11 Most Trusted Expat Insurance Options for Long-Term Living

Your home country plan stops covering you once you live abroad. These 13 insurers and one broker sell annual plans built for expats, and each section links to the provider and to the page where you request a quote.

Most home country health plans stop covering you once you move abroad full time, and travel insurance was never built for that life.

People find out when they file a claim. Some home plans lapse after 90 days overseas. Others deny claims because the policyholder no longer keeps a permanent residence at home. The gap between what you assume is covered and what actually gets paid shows up when you can least afford confusion.

Expat health insurance covers people who base themselves abroad for most of the year. It differs from travel insurance in three ways: annual renewable policies, hospital networks with direct billing, and claims processes designed for long-term residents instead of short trips.

The 14 options below include 13 insurers and one broker. Each section names the plans, states what the provider publishes about eligibility and limits, and links to the provider and its quote page. Plan names, limits, and eligibility change, so confirm terms with the provider before you pay. Information current as of October 2026.

Understanding Expat Health Insurance Before You Choose a Provider

Expat health insurance is annual renewable coverage for people who live outside their home country for extended periods, typically six months or more a year. It works like domestic health insurance, with international networks, multi-country cover, and routine care. Eligibility runs in the other direction: several providers below require a minimum time outside your home country, from three months a year at Blue Cross Blue Shield Global Solutions to six months at IMG.

Why you need expat health insurance even when public healthcare is free: Access to a public system depends on your visa category, your residency status, and sometimes your contributions. Some visas require proof of private coverage before you can enter. Check the insurance rule for your visa in ABA’s long-term visa and residency directory. Private cover also gives you immediate access to private hospitals and English-speaking doctors while public enrolment is pending, and it keeps working when you travel.

When local private insurance makes more sense: If you will stay in one country for three or more years, speak the language, and rarely travel or return home for care, a local private plan usually costs less than an international one. Countries with mature private insurance markets like Thailand, Malaysia, Mexico, and the Czech Republic offer strong local options once you have established residency and understand the system.

Expat insurance and travel insurance differ in design, in the patient’s intent, and in the insurer’s claims philosophy.

Travel insurance assumes a temporary trip. It covers emergency stabilization, medical evacuation, and repatriation, not routine care. See ABA’s guide to whether you need travel insurance and what it costs.

Travel insurance expires or becomes impractical after 12 months. Expat insurance renews annually for as long as you want it.

Expat insurance assumes you live abroad and need ongoing care: routine doctor visits, prescriptions, specialist consultations, and chronic condition management. Maternity, dental, and elective procedures usually require higher tiers or add-on modules.

Four questions narrow the field fast: Does the provider sell in your country of residence? Do you need US coverage, which raises premiums at every provider below? How does the plan treat pre-existing conditions? Does your hospital bill the insurer directly? Disclose every condition on the application. Insurers can exclude a condition, charge more for it, or decline you, and non-disclosure can void a claim.

Pricing: Insurers price each policy by age, nationality, country of residence, deductible, and area of cover, so no single number describes a provider. Each section below gives a premium line with its source, date, and the profile it applies to. Prices from an insurer’s own site or live quote tool come first. Figures from comparison sites and brokers are labeled as third-party estimates and flagged for rechecking. Most insurers show a price only after you give a name and email, so request quotes from three providers for the same profile and compare them side by side. Check each insurer’s financial strength rating (A.M. Best or S&P) before you pay.

Global Coverage Leaders with Comprehensive Networks

These providers sell worldwide plans backed by networks of roughly two million providers or more, and they suit expats who travel often or have not settled in one country.

1. Cigna Global

Cigna Global sells three tiers, Silver, Gold, and Platinum, to people in more than 200 countries and jurisdictions, backed by a network of more than 2 million provider relationships. It accepts applicants from age 18 with no upper age limit, which makes it a common starting point for families and retirees as well as working-age expats.

Best for: Expats of any nationality who want one worldwide policy with a choice of tier, deductible, and area of cover.

