Being an expat can be a very enjoyable and eye-opening experience, if not a constant adventure. We all know life has its twists and turns – accidents and surprises can and do happen, which is why the key to making your expat experience enjoyable and rewarding is to plan ahead.
Part of that planning is, of course, finding a reliable health insurance provider. It may not be the most exciting aspect of planning life abroad, but it’s a solid foundation upon which the quality of your new life will rest. Taking out the right insurance allows you peace of mind, but choosing the wrong policy could easily end up making things worse and impacting you and your family.
To help you plan ahead – and set the scene for success – we’ve put together this list of seven essential things to consider as part of your relocation checklist when looking for a health provider.
1. Coverage territory and geographical scope
What regions and countries does your policy cover?
When choosing expat health insurance, your first consideration should be the coverage territory. Most international health insurers structure their policies around geographical zones, and costs will vary significantly based on which regions are included.
Zones usually include:
- Zone 1: Worldwide coverage excluding the USA (most popular for expats)
- Zone 2: Worldwide coverage including the USA (highest premiums)
- Zone 3: Regional coverage excluding USA and expensive markets
- Zone 7: Local Southeast Asia only (lowest cost, excludes Singapore and Thailand)
For example, if you’re planning to move from London to Singapore and travel throughout Southeast Asia, ensure your policy covers all countries you’ll visit. Zone 7 coverage restricts treatment to local Southeast Asian countries but provides substantial premium savings for those happy to receive care locally.
Knowing exactly what you’re signing up for is important, so rather than skipping over the terms and conditions, read every last word of any policy you’re thinking of buying. If you’re taking your family with you, it’s even more important that you know what care they’re entitled to. Health insurance isn’t just there to cover the unexpected either – it can help with the management of pre-existing conditions like asthma.
"The general standard of healthcare in Singapore is excellent, although by no means cheap. There is a wide choice of government and private hospitals, polyclinics and specialist medical centres. Private medical insurance cover for the whole family is highly recommended for new arrivals."
– British expat Leo in his expat interview about Singapore.
Which countries require health insurance for visas?
Many countries now require proof of health insurance for visa applications and residency permits:
- Schengen countries (27 nations): €30,000 minimum coverage for medical expenses, hospitalisation, and repatriation
- Germany: Mandatory health insurance for all residence permit applications
- UAE (Dubai, Abu Dhabi): Compulsory for all residents, expats, and visitors from January 2025
- Portugal, Spain, Thailand: Proof of health coverage required for residency visas
- Australia, New Zealand: Health insurance requirements for specific visa categories
Even visitor visas to certain countries require health insurance coverage, so research the requirements well before your departure date to avoid visa processing delays.
2. Pre-existing conditions and waiting periods
How are chronic conditions and ongoing treatments handled?
When you’re selecting expat health insurance, pre-existing conditions and waiting periods are some of the most important considerations. Most international health insurers exclude pre-existing medical conditions from coverage initially, meaning any condition you had before joining the plan won’t be covered.
Many quality insurers will provide immediate coverage for pre-existing conditions if you can demonstrate continuous prior coverage without gaps.
What are typical waiting periods for different conditions?
Common waiting periods vary by condition type and insurer:
- Mental health conditions: 12 months (anxiety, depression, psychiatric treatment)
- Pre-existing conditions: 24 months continuous period without symptoms, treatment, or medication
- Maternity benefits: 10 to 12 months (pregnancy treated as pre-existing condition)
- Routine care: Usually no waiting period (check-ups, vaccinations)
- Emergency treatment: Immediate coverage from the policy’s start date
Some insurers may cover well-managed conditions after an underwriting review, although they often apply exclusions or charge higher premiums through medical underwriting.
"From personal experience, I have experienced both the good and bad in relation to healthcare. After suffering from two recurrent miscarriages in 2013, I underwent a battery of tests and was diagnosed with Antiphospholipid Antibody Syndrome. I was put under the care of a gynaecologist specialising in high-risk pregnancy, who started me on blood thinners immediately when I conceived the twins. I also had severe gestational diabetes that required daily self-administration of insulin.
"With respect to my pregnancy and delivery, we were very happy with the way everything was managed. My twins and I made it safely, and we will forever be grateful to the wonderful doctors and nurses who looked after us."
– Indian expat Megha in her expat interview about Singapore.
Why is continuous coverage necessary when moving abroad?
