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Frequently Asked Questions

Should I choose international health insurance or local insurance?

When moving to a new country, it’s important to think about your health insurance. But one question you may ask yourself is whether you should choose international health insurance from a provider in your own country, or a local health insurer in your new home.

Choosing international health insurance or local insurance

Are you unsure whether you should choose international health insurance or local health insurance? We look at the pros and cons of each to help you make a decision on which type of expat health insurance is right for you.

Before you start to compare international health insurance and local health insurance, you should familiarise yourself with what makes these policies different. If you haven’t already, you might like to start by reading our introductory articles:

  1. How does expat health insurance work?
  2. How to choose the best health insurance for expats
  3. Making sense of insurance jargon – Our international health insurance glossary

Choosing international health insurance: pros and cons

International health insurance is a special type of insurance designed with expats like you in mind. It goes above and beyond the minimum level of healthcare you’ll need to live overseas, giving you access to top-quality medical facilities anywhere in the world. It’s also designed for expats and digital nomads on the go – one policy can cover you in multiple countries, so whether you travel for business or pleasure, you can enjoy total peace of mind.

International health insurance is not without its downsides. But armed with the right info, you can avoid a lot of tricky situations. Let’s go over the pros and cons of international health insurance:

Pros of international health insurance

1/ Access to private medical facilities

Living abroad is challenging, and one of the biggest hurdles you’ll have to overcome is adapting to a new healthcare system.

Accessing healthcare can be difficult enough: you’ll need to know whether you’re entitled to free or subsidised healthcare as a foreign national. But even more difficult can be finding high-quality medical care.

With the standard of healthcare notoriously low in some countries, you may not get the same standard of treatment you’ve come to expect. Long waiting times, poorly trained staff and outdated equipment are some of the many issues you could encounter.

With international health insurance, you won’t need to worry. Instead of struggling with the local healthcare system, you can enjoy access to a global network of high-quality private healthcare facilities. Not only does this guarantee the highest quality medical care for any treatment, you’ll also enjoy shorter waiting lists, and you’re more likely to find medical professionals who speak your native language.

2/ Wide area of cover

International health insurance is truly international. It doesn’t just insure you in your new home country – it could also cover you wherever you go in the world, including trips back to your home country. That’s because your international health insurance policy comes with an ‘area of cover’, which could range from your local region, to an entire continent, to the whole world.

With international health insurance, you won’t need to buy individual travel medical insurance, or find local insurers in each new region you move to. Instead, you’re free to travel within your area of cover safe in the knowledge that your insurance travels with you. If anything goes wrong, you can access top-quality medical treatment within the region through your insurer’s network of hospitals.

3/ Medical evacuations (also known as Medevacs)

But what if you can’t find high-quality medical care anywhere in your new home country, even with your private healthcare? No worries. In these rare instances, your international health insurance will put their money where their mouth is and organise a Medevac.

A medical evacuation moves you to another region or country so that you can access treatment at a high quality medical facility, if the treatment you need is not available locally. If you need emergency life or limb threatening treatment, your insurer will cover the cost of transport and accommodation for you and a companion.

Want to learn more about medical evacuation?
Find out more here

4/ Flexible, comprehensive policies

With international health insurance, you’re in control of your policy. That means you can choose the level of cover you need. Whether you’re looking for the minimum level of insurance to help you get by, or you have special needs that will require a more comprehensive policy, your insurer will be able to offer the level of cover you’re after.

Furthermore, because international health insurance providers have so much experience working with expats, you can be sure they’ll understand your complex individual needs – and have a policy to suit you.

At William Russell, we even offer a host of optional extras, which you can choose to add to your policy. These include dental cover, personal accident cover, and extra cover for well-being.

Cons of international health insurance

1/ Higher premium

The higher quality and worldwide cover you get with international health insurance comes at a higher price. You may be expected to shell out more for international health insurance than you would for local insurance.

There are ways to reduce your premiums when choosing international health insurance. Firstly, be sure to shop around until you find the right policy to suit your and your loved ones’ needs. Then, choose an excess which fits your budget – the higher your excess, the lower your premiums will be.

2/ Lack of market-specific knowledge

Because international health insurance is so international, you may find that your provider lacks knowledge about your new home country or region. This can make it difficult when it comes time to find the best quality medical care, understanding the local healthcare infrastructure, and getting to know local laws around health insurance.

That said, we have 30 years’ experience in looking after the health and well-being of people living and working across Africa and Asia, so we do know quite a lot about healthcare in popular countries.

If you are looking for a provider who has a deeper knowledge of the local healthcare market in your new home country, you may be tempted to choose a local provider. But this may not always be the best option. Always be sure to compare different international health insurance providers, to see if you can find one with expertise in your local market. Many insurers, including us at William Russell, pride themselves on their local market expertise.

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Choosing local health insurance: pros and cons

The alternative to choosing international health insurance is to go to the health insurance market in your new home country.

If you are moving to the USA, this may be the only way to get comprehensive health insurance cover. Many international health insurance providers will only offer restricted cover in the USA, and many will exclude the USA from their area of cover altogether. If you are moving to the USA, make sure to do your research very thoroughly – the cost of health insurance in the USA can be extremely high.

