The best health insurance for expats is rarely a single “top plan”. It is the policy that matches three things: the country you are moving to, the rules attached to your visa, and how much medical risk you can afford to carry yourself.
This guide explains the main types of international health plans available in 2026, what the well-known insurers offer, and how to compare quotes line by line.
One note before we start: this article is general information, not financial or insurance advice. Policy terms differ by country and by insurer, so always read the policy wording before you buy.
What Counts as Expat Health Insurance?
Expat health insurance, usually called international private medical insurance (IPMI), is an annually renewable policy designed for people living outside their home country for a year or more. Unlike travel insurance, it is built for routine life abroad: GP visits, specialist referrals, planned surgery, chronic condition management, maternity and, on many plans, treatment back in your home country.
That distinction matters. Travel insurance is emergency cover for a trip with a fixed end date. It rarely covers routine or planned care. If you are taking a short assignment or a holiday, our guide to travel insurance for international trips is the better starting point. If you are relocating, you need one of the options below.
The Four Main Types of Cover for People Living Abroad
1. The host country’s public or mandatory system
Many countries require residents to join a national scheme, and in those places the “best plan” question is partly answered for you. Germany makes health insurance compulsory for every resident, and most employees join a public fund with contributions of roughly 14.6% of gross salary plus a small supplementary rate, split with the employer. The Netherlands and Switzerland both require new residents to take out local basic insurance within a few months of arrival. In the UK, most visa holders pay the Immigration Health Surcharge (£1,035 per adult per year at the time of writing) and then use the NHS.
2. Local private insurance
A private policy bought from an insurer in your new country is often cheaper than an international plan because it only pays for treatment in that country. It suits people who plan to stay long term and do not need cover at home or while travelling. The downside is portability: if you move again, the policy does not move with you.
3. International private medical insurance
IPMI follows you across borders. You choose an area of cover (commonly “worldwide” or “worldwide excluding the USA”), a core inpatient module and optional add-ons. It is the standard choice for globally mobile professionals and families in countries with weak public healthcare.
4. Employer group plans
Multinationals, NGOs and international schools often place staff on a group IPMI policy. Group plans can be generous — some accept pre-existing conditions without individual medical underwriting — but cover normally ends when the job does. Ask HR whether the plan has a continuation option that lets you convert to an individual policy without new underwriting.
Well-Known International Insurers: What Each Is Known For
The names below come up in almost every expat forum. This is a neutral overview, not a ranking; premiums depend on your age, destination, medical history and the options you choose, so get your own quotes.
| Insurer | Background | Typically suits |
|---|---|---|
| Cigna Global | International arm of the US insurer Cigna Healthcare; modular individual plans with a choice of tiers and optional outpatient, evacuation, wellness and dental modules. | Individuals and families who want to build a plan module by module and adjust deductibles to control cost. |
| Allianz Care | International health brand of the Allianz group, administered from Ireland; individual, family and corporate plans with a large direct-billing network. | Expats in Europe, the Middle East and Africa, and employers insuring mixed-nationality teams. |
| Bupa Global | International division of UK-based Bupa; positioned toward the premium end with high annual limits. | Senior professionals and families wanting broad cover and access to private hospitals in many countries. |
| GeoBlue | US-based provider associated with the Blue Cross Blue Shield system, known for access to a large provider network inside the United States. | US citizens living abroad, and expats who need regular treatment in the US. |
| IMG (International Medical Group) | US-headquartered insurer offering both long-term global medical plans and shorter-term travel medical cover. | Budget-conscious expats, missionaries, students and people between long-term plans. |
Other established names include AXA Global Healthcare, Aetna International, William Russell and April International. A specialist IPMI broker can quote several at once; ask how the broker is paid and whether they cover the whole market.
What Should You Compare Before Buying?
Two plans with the same headline limit can behave very differently at claim time. Compare these points on every quote:
- Area of cover. Including the United States can raise the premium sharply because US treatment costs are so high. If you will not live in or regularly visit the US, “worldwide excluding USA” is usually the sensible choice; many plans still include short emergency trips there.
- Annual limit and sub-limits. A high overall maximum means little if outpatient visits, physiotherapy or cancer drugs carry small sub-limits. Read the benefits table, not the brochure.
- Inpatient versus outpatient. Core modules usually cover hospitalisation only. Day-to-day care (GP, prescriptions, diagnostics) is normally an optional module.
- Deductible and co-insurance. A higher annual deductible lowers the premium.
- Pre-existing conditions. Find out whether they are excluded, covered after a waiting period, or covered for an extra premium.
- Maternity. Most individual plans impose a waiting period of around 10 to 12 months or more before maternity benefits apply. Buy well before you plan a pregnancy.