Plans and limits:

• Silver: $1,000,000 annual inpatient and day-patient maximum. Routine maternity is not covered.
  
• Gold: $2,000,000 annual inpatient and day-patient maximum. Routine maternity up to $7,000.
• Platinum: inpatient and day-patient care paid in full. Routine maternity up to $14,000.
• Area of cover: worldwide including the US, or worldwide excluding the US. The US option costs more.
• Cigna Close Care covers you only in your country of residence and your country of nationality.

The care experience: In-network hospitals bill Cigna directly, and Cigna requires prior authorization for all inpatient and day-patient treatment. Support runs 24/7 through a multilingual team.

Pros: Wide tier range, 200+ countries, no upper age limit, in-network direct billing, 24/7 multilingual support.

Cons: The US module raises premiums, premiums are priced by age, and Silver limits are tight.

Gotchas: Pre-existing conditions go through medical underwriting, and Cigna can cover, exclude, surcharge, or decline them. Silver caps mental health at $5,000 and advanced imaging (MRI, CT, PET) at $10,000 per year. Outpatient is an optional module with annual maximums of $15,000 on Silver and $35,000 on Gold. Cigna cannot accept addresses in several sanctioned countries, including Iran and Syria.

Official site: cignaglobal.com | Plans: Cigna international health plans | Get a quote: Cigna Global quote tool

2. Allianz Care

Allianz Care replaced its core individual lineup in November 2025 with three plans for new customers: Care Base, Care Enhanced, and Care Signature. Every tier includes inpatient care with a private room and medical repatriation, and you add outpatient and dental as modules.

Best for: Expats who want to build a plan from modules, and nomads or families abroad for under a year who want a short-term option.

Plans and modules:

• Care Base: inpatient core. No maternity or fertility treatment.
• Care Enhanced: adds maternity (12-month waiting period) and bariatric surgery (24-month waiting period).
• Care Signature: top tier, with maternity and fertility treatment (12-month waits) and bariatric surgery (24 months).
• Outpatient module: consultations, diagnostics, prescribed medication, therapies, and wellness benefits.
• Dental module: preventive, basic, and major levels matched to your core tier.
• Areas of cover: worldwide, worldwide excluding the USA, Europe, or Africa.
• Flexicare: a short-term plan for 3, 6, 9, or 12 months.

The care experience: Members search in-network providers through Allianz’s provider finder.

Pros: Modular design, clearly stated waiting periods, a short-term option, and the backing of a major insurance group.

Cons: Modules add cost, and maternity and bariatric waiting periods delay those benefits.

Gotchas: The November 2025 plans apply to new business and launched first for the EU and UK markets, with Dubai and APAC offerings to follow, so plan names differ by region. Care Base excludes maternity entirely. Hormone replacement therapy and sleep apnoea treatment are optional on Enhanced and Signature, subject to underwriting.

Official site: allianzcare.com individual plans | Get a quote: Request a callback from Allianz Care

3. AXA Global Healthcare

AXA Global Healthcare sells five cover levels to expats who live or work overseas long term: Foundation, Standard, Comprehensive, Prestige, and Prestige Plus. AXA cites more than 2 million recognised medical facilities worldwide.

Best for: Long-term expats who want a large insurer brand and the option to drop US cover to cut cost.

Plans and options:

• Foundation and Standard: outpatient cover is an optional upgrade.
• Comprehensive, Prestige, and Prestige Plus: outpatient cover included.
• Optional extras: dental, outpatient, and pregnancy care.
• Area of cover: you can exclude the USA to lower premiums, and most plans still cover emergencies there.

The care experience: The AXA Select network lists hospitals where AXA pays treatment costs directly. You can quote online or by phone.

Pros: Five clear cover levels, outpatient built in from Comprehensive up, and a US-exclusion option.

Cons: Pre-existing conditions are generally not covered, and cover is not available in every country.

