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Complete guide to getting health insurance for American citizens living abroad

Thousands of US citizens move overseas every year, either for work, studying, or just to visit a new place and experience different cultures. One of the main challenges for US citizens abroad is the matter of health insurance: do you need it, where to get it, and does your current domestic plan offer any coverage?

Do I Need Health Insurance If I Live Abroad?

Yes, all US citizens who live abroad should get international health insurance since domestic insurance plans do not offer protection outside the borders of the US.

If you are moving abroad on a long-term basis or permanently, then you should get expatriate health insurance. Expatriate health insurance plans offer a broad range of protection during your time living abroad and are valid for a longer period of time. If you are simply going abroad for a vacation or temporarily, then you can just get travel health insurance.

You can get a free quote at Insubuy or International Citizens Insurance.

What Type of Health Insurance Can Americans Expats Get?

US citizens moving abroad have three health insurance options, depending on the country they are moving to:

  • National (public) insurance. Some countries have state-run public health insurance schemes. If you are employed in a country with a good public insurance scheme, you will (usually) be automatically enrolled by paying monthly contributions, similar to taxes. In turn, you will get access to free or inexpensive health care in public hospitals or clinics.
  • International (private) insurance. In countries without a good public healthcare system, many Americans rely on private insurance, offered by private companies. That’s because, in those countries, expats prefer to seek medical assistance in private hospitals and clinics, which are usually better equipped but more costly to pay out of pocket.
  • Combination of public and private health insurance. Sometimes, even though public healthcare is of good quality, the waiting times can be long and the clinics can be overcrowded. This is why many expats choose an additional private insurance plan to complement their state insurance and allow them access to private hospitals and clinics.

Best Health Insurance for US Expats Abroad

Some of the best international health insurance for US citizens abroad include:

How to Buy Overseas Health Insurance?

You can buy an international health insurance plan 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.

What Does Overseas Health Insurance For US Citizens Cover?

Expat health insurance offers similar coverage as your health insurance in the US. This includes:

  • Doctor’s consultation.
  • Specialist’s consultation.
  • Hospitalization.
  • Surgery and anesthesia.
  • Urgent care.
  • Ambulance.
  • Prescription medication.
  • Lab tests and X-rays.
  • Emergency evacuation to the US.
  • Chemotherapy or radiation therapy.
  • Maternity.
  • Dental care.
  • Emergency reunion.

Naturally, each insurance policy has different degrees of coverage. For example, not all international health insurance plans cover maternity-related costs or dental care, except in emergencies.

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; for that, you need a worldwide health insurance policy, including the US.

Worldwide insurance policies including the US are usually more expensive than those excluding it, simply because of the high cost of health care in the States.

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.

How Much Does Expat Health Insurance for Americans Cost?

Health insurance for American expats can range from as little as $170/month to almost $1,000/month per person or more. The price depends on the deductible, the coverage maximum, your age, and – most importantly – whether you need coverage in the US as well as abroad. Usually, insurance policies with coverage extended to the US are more expensive, due to the high cost of American healthcare.

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.

Does US Medicare Cover Me Abroad?

No, in most cases Medicare will not cover your medical expenses outside the US. There are a few very specific instances during which Medicare might cover you even if you are treated in a foreign hospital:

  • You are in US territory at the time of the medical emergency, and the nearest hospital that can treat you happens to be foreign.
  • You are travelling through Canada “without unreasonable delay” using the most direct route between Alaska and another state at the time of the medical emergency and the nearest hospital happens to be Canadian rather than American.
  • You live in the US, but the nearest hospital that can treat your medical condition happens to be foreign rather than American, even if the condition is not an emergency.

In any of these cases, Medicare will only cover you for the Medicare-covered services. They also decide what it means to be travelling “without unreasonable delay” on a case-by-case basis.

Does Obamacare Cover Me Abroad?

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

Free Healthcare for US Citizens Abroad

In some countries, American expats can have access to “free” healthcare, in the sense that you do not have to pay anything when you see a doctor or if you need medical treatment. However, it’s not really free, as you will be paying monthly contributions to the national healthcare fund of that country, either through deductions to your salary or directly.

But even in countries with free healthcare for expats, sometimes you have to pay small fees for certain procedures, hospital stays, or medications. Additionally, national health insurance does not cover treatment in private hospitals or evacuation to the US in case of emergencies.

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