Young mother, holding her children hand in hand, walking on colorful street in the town of Villefrance, French Riviera

Expat health insurance costs can vary considerably, depending on several factors, so choosing the right policy is critical. As Expats ourselves, we know that the cost of international health insurance can be a big-budget item for many families. However, the peace of mind that you get with good coverage is priceless. We’ll help you find the best international medical insurance policy for you and your family, no matter where you live.

How much does Expatriate Health Insurance Cost?

In 2020, the average policy written by one of our recommended insurers was $3,740 for a year of coverage. However, annual Expat medical insurance policies can cost as little as $500 and as much as $15,000.

What Impacts Your Expat Health Insurance Cost?

Six things significantly impact the price of your medical insurance policy.

  • The countries you need cover for.
  • The insurer you choose for your cover.
  • The medical services that are included and excluded by the cover you choose.
  • Your age and existing medical conditions when you take out the policy.
  • The excess or co-payment you must pay when you claim.
  • Do you pay monthly, annually, or by direct debit?

The Countries of Your Cover

Most insurers offer policies for three geographical regions.

  • Europe and the EU
  • Worldwide (excluding the USA)
  • Worldwide (including the USA)
  • The Worldwide + USA is the most expensive due to the high cost of healthcare in the States.

The Insurer You Choose

Policy prices for cover vary between insurers. However, the cheapest policy is seldom the best value. Your insurer must deliver when you need it most, without hidden costs and fees.

Which Medical Care Specialties and Services Are Included

Most quality plans will cover:

  • Emergency care both from a GP or a Hospital
  • Diagnostic tests, x-rays, scans, and pathology
  • Physiotherapy
  • Cancer care (with limits on treatment types)
  • Emergency medical evacuation to your home country is also a common inclusion

Optional cover that may cost extra can include:

  • Maternity Care
  • Dental
  • Mental Health Support (psychologists or psychiatrists)
  • Expatriate Assistance Programs (EAPs)

Your Age And Medical History Impact Your Expat Health Insurance Cost

In short, the younger and healthier you are when you take out your policy, the cheaper it will be. Many insurers also have a maximum age for signing up – some even stop covering after a certain age. Please note: our recommended insurers won’t cancel your coverage just because you get older!

Check to make sure that you are covered without big increases as you get older. You must be aware of any such automatic changes in your plan.

Pre-existing conditions can also impact the cost of your international medical policy. Please see the section on how pre-existing conditions can affect the cost of your Expat Health coverage for more information.

Co-Payment and Excess

Many companies offer you an option to reduce the cost of your policy by contributing to the cost of claims.

You agree to meet some of the cost of each claim you make, and the exact amount can vary. In general, the higher the portion of the claim that you’ll pay, the lower your premium cost.

NOTE: Many popular residency programs require health insurance coverage with no co-payment or excess. These include Spain’s non-lucrative visa and Portugal’s D7 Passive income Visa.

How You Pay For Your Policy

Many insurers offer discounts if, for example, you pay for an entire year upfront or use direct debit as a payment method. Paying for your health insurance plan each month is often more expensive.

The Three Types of Health Insurance

Many people have the same question when searching for health insurance. What is the difference between:

  • Expat Health Insurance
  • Local Private Health Insurance Coverage
  • Travel Cover

While individual policies may differ, here’s a guide to the general offerings. We’ve also summarized the difference between Expat, Local, and Travel insurance in the table below for a quick guide.

Expat Health Insurance

Expat policies are aimed at those living abroad. The policy should cover all your medical expenses for long-term and emergency treatment. The policy should also have the flexibility to cover all areas, including dental, eye health, maternity, and care of chronic conditions.

There should also be flexibility in where you receive your care. It can include being repatriated to your home or another country for treatment.

You can also be covered regardless of where you are in the world. Being at home, recreational travel, and business travel can all be covered by a single policy.

Importantly, your cover (with benefits) travels with you wherever you go. This means that you’ll have less exposure to pre-existing condition price hikes, and you’ll hold onto no-claims bonuses if you move abroad again

I love living in Spain, but the ability to talk to qualified professionals in English is a real comfort for my family. Be aware, that many companies also offer support and advice in your language. With some, this extends to Expat Assistance Programs that cover a wide range of well-being issues.

