What is international health insurance?
International health insurance provides private medical cover for people living, working, or retiring outside the UK, or for those who split their time between countries. Unlike travel insurance, which covers short trips and emergencies, international health insurance is a comprehensive ongoing policy covering routine treatment, specialist consultations, hospital stays, and chronic conditions.
For UK expats, international health insurance is often essential because the NHS only covers UK residents. Once you move abroad, your access to NHS services is limited. Some countries have reciprocal healthcare agreements with the UK, but these typically cover only emergency treatment, not ongoing or elective care.
Who needs international health insurance?
- UK expats: People relocating abroad for work or retirement who need ongoing healthcare access
- Frequent travellers: Business people who spend extended periods in multiple countries
- Remote workers: Those working remotely from different countries
- Retirees abroad: People retiring to countries like Spain, France, or Portugal
- International families: Families with members in different countries who want consistent cover
If you will be outside the UK for more than six months per year, you should seriously consider international health insurance, as your NHS eligibility may be affected.
What does international health insurance cover?
Comprehensive international health policies typically include:
- Inpatient treatment: Hospital stays, surgery, and intensive care
- Outpatient treatment: Consultations, diagnostic tests, physiotherapy
- Mental health: Psychiatric treatment and counselling
- Maternity: Pregnancy, childbirth, and postnatal care (usually with a waiting period)
- Dental and optical: Often available as add-ons rather than standard cover
- Medical evacuation: Emergency transport to the nearest suitable medical facility or repatriation to the UK
- Cancer treatment: Including chemotherapy, radiotherapy, and targeted therapies
💡 When choosing international health insurance, decide whether you want cover for treatment in your country of residence only, or worldwide cover including the USA. Policies covering the USA are significantly more expensive (often 50–100% more) due to the high cost of American healthcare. If you do not plan to receive treatment in the US, excluding it saves substantial money.
Costs of international health insurance
Premiums vary widely based on age, coverage area, level of cover, and deductible. As a rough guide for a UK expat:
- Europe only, basic cover, individual aged 35: £1,500–£3,000 per year
- Worldwide excluding USA, comprehensive, individual aged 35: £3,000–£5,000 per year
- Worldwide including USA, comprehensive, individual aged 35: £5,000–£10,000 per year
- Family policies: Typically 2–3 times the individual premium depending on family size
Choosing a higher annual deductible (£500–£2,000) can reduce premiums by 20–40%. Premiums increase with age, particularly after 50, and some insurers apply loading for pre-existing conditions.
Key considerations for UK expats
NHS eligibility: If you move abroad and are no longer ordinarily resident in the UK, you lose your entitlement to free NHS treatment. When you return to the UK, you need to re-establish ordinary residence before NHS cover is restored. International health insurance bridges this gap.
EHIC/GHIC: The UK Global Health Insurance Card (GHIC) provides some access to state healthcare in EU countries, but it only covers treatment on the same basis as local residents — not private treatment. It is not a substitute for comprehensive health insurance.
Local healthcare quality: The quality and availability of healthcare varies enormously between countries. In some destinations, private healthcare is significantly better than public options, making international insurance essential for quality care.
Pre-existing conditions and international cover
International health insurers handle pre-existing conditions similarly to UK domestic providers. Full medical underwriting and moratorium approaches are both common. If you are moving abroad with a pre-existing condition, arrange cover before leaving the UK while you still have options.
⚠️ Do not leave the UK without health insurance in place. Arranging international cover is much easier while you are still a UK resident. Once you have moved abroad, your options may be more limited and more expensive, particularly if you develop new health conditions after relocating.
Choosing the right provider
Look for providers with strong claims settlement records, a wide hospital network in your destination country, 24/7 multilingual support, and direct billing arrangements (where the insurer pays the hospital directly rather than requiring you to pay upfront and claim back).
Get expert help with international health insurance
Choosing the right international health insurance requires understanding the healthcare system in your destination country and matching it to the right level of cover. Nesto connects you with experienced health insurance brokers who specialise in international cover for UK expats and frequent travellers.