Expat Health Insurance Cost: What You’ll Pay and Why

Expat health insurance typically costs anywhere from $500 to $15,000 a year, and where you land in that range depends mostly on your age, where you live, and how much of the world you need covered. That’s a wide spread, so it pays to understand what actually drives the price before you start comparing quotes.

This page breaks down what international medical insurance costs by country and by age, the six factors that move your premium the most, and practical ways to bring the cost down without giving up the cover you need. As expats ourselves, we’ve been through this, and we can help you find the right policy for you and your family wherever you live.

How much does expatriate health insurance cost?

There’s no single price for expat health insurance. The same person can be quoted very different premiums depending on the insurer, the regions they cover, and the level of cover they choose. As a rough guide, a basic policy covering one region can start around $500 a year, while comprehensive worldwide cover including the United States can run to $15,000 or more.

The figure that matters is your figure, not an average, so the rest of this page focuses on what moves the price up or down and how to keep it in check.

What impacts your expat health insurance cost?

Six things move the price of a policy more than anything else: where you need cover, which insurer you choose, which medical services are included, your age and medical history, the excess or copayment you agree to, and how you pay. Here’s how each one works.

The countries of your cover

Most insurers price cover in three geographic tiers: Europe and the EU, worldwide excluding the United States, and worldwide including the United States. The worldwide-plus-USA tier is by far the most expensive, because medical care in the States costs more than almost anywhere else. If you don’t need to be covered in the US, dropping it is one of the biggest single savings available to you.

The insurer you choose

Prices for the same cover vary from one insurer to the next, so it’s worth comparing. The cheapest policy is rarely the best value, though. The insurer has to deliver when you need it most, without hidden costs or fees, so weigh service and reliability alongside the premium.

Which medical services are included

Most quality plans cover:

• Emergency care, from a GP or a hospital
• Diagnostic tests, x-rays, scans, and pathology
• Physiotherapy
• Cancer care, usually with limits on treatment types
• Emergency medical evacuation to your home country

Cover that often costs extra includes:

• Maternity care
• Dental
• Mental health support
• Expatriate assistance programs

Your age and medical history

The younger and healthier you are when you take out a policy, the cheaper it will be. Many insurers also set a maximum age to sign up, and some stop offering new cover past a certain age. Our recommended insurers won’t cancel your cover simply because you get older, but check that your premium won’t jump sharply with age, and be aware of any automatic changes built into your plan.

Pre-existing conditions can also raise the cost, though many providers have improved how they handle them. See the section on pre-existing conditions below for more.

Co-payment and excess

Many insurers let you lower your premium by agreeing to pay part of each claim yourself. The larger the share you cover, the lower your premium. That can be a sensible trade if you rarely claim, but it doesn’t suit everyone.

Note: Some residency programs set strict rules for the insurance they accept. Spain’s non-lucrative visa requires a policy from an insurer authorized in Spain with no copayment, no deductible, and no coverage limit. Portugal’s D7 visa requires comprehensive private health insurance valid in Portugal, usually with at least €30,000 of cover, but it does not impose the same no-copayment rule. Always confirm the exact wording your consulate expects before you buy.

How you pay for your policy

Many insurers offer a discount if you pay for the full year upfront or set up direct debit. Paying month to month is usually the most expensive option.

The three types of health insurance

When you start looking, three products get confused with each other: expat health insurance, local private health insurance, and travel insurance. They cover different things. Here’s how they differ, with a comparison table further down.

Expat health insurance

Expat policies are built for people living abroad long term. A good one covers your medical costs for both routine and emergency treatment, with the flexibility to add dental, eye care, maternity, and care for chronic conditions.

They also give you flexibility in where you’re treated, including being sent home or to another country for care, and they cover you wherever you are in the world. Being at home, traveling for leisure, and traveling for work can all sit under a single policy.

Your cover travels with you, which matters more than it first appears. It means less exposure to pre-existing-condition price hikes, and you keep any no-claims discount if you move abroad again.

Many providers also offer support in your own language, and some include expat assistance programs covering a range of wellbeing issues. The ability to deal with qualified professionals in English is a real comfort for a lot of families living abroad.

What is a “qualified expatriate”?

Most expat plans expect you to be living outside your home country for a meaningful part of the year, often around six months, but the exact threshold varies by insurer. Check the specific requirement for your situation before you take out cover.

This type of policy may also be called overseas health insurance, international medical insurance, or international health insurance.

