Health Insurance for American Expats

Complete guide to getting health insurance for American citizens living abroad

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If you’re an American planning to live or travel abroad for an extended period, you’re going to need international (or expat) health insurance.

In this guide, we’ll break down why international coverage is essential, what to look for in a good policy, and how it compares to travel insurance.

Do I Need US Health Insurance If I Live Abroad?

If you’re living abroad, you won’t need a traditional US health insurance plan, but it is still important to have some form of health insurance. Here’s why:

  • Local restrictions – You may not be eligible for the local health system (in the country you are moving to) since many countries don’t extend public health coverage to temporary residents or expats.
  • Cost of healthcare – Without insurance, paying for medical treatment out-of-pocket can be expensive and financially risky.
  • Travel plans – If you plan to travel between countries, international health insurance ensures you’re covered wherever you go. For example, if you’re an American living in Spain but frequently visit other EU countries or return to the US, international coverage makes sure you’re protected in all locations.
  • Access to private healthcare and English-speaking doctors – International insurance can give you access to private clinics and English-speaking doctors, which may not be readily available in public healthcare systems abroad.

International health insurance is designed to cover you in multiple countries, not just one. This is ideal if you’re moving between places or taking trips while living abroad.

Best Health Insurance for US Expats Abroad

Here are some of the best health insurance plans you can buy as a US expat:

GeoBlue Xplorer Essential

This is one of the most popular international health insurance plans among American expats, considering it is an independent licensee of the Blue Cross Blue Shield Association.

  • It offers different levels of coverage, so the price can vary, but the GeoBlue Xplores Essential average cost is around $400 per month/per person in their early thirties.
  • This plan has a zero deductible.
  • Unlimited policy maximum per person.
  • Evacuation and repatriation are also covered.
  • Worldwide coverage, excluding the US.

Meridian Essential

This plan for American expats costs around $117 per month/per person in their early thirties.

  • It has a $250 deductible.
  • After the deductible, you pay 20% of the first $5,000 eligible expenses, and the rest are covered up to the policy maximum.
  • It also includes coverage for evacuation and repatriation.
  • Worldwide coverage, excluding the US.

GMI

This plan has different coverage levels, for example, GMI Gold, Bronze, and Platinum.

  • The cost of the plan varies on your chosen coverage level, but GMI Platinum can go up to $400 per month/ per person in their early thirties.
  • The deductible is usually $250 with most levels, but it can change depending on the coverage level.
  • Worldwide coverage, excluding the US.

Allianz Care Plus

This is one of the many international health insurance plans Allianz offers. The company is a global leader in health insurance.

  • The Care Plus plan costs around $115 per month/per person in their early thirties.
  • The deductible may change depending on the benefits level and the option you choose.
  • Worldwide coverage, excluding the US.

US Healthcare System vs Worldwide

Healthcare in other countries is different from the healthcare system in the US, and international health insurance allows you to get access to healthcare and converge wherever you are. This is why we’ve detailed all the health insurance information you need as an American expat and where to get the best insurance for you.

Aspect U.S. Healthcare Worldwide Healthcare (General Overview)
Cost of Healthcare
  • Average cost of an ER visit: $1,200+
  • Hospital stay (per night): $3,000+
  • Routine checkup: $150–$250
  • ER visits: $50–$300 (varies by country)
  • Hospital stay (per night): $50–$600
  • Routine checkup: $30–$100
Insurance Requirements
  • Health insurance is mandatory under the Affordable Care Act (ACA).
  • Without insurance, costs can be catastrophic.
  • Average monthly premium: $400–$600 (individual).
  • Varies by country; many offer universal healthcare.
  • Expats often need private insurance to access care.
  • Monthly premiums for expats: $115–$400.
Access to Healthcare
  • Access depends on insurance network.
  • Wait times for specialists can vary significantly.
  • High costs limit access for uninsured individuals.
  • Public healthcare is widely accessible in many countries.
  • Private healthcare offers shorter wait times.
  • Access is usually more affordable, even for uninsured individuals.
Quality of Care
  • World-class hospitals and advanced technology.
  • Care quality can vary significantly by location.
  • High costs don’t always equal better care.
  • Quality of care is high in many countries (e.g., Germany, Singapore, France).
  • Developing nations may have more limited options.
  • Private hospitals often provide excellent care for expats.
Emergency Evacuation
  • Not typically covered by standard U.S. insurance.
  • Emergency medical flights can cost $25,000–$50,000.
  • Expat insurance often includes emergency evacuation.
  • Costs for evacuation are typically covered in full by comprehensive plans.

