Moving abroad is an exciting experience, but you need to keep in mind that this isn’t just an extended vacation. Which means there are certain expat-specific things you need to prepare before you pack your bags and head to the airport.
One of the most important things you should do? Get a health insurance plan.
Most U.S-based health insurance policies don’t cover your medical expenses while you’re out of the country. This means as soon as you leave U.S. borders, your policy essentially becomes ineffective. And even for the healthiest of people, having health insurance while you are living overseas is essential.
Fortunately, there are ways to get health insurance as an American living abroad. Let’s go over where to look for international health insurance and what options are available.
Talk to your existing health insurance company
Most health insurance plans don’t cover you abroad but if yours does, you should check the extent of that coverage with your insurance company first.
For example, some plans may cover emergencies only, or if they do cover routine medical services, it’s at the out-of-network rate (which is much higher than the in-network rate).
If you can keep your U.S. health insurance plan while living abroad, it probably offers limited coverage. Make sure to ask the following questions about your plan before you move:
- Are pre-existing conditions covered?
- Do you need to pay anything upfront before traveling?
- Are there any exclusions for “risky activities,” such as scuba diving or mountain climbing?
- Is preauthorization necessary?
- What are the deductibles and copays?
- How long does the coverage stay in effect?
Consider travel medical insurance
Travel medical insurance is short-term health insurance that provides medical coverage while you travel. However, it usually only covers emergencies due to unexpected illnesses or injuries. Travel medical insurance doesn’t cover elective procedures or standard doctor’s visits while you’re living in another country.
Like a regular health insurance policy, every travel medical insurance plan is different, so you should always check the details. However, here are some services that might be covered:
- Emergency room visits.
- Ambulance rides.
- Labs and imaging.
- Prescription medications.
Depending on what other coverage you have, travel health insurance can be a primary or secondary policy:
- A primary policy means that it’s the only policy you have that will cover your medical needs while abroad.
- A secondary policy (or supplemental policy) means it will supplement your coverage after your primary insurance provider pays their portion.
Most importantly, though, travel medical insurance isn’t permanent. It only lasts for a short amount of time, and if you are staying for an extended period, your coverage may run out. Typically, travel medical insurance lasts one year or less. If you’ll be living abroad for longer, you may want to look at other options.
See if you qualify for a national health plan
Depending on where you are moving to and your situation, you may qualify for a health insurance plan in the country where you’re living.
For example, if you’re attending an international university or you got a job working for an employer in another country, you can probably get health insurance from a provider in your new country of residence.
If you can qualify for a national health insurance plan, it should closely resemble your old U.S. health insurance policy. Most plans cover the cost of routine doctor’s visits, prescriptions, some elective procedures, lab testing, and emergency care.
However, you will still want to pay attention to out-of-pocket costs and what doctors and health facilities are in the network.
Learn about public health plans in your country
In some countries, Americans can take advantage of publicly funded health plans.
Typically, these international health insurance plans cover emergency care only and other medical services cost extra. However, knowing that emergencies are covered can still provide you with peace of mind.
Here are a few examples of international healthcare systems that Americans can utilize while living in the country.
Americans living in the United Kingdom can receive emergency care at a National Health Service (NHS) facility. However, you must be able to prove that you are an American living temporarily in the U.K. to qualify. American tourists are not eligible for NHS medical benefits.
To qualify for free or subsidized health insurance as an American living in Ireland, you must prove that you intend to live in Ireland for at least one year to be considered “ordinarily resident.” If you are living in Ireland for less than one year, you aren’t allowed to get health insurance through the country’s public health care system.
The NHS in Italy offers expat health insurance for U.S. citizens living in Italy for at least three months. Depending on your situation, you might be able to qualify for free basic health care. Otherwise, it costs a small fee to enroll in the country’s health insurance program.
To get public health insurance in Canada, you must have a work permit that’s valid for at least six months and you must be working full-time. You can also qualify if you have a work permit under the Live-in Care Program or Seasonal Agricultural Worker Program (SWAP).
If your spouse qualifies for public health insurance through their work permit, you can take advantage of the health insurance program, even if you don’t meet the requirements.
Frequently asked questions
How much does expat health insurance cost?
The cost of expat health insurance varies, just like domestic health insurance. The average American pays roughly $2,000 to $4,000 per year for health insurance abroad, but factors like your age, pre-existing conditions, and out-of-pocket costs will affect the premium.
If you are able to get health insurance through a public health system like the NHS, the cost could be significantly lower.
Private health insurance plans are almost always more expensive than public plans, but keep in mind that public health insurance can have limitations.
Can you get international health insurance abroad with pre-existing conditions?
Many international health insurance policies have exclusions for pre-existing conditions, just like plans in the U.S. do. However, it depends on the specific condition. Some plans will cover certain pre-existing conditions, but you must pay a higher deductible or copay when you get treatment.
If you have a pre-existing condition, make sure to ask the plan provider if treatment is covered before you purchase a policy.
Is health insurance required to get an international visa?
Most countries require you to have some form of health insurance before you can get a visa. Depending on the country you’re moving to, a U.S-based health insurance or travel medical insurance policy may suffice.
Ultimately, you need to prove that you can financially cover any medical emergencies that may arise when you visit the country.
Also, keep in mind that some countries require you to have health insurance to visit the country, not just to get a visa. Many countries today also require a health insurance plan that has COVID-19 coverage.
How much international health insurance is necessary?
Just like U.S-based health insurance, the amount of international health insurance you need will vary. Your age, pre-existing conditions, and financial situation all play a role.
When choosing your plan, you should also consider other factors, including:
- The risks present in the country you’re visiting.
- The types of activities you’ll engage in.
- How long you’ll be abroad.
Whether you get sick or get into an accident, having enough health insurance coverage is essential. Although health care costs abroad are often less expensive than in the U.S., you could still face a huge medical bill if you needed treatment and didn’t have a good health insurance plan to cover it.
If you’re moving abroad for any length of time, getting international health insurance is vital.
Whether you have coverage from your existing U.S. insurance policy, purchase travel medical insurance, or can qualify for the country’s public insurance program, make sure you have some form of coverage. A medical emergency while abroad is scary enough, but not knowing how you’ll cover the expense can add even more stress.
Ultimately, the most important thing is to make sure the plan is suitable for your needs, where you’re going, and how long you’re staying.
Finding the best plan might take some research and comparison, so give yourself adequate time to pick a plan before the move.
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