Moving abroad represents a new chapter in your life and requires a lot of preparation and planning. It’s easy to get overwhelmed with paperwork, finding accommodation, and acclimating to your new surroundings. In all the logistics, many people forget to consider their health insurance.
You have many international health insurance companies available, so finding the right one can be a daunting task. Not only do you have to consider your own medical needs, but you have to take the healthcare situation in your new country into account as well. Another decision is between opting for travel insurance or a comprehensive cover option for longer-term stays.
Your first step in the hunt for global health insurance should involve narrowing down your options to three or four insurance providers. These providers should be reliable, accessible, and have flexible coverage options that fit your lifestyle and requirements.
We’ve evaluated many of the top health insurance providers and identified which ones offer the most excellent international health insurance plans. These top four international health insurance companies should be first on your research list.
Husband and wife duo Inez and James Cooper founded William Russell (read our full review) in 1992 to provide extensive insurance options for expatriates, with a strong focus on life and health insurance. The company focuses on providing international services as a core business unit, setting it apart from other large health insurers that offer international health insurance plans as an additional service.
An independently owned and operated company, William Russell offers health insurance in over 160 countries and provides individual, family, and business plans. It focuses on providing high-quality products and services instead of racing to improve the bottom line. The result is an insurance provider that offers benefits such as:
A 30-day money-back guarantee
A 5-day claims-assessment process
A GDPR-compliant and ISO 27001-certified company
Plans that are insured by the largest financial services group in the world: Allianz
It’s important to note that William Russell isn’t an insurer itself — the company has a partnership with Allianz, which provides the actual insurance plan. However, William Russell acts as the intermediary, which means that you’ll never have to deal with Allianz directly and will only ever speak to William Russell staff.
William Russell has an extensive provider network with over 40,000 healthcare providers globally and has recently started expanding its Asian network to include more healthcare practitioners and specialists. Currently, the company provides direct billing to most Asian facilities, while other areas still require up-front payments that you then claim back from the insurer.
As with most international health insurance companies, William Russell does not offer coverage in the United States. If you frequently travel between the U.S. and other areas, you may need to take out an additional rider that gives supplemental U.S. coverage for up to 90 days.
William Russell provides coverage to expatriates from all around the world. The eligibility criteria for its international health insurance plans are that you must be living in a country different from your nationality and that you are under 75 years old.
PLANS
William Russell offers four plans ranging in affordability and coverage: Bronze, Silver Lite, Silver, and Gold.
The Bronze plan is the urgent-care plan that covers the costs of emergency medical concerns. While basic, the plan still covers cancer treatment, mental health treatment, and emergency medical evacuations. The plan has an annual limit of $1.5 million for all medical care.
The Silver Lite plan extends the coverage of the Bronze plan but removes the mental health coverage. Instead, customers get coverage for outpatient treatment, cancer treatment, limited emergency dental coverage, medical evacuations, and hospitalization. The plan has the same annual limit as the Bronze plan.
The Silver plan offers comprehensive care, including all of the coverage in the Bronze and Silver Lite plans, and provides optional add-ons for wellness care and optional dental care. The plan also has a higher annual limit of $3 million.
Only the Gold plan covers pregnancy and childbirth and covers almost all potential medical costs you may encounter while abroad. It also has the highest annual limit of $5 million per year, and has several optional add-ons for one of the most complete health insurance packages on the market.
While these plans cover most of the typical healthcare costs, you also can customize your plan further with add-ons such as dental care, maternity, well-being, and outpatient procedures.
PROS
Coverage of pre-existing conditions after a two-year waiting period
Transparent policy conditions and benefit guides
No call centers
Versatile range of plans and add-ons
CONS
Only Allianz insurance plans
No coverage for the USA
🏛️ Established
1992
🌎 Clients
Global
⚕️ Team
73 staff worldwide of which 70% are women
🏢Offices
UK, Indonesia, UAE and Belgium
📱 Platforms
Online
⚖️ Underwriter
AWP Health & Life SA, an Allianz group company registered in France.
🏆 Awards
10+ awards, including Feefo Gold Trusted Service Award three years in a row and Intermediary / Affinity Partner of the Year in the ITIJ Awards 2021
Cigna is one of the largest U.S. health insurance providers, and it offers a vast array of insurance plans and products, including international health insurance. Cigna’s international health insurance plans provide the following:
24/7 access to multilingual service centers
Access to medical support in 200 countries and territories
A global network of over 1.65 million hospitals and healthcare professionals
The Cigna Global division offers individuals and families coverage while living abroad. Cigna Global does not offer employer health insurance or other similar commercial options; Other divisions have those plans if you are looking for them.