How Is Expat Insurance Different From Travel Insurance?

The difference between an international health insurance plan for expats and travel insurance is down to the length and scope of coverage.

Travel insurance

A travel insurance  plan is meant for short trips and typically only covers medical emergencies (accidents, sudden illness). Often, it also covers trip-related claims, such as flight cancellation and loss of luggage.

International expat insurance

An international health insurance plan for expats is meant for longer stays abroad. Depending on the plan, it can cover any of the following:

  • Hospital stays
  • Routine check-ups
  • Pre-existing conditions
  • Chronic conditions
  • Choice of medical providers

What to Look for in a Good Expat Health Plan?

Here’s what you should look for when choosing an expat health insurance plan:

  • Geographical coverage: Are you covered in the country you plan to move to and other countries you might visit?
  • Inpatient and outpatient care: Does the plan cover hospital stays, doctor visits, exams, and prescriptions?
  • Access to quality care: Can you choose hospitals and doctors? Can you access care in English?
  • Preventive care: Are routine check-ups, vaccinations, and health screenings included?
  • Chronic and pre-existing conditions: Are ongoing conditions covered, and are there exclusions or waiting periods?
  • Claims and reimbursements: How does the reimbursement process work? Is it fast and easy with online tools, and is direct billing possible?
  • Maternity and child care: Does the plan include prenatal, delivery, and pediatric care, and are there waiting periods?
  • Emergency assistance and repatriation: Are you covered for medical evacuation and emergency help abroad?
  • Cost and value: Does the plan offer good value for money based on your needs and budget?

Frequently Asked Questions

Does Expat Health Insurance Cover Evacuation to the US?

Yes, most international health insurance policies offer coverage for emergency repatriation to the US for medical treatment. However, they do not necessarily cover the cost of hospital treatment once you are back home.

In this case, you need to use health insurance that is valid in the US, which can be your old insurance plan if you still have it from when you were living in the country, or purchase expat health insurance that offers worldwide coverage, including the US.

Does Health Insurance for US Citizens Abroad Cover Maternity?

Some international health insurance policies include maternity and newborn care, but they usually have a waiting period of at least ten months. Maternity coverage includes all medical expenses related to pregnancy, such as checkups, delivery, and post-natal care.

Not all policies offer maternity care, and the coverage may be limited or under certain conditions, so make sure you read the fine print well before purchasing.

Does US Medicare Cover Me Abroad?

Medicare Part A and Part B do not cover healthcare services outside the US, except in very rare cases, such as emergencies during travel near the US border. If you’re over 65, consider pairing international health insurance with a Medicare Advantage Plan that offers limited travel coverage.

Does Obamacare Cover Me Abroad?

No, health insurance plans you bought under Obamacare or the Affordable Care Act do not extend outside the US. If you are traveling or moving abroad, you have to get either travel insurance or international health insurance.

How to Buy Expat Health Insurance?

You can buy an international health insurance plan or expat insurance online, either directly from an insurance company or through online marketplaces like Insubuy or International Citizens Insurance.

When browsing for expat health insurance, make sure to compare different policies and see whether you have the coverage you need and are comfortable with.

How Much Does Expat Health Insurance for Americans Cost?

Expat health insurance costs range from $170 to $1,000 per month per person, depending on factors like deductible, age, and coverage. Plans, including the US, are usually more expensive than those excluding it, simply because of the high cost of health care in the States.

If you include your spouse, the policy will be more expensive, but not as much as purchasing two separate policies. Including dependent children in the policy will also increase the monthly premiums.

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