Local health insurance

Local health insurance covers much the same medical areas as an expat policy, but only in the country where you bought it. If you need care, you may not get to choose where you’re treated, and advice and support are often only in the local language. Move to a new country and you’ll need to find a new provider and start a new policy.

Travel insurance

Travel insurance covers you when you’re away from your usual home, so it only applies to holidays or short trips abroad, and work travel is often excluded. It covers emergency treatment that can’t wait until you get home, and you can usually add cover for non-medical costs like cancellations and theft.

Local versus international health insurance

International Health Insurance	Local Health Insurance
Covers private medical care in any country, based on your chosen plan	Covers care only in the country where you bought it
Higher coverage, higher premiums	Lower coverage, lower premiums
Built for a global audience and usually offered in English, which is easier for expats	Service and marketing aimed at one region, often in the local language
Access to top private hospitals and specialists in your country of residence	Often limits you to a smaller set of hospitals and doctors
Covers treatment in multiple countries, including home, so no new policy if you move or return	Tied to one country, so no use if you move or travel
Added expat benefits like emergency evacuation and 24-hour assistance	Local cover only, with no added expat benefits

Expat vs local vs travel insurance

	Expat	Local	Travel
Emergency care	Yes	Yes	Yes
Check-ups (dental, optical, annual physical)	Yes	Yes	No
Treatment in any country / global cover	Yes	No	No
Maternity cover	Yes	Yes	No
Treatment of chronic conditions	Yes	Yes	No
Ongoing treatment of serious illness	Yes	Yes	No
Non-urgent care	Yes	Yes	No
Repatriation for care	Yes	No	Yes
Pre-existing conditions	Yes	Yes	No
Accepted for visas and residence permits	Yes	Yes	No
Cover if you move or relocate abroad	Yes	No	No
Unlimited time abroad	Yes	No	No
Cover for business travel	Yes	No	No
Support in your language	Yes	Maybe	Yes
Expat assistance programs	Yes	No	No
Travel-related expenses (cancellation, theft)	No	No	Yes

Why do you need overseas health insurance?

The ability to access quality healthcare in your new country

Healthcare works very differently from one country to the next. In most places, as an expat you’re expected to pay for your own treatment, and without adequate cover that gets expensive fast.

Some countries, including Spain, run public systems that residents can use at little or no cost. But as an expat you often can’t access the public system until you’re making social security contributions, and even then, public waiting times can be much longer than private care, especially for non-urgent procedures.

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 cover for your whole family. The exact standard varies. Spain’s non-lucrative visa requires a policy with no copayments, while Portugal’s D7 visa requires comprehensive private cover but not specifically a no-copayment policy. Budget the insurance cost into your moving plans, and confirm the precise requirements with a qualified immigration lawyer or your consulate before you apply.

Public healthcare might not cover the services you need

Even where you can use the public system, it often won’t cover everything. Dental, optical, and other services are commonly excluded, and they can be expensive to pay for out of pocket. Many expats take out private cover alongside public healthcare to fill those gaps.

You need cover in more than one country

Overseas health insurance covers you across borders without gaps, which saves you arranging a fresh travel policy every time you leave the country. It’s worth considering if you:

• Are unsure about the standard of healthcare where you’re moving
• Plan to visit home often
• Travel a lot, or may relocate at short notice
• Don’t speak the local language
• Want to add services like dental or maternity
• Work as a digital nomad

Picking the right policy at the start also means you can keep it as you age, so you won’t have to declare pre-existing conditions again each time you switch.

Pre-existing conditions

Your medical history covers any existing conditions or chronic illnesses. The more you have, the more likely you are to need treatment, which raises the cost of cover.

Not every insurer covers every pre-existing condition, but many have improved their terms in recent years. Either way, declare any conditions when you apply. Being upfront protects you from rejected claims later. To get an accurate picture, request quotes from several insurers and compare what each includes, excludes, and charges before you decide.

How does international health insurance work?

Most basic plans include:

• Hospitalization
• Surgery
• Emergency dental care
• Emergency outpatient treatment
• Cancer treatment
• An expat assistance program

From there, you tailor the cover to your life. You decide what to add, with dental, eye care, maternity, and physiotherapy among the most popular options. Once you’ve settled on the cover, you choose which regions or countries to include.

How to choose the best international health insurance for you

Start with what matters to you, then work through the details.

Step 1: Cover the basics

• How long will you need cover?
• Which countries and regions do you need?
• Which services and treatments matter to you and your family?
• What’s your budget?
• Does your visa or residence permit set any specific requirements?