Gotchas: Plans cover conditions that arise after you join. If you leave a company scheme, you can move to a personal plan within 120 days and keep cover for existing conditions, subject to the new plan’s terms. After 120 days, AXA cannot guarantee continuous cover. Premiums vary with location, age, and extras.

Official site: AXA Global Healthcare expat insurance | Get a quote: AXA online quote

4. Bupa Global

Bupa Global sells international private medical insurance only, with no domestic-only or travel products, and cites a network of more than 2 million providers. Its individual plans step up in tiers from inpatient-only cover to broad outpatient, preventive, and family benefits.

Best for: Expats who want a premium-tier plan with direct claim settlement and high annual limits.

Plans and limits (from Bupa Global’s Hong Kong site; names and availability vary by country of residence):

• Major Medical: inpatient cover, HKD 35,000,000 annual limit (about US$4.5 million).
• Select: adds outpatient cover and health checks, HKD 35,000,000.
• Premier: richer inpatient and outpatient cover with screening and preventive care, HKD 39,000,000.
• Elite: built for families, with optional maternity, HKD 78,000,000 (about US$10 million).
• Area of cover: worldwide, or worldwide excluding the US.

The care experience: Bupa says it settles claims directly, and its Facilities Finder lets you check a provider before you book.

Pros: Very high annual limits, a single-purpose international product, and direct settlement.

Cons: Plan names and availability depend on your country of residence, and some plans cannot be bought online.

Gotchas: Bupa’s quote form asks for your country of residence and requires a registered address there. Read the benefit schedule for your market, because tier names and limits differ by country. Some plans require a call with an adviser.

Official site: bupaglobal.com | Get a quote: Bupa Global quote form

Regional Specialists With Targeted Coverage

These providers fit a specific profile: US citizens abroad, budget buyers, or expats based in Asia and the Middle East.

5. IMG Global Medical Insurance

IMG (International Medical Group) has sold international coverage since 1990 from its Indiana headquarters, and its Global Medical Insurance plan is annually renewable cover for expats aged 14 days through 74. Silver, Gold, and Platinum appear on IMG’s site, and broker materials also list a Bronze tier.

Best for: Budget-conscious and younger expats who want deductible flexibility, including US citizens living abroad.

Plans and limits:

• Lifetime maximum per person: Bronze $1 million, Silver $5 million, Gold $5 million, Platinum $8 million.
• Deductibles run from $250 up to $10,000 on Bronze and Silver and $25,000 on Gold and Platinum.
• Area of cover: worldwide, or worldwide excluding the US, Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan.
• Maternity: Platinum only, $50,000 lifetime maximum.
• Emergency evacuation: $50,000 on Bronze and Silver, up to the lifetime maximum on Gold and Platinum.

Pros: A wide deductible range, a choice of area of cover to cut cost, and a Global Senior Plan option for members who enrol by 65 and stay continuously covered to 75.

Cons: Benefits run against lifetime maximums instead of annual ones, and maternity is Platinum only.

Gotchas: US citizens who choose worldwide cover must be abroad on the start date and spend at least six of the following 12 months outside the US, plus six months abroad in each renewal period. The excluding-US option gives only emergency US cover, limited to 30 days per coverage period. Applicants aged 75 and over cannot enrol. Disclosing a pre-existing condition does not guarantee cover, because IMG can approve, exclude, surcharge, or decline.

Official site: IMG international health insurance | Expat page: IMG expat insurance

6. Blue Cross Blue Shield Global Solutions (formerly GeoBlue)

GeoBlue became Blue Cross Blue Shield Global Solutions in February 2026, and the GeoBlue name retires by the end of 2027. Coverage and benefits stay the same. Its long-term plans for people living abroad, Worldwide Premier and Outside the U.S., provide unlimited medical benefits annually and for life.

Best for: US citizens, US permanent residents, and legal US residents who live abroad and want in-network access to Blue Cross Blue Shield providers when they visit the US.

