QUICK SUMMARY- expatriate health plans
I've been an overseas expat for the last 8 years. I understand the complicated administrative details of an international move— from visas to travel plans, living costs, and, ultimately, expatriate health insurance. Aside from rent, your choice of an expat health insurance plan can be the most expensive decision you make.
For US citizens and other expats living abroad, understanding your international healthcare coverage options can get complicated. Do you need Expat health insurance, Public Insurance, Private Insurance, or Travel insurance? Can I choose which country I get medical treatment? Does expat medical insurance cover me when I travel to another country?
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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.
Click here to get free quotes from multiple international insurance brokers to compare prices and save time.
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.
My Recommended Expat Health Insurance Partners
Cigna Global Medical Insurance Plan
- Perfect for expats who need need comprehensive protection and 24/7 service
- An international network with over 1.65 million trusted hospitals and doctors.
- All plans include mental health and cancer care
Xplorer Worldwide Medical Plan
- Ideal for older expats or expat families who need a comprehensive benefits
- Premium Benefits, Extensive Coverage and Quality Member Service
- International health insurance that covers you inside and outside the USA
IMG Global Medical Plan
- Excellent for expats looking for an affordable global plan with the flexibility
- Your choice of plan options, geographic area, and deductibles
- Enjoy preventative care with no waiting period on wellness benefits
William Russell International Health Insurance Plan
- Perfect for expats who need customized care and don't visit the United States
- Get complete coverage for inpatient care including full cancer treatments
- Global coverage with a very strong network in SE Asia
INSIDER TIP : Dependent Children- While primarily used as a marriage visa, the 13a also applies to if you want to bring your unmarried minor child (they must be under 21 years old) with you to the Philippines.
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:
- Your current health - Does the policy cover pre-existing conditions?
- Your future plans - For example, are you planning on starting a family and needing maternity coverage?
- 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.
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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.
Compare quotes from different expat medical insurance companies within 60 Seconds
Nomadic FIRE has partnered with the most trusted international insurance brokers in the world. Trained to meet the specific needs of expats and digital nomads living or traveling abroad. They provide enhanced service responding in 24 hours or less to all of your questions.
Click here to find the FREE estimates from top global insurers to find the best plan right for you.
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
|Europe||Isle of Man|
|Asia||North Korea (DPRK)|
|Middle East||Saudi Arabia|
|Asia||South Korea (ROK)|
|Europe||Isle of Man|
|North America||Costa Rica|
|North America||The Bahamas|
|North America||Trinidad and Tobago|
|Asia||North Korea (DPRK)|
|Asia||South Korea (ROK)|
|Middle East||Saudi Arabia|
Pros And Cons For Expats Using Public Insurance vs. Private Insurance
Advantages for expats using public insurance
Disadvantages for expats relying on public insurance
INSIDER TIP : Expat health insurance plans are designed to cover the unique needs of people who live and work in foreign countries, such as evacuation and repatriation coverage. These additional benefits are valuable if you are stuck in a foreign country during a natural disaster or political unrest. Two years ago, during the height of the pandemic, when expats were stuck overseas, expats without repatriation coverage paid $10,000 to get a flight back home.
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.
The Advantages and Disadvantages Of Expat Private Insurance
Pros of expat health insurance plans
Cons of expat health insurance plans
INSIDER TIP : Combine Public Healthcare With Private Insurance- In countries with low-cost healthcare, you can combine the best of both worlds. Use public health coverage for expensive treatments, but purchase a private insurance policy when public hospitals are overcrowded, or your medical treatment isn't serious, but you want to see a doctor immediately.
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.
Affordable Travel Medical Insurance Starting At $50 per Month
This will cover you for unexpected medical issues while overseas. However, the coverage requires you to maintain insurance in the United States or your respective home country.
This plan also meets foreign government requirements mandating COVID insurance to enter the country.
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.
- Pay for your medical treatment in your current country. Or, if it is cheaper for the insurer, they can
- 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:
- 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)
- 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)
INSIDER TIP :
Pay attention to the fine print- Read the insurance contract and policy documents thoroughly. Even with basic plans, the benefits and levels of cover can vary significantly between different expatriate health insurance issuers. Plan options can change dramatically even when comparing international health plans from the same issuer.
