For US Citizens Abroad, Expatriate Health Insurance Explained
Every year, thousands of Americans realize their lifelong dream and move abroad to another country. From spirited students on a gap year to gain work experiences to executives relocating to launch a new business to retirees eager to learn a new language, being an American expat knows no limits when it comes to ages and interests. But living overseas comes with challenges. How do you find an internet provider? Where can you register for classes? And what the heck do all those highway signs mean? Hopefully, as you embrace the obstacles of your new home, your health doesn't have to be on your mind. Here’s what Americans abroad need to know about expat insurance.
Health Insurance for US Citizens Living Abroad
If you are moving abroad it is important to know the risks of living abroad without medical coverage. You may experience massive hospital bills or limited access to medical care. Should you get sick or injured while living abroad, a quality international health insurance plan will cover your expenses and allow you to choose where you will be treated. Also, there are newer requirements for certain expats on select visa types that may require you to have health coverage.
Related: There are more than 8 million Americans Living Abroad (Source AARO)
Best Health Insurance for Americans Living Abroad:

Cigna Global Insurance Plan
- The flexibility to tailor a plan to suit your individual needs
- Access to Cigna Global’s trusted network of hospitals and doctors
- The convenience and confidence of 24/7/365 customer service

Xplorer Worldwide Medical Plan
- Premium Benefits, Coverage and Service
- Define your deductible and prescription benefits
- For Foreigners in the US or US Citizens Abroad
Learn More About Global Health Insurance
Frequently Asked Questions
US Health Insurance plans will cover you in a specific region within the USA. Sometimes they will offer limited coverage outside of the USA, but not always. The US government strongly recommends that all Americans carry private health care insurance when traveling or living overseas. It also warns that their national coverage will not protect them in other countries. On https://travel.state.gov, it says: “You should purchase insurance before you travel (or move abroad)...In general, Medicare and Medicaid do not cover medical costs overseas." Therefore, you are responsible for researching, comparing, and choosing a quality international health insurance plan
“Free” healthcare isn’t free… and it isn’t for US Citizens living abroad. Countries with socialized medical care are often spoken of as having “free” healthcare. But the costs of healthcare insurance in those countries is automatically built into the expenditures of everyday life for their citizens. This includes compulsory payroll deductions and taxation on goods and services.
In many cases, expat healthcare is excluded from these “free” benefits. Simply put, US expats are not citizens and thus have not contributed to healthcare costs. While many countries have provisions to treat all people who visit hospital emergency departments, regardless of nationality or ability to pay, this is no substitute for expatriate health insurance.
In general, yes. Health insurance will cover your medical costs if you need it. The US government mandates that US citizens have an ACA compliant plan in place if you are living in the USA for at least 35 days each year. If you live abroad for at least 330 days in a calendar year, you are not obligated to have an ACA compliant plan. The penalty for not having a compliant plan has been eliminated for the time being so that is a consideration. Most US citizens living abroad will choose to purchase a global health insurance plan that will cover them worldwide, including in the US.
US Medicare does not cover you when you are living outside the US for more than six months. You will need to purchase an international health plan. A good option is the Cigna Global plan as it is a comprehensive plan and covers all ages.
Obamacare or the Affordable Care Act does not cover you when you are living abroad. It is necessary to obtain international health insurance.
Your US health insurance plan will not cover you in Canada but there are options! You could qualify for the Canadian health insurance program, Medicare, but be sure to do some research on whether this is the right fit for you. You will be surprised to hear about the many inconveniences.
An alternative is to get a global medical plan that will cover you in Canada and in the US. GeoBlue Xplorer is a great option for this situation.
What Should US Expats Look for in an International Insurance Plan?
Cheap Health Insurance Is Not Always Best
Moving to a new country is very tempting. You'll be packing your bags after listening to an expatriate. They live in paradise! And the cost of living is so low they can eat out every day. Plus, they can hire a private gardener! And, best of all a trip to the local doctor is only a couple of bucks.
A lower cost of living is a significant attraction in the decision to become an expat. And minor maladies are potentially treated for just a modest cost. However, it's foolhardy to expect this same level of care and expense for more severe problems. The cost of specialist treatments, MRI diagnostics, support systems like translators, and home care nurses can add up to an astronomical cost - and at an astronomical speed. And that doesn’t take into account transportation. The very isolation that attracted you to a beloved island, reef, or mountain village will work against you when you need to hire an air ambulance for a medical evacuation.
When Choice Equals Comfort
When you are sick, you want a choice. One of the most frustrating things about being ill is feeling like you’ve lost control. Suddenly, your well being, your energy, your appetite is beyond your control. As a result, you're very frustrated. Talking to your insurance representative about the choice of hospital and specialist can help. Would you prefer a male or a female specialist? Would you be more comfortable in a hospital across town, where you’ll be close to friends and colleagues? These are the kinds of freedom the right insurance package can provide. And making these decisions will help you feel you’ve regained some autonomy.
Don't Skip Preventative Care When You Move Abroad
While time may seem to stand still when you’re working and living in Paris or Bali, your body never takes a break. It is continually warding off infections, taking a beating on hikes, and adjusting to the new food. And you don't want that to change! That means using preventative care, visiting the dentist and optometrist, and having an annual physical health care examination. The best way to ensure continuing good health is to safeguard your current good health. Having an expat health plan that covers preventive care will encourage you to seek preventative care!
Be Sure You Don't Have a Gap in Coverage
Do not gamble with a coverage gap. It’s common for many internationals and executives to stay abroad for an extra month or even an additional year. They’re volunteering, they’re honing their photography skills, and they’re perfecting a new language. And after being previously covered by their employer's’ or school’s insurance policy, they’re feeling healthy and confident. But your health and safety don’t come with any guarantees. Therefore, make sure you aren’t gambling with a coverage gap. Always ensure your new expat health insurance takes effect before any other coverage ends.
In conclusion, the best thing about expatriate life for Americans abroad is living life to the fullest. Take care of your health and your health will take care of you, no matter where you are in the world.
Expatriate Health Insurance for American Expats Abroad:
We would suggest three options for US citizens living abroad. The most popular plan would be the Cigna Global Medical plan as it offers a wide range of plans and a modular plan design allowing US Expats to design a plan to meet their needs and their budget. Probably our best plan is the GeoBlue Xplorer plan. It is more expensive but the benefits are comprehensive and the service is excellent. A more affordable option is the IMG Global Medical Insurance plan. The plan has some very affordable options for budget-conscious US expats living abroad.

