International Health Insurance Guide
Choosing the wrong health insurance could leave you with a huge bill in a medical emergency. This guide explains policy types, must-have features, common exclusions and the questions you must ask before buying.
Policy types explained
International Private Medical Insurance (IPMI)
Comprehensive cover for treatment worldwide (or selected regions). Can include in-patient, out-patient, dental, optical and mental health. This is what most UK expats need.
In-patient only cover
Covers hospital stays, surgery and overnight care. Does NOT cover GP visits, specialist consultations or diagnostic tests unless leading to hospitalisation. Lower premium — good for healthy individuals in countries with affordable out-patient care.
Medical evacuation & repatriation
Covers emergency transport to nearest suitable hospital and/or repatriation to UK. Essential in remote locations or countries with poor facilities. Often included in comprehensive plans — check your policy.
Local / domestic health insurance
Insurance in your country of residence only. Often cheaper but won't cover you if you travel elsewhere. Some countries (UAE, Saudi) require minimum local insurance from your employer.
Travel insurance (NOT suitable as primary cover)
Designed for short trips, not long-term expat living. Typically 30–90 day limit. No good for chronic conditions or routine care. Don't use this as your main health cover abroad.
What each tier covers
| Feature | Essential | Standard | Comprehensive |
|---|---|---|---|
| In-patient hospital treatment | ✅ Yes | ✅ Yes | ✅ Yes |
| Day-patient surgery | ✅ Yes | ✅ Yes | ✅ Yes |
| Emergency evacuation | ✅ Yes | ✅ Yes | ✅ Yes |
| Out-patient consultations | ❌ No | ⚠️ Limited | ✅ Yes |
| Specialist referrals | ❌ No | ✅ Yes | ✅ Yes |
| Diagnostic tests / scans | ⚠️ Limited | ✅ Yes | ✅ Yes |
| Cancer cover | ⚠️ In-patient only | ✅ Yes | ✅ Yes |
| Mental health cover | ❌ No | ⚠️ Limited | ✅ Yes |
| Maternity cover | ❌ No | ❌ No | ⚠️ Add-on (waiting period) |
| Dental cover | ❌ No | ❌ No | ⚠️ Add-on available |
| Optical cover | ❌ No | ❌ No | ⚠️ Add-on available |
| Chronic conditions (ongoing) | ❌ No | ⚠️ Varies | ✅ Yes (if disclosed) |
| USA cover | ❌ No | ⚠️ Add-on | ⚠️ Add-on (expensive) |
Common exclusions — read carefully
Pre-existing conditions
Most policies exclude conditions you had before taking out the policy (moratorium underwriting) or conditions you disclosed at application. Some insurers offer full medical underwriting (FMU) where declared conditions may be covered after a waiting period.
Hazardous activities
Extreme sports, motorcycle riding, diving — often excluded or require additional cover. Check if your hobbies abroad are covered.
Cosmetic and elective procedures
Non-medically necessary procedures, cosmetic surgery, elective sterilisation typically excluded.
Pandemic / epidemic
Some policies have pandemic exclusions (especially post-COVID). Check carefully if global health events concern you.
20 questions to ask before you buy
Major providers for UK expats
${[ ['Cigna Global', 'Good coverage, modular plans, widely available'], ['Bupa Global', 'Premium product, excellent network, UK brand'], ['Allianz Care', 'Strong in Europe and Middle East, good for families'], ['William Russell', 'Long-established, good for Asians and Africa'], ['Now Health', 'Competitive pricing, good value plans'], ['April International', 'Good for Europe, French-backed'], ['Vitality / MSH', 'Rewards-based, good for active individuals'], ].map(([name, note]) => `- Buy when you're young and healthy — premiums rise sharply with age and claims history
- Choose a high annual deductible to lower premiums significantly
- Check the claims process — direct billing vs. pay-and-claim matters enormously
- Read the policy wording, not just the brochure
- Check how the provider handles renewals if you make a claim