Ensure you understand the policy. Google any words you don't understand. I provided a Health Insurance Terms and Definitions Explained to help you decode your plan documents.
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.
- 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.
- 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.
- 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.
- 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.
INSIDER TIP :
Direct payment of medical expenses- An overlooked additional benefit is many expatriate health insurance plans offer direct billing. Many hospitals in developing countries can refuse to treat you without a cash deposit for medical expenses. Direct billing pays the cost of hospital treatment directly, avoiding the need for a cash deposit.
Try figuring out how to find an ATM after getting into a motorbike accident or arranging a cash advance from your credit card after getting a concussion bungee jumping.
Imagine badly needing medical attention in a foreign hospital's emergency room, in a strange country, without the support of family or local friends. Having an English-speaking international health insurance company you can talk to and pay medical costs directly can make all the difference in the world.
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.
Key Takeaway: Expat Health Care Options
There is no shortage of options for medical insurance for foreigners. Some public plans are free but come at the cost of long wait times and limit treatment to a narrow selection of doctors and hospitals. Some travel medical plans are cheap but skimp on the coverage and force you to buy home insurance.
Expat medical insurance provides peace of mind while protecting you and your family when living abroad. By providing coverage for routine healthcare needs and more severe hospitalization and surgery, international health insurance is essential for expats living overseas. With the right plan, you can be sure that you and your loved ones are covered while living in any country in the world.
When choosing an expat insurance plan, know that it is not just about finding the lowest-cost policy that fits your needs. It's also about ensuring that you get a company that will provide you with stability and security.
How can you ensure which expat insurance plan is best for you? Narrow down your options and request a free quote for the best global health care plans available on the market!
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FAQs: Overseas Health Insurance For Expats
It depends on your destination. Some countries like Spain and Croatia want to ensure you will not burden their public healthcare system. These countries require a certificate of insurance as part of your visa application. Other countries require COVID insurance for anyone entering the country.
No. The Affordable Care Act (ACA), also known as Obamacare, does not cover US citizens for medical treatments outside the United States.
However, some states impose a tax penalty on US citizens and legal residents for not having ACA qualified health insurance. This penalty includes any expats living abroad unless they meet certain exceptions.
- If you can pass the IRS Bona Fide Residence or Physical Presence test as a full-time expat (roughly defined as a US citizen who lives at least 330 days outside the US) or
- If you have a qualified international medical plan, you may be clear of the ACA requirement.
Note that trip insurance, travel medical insurance, any short-term health insurance, and even some expat health plans are not ACA-qualified plans. All medical insurance for expats must provide Minimum Essential Coverage to exempt you from the ACA requirement.
No, Medicare will not cover any medical expenses for US citizens outside the US, except for travel to Puerto Rico, US Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. They're rare exceptions if you are in the US, but the closest medical facility is in a foreign country.
Examples of when Medicare might cover expat medical care in a foreign country:
- If you need emergency medical care while in the US near the Canadian or Mexican border and the closest hospital is in a foreign country (Canada or Mexico).
- If you need specialized treatment, but where you live in the US is closer to a foreign hospital than the nearest US hospital.
- If you are traveling from the US to Alaska and require emergency medical treatment and the nearest hospital is in Canada.
It depends. Some expat plans have an upper age limit. Other plans have a maximum age limit of 70 years for new applications but allow unlimited renewals with no maximum age. Age limits vary by the expat policy and by the international health insurance provider.
No, travel medical insurance does not provide sufficient healthcare coverage for most expats living abroad. Travel insurance does not cover routine checkups or preventative care. However, the biggest drawback of travel medical is the requirement to maintain health insurance in your home country.
This requirement is because a travel medical insurance company can decide to fly you home and have your home country's insurance pay for your medical treatment. This can leave you vulnerable to significant costs and challenges in returning home.
The best international health plan depends on your needs and budget. Value plans suit younger expats not intending to see a doctor often. Comprehensive plans are ideal for older expats with health issues. Travel Medical plans are only recommended for expats maintaining their home insurance.