What Is The Definition Of A “Qualified Expatriate”?

You’ll need to be a “qualified expatriate” to qualify for an expatriate health plan. Generally, this means that you live outside your home nation for at least 180 days per year of coverage. However, you’ll need to check the specific requirements for your situation when you are taking out cover.

NOTE: This type of cover may also be called overseas health insurance, international medical insurance, or international health insurance.

Our recommendations for Expat Health Insurance

We recommend two companies if you want quality coverage at an excellent price point.

Cigna Health Logo

Cigna Global is an American company with access to medical support in over 200 countries and territories. They provide 24/7 access to multilingual service centers and flexible plans depending on your needs and budget. The Customer testimonials from our clients are excellent!

Get a quote here.

International Insurance Logo

International Insurance offers a global brokerage service that represents many insurers. They assess your needs and suggest the best company and policy for your needs. Rest assured, because of their bulk purchasing deals, their rates are often less than going direct to the insurer. They work with a range of large and small companies, both global and regional, and our clients report significant savings and excellent service!

Get a quote here.

Local Health insurance

Local health covers much the same healthcare areas as Expat health insurance. However, you are only covered in the country where you took the policy. And, if you do need care, you may not be able to select where you receive treatment. And these medical insurance policies will often only (but not always) provide advice, support, and care in the local language. If you move to a new country, you’ll need to find a new provider and take out a new policy. 

Check out our guide to Private Health Insurance in Spain for examples of local insurers.

Travel Insurance

Travel medical insurance covers you when you are away from your regular place of residence. So, you are only covered if you are going on holiday or on a short-term visit overseas. Generally, professional and work travel is not covered.

You’ll only be covered for emergency treatment that cannot wait until you return home.

You can also choose to cover non-health-related expenses like cancellations and theft while away.

Local versus International Health Insurance 

International Health Insurance Local Health Insurance 
Covers private medical care in any country based on the chosen planCovers medical care in the country where insurance is purchased
Provides high medical coverage at the cost of high premiumsProvides lower medical coverage and also has lower premiums
It is the more expensive option It is the cheaper option 
Targeted toward a global audience and uses English instead of local languages, making the process more expat-friendly.Customer service and marketing are targeted toward a particular region. Expats may have trouble understanding the native language.
Provides access to the highest quality medical care including hospitals, practitioners, and facilities in your country of residenceOften restricts expensive private healthcare and limits you to a couple of hospitals and medical professionals 
It covers medical treatment in multiple countries including your home country. You don’t need to get a new insurance policy if you decided to return home or move abroad.It’s limited to a single country. It won’t be useful if you decide to travel or move to another country.
Added benefits for expats and global citizens including emergency evacuation and 24-hour emergency assistanceLimited coverage based in the local vicinity and no added benefits for expats 

Insurance Comparison Table: Expat vs. Local Private vs. Travel

Expat Health InsuranceLocal Health InsuranceTravel Insurance
Emergency CareYesYesYes
Check-ups (Dental, optical, annual physical etc)YesYesNo
Preventative healthcare (annual physical etc)YesYesNo
Treatment in any countryYesNoNo
Maternity CoverYesYesNo
Treatment of chronic conditionsYesYesNo
Ongoing treatments of serious illnessYesYesNo
Non-urgent careYesYesNo
Repatriation for careYesNoYes
Pre-existing conditionsYesYes
Accepted for visas and residence permitsYesYesNo
Cover if you move to a new countryYesNoNo
Global CoverYesNoNo
Cover if you move homeYesNoNo
Long-term contractsYesYesNo
Unlimited time abroadYesNoNo
Cover for business travelYesNoNo
Support in your choice of languageYesMaybeYes
Expat Assistance ProgramsYesNoNo
Travel related expensesNoNoYes
Comparison of the differences between Expat, Local, and travel insurance.

Why Do You Need Overseas Health Insurance?

The Ability To Access Quality Healthcare In Your New Country

Healthcare delivery varies hugely around the world. As an Expat, in most countries, you’ll be expected to pay for your medical expenses. If you don’t have adequate coverage, this can be very expensive.

