Health Insurance for People Moving Abroad

Health insurance is vital if you are moving to a country with a private healthcare system - and often even if it has a socialised system. Many countries won't even give you a visa until you've sorted your health insurance, and for good reason: medical care is expensive.

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Most expats, even if they live in a country with free healthcare, take out private health insurance as well. This often guarantees a higher standard of care, as well as a higher likelihood of being treated by someone who speaks their language.

Reciprocal healthcare agreements

Many countries have reciprocal, or bilateral, healthcare deals with each other. The widest-ranging of these is the EHIClightbulb image, for EU citizens.

While these are useful for travellers, expats must take note that they almost always cover urgent or emergency care only: they are not a replacement for health insurance if you live in the country.

What kind of health insurance do you need as an expat?

This will depend on the country you’ll be living in.

In some countries, you won’t have much of a choice: it will be a condition of your visa that you buy certain insurance through government-approved sources.

If you are going to a new country to work, your employer might supply health insurance. If this is the case, check the policy as thoroughly as you would if you were choosing it yourself. Make sure that the policy includes your family as well.

Should you insure “back home” or in the country where you are living?

This will usually depend upon the circumstances of the insurance.

If you are a truly ‘international person’ who works, travels and lives in various countries, you will probably want international insurance from one of the many specialist expat providers.

On the other hand, if the insurance is in respect of a permanent stay in a particular country, then insuring in the main country can make sense, It then comes down to who offers you the best deal: the best deal, not the cheapest deal.

International insurance

In many countries there will be companies providing insurance covering healthcare in another country.

There are several benefits to using reputable international providers:

  • Your dealings with the company – both when you take out the policy and if you have to make a claim – will be in your own language
  • The policy document will be in your own language
  • The policy will probably be specified in terms with which you will be familiar, so that the extent of your cover is clearer to you
  • International plans will often cover you ‘back home’ as well as in your new country – useful if you’re forfeiting your right to free healthcare by claiming residency elsewhere

On the other hand, if you have to make a claim there could be a time difference between where you are and the place where the company has its office staff. If you live in a country that doesn’t have a large expat population, the company could be inexperienced in processing claims where you are.

Locally sourced insurance

In some countries, you will be required to sign up for government-approved health insurance, and so the choice will be made for you.

Some local companies may operate a claims line and provide policy documents in your language. It is worth finding one that does.

If you do this, there can be advantages of dealing with a local company:

  • The name of the company is likely to be more familiar to the doctor or hospital, leading to less delay and confusion before treatment can start
  • The policy might make provision for items necessary or useful in this country but unfamiliar in your own country – and so, maybe, not covered by your “back home” policy

Things to look out for

Wherever you’re buying your insurance, look out for a reasonable excess – this is the amount you have to pay out of pocket before the insurance ‘kicks in’

You must read your policy thoroughly. It is tedious, but it is vital.

  • Existing medical conditions (both physical and mental health) – does the policy cover these? If so, how much coverage do you get per year, or per condition?
  • Prescription drug coverage – will you have to pay out of pocket for medicine?
  • Maternity coverage – if you are planning to get pregnant while abroad (and possibly even if you’re not), make sure you have maternity coverage. Be aware that most insurance policies don’t include maternity coverage until 12 months after they’re taken out – so if you take a health insurance policy out when you’re already pregnant you’ll likely end up paying out of pocket
  • Evacuation coverage, especially if you are in a dangerous country (whether that’s a high likelihood of natural disaster or a high rate of terrorist attacks)
  • Age restrictions – does the cover cut out after you reach a certain age?
  • Does the policy cover dental and optical care – and does this include braces and glasses for your children?

Choosing a health insurance provider as an expat

A lot of this advice applies wherever you’re buying insurance, and whatever it’s for – but there are some extra challenges associated with being an expat.

  • Remember that cheapest doesn’t always mean best. If a particular company’s coverage is much cheaper than similar policies, there’s probably a reason: it might be missing something vital (see above), or it might be unreliable with claims.
  • Research the company online – Google ‘Insurance Company X claim problems’ and see what comes up. Difficulty in getting your money back is one of the most common, and most frustrating, issues with any insurance.
  • That said, don’t put all your trust in online review sites. Companies have ways of shifting the results in their favour, be it through paying people for faked good reviews, or manipulating actual customers into not posting bad ones.
  • Ask fellow expats – whether you’re buying locally or from an international company, the best people to talk to are people in similar situations to yours. If you know people personally (friends, family, or even your lawyer), they’re the ideal people to ask. If not, ask on an online forum or Facebook group.

Telling the truth on your insurance application

Whatever you do, don’t lie or underplay your medical conditions. Insurance companies make their money from not paying out, and it is foolish to give them a good reason to refuse.

They will investigate your claim, and they will probably find out if you have lied to them. They will then, totally legally, refuse to pay out.

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