You need to maintain continuous coverage to preserve your pre-existing condition benefits. If you’re relocating multiple times, ensure there are no gaps in your coverage – otherwise, you might reset your waiting periods or exclude previously covered conditions.
Health insurance portability is a feature that lets you maintain healthcare coverage under the same terms when moving to a new country without losing the benefits from your waiting periods.
What must you disclose during the application?
Disclosure requirements are strict and non-negotiable. You must declare all medical information honestly, including:
- All diagnosed conditions: Even if well controlled or considered minor
- Current medications: Prescription drugs, supplements, ongoing treatments
- Recent symptoms: Any health issues in the past two to five years (varies by insurer)
- Family medical history: Some insurers require disclosure of hereditary conditions
- Lifestyle factors: Smoking, alcohol consumption, high-risk activities
Failure to disclose conditions can void your entire policy, leaving you without coverage when you need it most. Insurance fraud related to non-disclosure can result in claim denials and policy cancellations, potentially making it difficult to obtain coverage elsewhere.
"The healthcare system in Ireland takes a lot of time to understand. Someone moving to Ireland with a chronic medical condition would want to research the system extensively beforehand."
– American expat Terri in her expat interview about Ireland.
3. Emergency services and medical evacuation
What happens in a medical emergency?
Emergency services and medical evacuation coverage can literally be lifesaving for expats, particularly those living in remote locations or countries with limited medical facilities. Quality expat health insurance should include thorough emergency support, including:
- 24/7 emergency hotlines: Multilingual support staff available across time zones
- Medical coordination: Working with treating medical teams and local healthcare systems
- Transport arrangements: Ground ambulances, medical escorts, or air ambulances as needed
- Documentation support: Liaising with immigration authorities and hospital admissions
- Bed-to-bed service: Complete patient journey from current location to destination facility
If you suffer a serious injury while trekking in rural Nepal or need specialist cancer treatment that’s not available in Kenya, emergency evacuation services become crucial. These services coordinate everything from initial emergency response to final hospital discharge, ensuring you receive appropriate care regardless of location.
"There is a huge spectrum of available healthcare in Kenya, from the very questionable clinics available in the slums, to very modern, reputable private hospitals accessible only to those with means. As an expat (especially if your employer offers you health insurance), you will have access to the finest doctors and hospitals in Nairobi."
– American expat Tara in her expat interview about Kenya.
What types of emergency transport are available?
Emergency medical transport options vary based on your condition, location, and urgency. There are ordinary ground ambulances for local hospital transfers and short distances. Medical escorts are nurses who accompany you on a regular commercial flight. Air ambulances are dedicated medical aircraft for serious conditions, and helicopter evacuation is an option for remote areas or urgent short-distance transport.
Do you need medical evacuation coverage?
Medical evacuation may be necessary if local medical facilities cannot adequately treat your condition, so consider it a necessity if you’re moving to a destination with inadequate facilities. The costs involved are substantial and can create serious financial hardship without proper coverage. Most quality expat health insurance plans provide some coverage for medical evacuation and repatriation, although some offer unlimited coverage.
4. Claims process and customer support accessibility
How do you apply for coverage and make claims?
The claims process and customer support accessibility can make or break your expat experience when you need healthcare. Not all providers have the same claim processes, so it’s vital to know exactly how and when you need to apply for health insurance and how to go about making a claim.
The application process varies significantly depending on the type of coverage you’re looking for. Basic policies can be bought online or over the phone with immediate coverage activation.
For comprehensive coverage, the process can take longer than you might think, especially with medical underwriting. You may be asked to provide extra or original documentation in support of your application, like birth certificates or prescriptions.
When making a claim, it’s important to know ahead of time what documents your health provider will need, including the format and language in which they should be submitted.
What are modern digital claims processes like?
The insurance industry has largely adopted mobile-first technology, making claims submission faster and more convenient than ever. Most modern insurers now offer photo-based submissions where you simply take pictures of medical bills and receipts through mobile apps, and real-time tracking lets you monitor your claim status and processing updates instantly. Most quality insurers now process fully completed claims within 48 hours.
Can you access support across different time zones?
As an expat, you’ll be living in another country, possibly in another timezone compared to your provider’s primary customer service team, so it’s good to know exactly how and when you can make contact with them. Any serious provider should give you a dedicated telephone number to call 24/7.
Many insurers have international offices, and their customer service might be more accessible and responsive if you do need to make contact. Plus, if they have an office in the same country or region, the chances are good they’ll have local knowledge and language proficiency.
