How to choose the best health insurance for expats
Health insurance might be low priority when you move abroad as an expatriate. However, there is a massive risk of getting ill abroad – which is why it pays to be prepared. With this guide, you can learn the basics of expat health insurance and choose the best health insurance plan for you and your family.
- Know the different types of healthcare systems worldwide and which type exists in your country of residence before you decide on health insurance for expats.
- Most of the best health insurance for expats will give you access to local private healthcare.
- It’s important to choose your insurance policy based on your specific healthcare needs as an expat – your plan will define the countries covered and your level of private medical coverage.
- Make sure you find a health insurance provider that can cover your country of residence and any destinations within your travel plans to avoid low-quality care and high costs if you have sudden, serious health issues.
Let’s start with the basics.
What is expat health insurance?
Expat health insurance, also known as global health insurance, is a type of insurance designed to provide medical cover for individuals, couples and families living and working abroad. It’s there for you whether you are:
- Expatriates, i.e. living in a country in which you are not a legal resident or citizen
- Frequent travellers who move regularly between different countries
- Remote workers, AKA digital nomads
- International business travellers
- Governmental or NGO workers based overseas
- And many more categories
Depending on the type of policy taken out, expat health insurance can cover you for a wide range of potential medical expenses, including:
- Hospital fees, including both out-patient and in-patient treatments
- Specialist care for illnesses such as:
- Heart disease
- Kidney conditions
- Other congenital or hereditary conditions
- Mental health
- And much more…
Understanding health insurance for expats
Now that we’ve got that out of the way, here’s an explanation of some of the terms we use in this guide.
- Benefit – A specific medical treatment or medical service that is recognised by a health plan & covered up to a specified limit
- Country of residence – The country where you’ll be living & working, or spending most of your time
- Country of nationality – The home country that issues your passport
- Health plan – The insurance coverage that defines the limits & restrictions on the treatment you can receive in local medical facilities
- Member – When you purchase a health plan, you become a member of William Russell
- Period of cover– The duration of your health plan (usually one year)
- In-patient – Someone who’s been formally admitted to hospital for medical treatment, staying in a hospital bed for at least one night
- Day-patient – Someone who’s been formally admitted to a hospital for medical treatment, but doesn’t stay overnight
- Out-patient – Someone who visits a doctor, specialist, or receives minor treatment, but who is not formally admitted to hospital or clinic
- Post-hospital – The period after your discharge from hospital, during which you might attend consultations or receive follow-up treatment as an out-patient
- Pre-existing conditions – Any medical conditions you’ve had in the past or currently have
- Medical evacuation – Also known as medevac, this is emergency transportation to the closest medical facility with the best treatment for your health condition
- Repatriation – Transportation back to your country of nationality when you need ongoing, critical medical treatments not provided in or near your country of residence
- Waiting period – The length of time you must be covered by your plan before you can claim for a particular benefit
If you want access to private healthcare as an expat, there are typically three types of insurance policies you can consider:
- Local health insuranceExpatriates who live permanently in another country sometimes purchase domestic health insurance policies. Whilst this is fine for some expats or for short-term arrangements, it can also be restrictive. For example, you may only have coverage for treatment in low-quality hospitals and won’t necessarily have medical cover for trips abroad.
- Travel insuranceTrip insurance can sometimes include health coverage for accidents and medical emergencies, but usually it covers you only for temporary trips abroad.
- Global health insuranceGlobal health insurance is a good solution for expatriates who want access to the best hospitals and doctors where they live, and who want full medical coverage when they travel or make trips to their home country.
An international policy seems like the obvious choice. The downside? International health insurance is more expensive than both travel medical insurance and local health insurance. However, many expats find access to high-quality hospitals and English-speaking doctors priceless. Especially in places like Southeast Asia and Africa, which both have very different public healthcare systems than those found in Europe or North America.
The choice of your health insurance will depend on the characteristics of your country of relocation. Be sure to find out about:
- The quality of the health system and the medical care provided
- The cost of medical care in your host country
Be aware of the types of healthcare systems
At William Russell, we provide private health insurance to expats in over 150 countries. The rules for each country are different, so it’s always best to check the official advice from your country’s government or health service before moving there. You should be aware of which type of healthcare system your new country uses. There are four main healthcare systems worldwide:
- Single-payer healthcare system, where healthcare is nationalised and paid for by the taxpayer. Healthcare is provided free to all citizens and may also be free for temporary residents. This is the system in place in the UK, UAE, Spain and Hong Kong.
- Government-subsidised private healthcare, where citizens pay into a privatised, but government-regulated national health insurance system. Expatriates and non-citizens very often need private insurance in these systems. This is the system in Japan and China.