Xplorer Worldwide Medical Plan
- Premium Benefits, Coverage and Service
- Define your deductible and prescription benefits
- For Foreigners in the US or US Citizens Abroad

Cigna Global Insurance Plan
- The flexibility to tailor a plan to suit your individual needs
- Access to Cigna Global’s trusted network of hospitals and doctors
- The convenience and confidence of 24/7/365 customer service

IMG Global Medical Plan
- Four plan options and additional optional coverages
- Choice of the coverage area to reflect your geographical area of need
- Freedom to choose your health care provider wherever you are in the world
Related: Or You Can Compare: Compare and Review Global Medical Plans
Also Read:
- Health Insurance When Working Abroad
- Overseas Medical Insurance Plans
- US Health Insurance for Internationals Living in America
Travel Health Insurance for US Expats Visiting the USA
Life as a US expatriate is more fluid than ever. Freelancers with flexible schedules can take advantage of sales to travel all over the world. Overseas teachers enjoy extended summer holidays. Come the high season, retirees rent out their apartment to holidaymakers and take up temporary residence elsewhere. And for American expats, there’s always the temptation to travel home to the United States for a short visit to catch up with friends and family, renew connections with colleagues, celebrate the holidays, or even travel to a new part of the country. Travel connections are easier to arrange than ever before - and so is travel health insurance. Here’s what American expats need to know before visiting the United States.
Insurance Coverage for US Citizens Returning to America
If you have a comprehensive global insurance plan, there is a chance that it also includes coverage in the USA. Start with checking your existing coverage. If you have a local plan in your new country that does not cover you when you travel, then you likely will need cover when you visit the USA. We have a couple of options.
Any form of insurance coverage will have restrictions and limitations. American expatriates returning to visit the United States are not exempt. You have to meet the insurance provider's definition of being an expat. In many cases, that may include proof that you’ve resided outside of the United States for a certain period. Others may require you to have pre-existing coverage already established in your new home before they extend coverage for your trip to the United States. They may also limit the length of time you’re covered while in the United States before you’re considered a permanent resident once more.
Travel Medical Insurance for US Expats Traveling to the USA
Patriot America Plan
The Patriot Travel plan provides coverage for people traveling outside their residence country whose destination includes the U.S. or its territories. Meaning, a U.S. citizen residing in a foreign country can purchase a Patriot America plan to visit the U.S.

Patriot Travel Insurance
- International travel medical coverage
- Coverage for individuals and dependents
- Freedom to seek treatment with hospital or doctor of your choice
It’s important to note that while travel medical plans like Patriot offer a complete package of international benefits for medical emergencies, they won’t cover you if you want to get a checkup from your old primary care doctor.
Travel Medical Insurance for all Situations and Nationalities
We offer a variety of travel medical insurance plans for all nationalities traveling anywhere in the world. Click here to: Compare Travel Medical Insurance plans. We also offer Visitors Insurance for anyone traveling from one country to visit another country.
Budget Like an American
One of the best things about expat life is the affordable quality of life. But if you've been away for too long, you might be forgetting the real costs of health care coverage in the United States. Make sure you’re up to date on your facts and figures and compare insurance packages with a realistic eye. $150 a night for hospital indemnity might sound very generous if you’ve been living in Guatemala or Thailand. However, it may not be sufficient coverage if you’re visiting New York or Los Angeles. It's time to budget like an American once more!
Emergency Care Versus Preventative Care
It's always tempting to catch up with old acquaintances when you return to the United States. But before you pop in to say hello to your childhood ophthalmologist, remember that you'll likely be paying privately for a visit. Your insurance coverage for returning home for an American visit is primarily for emergencies, not routine or preventative care. That said, many expat insurance plans include comprehensive care, including routine checkups. Having comprehensive insurance to cover your non-American, expatriate living is essential for enjoying good health no matter where you go in the world.
Related:
- Travel Insurance for Visitors to the USA
- US Health Insurance in the USA for Expats
- Health Insurance in Mexico for US Citizens
Written by Joe Cronin. Joe Cronin is an expert in the areas of global health and international insurance, with specific expertise in advising individuals and groups on international health insurance plans. Follow Joe @Joe_Cronin_Jr