But why else might you choose to go to a local health insurance provider? There are several benefits to choosing a local health insurer, including:

Pros of local health insurance

1/ Local market knowledge

A local health insurer is guaranteed to have deep knowledge on the local healthcare system in your home country. Not only will they be able to recommend you to top-quality hospitals and medical treatment facilities, they may also be able to help you wrap your head around the local healthcare system.

If the healthcare system in your new home is complicated, having a local provider to explain it to you can be a huge benefit. This can be especially useful if you need health insurance in order to apply for a visa or residency, to start a job or to secure a bank account or place to live.

2/ Lower price

The cost of your health insurance premiums is likely to be lower if you choose a local insurer. However, this is usually because you will receive a far less comprehensive service. For instance, you won’t be insured if you travel abroad or make a trip home. You’ll have to take out a new medical travel insurance policy for each new trip.

Cons of local health insurance

1/ Communicating in another language

Navigating the local health insurance market can be exceptionally difficult if your insurer does not speak your language. From their website to their policy wording, their online claims portal to their customer service representatives, you must ask yourself the question: would you be comfortable communicating complex health needs to someone who might not understand you? (One study found it can take up to three times as long to communicate health needs through the language barrier.)

2/ Understanding the regulatory system

What happens in the worst-case scenario if you and your local supplier are unable to communicate? Will you be able to escalate your grievance to a regulatory body in your new home country? Will you know how to do this and, if so, could you communicate adequately enough to get your point across? If your insurer does let you down, and you can’t get to grips with the new regulatory system, you could end up paying a significant amount of money for your treatment.

However, if you choose an international health insurance provider, you may find that your policy is regulated by strict foreign or international laws. For instance, if you choose a provider in the UK, your policy will be regulated by the Financial Conduct Authority (FCA), who have a commitment to customer fairness and structured dispute resolution frameworks. You can also bring disputes to the financial ombudsman.

3/ Paying in another currency

If you choose a local health insurance provider, you will most likely need to pay in the local currency of your home country. This could be a problem if, for instance, you are an expat or digital nomad who takes payment in your home country’s currency. It can also make it hard to ascertain what good value looks like in a foreign market – you may even end up paying more for lower quality insurance than you would by choosing international health insurance!

4/ Limited to one country

Perhaps one of the ultimate downsides to choosing a local insurer is that you won’t be able to benefit from having an area of cover. As an expat, you are likely to want to explore your new home region and discover everything it has to offer. But if you do, you will need to take out individual travel insurance policies every time you leave your home country or region. It’s even worse if you are a digital nomad: you’ll need to take out a new local health insurance for each new country you choose to work in.

This is where you would benefit most from international health insurance. Thanks to having a wide area of cover, you could move freely throughout your region, or even the whole continent, without having to worry about choosing new, local policies with each new place you visit. This could not only save you time, it could save you money too – and would always guarantee you the highest quality treatment no matter where you go.

We all know insurance can be confusing, and it’s difficult to tell sometimes what insurance products cover you for what eventualities. Making sure you’re fully informed is really important. That’s one of the good things about being a member with William Russell—we want to make sure you can make informed choices about your cover, health, and well-being.
Joe Holden
Global Relationship Manager at William Russell
Female doctor using stethoscope on male patient - What is the difference between international health, travel and local insurance?

The differences between international health insurance and local health insurance at a glance



International health insurance
Cover when you’re home & abroad
Cover is usually quite expensive
Cover for elective medical treatment
Unique benefits for expats such as 24-hour emergency assistance & cover for emergency evacuations
Local health insurance
The insurer of your plan will usually be in the country where you’re living & working
You may need familiarity with the local language
Cover is usually cheaper
Cover will typically be less extensive, with no or little cover for treatment abroad

Regardless of which product you decide to purchase, you should always make sure that you fully understand the benefits, coverage, and terms & conditions.

You’ll need to know if there are limits on what the insurer will pay, if there are any restrictions on certain benefits, and how much you’ll need to contribute towards the cost of your claims in the form of excesses or deductibles.

Find out more about the differences between
travel insurance, local & international health insurance

Which type of health insurance is best for expats?

There’s no right or wrong answer when it comes to choosing health insurance. Choosing the right health insurance will depend on you and your individual needs.

If you are looking for:

  • The best price
  • Cover for one country or region only
  • Local expertise, such as guidance on how to choose a policy that will satisfy visa requirements

Your best option may be to choose a local health insurance provider.

However, if you would prefer:

  • A comprehensive policy with optional inclusions
  • Cover that extends across multiple countries and regions
  • Access to the highest-quality medical care, wherever you are in the world

Then you should undoubtedly look towards international health insurance.

Why choose William Russell?

At William Russell, we have over 30 years' experience of helping expatriates settle into their new lives overseas by providing world-class international health insurance.

Any time you need us

You can call our 24/7 emergency medical helpline

Choose your hospital

You're free to choose which hospital you visit for treatment

Worldwide network

We have a worldwide network of hospitals and doctors to call upon

Looking for international health insurance? Get an online quote now

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