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What’s the Difference Between Domestic, International & Travel Insurance?

The difference between travel insurance and international medical insurance can be confusing for expats and frequent travellers. Both types of insurance are designed for people who are living & working abroad, but each has a different purpose. There is also a local health insurance option. This article will help you make an informed choice on the right insurance cover for your needs.

Sure, both travel insurance and international health plans will cover you when you’re spending time abroad. And you may have some cover in your home country with a local health insurance policy. But having the wrong cover might leave you with unexpected medical expenses when you’re living, working or travelling abroad.

So, what product covers you best for which circumstances? On this page, we’ll help you understand the similarities and differences between these various health insurance products, so you can make an informed decision and stay safe.

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How are international and local health insurance different?

What is local health insurance?

Local health insurance (also known as domestic health insurance) gives you cover for private healthcare in a single country. Your level of cover depends on the plan you purchase. People who want cover only for serious health risks will typically buy an in-patient plan, which covers them if they need hospital admission. People who expect to visit their doctor or local clinic regularly will typically purchase a comprehensive plan, which covers them for regular out-patient treatments and visits. And, of course, health insurance means different things in different countries:

  • In countries like the UK, New Zealand, Italy, and the Iberian countries, there is a well-developed public healthcare system. These systems typically deliver treatment to patients free of charge. Rather, taxpayers pay a national insurance contribution, which helps fund the public healthcare system and gives them access to high-quality medical treatment that’s free at the point of delivery. It stands to reason that, in such countries, private health insurance is a less common thing to have. The Commonwealth Fund estimates that only around 10% of the UK population has private health insurance.*
  • It’s a different story in countries like the USA, where there is no public healthcare system. In the USA, all access to healthcare requires some form of health insurance. Given that health and well-being are typically bundled together with models for human rights by international organisations such as the UN and the WHO, it’s easy to see why the provision of healthcare can be a sensitive political issue in countries with an underdeveloped or no public healthcare system.
  • Some countries such as France have something in between these two models, whereby public healthcare is largely provided by the market under the authorisation and supervision of the government.

What is global health insurance?

International health insurance gives you access to private healthcare in multiple (or even all) countries. It’s great for people who live and work abroad, for people who spend lots of time travelling, and for people who frequently require cover in more than one country. You can also cover your spouse or partner and children in the same way you can with local health insurance.
The benefits are more or less the same with international and local health insurance, but you’ll find some international policies that include unique benefits for expats and global citizens. These unique benefits typically include emergency medical evacuation, a 24-hour emergency assistance helpline, and cover for repatriation. Some providers also give their members access to a global network of hospitals and medical facilities. Such networks can make finding and receiving private medical treatment in a foreign country a lot easier.

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How does international and local health insurance differ?

Naturally, local health insurance is cheaper. But expats and frequent travellers are generally better off with the services and products offered by specialist international providers.

  • Local health insurance providers typically work in the language of the country where the provider is based, so the customer service, policy wording, and claims process may be in a language with which you’re not familiar.
  • You may also find that local health insurance policies entitle you only to treatment in a limited number of hospitals and clinics, and it may restrict your cover in the more expensive private hospitals.
  • With global plans, you’ll have freedom to seek medical treatment in multiple countries.
  • International providers are generally able to communicate with you in English.
  • With an international policy, you’ll usually have access to the top tier of hospitals, doctors, and medical facilities in the country where you’re living or working.
  • An international plan often covers you for private medical treatment in your home country. This gives you the option to return home for elective medical treatment.

Even when you need medical treatment at home, it can be a stressful experience. So, when you need treatment in a foreign country and you’re dealing with unfamiliar hospitals and doctors, having a global policy can help minimise anxiety and distress. For example, you’ll generally have access to private hospitals and clinics, with expert doctors who speak good English.

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
Relationship Manager, UK, William Russell

A worldwide policy is useful because it gives you peace of mind that you can stay healthy even when you’re abroad. Plus, it’s a bonus being able to choose where you receive your medical treatment and knowing there’s a 24-hour emergency assistance helpline if the treatment you urgently need is not available locally.

The differences, at a glance


Advantages Disadvantages
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


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Always read the small print

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.
You also need to check out the geographical limits of the cover you purchase. Some policies are worldwide, some exclude cover in the USA, and others offer only regional cover.

Am I entitled to subsidised healthcare where I’m living?

This depends on what country you’re living in, as well as your personal circumstances. If, for example, you’re paying national insurance contributions in Spain, then you may be entitled to join the state-run healthcare system. In other countries, you may have no access to free or subsidised public healthcare unless you have finalised your permanent residency. If you want to check whether you qualify for state care in the country where you’re living and working, take a look at the NHS’s country-by-country guide. It’s written for UK nationals, but it provides some useful information on what kind of healthcare system you can expect in a given country.

What’s the difference between international health and travel insurance?

What's the difference between travel, domestic and international health insurance

Getting started

These two products are often confused in travel guides and on the internet. Some travel insurance products include an element of cover for private medical treatment, while international health policies may come with an optional travel insurance rider.
It’s important to stress, however, that they’re two very different kinds of insurance, designed for two very different purposes. It’s possible that, depending upon your circumstances, you might want to purchase both products.

What is travel insurance?

Travel insurance is designed to protect both you and your possessions while you’re travelling on short, clearly defined trips abroad. Most travel insurance products include cover for cancellations, delays, lost baggage and passports, but some will also cover you for emergency medical treatment.

Travel insurance benefits for medical treatment can be capped at a low level, and you may have little choice about which hospital or medical facility you can attend for treatment. The aim of a travel insurance policy is simply to get you home for treatment if you fall seriously ill or you suffer a serious injury while you’re travelling abroad. The policy is unlikely to cover any treatment that you need once you’re home.

Travel insurance policies often cover a specific time period, for example a trip overseas. Annual policies may cover multiple overseas trips, but you will have little or no cover while you’re in your home country. Furthermore, a travel insurance policy will not cover elective treatment for which you decide to travel abroad: it only covers emergency or unexpected medical treatment that you receive overseas.

How is that different from a global health plan?

An international policy will provide you with cover for medical treatment that you receive while you’re at home and abroad, and it’s not just for emergency treatment. You may also have cover for elective treatment, routine or everyday out-patient treatment, and cover for things like well-being, vaccinations, and childbirth. Of course, how much cover you have depends on the plan you choose and the price you pay!

What it can cover What it doesn’t cover
International health insurance Treatment in multiple countries Cancellations & delays
Routine out-patient treatment Luggage
Hospitalisation Belongings
Elective medical treatment
Maternity cover
Psychiatric cover
Emergency medical evacuation if the treatment you need is unavailable locally
Travel insurance Emergency medical treatment Long trips abroad
Repatriation in the event of serious & unforeseen illness or an accident Elective medical treatment
Lost or damaged luggage, travel documents & personal belongings
Cancelled or delayed trips
Accommodation cancellations


So, which should I choose?

You should pick the right product for your circumstances. Suppose you’re only travelling abroad for a short period; in that case, travel insurance is probably what you need.

If you’ll be living or working abroad for an extended period, and you want to ensure you have cover for any medical treatment you may need, then global health insurance policy might be more appropriate for you.


*Commonwealth Fund, Profile of English healthcare system

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