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Lee Doran

Underwriting Manager

How does expat health insurance work?

With each country having its own unique health system, taking out international private medical insurance (IPMI) or expat health insurance is the best (and sometimes only) way to guarantee you’ll have the coverage you need, when you need it.

But how does expat health insurance work? Why is it so essential? And what should you know before starting any expat health insurance policy? Here, we’ll try to explain some of the must-know things about expat health insurance so you can make an informed decision when it comes to starting a policy.

Key takeaways:

  • International private medical insurance (IPMI) or expat health insurance can be essential for expats and their families when living and working overseas
  • You need to be sure your policy covers you for the medical treatments you’ll need, plus any accidents or emergencies
  • Get familiar with the healthcare system in your new home country, then shop around for a deal that suits your budget and requirements

What is expat health insurance?

In the UK, the National Health Service is available to you if you are an expat. In emergencies, the NHS is unbeatable, as its large hospitals are well-staffed around the clock. However, it is recommended to use expat health insurance for more routine treatment – a health package that gives sometimes speedier, more flexible private treatments, often in hotel-style comfort. Put simply, expat health insurance is global health insurance 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
  • Retirees
  • And many more categories

Depending on the type of policy taken out, expat health insurance can cover you and your family 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:
    • Cancer
    • Diabetes
    • Heart disease
    • Kidney conditions
    • HIV/AIDS
    • Other congenital or hereditary conditions
  • Maternity
  • Mental health
  • Dentistry
  • And much more

Learn more about what may be covered through your international health insurance policy.

Worried about the cost of health insurance?
Get 15% off your first-year premium with William Russell

How do I know if I need expat health insurance?

Every country has its own unique healthcare system, and healthcare in some countries is better than in others. There are also different ways of paying for healthcare in foreign countries – some are paid for by the state, while others are paid for out-of-pocket by individuals.

It’s important to know what type of healthcare system a country has before moving there. If the country uses an out-of-pocket system (where people pay for treatment as and when they need it), you will almost certainly need expat health insurance. In some countries, such as the United States, you may even need highly specialised insurance (see ‘Where you have cover’ for more information).

Make sure to check with your employer if you’re living abroad for work, as they may offer IPMI as part of their global employee policy. If you’re an employer managing global employees, you may be interested in our curated Employee Benefits package which includes IPMI for your worldwide staff.

What makes a good IPMI policy for me?

When shopping for an international health insurance policy, you should have three questions in mind:

  1. Will this policy meet my needs, i.e. will it cover everything I need it to cover?
  2. Will this policy meet the requirements of the country/countries I want to live in?
  3. Can I afford this policy?

Ultimately, you’ll want to find a global health insurance policy that covers you for eligible medical conditions relevant to yourself and your family, gives you peace of mind for the future, and suits your lifestyle and budget.

A comprehensive IPMI policy may cover you for a variety of medical conditions, including but not limited to:

  • Any long-term illnesses, hereditary conditions, or disabilities you already receive treatment for at the time you move abroad, e.g. diabetes
  • Accidents and emergencies, especially where these require urgent treatment in a hospital
  • Diagnosis, treatment, and after-care consultation for major illnesses such as cancer
  • Mental health conditions, since it has been shown expatriates are at high risk of experiencing mental health illness
  • Maternity cover that covers all aspects of pregnancy, delivery, and after-care for newborn children
  • Optional extras such as dentistry and physiotherapy
  • Contingency plans in case you’re unable to receive medical treatment in your country of residence, e.g. medical evacuations

You may also wish to consider taking out a separate life insurance policy and income protection, especially if you’re living abroad with your family.

The cost of international health insurance varies greatly
Find out more about average costs

Who can I trust to provide expat health insurance for me?

When choosing international health insurance, it’s best to work with a provider that has expertise in three areas:

  • The ability to work in any country worldwide with an international network of recommended clinics and medical facilities, so you have total peace of mind no matter where you travel
  • Specific expertise in providing international long-term health insurance, as opposed to short-term alternatives such as travel insurance
  • A suite of additional services beyond comprehensive health insurance, such as medical evacuations and maternity cover

At William Russell, we have 30 years’ experience providing exclusive insurance for expatriates. Our policies include hospital treatment as standard, and we have an additional range of extra treatment plans, from well-being services to dentistry and mental health consultations.

Our 24-hour helpline means that you can access our services any time, from anywhere in the world, and we will connect you with a named claims manager at the earliest opportunity to ensure your claim is dealt with quickly, and that you have a consultation when you need it.