Translation services extend beyond simple language support to include assistance with medical documents and prescriptions in local languages, plus cultural liaison services to help you understand local healthcare systems and customs.
"In the US, you don’t really choose: you get the healthcare that you can afford, and the health plan you have dictates which hospital(s) you can go to and which doctors you can see. If you work for a large company, you probably have various options to choose from in terms of health plans."
– Italian expat Simona in her expat interview about Northern California.
What telemedicine and virtual consultation options are available?
The Covid-19 pandemic accelerated telemedicine adoption, and virtual healthcare is now a standard feature of modern expat insurance plans. Virtual healthcare typically includes 24/7 access to qualified physicians, which is particularly beneficial for expats facing language barriers or unfamiliar healthcare systems in their host countries.
Electronic prescription services may be able to send prescriptions directly to your local pharmacy. Virtual consultations are particularly valuable for expats dealing with minor ailments, mental health support, medication management, and follow-up care for chronic conditions.
What mobile apps and digital tools should you expect?
The leading insurers all have mobile apps that are indispensable for managing your international health insurance. You can typically use them to handle claims, review your policies, access customer service, and sometimes chat with a healthcare professional.
Instant reimbursements allow you to submit photos and receive payment within days, and digital policy documents let you keep an online copy and download insurance certificates and ID cards instantly. Provider directories help you find approved doctors and hospitals in your current location, and emergency assistance features provide one-touch access to emergency services and medical coordination.
5. Network access and provider quality
Which hospitals and doctors can you trust and access?
When you’re far from home and familiar healthcare systems, having access to the right network and quality providers is necessary. When in doubt, look for hospitals with Joint Commission International (JCI) accreditation, which is the gold standard for international healthcare quality. JCI-accredited facilities meet rigorous safety and quality standards.
Many countries maintain public databases of licensed medical professionals, and embassies often publish lists of English-speaking doctors and medical centres. For expats specifically, Global Healthcare Accreditation (GHA) focuses on facilities that primarily serve international patients and medical tourists.
"Healthcare has its positives and negatives. It is nice because many medications don’t need a prescription from the doctor, but finding a good doctor if you need one can be difficult."
– American expat Bree in her expat interview about life in Greece.
"Doctors in villages range from very competent to, ahem, idiosyncratic. In Vratsa, there is a choice of institutions. The Embassy very kindly publishes a list of medical centres with English speakers."
– British expat Lorraine in her expat interview about Bulgaria.
6. Policy flexibility and portability
Can your coverage move with you?
Policy flexibility and portability are essential for expats who relocate frequently. Truly international health insurance is designed to be portable – you can take your coverage anywhere in the world without needing to reapply or undergo new medical underwriting.
To qualify for international expat health insurance, eligibility requirements vary between insurers but generally require living outside your home country for at least three to six months per year. The best policies maintain continuity of coverage regardless of how many countries you move between during your expat journey.
Ideally, aim to obtain quotes months or even a year before your departure and arrange to activate your coverage 30 to 45 days before leaving.
"If you’re dealing with public healthcare – get ready to see it all. If you can pay for private healthcare, you may also have an array of surprises, but most of the time, the level of professionalism is equal to what you may be used to at home."
– Puerto Rican expat Yadira in her expat interview about Greece.
7. Value and cost considerations
How do you evaluate the company behind the policy?
Value and cost considerations go beyond just the premium price. How big is the company? How long have they been operating? Is health insurance their specialist field or just one of a number of services they offer?
Taking a deeper look into the company’s service portfolio and history can help reassure you about their level of expertise and dedication to delivering good service.
What represents good value for expats in 2025?
Understanding the true cost of expat health insurance requires looking beyond the headline premium to evaluate total value and potential out-of-pocket expenses. Think about the total cost, including deductibles and co-payments. You can lower your premium by choosing a higher deductible or co-payment scheme, but this increases your financial exposure when you need treatment.
Region matters too: The most expensive countries for expat health insurance include the United States, Hong Kong, and Singapore, while more affordable destinations like Thailand and Poland offer significantly lower costs. Due to America’s expensive healthcare system, plans that exclude coverage in the United States typically cost significantly less.
In conclusion, the right insurance policy is one that provides you with both financial protection and peace of mind. Don’t let insurance be an afterthought that could derail your expat dreams. Smart planning today ensures you’re prepared for whatever health challenges tomorrow might bring.
