Living abroad? Your U.S. health insurance likely won't cover you. International expat health insurance provides medical coverage worldwide, from routine care to emergency evacuation.
If you're living or planning to live outside the United States, your domestic health insurance won't follow you. Most U.S. health plans provide limited or no coverage abroad, leaving you exposed to potentially catastrophic medical costs. That's where expat health insurance comes in.
Expat health insurance (also called international health insurance or expatriate medical insurance) is designed specifically for people living outside their home country for extended periods—typically six months or more. These plans provide comprehensive medical coverage that travels with you, whether you're a retiree in Portugal, a digital nomad hopping between countries, or an employee on an overseas assignment.
Unlike short-term travel insurance (which covers only emergencies during brief trips), expat health insurance provides ongoing, renewable coverage similar to what you'd expect from a domestic health plan—including preventive care, routine doctor visits, hospitalization, and more.
Your U.S. health insurance won't cover you abroad. Most domestic health plans, including employer-sponsored coverage and ACA Marketplace plans, don't provide coverage outside the United States. Even if you have coverage that includes some international benefits, it's typically limited to emergencies and short-term travel—not ongoing care for someone living overseas.
Healthcare costs vary dramatically by country. A doctor's visit might cost $30 in Thailand but $300 or more in Switzerland. A hospital stay in Singapore can easily exceed $1,000 per day. Without insurance, even routine care can strain your finances—and a serious illness or accident could be financially devastating.
Many countries require health insurance for visas. If you're applying for a long-term visa or residency permit, many countries now require proof of health insurance. The Schengen Zone (26 European countries) requires a minimum coverage of €30,000. The UAE, Thailand, Germany, Australia, and many others have similar requirements. Without adequate insurance, your visa application may be denied.
You may not have access to local public healthcare. While some countries have excellent public healthcare systems, access is often restricted to citizens and legal residents who contribute to the system through taxes or social security. As an expat, you may not be eligible—or you may face long wait times and language barriers.
Emergency evacuation can cost hundreds of thousands of dollars. If you're in a country with limited medical facilities and need specialized treatment, medical evacuation to a better-equipped hospital—or repatriation to the U.S.—can cost $50,000 to $250,000 or more. Expat health insurance typically covers this.
Coverage varies by plan and provider, but most comprehensive expat health insurance plans include:
Core Medical Coverage:
Inpatient hospitalization (room, board, surgery, specialist fees)
Outpatient care (doctor visits, specialist consultations, diagnostic tests)
Emergency treatment and ambulance services
Prescription medications
Laboratory tests, X-rays, and imaging
Emergency Services:
Medical evacuation to the nearest adequate facility
Repatriation to your home country for treatment
24/7 emergency assistance hotline (often multilingual)
Optional Add-Ons (may increase premium):
Preventive care and wellness visits
Dental coverage
Vision coverage
Maternity and childbirth care
Mental health services
Physical therapy and rehabilitation
What's Typically NOT Covered:
Pre-existing conditions (most plans exclude them, at least initially)
Cosmetic procedures
Experimental treatments
Treatment related to substance abuse (varies by plan)
Injuries from high-risk activities (unless specifically covered)
Expat health insurance costs vary significantly based on several factors. Here's what to expect in 2025:
Average Annual Premiums:
Individual: $500 to $10,000+ per year (average around $2,500/year for mid-tier coverage)
Couple: $4,000 to $15,000+ per year
Family: $6,000 to $25,000+ per year
Factors That Affect Your Premium:
1. Location (the biggest factor). Healthcare costs vary dramatically by country. Plans covering high-cost regions (the United States, Singapore, Hong Kong, Western Europe) cost significantly more than those for lower-cost regions (Southeast Asia, Latin America, Eastern Europe). A plan with U.S. coverage can cost 50-100% more than one without U.S. coverage.
2. Age. Premiums increase with age. A plan for a 30-year-old may cost $1,500/year, while the same plan for a 60-year-old could cost $5,000 or more.
3. Coverage level. Basic/catastrophic plans cost less than comprehensive plans. Adding optional benefits such as dental, vision, or maternity coverage increases premiums.
4. Deductible. Higher deductibles ($1,000-$5,000+) result in lower premiums. A high-deductible plan can save 30-50% on premiums while still protecting you from catastrophic costs.
5. Medical history. Pre-existing conditions may result in higher premiums, exclusions, or denial of coverage depending on the insurer.
Cost Examples by Region (2025 estimates, individual mid-tier plan):
Southeast Asia (Thailand, Vietnam): $2,000-$4,000/year
Latin America (Mexico, Costa Rica): $2,500-$5,000/year
Western Europe (France, Spain, Germany): $3,500-$7,000/year
Singapore, Hong Kong: $6,000-$10,000+/year
Plans including U.S. coverage: $7,000-$12,000+/year
It's critical to understand the difference between short-term travel insurance and long-term expat health insurance. They serve different purposes:
Travel Medical Insurance:
Designed for short trips (days to a few months)
Covers emergencies and unexpected illnesses only
Does NOT cover routine care, preventive services, or pre-existing conditions
Goal: stabilize you and get you home for treatment
Affordable ($50-$200 for a short trip)
It may also cover trip cancellation, lost luggage, and other expenses.
Expat Health Insurance (International Health Insurance):
Designed for long-term stays (6 months to indefinite)
Covers routine care, preventive services, hospitalization, and more
Works like a comprehensive domestic health plan
Annually renewable (some offer lifetime renewability)
Portable—coverage follows you if you move countries
Higher cost ($2,000-$10,000+/year)
Local Health Insurance:
Purchased in your destination country
Often less expensive than international plans
Coverage is limited to that country only
May have language barriers (policies and customer service in the local language)
Not portable—if you move countries, you start over
Which do you need? If you're living abroad for more than 6 months, expat health insurance is typically the right choice. Travel insurance is a stopgap, not a solution for long-term overseas living.