What is health and how does insurance protect it?
We look at what international health insurance actually protects

Three expat health insurance need-to-knows

Expat health insurance covers planned consultations, treatments and operations when you leave and work abroad – be it hips, cataracts, ears and sometimes mental health too. It’s a lifestyle choice. If you’re considering it, or want to measure how your current policy stacks up, here are key need-to-knows:

1/ The excess matters

This is the amount you’ll pay towards any individual claim or all claims per year (check which one – per year is better, but costs more). It has a huge impact on cost. A £1,000/yr policy with no excess reduces to £720/yr if you set a £500 excess.

So think about at what level you’d claim and whether you’re wanting a ‘cover everything’ policy or only a ‘cover big things’ policy.

2/ Pick the right health insurance cover

– Which hospitals can you use? Bigger choice = bigger cost. So once you home in on a policy, check its hospital list and options.

– What treatments do you want to cover? Options can include improved cover for cancer and mental health. Consider what you’d be happy to use the NHS for.

– Consultant limits. If you have a specific consultant you like to see, if they’re not on the approved list they may be part-covered, so you pay the difference, or not covered at all.

– ‘Full medical underwriting’ (FMU) vs ‘moratorium’. With FMU you disclose your medical history at sign-up (possibly via a check-up). Moratorium doesn’t need that, but if you claim for a condition within the first 2 (or sometimes more) years, you’ll often need to prove you haven’t suffered from it before, which can slow things down.

3/ Get in touch if you are confused

Can’t find what you want or are confused? If you’re confused or have conditions that make things difficult, get assistance from one of our team members. We can answer questions about cover, particular insurers’ records, rules and more.

Inez Cooper – Founder of William Russell
Inez shares her recommendations on what expatriates should look for when choosing a global health insurance policy…

The expert view

Getting familiar with a country’s healthcare system and health culture is one of the biggest challenges that expats face when relocating overseas.

Whether you are moving abroad for the first time or you have experience being an expat in many different locations, it’s beneficial to understand the key healthcare factors when deciding to live and work abroad.

Not only this, the pandemic has caused additional challenges that you need to be aware of when researching the healthcare system of your potential new home.

You need to ask yourself several important questions, such as:

Do you already have healthcare cover?

If you’re relocating abroad for work, it’s common to receive health insurance through your job. Therefore, you may already be covered, especially if you are moving abroad with your company.

However, it’s good to look into what your company healthcare plan covers you for, as it may not be sufficient for your specific needs. These plans often do not become effective immediately.

How good is the healthcare system in your new country?

You probably already know that healthcare quality can vary significantly from country to country.

In some cases, the healthcare standards in your new home might be as good or even better than those you’re used to in your current one. In other cases, healthcare standards may not be as high as they are in your home country.

Find out whether it’s better to visit private hospitals or use the public healthcare system in your new home. You can often do this through your embassy or consulate, or you can reach out to other expats in the community for recommendations. Also, make sure that you are aware of how the emergency medical services function in the country that you are moving to.

Which insurance coverage do you need: local, private or expat insurance?

If you already have private insurance in your home country, you should speak to your provider before your move – their plan may cover you in your new country.

On the other hand, remember travel insurance policies are usually designed for short stays and typically only cover medical emergencies.

Globally mobile citizens will therefore typically require an expat health insurance plan if they want to be fully covered in the countries they frequent.

How to pick the best expat health insurance cover?

When picking a plan, make sure all your needs are tailored for.

This includes making sure your plan covers your destination, or destinations, and considering what level of coverage you are going to need.

While most health insurance gives you access to private healthcare, the health plan you choose defines the rules and limitations of that access. Consider age restrictions, how pre-existing conditions are handled and what exclusions might exist when making a claim.

Finally, remember it’s better to be safe than sorry. Accidents, emergencies, and new diagnoses can seriously disrupt your life and – depending where you live – can have a serious impact on your finances too. Think carefully about the risks attached to not having a comprehensive health insurance plan.

Choosing expat health insurance? Choose an insurer with 30 years’ experience

In 2022, William Russell celebrated 30 years of helping expatriates like you to settle into their new lives overseas by providing world-class global health insurance in over 200 countries.

No matter where you go, and no matter what your individual requirements, you can take one thing off your mind. William Russell offers international health insurance that covers you for everything from minor injuries to long hospital stays, and we can even offer medical evacuations to patients who require treatment in other countries.