Many countries, such as Spain and Hong Kong, provide free and efficient healthcare to all their citizens. If your new country is one of the countries that offer free or low-cost healthcare, you may have adequate coverage from the public system.

However, as an Expat, you are often not entitled to use the healthcare system unless you make social security payments.

And, if you are accessing public treatment, the waiting times can be much longer than in private care. For non-essential procedures, the amount of time may be even longer.

Visas and Residence Permits Can Require You To Have Private Healthcare

In many countries, comprehensive Private Health Insurance is a residency requirement. And, you’ll need to show the cover for your whole family. In some countries, it must be comprehensive coverage with no co-payments. This ensures that the country’s healthcare system is not overburdened.

You should budget the Expat Health Insurance cost into your moving cost budget.

Popular immigration programs like Spain’s non-lucrative visa and Portugal’s D7 Passive Income visa require this coverage.

If you need cover for your immigration application, make sure the policy you select has the appropriate cover to meet the requirements. A good immigration lawyer will be able to advise you.

Public Healthcare Might Not Cover the Services You Need

Many Expats take out private health coverage in addition to local healthcare to cover additional eventualities.

Dental, optical, and other services are often excluded from public health services. These specialties can be expensive; you want to ensure your budget if you don’t have coverage.

You Need Health Insurance Coverage In More Than One Country

Overseas health insurance offers a personalized plan that allows you to live abroad and travel without gaps in your health coverage. Moreover, it can save you the hassle of taking out a travel policy and dealing with paperwork every time you travel. You may need to opt for overseas health insurance for Expats if you:

  • Are worried about the standard healthcare in your new country of residence.
  • Are planning to visit home often.
  • Travel a lot.
  • May relocate or travel on short notice.
  • Don’t speak the language of your country of residence.
  • Would like to include additional services.
  • Are a digital nomad.

If you pick the right policy at the start, you can keep it as you get older. And that means that you won’t need to declare pre-existing conditions each time you sign up for a new policy.

An couple who are hugging, covered by quality Expat health insurance.

Pre-existing conditions

Your medical history refers to any pre-existing medical conditions or pre-existing chronic illnesses. The more health issues you suffer from, the higher the chance you will need medical treatment, implying higher healthcare costs.

Although not all companies cover all pre-existing conditions, many providers have updated their policies on this matter. This change is positive. In any case, experts recommend that you highlight any health conditions or chronic illnesses in your application. This transparency will ensure that you don’t have issues with rejected claims in the future.

To receive an accurate estimate for your requirements, we advise you to request quotes from a wide range of companies. Carefully compare their services, inclusions, exclusions, and price. From there, you can decide on the provider that best fits your needs and budget.

How Does International Health Insurance Work?

Most basic packages include:

  • Hospitalization
  • Surgery
  • Emergency dental care
  • Emergency outpatient benefits
  • Cancer treatment
  • Expat Assistance Program (EAP)

International insurance should allow you to tailor the coverage to your needs and lifestyle. What your plan covers depends on you. You can add many extra services to your package and personalize it. The most popular are dental, eye care, maternity cover, and physiotherapy.

Once you’ve selected your coverage, you can choose which regions or countries to include in your policy.

How To Choose The Best International Health Insurance For You

First, understand the things that matter to you in choosing a policy.

Step 1: Cover the Basics

  • How long will you need coverage?
  • Which countries and regions do you need coverage in?
  • What services, treatments, and options are important to you and your family?
  • What is your budget?
  • Does your visa or residency permit have any specific requirements?

Once you have that clear, consider some other aspects of the choice.

Step 2: Choose the Specifics (Treatment, physician, etc.)

How do you go about getting treatment? Can you pick the healthcare professional who you see?

And, can you access various modes of care, like telehealth and video consultations?

Having this level of control can be very reassuring but can increase costs.

Step 3: Decide whether you want Home Coverage

If you intend to visit your home country often or for long periods, make sure you include home coverage with your plan. Some companies cover your home visits only for a limited time (usually two weeks).