Many countries now require proof of health insurance as part of the visa or residency application process. In 2024, more than 40 countries required visitors or residents to provide proof of health insurance. Common examples include:
Schengen Zone (26 European countries): Minimum €30,000 coverage required for visa applicants. Must cover medical expenses, hospitalization, repatriation, and emergency care across all Schengen countries.
Germany: All foreign nationals on work or study visas must have health insurance.
United Arab Emirates: Mandatory for all residents and expats. As of January 2025, this requirement applies across all Emirates.
Thailand: Required for the One-Year Non-Immigrant visa and certain retirement visas. Must include coverage for COVID-19 treatment in some cases.
Australia: Nearly all work and study visas require health insurance.
Malta: Non-EU nationals must have a minimum of €100,000 in coverage valid for at least 1 year.
Cuba: Mandatory for all visitors. If you can't show proof at the border, you may be required to purchase government insurance.
Important: Always check the specific requirements for your destination country before applying for a visa. Requirements change, and your insurance must meet the country's minimum standards to be accepted.
Choosing the right plan requires balancing coverage, cost, and your specific needs. Here's what to consider:
1. Determine your coverage area. Do you need coverage in one country, one region, or worldwide? Plans are often priced by zone. If you'll only be in Southeast Asia, don't pay for worldwide coverage. If you need U.S. coverage (even for visits home), factor in the higher cost.
2. Assess your healthcare needs. Are you generally healthy and just need catastrophic coverage? Or do you have ongoing health needs, take regular medications, or anticipate needing maternity coverage? Choose a plan that matches your reality.
3. Understand the deductible options. Higher deductibles lower your premium but increase out-of-pocket costs when you use care. If you're healthy, a $2,500 or $5,000 deductible can save significant money on premiums.
4. Check the provider network. Does the plan have a network of hospitals and doctors in your destination country? Can the insurer pay providers directly, or will you pay out of pocket and submit claims for reimbursement?
5. Review exclusions carefully. Pay attention to what's NOT covered. Pre-existing conditions, mental health, maternity, and high-risk activities may be excluded or require additional coverage.
6. Confirm visa compliance. If your destination requires health insurance for a visa, make sure the plan meets the country's specific requirements (coverage amount, covered services, validity period).
7. Look for portability. If you might move to a different country, choose a plan that follows you. With local insurance, you'd have to cancel and start over with a new insurer—potentially facing new underwriting and exclusions.
8. Consider the insurer's reputation. Choose a reputable, established international insurer. Look for 24/7 customer support, multilingual assistance, and strong reviews for claims processing.
If you're relocating for work, your employer may provide international health coverage as part of your expatriate benefits package. Before assuming you're covered, ask these questions:
Does the coverage apply in my destination country?
What services are covered? (Hospitalization, outpatient, dental, vision, maternity?)
Are my dependents covered?
Does it include medical evacuation and repatriation?
What happens if I leave the company? Can I continue coverage?
Does the coverage meet visa requirements for my destination country?
If your employer's coverage is insufficient or doesn't include dependents, you may need to purchase supplemental international coverage.
Beyond medical coverage, many expat health insurance plans offer valuable additional services:
24/7 emergency assistance: Multilingual support for medical emergencies, anywhere in the world
Virtual doctor/telemedicine: Access to doctors via video or phone, often in English
Second medical opinion: Expert review of diagnoses and treatment plans
Direct billing: Insurer pays hospitals directly, so you don't have to pay out of pocket
Translation services: Help communicating with local healthcare providers
Mental health support: Counseling and psychological services (increasingly common)
Online account management: Tools to view coverage, submit claims, and find providers from anywhere
At Health Plans of NC, our licensed insurance agents specialize in helping North Carolina residents find the right health coverage—whether you're staying local or moving abroad. We research international health insurance options and help you find a plan that fits your destination, healthcare needs, and budget.
Contact us at 1-800-797-0327 to speak with an agent about your expat health insurance options.
What is expat health insurance?
Expat health insurance (also called international health insurance) provides medical coverage for people living outside their home country for extended periods. Unlike travel insurance, it covers routine care, hospitalization, and ongoing medical needs—similar to a domestic health plan but with worldwide coverage.
How much does expat health insurance cost?
Costs vary widely based on your age, location, and coverage level. In 2025, individual premiums range from about $500/year for basic coverage to $10,000+/year for comprehensive plans including U.S. coverage. The average is around $2,500/year for mid-tier coverage in moderate-cost regions.
What's the difference between travel insurance and expat health insurance?
Travel insurance covers emergencies during short trips and aims to stabilize you and get you home. Expat health insurance provides comprehensive, ongoing coverage for people living abroad—including routine care, preventive services, and hospitalization. If you're abroad for more than 6 months, you need expat health insurance.
Do I need health insurance to get a visa?
Many countries require proof of health insurance for long-term visas or residency permits. The Schengen Zone involves a minimum of €30,000 in coverage. Other countries with requirements include Germany, the UAE, Thailand, Australia, and Malta. Always check the specific requirements of your destination country.
Does expat health insurance cover pre-existing conditions?
Most expat health insurance plans exclude pre-existing conditions, at least initially. Some plans offer coverage for pre-existing conditions after a waiting period, or you may be able to obtain coverage with a higher premium or limited benefits. Disclosure is important—failing to disclose conditions can result in denied claims.
Can I get expat health insurance if I'm already living abroad?
Yes, you can purchase expat health insurance while already living abroad. However, you'll go through medical underwriting, and any conditions that developed since you moved may be considered pre-existing. It's generally easier (and cheaper) to get coverage before you leave.
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