments or additional expenses you incur. However, if you slice your foot on coral while swimming, trip insurance will not cover your emergency room visit for stitches.  

While an international travel insurance plan may make sense for digital nomads and some expats, I don't recommend trip insurance to anyone.

The Benefits of International Expat Insurance

Generally, medical insurance for expats can include:

Basic Plan

• Access to quality healthcare facilities
• Preventive care, such as routine checkups and vaccinations
• Inpatient and outpatient medical coverage, including hospitalization, surgery, emergency care, and limited prescription drugs
• Freedom to choose your medical providers from a wide range of doctors, medical facilities, and network of hospitals
• Worldwide coverage can include your country of origin; however, coverage for the United States is usually reserved for only the most expensive plans (a few select countries are excluded)

Comprehensive Plan

• 24/7 health advice via phone, video, or chat from any device with internet access
• Emergency evacuation and repatriation flights
• Enhanced Prescription benefits
• Wellness checkups
• Adult preventative care
• Cancer treatment and oncology health insurance
• Dental benefits
• Maternity and birth coverage
• Vision coverage
• Mental health assistance and substance abuse treatment
• Flexible plan payments in the currency of your choice

Not covered in most plans:

• Care that is not medically necessary, such as cosmetic surgery
• Experimental treatments or procedures
• Long-term care (such as nursing home care)

Some Little-Known Advantages of Expatriate Health Insurance Plans

The main advantage is that you have easy access to healthcare anywhere in the world and the benefit of choosing your clinic or doctor without having to worry about the different regulations or administrative procedures of certain countries. However, depending on your lifestyle and budget, these add-ons can be crucial for expats overseas.

1. Expat health insurance can include wellness benefits. Benefits such as gym memberships and free health screenings can help you maintain your health while living abroad.
2. Mental healthcare coverage is another vital benefit of expat health insurance. Many people struggle with adjusting to life in a new country and having access to mental healthcare can be a lifesaver.
3. Some expat health insurance plans also cover repatriation costs. Repatriation drops your anxiety and stress levels by returning you home to be with friends and family during your medical treatment.
4. Another benefit of expat health insurance is that it can often be used to supplement public insurance. This hybrid approach is ideal in countries where you are uncomfortable with the quality of healthcare services in public hospitals. You can use a cheap or free public hospital facility for primary wellness care. But trust your global medical insurance plan for any serious medical treatment.

A Few Details to Consider Before Choosing An Expatriate Insurance Plan

• Before selecting your expatriate health insurance, you should carefully analyze your existing situation — your health status, medical history, current location, length of time overseas, and family status are all aspects that will influence which coverage best meets your needs.
• When examining your insurance alternatives, you should also evaluate any limitations per country — some insurers only offer particular types of benefits inside their own borders due to pre-existing conditions, legislative restrictions, or limited provider networks available internationally.
• Keep in mind that even though you might have full medical coverage at home, most domestic insurance companies do not offer plans abroad, so it's safer to choose and pay for one of the expatriate health insurance plans for your own security.
• Cost is not the only factor. Choose an expat health insurance provider with global expertise and a solid reputation of customer service and member support among customers and experts.
• Choose a plan sufficient enough to cover the needs of your family and partner. Consult with them before choosing an expat insurance plan. Their gender, lifestyle, and medical history are crucial considerations and can sway plan options.