International and expat private health insurance — what it costs

If you are moving abroad, or already live abroad, and want to know what international health insurance costs, there is no general figure, and the reason is worth more than a number. International medical insurance is priced on different inputs from a UK policy, and the two largest, where in the world you want cover and whether that includes the United States, move the premium further than everything else combined. This site holds no premium data and will not invent an expat health insurance price for you. What it can do is set out what moves the price and show you, in UK insurers' own wording, what happens to a UK policy and to your NHS position when you leave. For a figure, fill in the form on this page and you will be put in touch with an FCA-authorised broker who can price international cover across several insurers in one conversation. It is free and takes a few minutes. You can also go direct to an insurer.

What this page answers

Three things: what international health insurance is and how it is priced, so you know which of your own choices is driving a quote; what a UK private medical insurance policy and the NHS do when you move abroad, quoted from the policy documents where we hold them; and how underwriting treats an existing condition, which decides how much of the cover you are paying for is useful to you.

It does not price a trip. Cover for a holiday or a stay of a week or a month is travel insurance, a different and much cheaper product, with its own page on cover while travelling. International health insurance is for people who live outside the country whose health system they are entitled to use.

What international health insurance is, and how it works

A UK private medical insurance policy sits on top of the NHS: it pays for private treatment of acute conditions in the UK and assumes the NHS is there for emergencies, GP care and anything long-term. Take the NHS away and that shape stops working, which is why international medical insurance is a separate product.

An international health insurance policy pays for private treatment in whichever countries fall inside its area of cover, which on most plans includes the UK. It is an annual contract built in tiers: a core plan covering in-patient and day-patient treatment, with out-patient consultations and diagnostics, dental, maternity, and medical evacuation and repatriation sold as higher tiers or optional modules. "Full coverage" is the top tier with the modules on; an "emergency" or in-patient-only plan is the bottom one.

Two features have no UK equivalent. The insurer asks for your country of residence, because that is where most of your claims will be paid, at local prices, and some will not write a policy without one. And the policy may limit how long you can spend in your home country in a year, which matters if your plan is to fly back to the UK for treatment.

How much does international health insurance cost? What moves the price

We will not give you a number: an international health insurance premium depends on choices you have not made yet, and this site has no premium data to draw on. What we can give you is the list of inputs, roughly in the order they matter.

• Area of cover. Worldwide including the United States, worldwide excluding it, or a region. It has its own section below.
• Country of residence. The insurer expects most claims to arise where you live and prices on what private treatment costs there.
• Age. Premiums rise through age bands at renewal, and some international insurers stop taking new customers beyond a given age.
• Level of cover. In-patient only is the floor; out-patient, dental, maternity, evacuation and routine health checks each add a step.
• The excess, and any co-insurance. A larger excess, which international insurers tend to call a deductible, lowers the premium; paying a percentage of each claim lowers it further.
• Underwriting. An existing condition may be excluded, covered at a higher premium, or declined.
• Who is on the policy. Each adult and child is priced separately and the figures added together.
• Currency and how you pay. Policies are written in sterling, dollars or euros, and paying monthly usually costs more over the year than paying up front.

The dials are yours to set, and a quote is what happens once they are. The comparison worth having is the same dials set the same way at several international insurers, which a broker can run in one conversation; the form on this page is how you reach one, with no obligation to buy.

Area of cover: why the United States changes everything

International insurers divide the world into areas and price each one. "Worldwide" and "Worldwide excluding the USA" are the two on nearly every international health insurance price list, with regional areas, such as Europe or a region of Africa or Asia, below them. The United States gets its own switch because private medical prices there are the highest in the world. If you will live there, you need it included. If you will only visit, ask whether the policy gives emergency cover there on a trip basis; the WPA clause below shows the shape of a trip-based option on a UK policy, where the USA is excluded altogether. If you will do neither, leaving it out is the choice that moves the premium most, and it removes cover only in a country you will not be in.

Costa Rica, Panama, the Dominican Republic, Bali, Lebanon and Rwanda all appear in the searches behind this page, and the answer for each is the same shape. The premium depends on which area the country sits in and what private treatment costs where you will actually live; where local private hospitals are limited, the evacuation benefit does more of the work. Several countries also make proof of health insurance a condition of a residence visa, with a minimum the consulate sets and the insurer does not, so check that before you choose a tier.

What named insurers say about treatment abroad (compare the policy wording)

These clauses are from UK domestic policies, and that is the point: they are what the policy you may already hold says about you leaving. We hold no international policy wording.

All three read 4 September 2026; one clause from each document, and we have not read the rest.

AXA's clause goes a step further than Aviva's: it excludes treatment received abroad and, separately, any costs at all if you live outside the UK, so on that wording moving abroad ends the usefulness of the policy whether or not you cancel it. WPA's is the one clause we hold that describes an option rather than an exclusion, and its per-trip day limits say what it is: trip cover attached to a UK policy, with the USA excluded, not cover for living abroad. The AXA and Bupa groups do sell international policies through separate businesses, AXA Global Healthcare and Bupa Global, on different terms and prices from their UK products; Bupa's international cover has its own page here.

If you hold a UK policy and are leaving, ask your insurer in writing on what date cover stops, whether it will move you onto an international product, and whether the gap counts as a break in cover if you return. Then take the answers to a broker: the form on this page puts you in touch with one who can price the international replacement across several insurers at once.

Do you keep the NHS while you are abroad?

We state here only what we are confident of, and say where to confirm the rest. NHS hospital treatment is free on the basis of being ordinarily resident in the UK. It is a residence test, not a nationality test, and past National Insurance contributions do not earn it. If you move abroad permanently you generally stop being ordinarily resident, and NHS hospitals in England can then charge you for planned hospital treatment on a visit home. Emergency treatment in A&E and a GP consultation remain free at the point of use; Scotland, Wales and Northern Ireland set their own charging rules.

There are exceptions, and they are specific. UK state pensioners living in the EU, the EEA or Switzerland with a registered S1 are one; the others are set out in GOV.UK's guidance on healthcare for UK nationals living abroad, which is where to check your own position before you rely on it. A UK Global Health Insurance Card covers necessary state healthcare on a temporary visit; it does not cover you to live abroad. And your new country's public system will usually treat you as a newcomer, which can mean no entitlement for a period, or none without a contribution record. That gap, between an NHS you have left and a local system that has not yet taken you on, is what international health insurance exists to fill. If you later return for good, your NHS entitlement resumes; a UK private policy you let lapse does not.

Excess, out-patient limits and co-payment: the dials, in the insurers' own words

Every international price list has a column of deductibles and, often, a co-insurance option, and the mechanics are the same as on a UK policy, whose documents show the detail a price list leaves out.

"Excess options £100 Benefits covered under this policy will be subject to an excess payable for each member every policy year. £200 £500 £1,000 £3,000 £5,000"

— Aviva's Healthier Solutions terms and conditions (April 2025 issue), page 11, read 4 September 2026.

Six tiers, from £100 to £5,000, each applied per member per policy year. Bupa's policy guide for Bupa By You (BINS 14718, read 4 September 2026) shows what "every policy year" means with an example on page 10: Helen's physiotherapy costs £250, Bupa pays the physiotherapist £150, Helen pays the £100 excess, and if she needs other treatment in the same policy year no further excess is due. Once a policy year, not once a claim; ask the international insurer which its deductible is, because the answer changes what a high deductible costs you in a bad year. The same guide shows an excess need not apply to everything: a Direct Access phone or video assessment carries no excess and is not taken from the out-patient allowance (page 7). