Expat healthcare: international vs. local insurance

When you’re starting a new life abroad, there can often be so many things to arrange that making sure you’re covered for health care can fall to the bottom of the list. A surprising number of expats find themselves caught out each year when they try to reimburse their healthcare costs on their travel insurance, not realising they aren’t covered for certain procedures, and end up paying out a lot of money. To ensure that you’re prepared, it’s worth taking out extra health insurance just in case. However, there are a few different options to choose from and it can be difficult knowing which one is right for you.


Expat health insurance generally falls under two categories – international health insurance and local health insurance. This tends to boil down to numerous factors, including lifestyle and whether you have any pre-existing health problems. As well as coughing up for medical bills that are excluded from certain care packages, some expats can also find themselves paying out far more than they need to on overly elaborate insurance plans. To help simplify things, we’ve broken down the differences between the two types of insurance to help you choose which is the option that best fits your needs.

International private health insurance

If you often travel between countries for work, or even just for pleasure, then it’s definitely worth taking out an international health insurance policy. This will cover you wherever you go, and even give you access to some extra services that may not be included on a local plan, such as dental and maternity care. It also usually offers you a wider choice of hospitals and better access to English speaking doctors. For these reasons taking out an international policy is recommended if you have any pre-existing illnesses as you will be guaranteed access to the best care and treatment. Some packages even cover you in the unlikelihood of natural disasters or terrorist attacks, and offer repatriation in the case of a medical emergency when you need to go back home.

It is worth noting, however, that some extra features, such as maternity care, require that you have already been covered for a minimum amount of time, which is usually about 6-12 months. Also make sure you take out a plan that excludes the USA if you don’t plan on spending any time there as having it included in your package can increase costs exponentially.

Local private health insurance

Local healthcare insurance plans are designed to keep you covered in your country of residence and the costs are generally much lower than those of international insurance plans. Some local plans even keep you insured when you travel to other places, but this is often limited to specific countries and for a set period of time. Local health care insurance is often provided either through state insurance providers which will provide access to state-run services or through a local private health insurer which offers access to private facilities.

If you’re a citizen from the EEA or Switzerland, you should keep in mind that if you have relocated or travel to another one of these countries, you are entitled to receive expat healthcare for the same price as a national of that country with the possession of an EHIC card. This is usually limited to necessary or emergency treatment, however, and the waiting times can often be much longer. Therefore, it’s usually worthwhile taking out a separate local insurance plan as well.

Mind the gap

Many expats also fall into the trap of failing to switch policies with sufficient leeway when moving abroad. As many insurance companies have restricted cancellation dates, such as three months in advance or at the end of each year, it is important to ensure you remain covered until the day of your departure. It can also take time to be able to apply for local healthcare insurance with some providers, depending on the requirements needed to open a policy, so while you’re in that transition phase, it can often be worth taking out an international policy that will keep you covered in both your country of departure and the place you’re moving to until you’re able to make all the necessary adjustments.

Image: Health Care Costs by 401(K) 2012, CC 2.0