Its focus is on providing high-quality, accessible healthcare for private customers worldwide. Cigna Global plans offer worldwide coverage with the option of getting coverage in the U.S. You have the option of excluding coverage in the USA but will still get limited emergency coverage for a maximum of 60 days per insurance period.
One of the largest drawbacks of Cigna is its reluctance to cover pre-existing conditions. Many health insurance providers will offer moratorium conditions in which they won’t cover pre-existing conditions for a certain length of time but will then provide coverage after the moratorium expires. Cigna doesn’t offer such terms and will not provide the option to cover many pre-existing conditions.
Cigna has a relatively streamlined claims process, and many simple outpatient procedures don’t require pre-approval. The pre-approval process is relatively straightforward, however. In most cases, Cigna customer support will find the right provider in your area and arrange direct billing for the procedure if you inform them in advance.
Cigna will even work with out-of-network providers to arrange direct billing, saving you a lot of stress and the difficulty of paying large medical bills and waiting for reimbursement.
PLANS
As with most providers, Cigna has several international health insurance plans that vary in cost and coverage. It’s relatively easy to tailor these plans to meet your needs and budget, especially with a large range of add-ons, including dental and optical care.
Cigna has three tiers: Silver, Gold, and Platinum. All plans cover inpatient and day-patient treatments and hospital stays, cancer care, and newborn care. Higher-tier plans have larger annual limits (Platinum has an unlimited annual benefit) and more extensive maternity care and mental healthcare coverage. The company also allows customers to choose their out-of-pocket maximums and deductibles to fit their budget, as these choices influence the final premium amount.
The Silver Plan offers a fairly comprehensive set of benefits, including medication, intensive care, cancer care, specialist, ambulance services, and even inpatient emergency dental treatments. However, it does have limitations on benefits such as imaging, alternative therapies, mental health care, and rehabilitation.
In addition to the $1 million annual limit for inpatient care, the Silver plan also provides up to $100,000 in benefits for outpatient care, such as GP and specialist consultations, annual vision and hearing tests, and prescribed medication. The plan also offers a small range of minimal preventative care benefits, including gynecological visits and mammograms.
The Gold Plan offers a significantly higher annual limit of $2 million for inpatient care and maternity care as a core benefit. While the Gold plan doesn’t differ much in coverage, it offers more generous limits for most benefits, making it the better option for people interested in routine and outpatient care.
The Platinum Plan provides the best coverage of almost all international health plans. It offers unlimited annual benefits, and while it restricts maternity benefits to $14,000 ($28,000 with complications), many other benefits are unlimited.
Since some countries have unique regulations, Cigna also offers specialized plans that are locally compliant for the United Arab Emirates and Thailand.
All of Cigna’s plans give access to the Cigna Wellbeing App and Global Telehealth service, which provide access to non-emergency healthcare services when necessary. These telehealth consultations are multilingual and free, with no deductibles or cost-share payments.
PROS
Access to a global network of trusted hospitals and doctors
Option to include or exclude coverage in the USA
24/7 customer service in over 50 languages
Specialized, locally compliant plans for expats in Thailand and UAE
Free Global Telehealth consultations
CONS
Poor coverage in some areas by Cigna’s global network of hospitals and doctors
Strictness in refusing coverage for pre-existing conditions
Can be more expensive compared to other less comprehensive plans
GeoBlue has specialized in providing global health insurance for 20 years and has proved itself as a leader in the international insurance industry. Their mission is to provide peace of mind to long- and short-term global travelers. They do this through their community of carefully selected, contracted doctors and hospitals, signature destination databases, mobile tools, and concierge-level services.
GeoBlue offers long-term coverage for those living inside or outside the U.S. GeoBlue’s international health insurance plans include:
Access to the Blue Cross Blue Shield PPO Network inside the U.S.
Coverage for pre-existing conditions
Unlimited annual and lifetime medical maximum
GeoBlue supplies members with carefully assembled in-depth provider profiles so they can choose a doctor with confidence. Additionally, the doctors and hospitals within GeoBlue’s provider network provide direct billing, so members do not have to worry about filing a claim.
