Expat Health Insurance
The Global Health Plan for a Life Abroad
When my friend moved to Spain for a two-year work assignment, she assumed her U.S. health insurance would cover her. She was shocked to learn it provided almost no coverage overseas except for true life-or-death emergencies. She quickly purchased an expat health insurance plan. It’s a specialized, global health plan designed for people living abroad long-term. It gave her access to a network of local doctors and hospitals in Spain, and also covered her if she traveled to other countries. It’s an essential tool for anyone planning to live outside their home country.
Moving Abroad? Why Your US Health Insurance is Useless Overseas
The “Out-of-Network” Problem on a Global Scale
My colleague got a fantastic job opportunity in London. He thought he was all set because he had a great PPO plan in the U.S. When he tried to find an “in-network” doctor in London, he discovered there were none. His U.S. plan’s network ended at the border. While it might have covered a true emergency, it would not cover any routine doctor visits, prescriptions, or specialist care. He learned a quick lesson: domestic health insurance is for domestic care. If you are moving abroad, you need a dedicated expat health insurance plan.
How I Found Comprehensive Expat Health Insurance for $300/Month
Getting Global Coverage Without Breaking the Bank
When I decided to become a digital nomad and live in Portugal for a year, I knew I needed real health insurance, not just travel insurance. I worked with a broker who specialized in expat plans. She helped me compare quotes from major global carriers like Cigna Global and GeoBlue. I found a comprehensive plan that included coverage in Europe and also provided coverage for short trips back to the U.S. The premium was about $300 a month. It was a significant expense, but it gave me the peace of mind to live abroad without financial fear.
Expat Health Insurance: Covering You Globally, Not Just for Emergencies
The Difference Between Travel and Expat Insurance
People often confuse travel insurance with expat insurance. Travel insurance is for short trips. It’s designed to cover emergencies, trip cancellations, and lost baggage. It is not for routine healthcare. Expat health insurance is true major medical insurance for people living abroad long-term. It covers everything from a routine checkup with a local doctor to a major hospitalization, both in your new country of residence and often globally. If you’re moving abroad for six months or more, you need a real expat health plan.
Comparing Expat Health Plans: Cigna Global, GeoBlue, Allianz, etc.
The Major Players in the Global Health Market
When you start shopping for expat health insurance, you will see a few major names come up repeatedly. Companies like Cigna Global, GeoBlue (which is affiliated with Blue Cross Blue Shield), Allianz, and Bupa Global are some of the largest and most reputable providers in this space. Each offers a range of plans with different coverage levels, geographic areas, and deductibles. It is crucial to get quotes from several of these top carriers to compare their networks, benefits, and costs to find the plan that best fits your specific international lifestyle.
Does Expat Health Insurance Cover Care Back in Your Home Country?
An Optional, and Expensive, Add-On
This is a critical feature to check. Most basic expat health plans will exclude coverage in your home country to keep costs down. My friend’s plan covered him everywhere in the world except the United States. However, most carriers offer an optional rider to include home country coverage. This is a popular, but expensive, add-on for U.S. expats who want to be able to come home for a few months a year and still have access to their doctors. Be prepared for this rider to significantly increase your monthly premium.
Understanding Geographic Coverage Areas and Exclusions
Choosing Your Zone of Protection
When you buy an expat health plan, you will have to select your “geographic area of coverage.” A common option is “Worldwide excluding USA,” which is often the most cost-effective. You can also choose “Worldwide including USA,” which is much more expensive. Some plans may offer more regional options, like “Europe only” or “Southeast Asia only.” It’s important to choose the coverage area that matches your travel and living plans. If you are an American living in France with no plans to visit the U.S., excluding it from your coverage can save you a lot of money.
Pre-Existing Conditions and Expat Health Insurance Underwriting
Underwriting Can Be More Stringent
Unlike ACA plans in the U.S., expat health insurance plans are medically underwritten. They can and will ask about your pre-existing conditions. Depending on the condition, the insurer might do one of three things. They might approve you with no restrictions. They might offer you a policy but with an “exclusion rider,” meaning they will not cover any costs related to your specific pre-existing condition. Or, for more serious conditions, they may decline your application altogether. It can be more difficult to get coverage if you have a significant health history.
Deductibles, Copays, and Out-of-Pocket Maximums in Expat Plans
The Same Concepts, in a Global Context
Expat health plans work much like the plans you are used to at home. You will have a deductible, which is the amount you have to pay first before the insurance pays its share. You may have co-pays or co-insurance, which is the percentage of the bill you are responsible for. And a good plan will have an annual out-of-pocket maximum, which is the absolute most you would have to pay for covered medical services in a given year. Understanding these cost-sharing features is key to choosing a plan that fits your budget.
Does Expat Health Insurance Cover Maternity? Often Optional.
Planning for a Family Abroad
If you are planning to start a family while living abroad, you must pay close attention to maternity coverage. Basic expat health plans often do not cover maternity care. It is typically available as an optional rider that you can add to your policy for an additional premium. Crucially, these maternity riders usually have a waiting period of 10 to 12 months. This means you must have the rider in place for almost a year before you can get pregnant for the costs to be covered.