- Medical evacuation and repatriation. Essential if you will live somewhere with limited specialist care.
- Direct billing. Check which hospitals near your new home bill the insurer directly, so you are not paying large bills up front and claiming them back.
- Renewal terms. Look for guaranteed renewability.
Full medical underwriting or moratorium?
With full medical underwriting you complete a health questionnaire and the insurer tells you up front what is excluded or loaded. With moratorium underwriting you skip the questionnaire, but anything you had symptoms of or treatment for in a set period before joining (often the past two to five years) is automatically excluded for an initial period. Full underwriting takes longer but gives certainty. Either way, answer every question honestly, because non-disclosure can void a claim.
Does Your Visa Set Minimum Insurance Requirements?
Often, yes — and an international plan does not automatically satisfy them. Check the official immigration site for your destination before you buy.
- Germany: you must show adequate health insurance for the visa and again for the residence permit. Once employed you will normally join the statutory system; the official portal Make it in Germany explains the options, and our Germany visa guide for immigrants covers the paperwork around it.
- United Kingdom: the Immigration Health Surcharge is paid with most visa applications of more than six months; details are on gov.uk. Private insurance is optional and used mainly to avoid NHS waiting lists.
- United Arab Emirates: employers are generally required to provide health insurance for employees, but dependants may not be included, so check your contract.
- New Zealand: eligibility for public healthcare depends on your visa length; see our guide to health insurance on a New Zealand work visa.
- United States: there is no public system for most newcomers and medical costs are the highest in the world. Depending on your immigration status you may be able to buy a marketplace plan through HealthCare.gov; our guide on how to choose a US health insurance plan walks through the metal tiers.
How Much Does Expat Health Insurance Cost in 2026?
There is no honest single figure. As a broad guide, a healthy adult in their thirties buying inpatient-only cover excluding the US can expect to pay somewhere in the low thousands of US dollars a year, while a comprehensive family plan that includes the US, outpatient care and maternity can run well into five figures. The main price drivers are:
- your age (premiums rise noticeably from the mid-forties and steeply after 60);
- whether the USA is in your area of cover;
- your country of residence, since some markets such as Hong Kong, Singapore, Switzerland and the UAE have high private hospital costs;
- the modules you add, especially outpatient and maternity;
- your deductible and co-insurance level;
If you pay premiums in a different currency from your salary, a specialist money transfer service will normally beat your bank’s exchange rate; we compare the options in our guide to sending money internationally.
How to Buy Expat Health Insurance: Step by Step
- Check the legal minimum. Read the insurance requirements for your visa and find out whether you must join a national scheme.
- Map your gaps. If you will be in a public system, decide whether you need a top-up for private hospitals, dental, evacuation or treatment at home.
- Ask your employer. Get the group policy’s benefits table in writing, including whether dependants and pre-existing conditions are covered.
- Set your area of cover and deductible. These two choices move the price more than anything else.
- Get at least three like-for-like quotes. Go direct to insurers or use an IPMI broker, and compare the same modules and deductibles.
- Read the policy wording. Focus on exclusions, waiting periods, pre-authorisation rules and the definition of “chronic condition”.
- Complete the application truthfully. Disclose everything asked about, even if it seems minor.
- Time the start date. Begin cover on or before your departure date so there is no gap, and keep the insurer’s emergency number and your membership card on your phone.
Frequently Asked Questions
Can I keep my home-country health insurance when I move abroad?
Usually not for routine care. Most domestic policies and public systems only cover treatment at home, with limited emergency cover abroad for short trips. Ask your current insurer in writing what applies once you become non-resident, and do not cancel anything until your new cover is confirmed.
Is international health insurance valid in the United States?
Only if you choose an area of cover that includes the US, which costs considerably more. Also note that an international plan is generally not the same as an ACA-compliant plan, so long-term US residents should check what their immigration status allows on the marketplace.
Will an expat plan cover my pre-existing condition?
It depends on the insurer and the underwriting method. Some conditions are excluded outright, some are covered after a waiting period and some are accepted for a higher premium. Large employer group plans are the most likely to cover pre-existing conditions without individual assessment.
Can I buy expat insurance after I have already moved?
Yes. Most international insurers accept applications from people already living abroad, though anything that has arisen since you moved will be treated as pre-existing.
Bottom Line
Start with what your destination and visa legally require, then decide whether the local system alone is enough for the way you live. If you need an international plan, compare established insurers on area of cover, sub-limits, underwriting terms and direct-billing hospitals rather than on headline price. The right expat health insurance is the one that will still be affordable at renewal and that pays, without argument, in the place you are most likely to need it.