International health insurance: buy local or private?

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International health insurance for expatriates: how to choose between local health insurance or international health insurance? When is expatriate health insurance necessary?

When should you consider international health insurance? How do you choose between so many expat medical insurance plans? Our guide will help you make an informed choice.

When moving abroad, many elements must be taken into account, especially those related to your health and well-being. Finding the right level of health coverage is essential for expats. But with so many options, it can be difficult to know which plan is right for expat healthcare. In how many countries do you need to be covered? Is local insurance adequate or do you need private health insurance?

Certainly, many countries have well-developed health systems that cover free or subsidized local health care for local residents and foreigners. State-run health and insurance schemes, as well as local private insurance schemes, often provide expatriates with an adequate level of basic health coverage. However, if you travel between countries frequently, international health insurance may be needed to fill gaps that local health care cannot cover.

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Local or international health insurance

Local health coverage is primarily designed to provide you with medical insurance in your designated country and comes in the forms of:

  • free health coverage, common in countries like the UK and Spain;
  • through health insurance funds, as in Belgium, France or the Netherlands;
  • through a private health insurance provider, which offers access to local private facilities and shorter wait times for treatment.

Many expats find local health coverage to be adequate, as the costs are generally lower than international health insurance plans. Some local health systems, however, have their limitations, in which case a local private scheme may be useful.

Doctor taking notes

An international health insurance plan, however, gives you coverage wherever you go. This includes your country of residence, your country of origin and any countries to which you are traveling abroad. It may also offer additional services in the country in which you live, such as a greater choice of hospitals, access to English speaking doctors, and additional treatment such as dental and maternity care.

However, it’s important to note that for some features (e.g. maternity coverage) you will need to have been covered for a minimum length of time, while state health coverage will sometimes cover you once you are enrolled.

Do you need international health insurance to travel abroad?

Some local private health insurance plans will cover you when you travel abroad. Usually, this only lasts for a limited time and is only intended for urgent medical treatment. If you travel frequently or spend long periods abroad, a local plan is often not adequate for expat health care.

In essence, international health insurance covers you wherever you go; that means you don’t have to purchase coverage every time you travel to a new country. A comprehensive package can cover a range of contingencies, including sudden illness, treatment of injuries, evacuation, and repatriation.

It should be noted, however, that if you are a citizen of the European Economic Area (EEA – European Union plus Iceland, Liechtenstein and Norway) or Switzerland based in Europe, the European Health Insurance Card (CEAM) entitles you to receive healthcare for expatriates in all EEA countries and in Switzerland. However, this does not entitle you to free treatment; instead, you will receive public health care at the same price as a national of that country. However, the EHIC generally only covers emergency or necessary treatment.

Avoiding a coverage gap: changing your policy when moving abroad

If you move to a new country, make sure that your current health insurance remains valid until the day you leave.

In many cases, health insurance companies will ask you to cancel your policy in writing, by mail, or online. Cancellation may incur charges, especially if you have overdue payments or cancel before the deadline. Some policies may have limited cancellation dates, such as three months before your plan expires or December 31 of each year.

If you have public health coverage, the cancellation process will vary depending on the country you are in. For example, in the Netherlands, where public health care is compulsory for all residents, your insurance automatically ends when you cease to be employed in the country.

Unless you already have international health insurance coverage, the next step is to organize health coverage in the country you are moving to. It can be public or private insurance.

However, in some cases this can lead to a gap in your coverage. It may take a while before you can get rid of the bureaucracy to access local health insurance abroad. There may also be restrictions on how long you have to pay Social Security before you are eligible for certain free medical treatments.

Some expatriates choose to take out international health insurance before moving to avoid this lapse. It also eliminates the need to purchase health insurance immediately after you arrive, so you can have time to take care of the urgent aspects of the move first.

Cost of international health insurance

Most international health insurance companies allow you to restrict your coverage to specific regions. Usually this is European coverage only, or global coverage that includes or excludes the United States. This is mainly due to the high cost of medical care in the United States; as a result, insurance companies offer huge discounts if you exclude the United States from your coverage. You can of course choose to include the United States in your package, but at a higher price.

Doctor consulting a patient

Even if the majority of your travels are in Europe, you can consider global medical insurance to be covered if you ever need to travel further afield on a short notice. You can find inexpensive international health insurance that excludes doctor visits or outpatient care, but instead focuses on inpatient care and other emergency treatment.

Another big influence on prices is the level of deduction. The higher the amount that you are willing to pay for your healthcare the lower your insurance payments significantly (eg paying the first $ 500 per year or more of all your claims). It can be a way to get cheap international health insurance.

The cost of your international health insurance is usually calculated based on many factors, such as:

  • your age;
  • medical background;
  • coverage area required.

What does international health insurance cover?

Typically, the basic package offered by international health insurance companies covers more or less the same treatments that you would receive from local coverage, such as:

  • hospital care;
  • surgery;
  • emergency dental care;
  • general consultation fees;
  • cancer treatment.

You can, however, customize your medical insurance with additional features to make sure your needs are covered. This can include everything from physiotherapy and psychiatric treatments to the cost of prescription drugs, vaccinations and eye tests. Women can opt for maternity coverage, which is usually included in premium international health insurance plans.

A doctor and a patient looking at a laptop

Traveling to areas where local health services are less developed may be of concern, especially for people with pre-existing health conditions. In such cases, look for insurance plans that include medical evacuation, allowing transfers to larger medical facilities.

Insurance comparison

Searching for “international health insurance comparison” will bring up a number of websites with details on policies from different insurance companies.

Doing an international health insurance comparison can increase your chances of finding cheap international health insurance, although this should be carefully weighed against the health care you really need to make sure it is useful.

Insurance companies

When evaluating different international health insurance companies, the first step is to read international health insurance reviews to get an idea of ​​the quality and involvement of their customer services.

Some of the largest international health insurance companies offering expat coverage plans include:

It takes time and planning to properly assess the additional services on offer when choosing between local and international health insurance. Physiotherapy or psychiatric treatment may not be on your priority list; however, these are the types of treatments that can prove costly if you need them urgently abroad. Supplemental insurance is particularly useful if there are certain treatments you plan to use or if you have an ongoing illness.

Details to look for in a health insurance plan

It’s easy to focus on keeping the cost of your health insurance as low as possible. However, it’s just as important to make sure your most urgent health needs are covered so that your insurance is useful to you. Consider all aspects of your lifestyle. For example, if you intend to participate in sports or scuba diving, it is important that you have a detailed overview of the activities covered by your health insurance policy. In the event that you sustain a serious sports injury and it is not specifically listed in your insurance contract, you may find yourself liable for all treatment costs. This would defeat the goal of purchasing a local or international health insurance plan in the first place.

Some points that are particularly important to check include:

  • The amount of the deductible and the user fee.
  • Guarantee of medical evacuation and repatriation.
  • What differences exist in coverage between local and international private health insurance plans.
  • If there’s 24/7 support, if it’s global (and free) and in your native language.
  • If the plan has a cooling off or cancellation period.
  • Exclusions for pre-existing conditions.
  • The system for paying and reimbursing invoices is easy.
  • The size of the network of hospitals, doctors and medical facilities that you can choose from.


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