- A sickness fund system is when the healthcare system is largely privatised and relies on personal health insurance, but this is often provided by employers with payments taken from payroll deductions. This is the system in place in France, Germany, Korea and the Czech Republic.
- Out-of-pocket healthcare is when the responsibility for paying for healthcare costs fall on the individual. In these countries, personal health insurance is absolutely essential, as without it a person may be liable for extremely high healthcare costs. This is the system used by the United States. Find out more about health insurance costs in the USA.
Now that you know the different types of healthcare systems around the world, you can begin to understand when you need private health insurance for expats and what kind of coverage is best for you.
For example, in countries that rely on private healthcare, you will definitely need health insurance. However, don’t fall into the trap of believing that countries with nationalised or socialised healthcare systems won’t require insurance. As a non-citizen of these countries, you may be placed on a long waiting list or charged some costs.
Some countries with national health systems may still deny healthcare to non-citizens. Many also demand that non-citizens show proof of health insurance as a requirement for remaining in the country. This is especially true for British citizens living in countries such as Spain after Brexit.
Once you know you want or need an international policy the first thing you need to do (if you haven’t already) is to work out where you’ll need cover. Finding a health insurance provider that covers your destination is essential to avoid wasting time.
All William Russell expatriate health insurance plans come with a choice of six different ‘zones’ of international cover. This way you can choose the right area of coverage based on your living and travel plans and avoid paying for generic worldwide coverage when you don’t need it.
Step 2 – Pick the right plan
With over 30 years of experience helping expats with international insurance, we know soon-to-be expats often take a casual approach to their health and well-being abroad. Most people simply want to ensure they have access to private care. But what most new expats don’t realise is that, while most global medical insurance gives you access to private healthcare, the health plan you choose defines the limits of your access. That’s why it’s so important to pick the right plan.
Many providers will give you standard and optional benefits. As standard, all our health plans at William Russell include cover for:
- Hospital treatment
- Cancer treatment
- Visits to the doctor*
- And emergency medical evacuation.
Beyond these standard benefits, we differentiate our health plans by their additional benefits (e.g., mental health treatment, maternity care) and their levels of cover (i.e., how much the plan benefits cover you for).
We have two types of plans: value plans and comprehensive plans.
Private healthcare and health insurance are expensive, so we designed our value plans to keep your costs down by focusing on cover for serious medical conditions.
The comprehensive plans give you a wider range of cover for health conditions and treatments, and the benefits generally come with higher annual limits.
Find out more about the different health plans and what they cover.
*If you choose the Bronze plan, we only cover your visits to the doctor following your discharge from the hospital.
Step 3 – Personalise your policy
Though often overlooked, personalisation is extremely important in global healthcare. A personalised insurance policy can complement certain lifestyles and make the difference in the quality of treatments if serious health conditions occur.
Once you’ve picked your health plan at William Russell, you can personalise it with a range of optional benefits and add-ons. For example, not everyone needs cover for expensive care like complex dental treatments, so we’ve made those benefits optional.
If you need them, there are several optional cover choices available with each plan for:
- Well-being: Increase your well-being benefit on the Silver and Gold plans
- Enhanced emergency medical evacuation: Increase your cover for emergency medical evacuations on all plans
- Private hospital accommodation: Choose private accommodation during hospitals stays on the Bronze and SilverLite plans
- Routine dental care: Add cover for routine dental care on the SilverLite and Silver plans
- Complex dental care: Add cover for complex dental care on the Silver and Gold plans
- Routine & complex dental care: Add cover for routine and complex dental care on the Silver plan
- Personal accident cover: Add cover for personal accidents
- Direct billing: Add direct billing for everyday medical care such as doctor visits and specialist consultations*
*Only available in certain countries.
Step 4 – Choose the right excess
When you first started thinking about health insurance, you were probably just looking for a policy to pay for your private healthcare. So, why bother with an excess? After all, an excess means you pay towards your medical bills before the insurance company starts paying.
Counter-intuitively, not having an excess (known as ‘nil excess’) is unpopular with our members. Why? Having a nil excess means more expensive premiums: sometimes, health plans with nil excess can be 20% more expensive than a plan with the smallest excess available.
Whilst the right excess amount depends on your circumstances, most of our members choose an excess somewhere between US$50 and US$10,000 per claim. Here are a couple of excess strategies that are popular with our members:
1/ Bronze plan with a high excess
If you’re only concerned about cover for serious medical conditions – such as cancer care and hospitalisations following an accident or illness – then chances are you’re considering a Bronze plan. With a Bronze plan, choosing a higher excess might be a good option to save money on your premium. True, you won’t have cover for medical expenses that fall under those amounts. But if you’re mainly concerned with serious medical conditions like cancer, your total medical expenses are going to dwarf you’re excess.