Plans and limits:

• Worldwide Premier: includes US in-network and out-of-network benefits.
• Outside the U.S.: excludes US cover, with optional limited US cover for up to three trips of 21 days per trip each calendar year.
• Deductible options: Elite ($0 outside the US and in the US network, $1,000 for US out-of-network care), $1,000, $2,000 or $2,500, $5,000, and $10,000.
• Unlimited telemedicine, same-day appointments, 24/7.
• Medical evacuation up to $250,000 per trip period. Basic prescriptions $3,500 per year, with an optional rider to $25,000.

Eligibility: You must plan to live outside your home country at least three months a year, and you must be 74 or younger when you apply. You qualify as a US citizen or permanent resident living abroad, as a legal US resident (including foreign nationals), or as an employee of a US company that pays the premium. Dependents include a spouse or partner and unmarried children under 26.

Pros: Unlimited medical benefits, pre-existing conditions covered, US network access, and included telemedicine.

Cons: Eligibility ties to US status, and the application age cap is 74.

Gotchas: Pre-existing conditions are covered, but a waiting period of up to six months applies unless you provide a letter showing at least six months of prior coverage. Emergency care and evacuation are covered during the wait. Foreign nationals applying for the Outside the U.S. plan must apply from the US. The older Xplorer name still appears on some broker sites, so confirm the current plan name when you request a quote.

Official site: Blue Cross Blue Shield Global Solutions | Plan details: Worldwide Premier and Outside the U.S. | Get a quote: Quote form (select Long Term)

7. April International

April International sells long-term expat health insurance, a dedicated digital nomad plan, and short-term cover from 3 to 12 months, in more than 180 countries. The French-founded insurer builds each quote through a consultant instead of a fixed price list.

Best for: Expats in Asia and Europe, and digital nomads who want a plan designed for frequent moves.

Plans:

• Long-term international health insurance for expats: 12 months or more.
• Digital nomad health insurance for people who work abroad or change their country of residence often.
• Short-term international health insurance: 3 to 12 months, including working holiday and Schengen travel.
• Student and travel plans are also available.

The quote process: April’s Asia site accepts applications from people 65 or younger, and a consultant builds a personalised plan after you submit the free quote form.

Pros: A dedicated nomad plan, short-term options, and consultant-built quotes.

Cons: Plan tiers and benefit limits do not appear on the individual-plans page, so you need a quote to compare them.

Gotchas: Ask for the full benefit schedule in writing before you pay, and confirm US cover, pre-existing condition terms, and eligibility for your country of residence.

Official site: April International plans | Get a quote: April International quote form

8. Now Health International

Now Health International sells two plan families, SimpleCare and WorldCare, with annual maximums from $1 million to $4.5 million.

Best for: Expats in Asia, the Middle East, and Europe who want a lower entry point with a path up to higher WorldCare limits.

Plans and annual maximums:

• SimpleCare CORE1: $1 million.
• SimpleCare 100 and 250: $1.5 million.
• WorldCare Essential: $3 million. Advance: $3.5 million. Excel: $4 million. Apex: $4.5 million.
• USA elective treatment benefit: fully paid in network and 50% co-insurance out of network. Check the Member’s Handbook for which plans include it.

Where it is available: Policies are issued by different regulated entities depending on where you live, including entities regulated in the UK, Malta, Dubai, Hong Kong, Singapore, Indonesia, and mainland China. Some plans are unavailable on certain policies for resident visa holders in Dubai and Abu Dhabi.

Pros: Eight plan levels with clearly stated annual maximums.

Cons: Availability and the issuing insurer change with your country of residence.

Gotchas: Your policy terms depend on the entity that issues it in your country. Confirm the insurer, regulator, and claims administrator in writing before you buy.

Official site: now-health.com | Compare plans: Now Health plan comparison | Get a quote: Now Health quote form

Specialized Providers for Specific Situations

These insurers serve narrower segments. They fit best when your situation matches their design.