Step 4: Consider Medical Evacuation

Don’t forget to keep your lifestyle in mind while studying your policy. If you are an adventure traveler who visits remote places and developing countries, we recommend that you include medical evacuation in your plan.

Expat health insurance cost is well worth it if it helps you stay safe, just like this street art suggests!

Step 5: Get to the Paperwork

Make sure you know the claim process your insurers require. Some ask for an application form to be completed, while the original bill is enough for others. In some cases, your insurer pays the hospital or doctor directly. In others, you may need to pay your medical bills yourself and then apply for reimbursement.

For instance, most insurers require you to contact them before any doctor appointment or scheduled hospitalization. They usually have a list of selected doctors and hospitals you can choose from for treatment.

A failure to contact your insurance company in time may lead to them not paying your medical bills in full. It is essential to be aware of the claim process from the beginning to avoid unpleasant surprises.

Expat health insurance cost is well worth it if it helps you stay safe, just like this street art suggests!
Expat Health Insurance means you can stay safe when things go wrong

Expat Health Insurance Cost for Students

Is student health insurance different from regular Expat insurance? Not really. But, overseas student policies can be more tailored to students’ needs and lifestyles. If you are on a Student Visa, this may be an option to consider.

Some companies offer competitive student plans with additional valuable features, including:

  • Easy digital access.
  • Repatriation.
  • Travel security services.

If these features are essential to you, then a student policy may be the best international health insurance for you.

Expat Health Insurance Cost for Retirees

Retirees will have many of the same considerations when choosing a policy. You may need to pay even more attention to things like pre-existing conditions and exclusions.

A good Expat insurance policy is critical for those looking to retire abroad.

International Medical Insurance Costs by Country of Residence

Due to high competition between international insurance companies, the pricing is often competitive. In addition to that, health insurance is more expensive in countries with higher expat ratios.

Country of Residence Annual Cost (USD)
Hong Kong$12,175
Costa Rica$7,153
United States $6,973
United Kingdom$6,189

Global Health Insurance Costs by Age

Insurance coverage costs also depend on the age of the clients. Since younger clients are healthier and require less medical care, they are charged less for health insurance. On the other hand, costs drastically increase as you grow older and eventually start a family.

Age GroupAnnual Cost (USD)
18 to 29$2,404
30 to 39$3,401
40 to 49$5,795
50 to 59$7,274
60 to 69$8,295

How to Lower the Cost of International Health Insurance Premiums

While the benefits of international health insurance policies are high, the premiums are higher. In some countries, the costs of global health insurance can be too expensive to afford. Here are some ways you can lower these premiums to maximize the potential and minimize costs: 

  • Cover the Necessary Regions Only: It’s possible to lower costs by dropping coverage for certain regions. Many expat insurance plans are made for specific zones and you can save a lot of money by picking the right zone for you.
  • Choose an Insurance Company with Customized Plans: Some insurance companies will provide tailor-made plans to suit your requirements. Instead of going for an expensive plan with unnecessary benefits, narrow down your needs and customize a bespoke insurance plan.
  • Build a Modular Plan from the Base Up: Find an insurance provider who will let you build a modular plan and start with a base plan to cover all your important needs. Then you can think about all the excess options you’d like to add to your plan. 

What Type Of Health Insurance Can Americans Expats Get?

As an American citizen, moving to a new country and navigating a new healthcare system can be a tedious challenge. If you’re planning to move abroad, you should be thinking about your healthcare insurance options from the get-go. While the specific insurance policies depend on the destination country, here are some general health insurance options available to United States citizens abroad:

  • National or Public Health Insurance: In countries with high-quality public healthcare systems, you can enjoy free or inexpensive medical care from public hospitals simply by paying taxes for it.
  • International or Private Health Insurance: If you’re moving to a country that lacks a decent public health system, you might want to turn to a private health insurance company. This gives you access to first-class medical care that’s normally quite expensive. 
  • Private and Public Health Insurance:  You can also go for a hybrid insurance policy by combining both public and private health insurance. Even the best public healthcare systems can be overcrowded and time-consuming. Many expats feel more comfortable with adding a private insurance plan along with public health insurance benefits. This might be more expensive but provides you with flexible healthcare options.

Expat Health Insurance may be the best thing you buy

Finding the best international health insurance for you and your family requires time and proper research. But, finding the perfect overseas health insurance policy means peace of mind for the times you need it most. Indeed, when you or your family encounter a health issue, you need to know that you can receive the best possible care. 

FAQ For Expat Health Insurance 

How much does international health insurance cost?

The cost of international health insurance depends on factors such as maximum coverage, age group of the client, medical history, and country of residence. On average, an international insurance plan can cost you anywhere from $500 to $15,000. In 2020, the average policy written by one of our recommended insurers was $3,740 for a year of coverage. Most insurance plans offer two categories of coverage: Worldwide coverage or worldwide excluding the United States. Some insurance plans allow you to drop other expensive countries like Hong Kong and Canada to reduce premiums. 

Are US citizens living abroad eligible for Medicare?

In most circumstances, US citizens who live abroad do not have Medicare coverage outside the US. However, there are a few specific instances where Medicare might apply in foreign hospitals. For example, if you find yourself in a medical emergency within US territory and the nearest hospital is foreign. Or if you encounter an emergency en route to Canada. Even in these cases it is only Medicare-covered services.

Which policy is best for health insurance for senior citizens?

Your senior citizen’s health insurance should be based on several factors including your country of residence and specific needs. If you live in the US, Medicare is the most cost-effective public health insurance plan with the best benefits. If you go for international health insurance, pick a policy that is both affordable and has the benefits that you require.

Is Travelling Covered by International Health Insurance?

International health insurance provides coverage for inpatient treatment, check-ups, hospitalizations, and more almost anywhere in the world, depending on your chosen plan. On the other hand, personal belongings, cancellations, and emergency treatments are covered by travel medical insurance. So, even if you have international health insurance, you might need travel insurance for the duration of your travels. 

What are the Cheapest Countries for Expat Health Insurance?

Thailand seems to rank as the country where expat health insurance is the cheapest. European countries like Slovakia, Netherlands, Norway, and Poland also have the cheapest health insurance for expats.

What Is the Eligibility Criteria for International Health Insurance?

Eligibility criteria may differ depending on the chosen insurance company and plan. However, the general criteria for most plans require you to live abroad for at least 3 months each year. You also need to present a medical evaluation and medical history to complete the application process. Some insurance companies also have age restrictions for certain plans.

Get two expat healthcare quotes here.


  1. Hi Alastair,

    Thank you for writing so many helpful articles for expats and hope-to-be expats.

    I think I noticed that you mentioned that you currently live in Spain.

    Can I ask what made you guys choose Spain?

    My wife and I are U.S. expats currently living in Puerto Vallarta, Mexico.
    But every few years we get itchy feet, which has been the case all of our lives it seems, and now we are trying to fulfill our lifelong dream of living in Europe.

    Because of our particular needs, we have narrowed our search down to three choices: Portugal, Spain, and France.

    These countries seem to provide what we are looking for: a low cost of living (specifically Brittany in the case of France), good national healthcare systems, areas with cooler climates, and a moderate amount of English speakers in some communities. (I speak Spanish and German but my wife has trouble with languages.)

    I plan to schedule phone interviews with immigration lawyers in these countries using the links on your website. Thanks for those connections.

    So, why did you choose Spain?

    Thanks very much.

    John and Cindy Corp

    1. Hi John. For us, four main things made Spain so attractive. 1) The lifestyle; outdoor cafes, community focussed and taking time to smell the roses 2) The excellent variety – mountains, oceans, rivers, cities, villages, etc. 3) Great value for money 4) Easy travel to Europe and beyond. We’ve not regretted our choice at all (although there are many other places we’d love to explore!). Cheers, Alastair

  2. Hi! Thanks for all your wonderful articles! I can’t decide where to relocate to. I’m considering Portugal, Spain (Canary Islands), and now even Panama, or some of the other South/Central American countries. My main concern is healthcare-I have Type I Diabetes, as well as a few other things. I’m a single senior citizen, ready to retire. I have pets I want to bring with me. I want warm, but not too humid. What do you recommend?

    Susan Anspach

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