GeoBlue’s online service portal allows members to obtain medical insurance ID cards, read about news and safety precautions within their area, and access TeleMedical appointments through GeoBlue’s partnership with Advance Medical, a teledoc company.
PLANS
The Xplorer Health Plan from GeoBlue provides members with coverage inside and outside the U.S. It is one of the best international health plans available today.
GeoBlue combines comprehensive worldwide benefits with a new generation of medical assistance services in their Xplorer product. GeoBlue Xplorer has two plan options, Essential and Premier. Both plan options include the same benefits, but Xplorer Essential does not provide coverage inside the U.S.
The Xplorer Essential plan is a great option for expats living outside the U.S. It is also budget-friendly because of the no U.S. coverage. Although, if you do plan on returning to the U.S. while traveling, you can elect to add basic U.S. coverage.
The Basic U.S. benefit add-on provides coverage limited to emergency medical care, illness, prescription needs, and accidental injuries. It is valid only up to a combined maximum of 3 trips of 21 days per trip per calendar year.
The Xplorer Premier plan is the most comprehensive policy with the maximum amount of coverage. It is the ideal insurance plan for U.S. citizens living abroad because it includes 9 months of coverage inside the U.S. for each policy period.
The Xplorer plan is the best premium insurance for foreigners living in the USA because the benefits, coverage, and service levels the policy provides are number one in the industry.
PROS
Coverage for U.S. citizens abroad or foreigners living in the USA
24/7 assistance around the world
Access to carefully selected doctors, dentists, hospitals, and clinics
Global TeleMD
CONS
GeoBlue can only provide coverage to U.S. nationals or foreigners living in the U.S.
Since 1990, International Medical Group Insurance (IMG) has risen to become one of the world’s leading providers of global travel and medical insurance. They offer a broad array of products and benefits. IMG has a robust provider network through its U.S. PPO and global IPA networks of over 17,000 providers and facilities.
IMG has several popular plans designed for expats, travelers, students and scholars, and missionary and volunteer groups. IMG also has designated global medical and travel medical plans for individuals living in or traveling to Europe.
Like other international insurance providers, IMG offers online services through its member portal, MyIMG.Their online tools allow members to complete routine tasks and phone and email points of contact for customer service.
MyIMG includes the following services to all members:
Obtain certificate documents
Request or print ID cards
Locate a provider
Submit and track claims
PLANS
With an IMG Global Medical insurance plan, you can select a tier with a benefits package that is most aligned with your needs. IMG’s Global Medical plan has four tiers, which range from least to most coverage, Bronze, Silver, Gold, and Platinum.
Depending on your chosen plan tier, members have the choice to add-on optional benefits. IMG’s optional benefits include Global Term Life, Accidental Death and Dismemberment, Terrorism, Sports, Dental and Vision. Each additional benefit includes its own medical maximum.
PROS
Plan tiers offer a range of maximum coverage from $1,000,000 to $8,000,000
Emergency Evacuation is included in all plans
All plan tiers include prescription coverage with varying limits
CONS
Claims turnaround time can be lengthy
Maternity coverage only available on the Platinum tier plan
International health insurance works exactly like local health insurance, but on a global level.
Global health insurance plans will often cover multiple regions, making them an excellent option for individuals who travel often and don’t stay in a single location for long. As with local health insurance plans, international health insurance covers the costs of medical emergencies and in-patient procedures, while higher-level plans will also offer coverage for dental costs, optometry, maternity and pregnancy care, and other less-urgent healthcare situations.
Some international health insurance companies will require that you use a hospital in their global network, while others will cover all private hospitals in a particular country.
Many providers will have certain exclusions to their health and wellness plans, such as not providing coverage in sanctioned countries or in particular regions and territories. Others will have specific insurance plans for certain countries, such as Cigna having Thailand and UAE-specialized plans that comply with local regulations.
DO YOU NEED GLOBAL HEALTH INSURANCE?
Many countries offer some form of nationalized health care, which is often available to residents of that country. Some countries will extend this free healthcare to non-resident individuals or offer emergency medical care for free. However, while it’s appealing to use this as an excuse to stop your health insurance, plenty of reasons still exist to consider getting global health insurance.
While nationalized healthcare programs may provide free care, this care often relies on public hospitals and overworked healthcare practitioners. Having insurance gives you access to private hospitals and priority care if you’re in the insurer’s network of hospitals.