2/ Silver or Gold plan with a low excess
If you’re considering a Silver or Gold plan, then you’re likely interested in cover for everyday medical care such as doctor visits and pharmacy prescriptions. The cost of a doctor visit or physiotherapy session depends on where you live, but they’re unlikely to cost more than a couple of hundred dollars. Now, if you chose a high excess such as US$800 per claim or US$500 per annum with your Silver or Gold plan, you wouldn’t have much cover for your routine healthcare provider visits. That’s why members with these plans typically choose a low or nil excess.
When you apply for an insurance plan with us, we assess your medical history, including any medical conditions or injuries you have suffered in the past. It helps us decide the terms on which we can offer you cover.
Since insurance is designed to cover the unexpected, its policies don’t typically cover pre-existing conditions unless specifically agreed beforehand. Medical underwriting helps ascertain what, if any, pre-existing medical conditions will be covered and at what cost. If you’re applying for a policy that includes medical underwriting, you’ll be asked to complete a health questionnaire. It will ask you about aspects of your health and lifestyle, such as:
- If you smoke
- Your age, weight, and height
- If you have any pre-existing conditions
- Your general health
The insurer might also ask for information from your doctor, and in some cases, you may need to have a medical examination. See more on medical underwriting explained here.
Frequently asked questions
Here are some common questions about the best international health insurance for expats. To see more FAQs on global health insurance click here.
Does expat health insurance cover my partner and children?
When you apply for your health plan, you can include your spouse/partner and any number of children/step-children for an additional cost. Both you and your spouse/partner must be under the age of 75 when you apply, but once you’ve purchased your health plan you can renew for as long as you need to.
You can include your unmarried children up to the age of 18 (or 25, if they’re in full-time education such as university studies).
Can I purchase expat health insurance for my employees or colleagues?
Yes, in fact, half of our customers are companies who want health insurance for their employees and the families of their employees.
Whether you’re a start-up with only one or two employees, or you’re an SME setting up an overseas office we can help you include international medical insurance as part of your employee benefits programme.
Employee eligibility is entirely flexible. You can cover only a certain tier of employee (e.g., directors, senior managers), or you can set different levels of cover for different tiers of employee (e.g., senior managers on the Gold plan, junior staff on the Silver plan).
Where can I see prices for a health plan?
You can see accurate prices on our online quote tool. It only takes a few seconds to see prices for all our plans for you and your family. It doesn’t cost you or commit you to anything. We’ll only call you to follow up on your quote and won’t spam you with calls and emails. If you tell us you’re not interested—we always respect your decision.
Our website is the best place to see prices for our plans. We don’t feature on price comparison websites and we don’t share our premiums with third parties.
Can I get health insurance if I live abroad?
You can get health insurance if you’re already an expat living abroad.
With William Russell, you can choose one of four different policies. Our value policies are the most affordable if you want to limit coverage to only emergency medical expenses. Our most comprehensive plans are more expensive. You’ll also be able to select up to 7 different areas of coverage.
|Zone 1||Zone 2||Zone 3||Zone 4||Zone 5||Zone 7*|
|Worldwide cover, with restricted cover in the USA||Full cover in most countries, with restricted cover where private healthcare is expensive but no cover in the USA||Special area of cover for residents in Indonesia, with restricted cover where private healthcare is expensive but no cover in the USA||Full cover in Africa & Indian Subcontinent, with restricted cover elsewhere but no cover in the USA||Full cover in Africa (except South Africa) & Indian Subcontinent, with restricted cover elsewhere but no cover in the USA||Full cover in Southeast Asia only|
*Zone 6 is used on our international life insurance plans only.
You can buy a policy with William Russell if you live anywhere except the US and certain countries.
What is the best overseas health insurance?
The best overseas health insurance will depend on your individual circumstances, including your country of residence and what areas you plan to be visiting during your coverage.
Some of the best overseas health insurance providers are:
- William Russell
- Cigna Global
- Now Health
It’s important to be aware of each provider’s nuances. Many international health insurance companies offer similar policies, though not all will include the same areas of coverage or quality of customer care.
Another distinction is that many overseas health insurance providers are not specialists and only provide overseas health insurance as a secondary offering. Look for overseas health insurance specialists with a personal touch, such as William Russell, who’s been helping expats with their medical insurance for 30+ years.
What does expat health insurance cover?
Expat health insurance can cover health expenses, which can range from emergency care to in-patient hospital treatments. Coverage depends on each expat insurance provider’s plans and your level of covered medical costs.
You can often personalise your coverage to include specific medical care. For example, with William Russell you can include add-ons, such as routine and complex dental treatments, well-being treatments, and routine doctor visits.