Step 2: Choose the specifics

Think about how you’ll actually get treatment. Can you pick your own doctor? Can you use telehealth and video consultations? That level of control is reassuring, but it can add to the cost.

Step 3: Decide whether you want home cover

If you plan to visit your home country often or for long stretches, make sure home cover is included. Some insurers only cover home visits for a limited period, often around two weeks.

Step 4: Consider medical evacuation

Keep your lifestyle in mind. If you travel to remote areas or developing countries, it’s worth including medical evacuation in your plan.

Step 5: Understand the claims process

Know how your insurer handles claims before you need to make one. Some want a form completed, others just the original bill. In some cases the insurer pays the hospital or doctor directly; in others you pay first and claim the money back.

Many insurers also ask you to contact them before any appointment or planned hospital stay, and they often have a list of approved doctors and hospitals. If you don’t contact them in time, they may not pay the bill in full, so it’s worth knowing the rules from the start.

Expat health insurance cost for students

Student cover isn’t really a separate product, but some insurers tailor plans to students’ needs and budgets. If you’re on a student visa, it’s worth a look. Student plans often add features like easy digital access, repatriation, and travel security services. If those matter to you, a student-specific policy may be the better fit.

Expat health insurance cost for retirees

Retirees weigh the same factors as anyone else, but with more attention on pre-existing conditions and exclusions, which tend to carry more weight as you get older. Good cover matters most at the point you’re most likely to need it, so it’s worth getting right before you move.

How to lower the cost of international health insurance premiums

Premiums can be high, and in some countries they’re a real budget item. A few things bring the cost down:

• Cover only the regions you need. Plans are priced by zone, so don’t pay for cover you won’t use. As noted earlier, dropping the United States is usually the single biggest saving.
• Choose an insurer that offers customized plans. Rather than an expensive plan packed with benefits you don’t need, narrow down your requirements and build cover around them.
• Start from a base plan and add to it. Find a provider who lets you build a modular policy, begin with the cover you actually need, then add optional extras from there.

What type of health insurance can American expats get?

If you’re a US citizen moving abroad, sorting out a new healthcare system is one of the things to plan from the start. The specifics depend on where you’re going, but the options generally fall into three categories:

• Public health insurance. In countries with strong public systems, you can get free or low-cost care once you’re paying the relevant taxes or contributions.
• Private or international health insurance. If the public system is weak, a private insurer gives you access to higher-quality care that would otherwise be expensive.
• A combination of both. Many expats pair public cover with a private plan. Even good public systems can be crowded and slow, so a private policy adds flexibility and faster access. It costs more, but it widens your options.

Getting the right cover

The right policy is the one that fits where you live, how you travel, and what you and your family actually need, not the cheapest quote or the one with the longest list of benefits. Get quotes from a few insurers, compare what each covers and excludes, and check the cover meets any visa requirements before you commit.

FAQ

How much does international health insurance cost?

Cost depends on your coverage level, age, medical history, and country of residence. On average, an international plan runs anywhere from $500 to $15,000 a year. Most plans offer two main coverage areas: worldwide, or worldwide excluding the United States, and some let you drop other high-cost countries like Hong Kong or Canada to bring the premium down.

Are US citizens living abroad eligible for Medicare?

In most cases, Medicare doesn’t cover you outside the United States. There are narrow exceptions, mainly emergencies where the nearest hospital is a foreign one, but even then only Medicare-covered services apply. If you’re retiring abroad, don’t count on Medicare for routine care overseas.

Which policy is best for senior citizens?

It depends on where you live and what you need. If you’re in the US, Medicare is usually the most cost-effective option. If you’re going international, look for a plan that’s affordable and carries the specific benefits you need, paying close attention to how it handles pre-existing conditions.

Is travel covered by international health insurance?

International health insurance covers medical treatment almost anywhere, depending on your plan, but it doesn’t cover things like trip cancellation, lost belongings, or short-trip mishaps. Those sit with travel insurance, so even with an international policy you may still want travel cover for specific trips.

What are the cheapest countries for expat health insurance?

Poland tends to rank as one of the cheapest, and most of the other low-cost options are in Eastern Europe, including Romania, Croatia, and Slovakia. Outside Europe, Thailand is among the more affordable destinations because local healthcare costs are low. Premiums still depend on your age, history, and chosen regions, so compare quotes for your own situation.

What are the eligibility criteria for international health insurance?

Criteria vary by insurer and plan, but most expect you to be living outside your home country for a meaningful part of the year, often around six months. You’ll usually need to provide a medical history, and some plans set age limits. Check the specific requirements with each insurer before you apply.