Having international health insurance also gives you peace of mind. Instead of worrying about whether you’re paying for a service or not, you can rest assured that your insurance company will cover any necessary costs. This can be especially reassuring while you’re still new to a country and aren’t completely familiar with how its nationalized healthcare system works.
If you travel to multiple countries, international health insurance allows you to continue any medical treatment without interruption or the need to navigate through a complex bureaucratic process in each nation. This coverage can be especially important if you take essential medication or require regular treatment to stay healthy.
Another benefit of having international health insurance is that most companies will have dedicated support teams to help you navigate a country’s healthcare system. These teams can often help you find specialists, obtain prescriptions, or find the best hospitals in an area.
CHOOSING THE BEST INTERNATIONAL MEDICAL INSURANCE COMPANY
Unfortunately, there is no easy answer to finding the best international insurance plan. You’ll need to identify important factors and compare global health insurance plans from a variety of providers. However, considering how vital good healthcare insurance is, it’s worthwhile spending the time and effort to find the best option for your needs.
The best place to start is to identify your needs. Are you a single, healthy individual who doesn’t take prescription medication? A lower-tier plan with a dental add-on may be the best solution for you. However, if you have a large family, are in retirement, or need specialist care, then it’s worthwhile to consider a plan that takes these factors into account.
Almost all basic international health insurance plans should cover:
Hospitalization and ICU
Surgery and anesthesia
Lab tests
Cancer care
General practitioner visits
Urgent care
Emergency room visits
Prescription medication
X-rays
Emergency evacuation or repatriation
Higher-tier plans will frequently have larger annual limits and cover more conditions and procedures. However, you can also get additional coverage through optional extras if you don’t want to pay for a higher-tier plan. Common add-ons include:
Dental care
Vision care
Physical therapy
Mental health care
Alternative care
Nursing care services
Maternity and pregnancy
Non-emergency evacuation
Preventative care
Generally, the more options you choose, the higher your premium will be. It’s a good idea to play around with your plan to get the optimal coverage-to-cost ratio. Many plans work on an annual basis, meaning that you can adjust your plan as your circumstances change.
When comparing providers to find the best international health insurance plans, keep the following factors in mind:
Payment options: As with local healthcare insurance, international health insurance companies will provide you with several options for paying your premium. Some allow you to choose your payment interval on a monthly, quarterly, semi-annually, or annual basis and may let you choose from direct debit, check, or bank transfer. Typically, insurers will encourage annual payments by discounting the cost of the premium, saving you between one to two months’ payments if you can afford the up-front cost.
Limits: Health insurance comes with several limits, including limits per procedure or claim and overall limits. Be careful whether these limits reset every year or whether they’re for the policy’s lifetime. Typically, higher limit plans will be more costly, with unlimited plans being the most expensive.
Deductibles and copays: The deductible is the amount you need to pay before the insurance provider kicks in and pays for the rest. Deductibles can apply for a certain procedure or are policy-wide, meaning that once you’ve paid the deductible for the year, the insurance company will fully cover all other claims. Many insurers offer several deductible options, with higher deductibles resulting in lower premiums. Try to play around with deductibles to find the sweet spot between monthly costs and having to pay out-of-pocket for certain procedures.
Exclusions: While it’s common knowledge that most international health insurance providers don’t cover existing conditions, many people get caught out by other exclusions in the fine print. Be sure to examine the policy thoroughly to avoid nasty surprises. Common exclusions include outpatient prescriptions, alternative medicine, HIV treatments, and sleep disorders.
Coverage area: Make sure that your chosen insurance plan actually covers the country you’re in. Some companies may claim to cover “Asia”—but does that include India or only Pacific Asia? Many companies will also not cover sanctioned countries like Iraq, Syria, and North Korea.
PPO network: Healthcare insurance companies often work on Preferred Provider Organizations or networks of hospitals and healthcare practitioners that accept health insurance from a particular company. When it comes to international health insurance, some companies don’t worry about PPOs, while others maintain an international network of preferred providers. If your chosen insurer uses a PPO network, make sure that you have access to hospitals and healthcare practitioners within that network.
Existing coverage: Before looking for individual international health insurance plans, speak to your employer as they may offer a workplace-based plan that provides adequate coverage for your needs. Or you may be in a country with national health insurance that you can access, making it unnecessary to seek out private health insurance.
TRAVEL INSURANCE VS. INTERNATIONAL HEALTH INSURANCE
If you’re traveling abroad for six months or less, it may be a good idea to look at travel insurance instead of specialized international health insurance. Travel insurance covers most medical emergencies, and some will provide more comprehensive coverage, typically at a lower cost than specialized health insurance.