Finding Doctors and Hospitals in Global Expat Health Networks
The Power of a Digital Provider Directory
A major benefit of a large expat insurance carrier is their extensive global network of doctors and hospitals. When I was living in Lisbon, I used my insurer’s mobile app to find an English-speaking, in-network primary care doctor just a few blocks from my apartment. The app showed me a map of all the clinics, hospitals, and specialists in their network. Before you buy a plan, it’s a good idea to use their online provider search tool to check the quality and breadth of their network in your specific destination city.
Direct Billing vs. Pay-and-Claim with Expat Insurance
How Your Bills Actually Get Paid
There are two main ways your medical bills are handled. The best-case scenario is direct billing. This is where your in-network hospital or clinic will bill the insurance company directly, and you only have to pay your co-pay. The other method is pay-and-claim. This is common for smaller doctor visits or out-of-network care. You pay the full bill yourself upfront, and then you submit the receipt and a claim form to your insurance company for reimbursement. It’s important to know which method is used by the providers in your area.
Emergency Medical Evacuation: A Critical Rider for Expat Plans
The Lifesaving Flight You Hope You Never Need
This is an absolutely essential component of any expat health plan. If you are living or traveling in a remote area with substandard medical facilities and you have a life-threatening emergency, a medical evacuation benefit will pay for you to be transported to the nearest high-quality medical center. This could mean a helicopter ride to a better hospital in a nearby city, or even a medical flight back to your home country. The cost of a medical evacuation can be over $100,000, making this a non-negotiable piece of coverage.
Dental and Vision Add-Ons for Expat Health Insurance
Bundling Your Global Benefits
Just like with a domestic health plan, your primary expat medical plan will not cover routine dental or vision care. However, most expat insurance carriers offer optional, supplemental dental and vision plans that you can add to your package for an additional premium. These plans work similarly to U.S. plans, providing benefits for cleanings, fillings, eye exams, and an allowance for glasses or contacts. If you know you will need regular dental or vision care while living abroad, bundling these benefits can be a convenient and cost-effective choice.
The Cost of Expat Health Insurance: Factors Affecting Premiums
Your Age, Location, and Coverage Area Drive the Price
The premium for an expat health plan is based on several factors. Your age is the biggest driver; older individuals pay more. The level of coverage you choose (deductible and out-of-pocket max) also has a large impact. But the most unique factor is the geographic area of coverage. A “Worldwide excluding USA” plan is significantly cheaper than a “Worldwide including USA” plan, because the cost of healthcare in the United States is so much higher than anywhere else in the world.
Expat Insurance for Retirees Living Abroad
Securing Healthcare in Your Retirement Paradise
Many American retirees dream of living abroad in a place like Mexico, Portugal, or Costa Rica. A critical part of making this dream a reality is securing a good expat health insurance plan. Medicare generally does not provide any coverage outside of the United States. Therefore, a private expat health plan is essential. It provides access to the private healthcare system in their new country of residence, ensuring they can get high-quality care without having to fly back to the U.S. for every medical need.
Digital Nomads: Do You Need Expat Insurance or Travel Insurance?
It Depends on the Length and Nature of Your Trip
This is a key question for the modern remote worker. If you are a true “nomad,” moving to a new country every 1-2 months, a robust, long-term travel insurance plan might be sufficient, as your needs are primarily emergency-based. However, if you plan to establish a base in one foreign country for 6 months or more, you have crossed over into “expat” territory. In this case, you need a comprehensive expat health insurance plan that covers not just emergencies, but also routine checkups and ongoing care in your new home base.
How Long Can You Keep Your Expat Health Insurance Plan?
Designed for Annual Renewal and Long-Term Living
Unlike a short-term travel policy, an expat health insurance plan is designed to be your long-term health coverage while you live abroad. These are typically annual policies that you can renew each year, as long as you continue to pay your premiums. You can keep the plan in force for as many years as you remain an expatriate. This provides a stable and continuous source of health coverage, which is essential for anyone who is making a long-term home in a foreign country.
My Experience Choosing an Expat Health Plan for Living in Europe
Balancing Cost, Coverage, and Network
When I was planning my move to Europe, I got quotes from three major expat insurance carriers. I chose a “Worldwide excluding USA” plan to save money. I then compared the networks in my target city, Lisbon. I also looked at the deductibles and the out-of-pocket maximums. I ended up choosing a mid-tier plan from GeoBlue. It had a $1,000 deductible, a good local network, and included medical evacuation coverage. It wasn’t the cheapest, but it provided the best balance of comprehensive coverage and affordability for my specific needs.
Filing Claims from Abroad: Language and Currency Issues
The Benefit of a Global Carrier
One of the challenges of getting sick abroad is dealing with bills in a different language and currency. This is where a major global expat insurance company shines. They have multi-lingual claims departments and are experts at handling international claims. I was able to submit my claim form and my receipt from a Portuguese doctor online. The insurance company handled the currency conversion and reimbursed me via a direct deposit to my U.S. bank account. Their expertise in managing these global transactions makes the process much smoother.
Expat Health Insurance: Essential for Peace of Mind While Living Overseas
The Bottom Line for a Global Citizen
Living abroad is an incredible adventure, but it comes with unique risks. The single biggest financial risk you can face as an expat is a major medical event without proper health insurance. An expat health plan is your financial and medical lifeline. It ensures you have access to quality healthcare wherever you are in the world, and it protects you from the potentially bankrupting cost of that care. It is the most essential purchase you will make before you embark on your journey, providing the peace of mind to truly enjoy your life abroad.