9. William Russell

William Russell is independently owned and designs its plans in partnership with Allianz, and a company in the Allianz group insures them. It sells four health tiers and requires you to live outside your country of nationality.

Best for: Expats who want account-manager service and no annual cap on outpatient care on the top three tiers.

Plans and limits:

• Bronze: $1.5 million annual overall maximum.
• SilverLite: $1.5 million, outpatient limited to $5,000 (extendable to $10,000), no mental health cover.
• Silver: $2.5 million.
• Gold: $5 million.
• Outpatient has no annual limit on Bronze, Silver, and Gold.
• Mental health lifetime limits: $50,000 on Bronze, $75,000 on Silver, $100,000 on Gold.
• Area of cover: worldwide excluding the US by zone, with optional short-term US cover (up to 45 days per trip) on Zone 1 only.

Eligibility: You must be under 76 to apply, and you can keep renewing after 76. Premiums rise with age and healthcare costs.

Pros: No annual outpatient limit on the top three tiers, personal service, and renewal after 76.

Cons: US cover is limited to short trips, and SilverLite has no mental health benefit.

Gotchas: William Russell’s site does not state how it treats pre-existing conditions, and brokers report that its plans exclude them, so get the position in writing before you apply. Life insurance is a separate product (up to $2 million from $39 a month), not a bundled benefit. The US add-on shows conflicting emergency limits ($50,000 and $250,000) on William Russell’s pages, so confirm the figure in your quote.

Official site: william-russell.com | Compare plans: William Russell plan comparison | Get a quote: William Russell quick quote

10. Integra Global

Integra Global now sits under HCI Group, and HealthCare International Europe GmbH administers the policy book and owns the brand. The insurer is MGEN. Online quotes appear instantly, enrolment asks up to six medical questions, and qualifying applicants can start cover the same day once they pay.

Best for: Expats and digital nomads who want an instant online quote and a fast start date.

Plans and areas of cover:

• InCare: inpatient care, medical evacuation and repatriation, and mental health. No outpatient cover.
• YourLife: adds outpatient care, routine checkups, preventive care, and prescriptions. Dental is optional.
• PremierLife: higher limits and dental cover.
• Cover 1: worldwide including the US and Canada.
• Cover 2: worldwide excluding the US and Canada.

Eligibility: Integra covers people who spend most of their time outside their home country. Applicants name a main country of assignment, and digital nomads can name the first country they will visit or the one where they will stay longest.

Pros: Instant quotes, a same-day start, nomad-friendly eligibility, and evacuation included on every plan.

Cons: InCare has no outpatient cover, and annual maximums are not shown on the pages we reviewed.

Gotchas: Some applicants need further medical underwriting after the six questions. In Switzerland and Germany, the plans are available only as top-ups to domestic policies. Stays of more than 180 days in the US in any 12 months can disqualify you. Compare benefit limits on the plan comparison page before you enrol.

Official site: Integra Global at HCI Group | Compare plans and get a quote: Integra Global plans

11. Foyer Global Health

Foyer Global Health, based in Luxembourg and trading online as Global Health, sells individual expat cover under the name Journey, in five plan levels with two geographic options: worldwide, or worldwide without the USA. Most plans carry no annual limit.

Best for: European-linked expats and families who want plans with no annual limit and strong online services.

Plan features:

• Free choice of doctor and 24/7 multilingual assistance.
• Evacuation and repatriation for urgent medical needs where local treatment is unavailable.
• Online consultations, second medical opinions, and mental health coaching (up to three sessions).
• A no-deductible contract reimburses from the first euro.

Contact: +352 270 444 1002 or [email protected].

Pros: No annual limit on most plans, a no-deductible option, and a bundled digital health toolkit.

Cons: Plan level names and pricing are not published on the main page, so you need to request the brochure.

Gotchas: Ask for the maternity waiting period, pediatric terms, and network size in writing, because the page we reviewed does not state them.