FACTORS INFLUENCING THE PRICE OF THE BEST INTERNATIONAL HEALTH INSURANCE PLANS
International health insurance plans tend to be more expensive than their U.S. counterparts. One of the main reasons for this difference is the increased demand for high-quality international care as more countries develop a robust private healthcare sector. Many countries have also developed more stringent licensing regulations that increase the administrative costs of insurance in these regions.
Since international health insurance companies try to offer global coverage, they will raise their cost to customers to cover the variances in international healthcare costs and deal with the increased administrative burden of working internationally.
In addition to these extra burdens, the cost of health insurance plans to private subscribers still depends on the same factors as U.S.-based plans, such as:
Age: Older individuals tend to suffer from more health issues and complications, and insurance companies will raise their premiums to offset these higher risks. Some insurance companies will even have a cutoff age (usually 80+) where they will stop accepting new customers older than the cutoff.
Coverage: Higher-limit policies will have higher premiums to offset the risk of higher claims to the insurance company. Most health insurance plans will have several annual or lifetime limits, and higher-tier plans usually have higher limits. More comprehensive plans will also be more expensive, and it’s worth investigating whether it’s better to have a lower-tier plan with an add-on or a higher-tier plan that has the add-on as part of its standard coverage.
Individual vs. family plans: Family plans are always more expensive than individual plans because they cover more people. However, the cost per individual may be cheaper in a family plan.
Deductibles: Insurance companies use deductibles to offset their expenses by relying on customers to pay the deductible themselves. Insurers try to incentivize higher deductibles by reducing premiums and increasing premiums on no-deductible plans. It’s worth considering whether the lower premium is worth the higher up-front cost or whether a lower deductible is better.
Coverage areas: Some insurers will view certain geographic areas as high-risk zones and increase policy premiums in these areas accordingly. Most global insurance plans won’t cover healthcare in the U.S., but plans that do are much more expensive to cover the disproportionately higher cost of healthcare in the U.S.
Medical history: All health insurance companies will consider your medical history and pre-existing conditions when calculating your premium. Some companies may even exclude certain pre-existing conditions, resulting in you paying for treatment of these conditions yourself. Other companies may cover these conditions as an add-on but at a significant additional cost.
The two major methods of obtaining international health insurance are through the insurance company itself or through a broker.
Many health insurance websites will have a streamlined application process that only takes several minutes to complete, and you may have your plan in place within two days. However, the main drawback of doing so is that you’ll need to go through the fine print yourself and hunt for the right insurance policy for your needs. It’s easy to get confused with exclusions, pre-existing coverage, and limits and choose the wrong option for your needs. Unfortunately, the wrong choice can have serious consequences when you make a claim only to find out that you don’t have the appropriate coverage.
A broker or insurance aggregator site can simplify the application process. Instead of applying to each insurance company individually, brokers will send your information to several companies and compare your quotes. They’ll be able to identify potential red flags and help you make an informed decision about which plan is best for your needs.
The good news is that no matter what path you choose, insurance companies tend to offer rapid coverage. If you’re traveling unexpectedly, you can still have your health insurance in place before you arrive at your destination, or you can set your insurance to kick in on a certain date to ensure that you have adequate coverage while abroad.
Once you’ve signed up for an insurance plan, the company will send you several documents, including a comprehensive brochure, insurance card, and policy outline. Make sure to keep these documents in a safe place and to take them along when you travel. Some more modern insurers will also have an online portal where you can access this information at all times, which can be a reassuring security measure.
Any good international health insurance company will have a 24/7 claims process. Many will have an online system and a dedicated process, so be sure to understand how to make a claim before you need to. Whenever possible, make sure to go to a treatment facility that’s in your insurance’s PPO network. Not only will this usually get you access to priority treatment, but the staff in the hospital will also be more familiar with your insurer’s claims process.
As with local health insurance, you’ll need to provide proof of treatment, so make sure to keep all of your bills, receipts, and prescriptions in a safe place until you need to submit them.
With some 40+ years’ experience in the International moving and relocation industry Warwick has held senior management roles and Directorships both in New Zealand and Asia. He was a trainer for the FIDI Academy over a number of years teaching the EiM course to many students all over the world. He has had considerable exposure to all facets of international transport including shipping, airfreight, marine insurance, logistics and global mobility.