Official site: Foyer Global Health

Emerging Providers with Modern Approaches

These newer companies sell online, bill monthly or every four weeks, and target location-independent professionals. Their track records are shorter than those of established insurers.

12. Genki

Genki sells two plans for nomads, Genki Traveler and Genki Native, and says it has more than 75,000 members from more than 195 countries. Squarelife is the insurer. Genki pays hospital bills directly and reimburses regular visits after you pay first.

Best for: Nomads who want to sign up online, even if they are already traveling.

How it works:

• Genki Native: long-term cover you can cancel monthly after the first month. Basic carries a €1,000,000 annual limit, and Premium adds dental, vision, mental health, maternity, and preventive care with a €3,500,000 limit.
• Native Basic covers your country of nationality for the first 182 days of each stay, and covers the USA only for emergencies that start within 91 days of arrival.
• Treatment at any licensed doctor or hospital worldwide, public or private.
• Hospital bills are paid directly. For regular visits you pay first and request reimbursement, and Genki says it pays 80% of reimbursements within two business days.
• Genki says it covers almost all sports and activities at no extra charge.

Pros: Fast online sign-up, direct hospital payment, and broad sports coverage.

Cons: Native Basic leaves out dental, vision, mental health, and maternity, and Native has waiting periods of 3 to 12 months on several benefits.

Gotchas: Native excludes professional sports, treatment you already need, and anything not medically necessary. Check the age limits and pre-existing condition terms in the policy wording before you pay.

Official site: genki.world | Check price and sign up: Genki sign-up

When a Broker Makes Sense

13. Pacific Prime

Pacific Prime is a broker, not an insurer. Pacific Prime Insurance Brokers Limited is licensed and regulated by the Hong Kong Insurance Authority, cites more than 20 years as a broker, and says it compares plans from more than 60 insurers.

Best for: Complex cases: a complicated medical history, a family with mixed nationalities, an unusual country combination, or coverage needs that exceed standard policy maximums.

What a broker does:

• Compares quotes from multiple insurers through one relationship.
• Explains underwriting differences, such as which insurers accept specific conditions or countries.
• Helps with claims and policy changes after you buy.

What it costs: Brokers are normally paid commission by the insurer, so a broker quote generally matches the insurer’s direct price. Ask for written confirmation that your quote carries no broker surcharge.

Pros: One conversation reaches many insurers, and a good adviser can match unusual profiles to the right underwriter.

Cons: A middleman sits in the claims process, and advice quality depends on the individual adviser assigned to you.

Gotchas: Commissions can create an incentive to recommend higher-premium plans, so ask the adviser to show the cheapest comparable option and explain why it was not chosen. Not every insurer is available in every country.

Official site: pacificprime.com | Get quotes: Pacific Prime quote comparison

The right provider depends on where you live, how long you plan to stay, your nationality, and how much risk you can carry yourself. Start with your actual coverage needs instead of the most comprehensive plan on offer, because premiums accumulate every year. Overpaying by $2,000 annually costs $10,000 over five years, money that could fund real out-of-pocket care.

If you are healthy, under 45, and live in a country with strong private healthcare, a mid-tier plan with a moderate deductible usually beats a zero-deductible plan that costs twice as much. Bank the difference, pay for routine care yourself, and keep catastrophic protection for the events that could bankrupt you.

Sources:

• Cigna Global: international health plans
• Allianz Care: plan update, 19 November 2025
• AXA Global Healthcare: expat health insurance
• Bupa Global: individual plans (Hong Kong)
• Blue Cross Blue Shield Global Solutions: Worldwide Premier and Outside the U.S.
• Blue Cross and Blue Shield of Oklahoma: GeoBlue rebrand notice, 18 February 2026
• Now Health International: all plans
• HCI Group: Integra Global
• William Russell: plan comparison
• SafetyWing: Nomad Insurance
• April International: individual plans
• Foyer Global Health
• Genki
• Pacific Prime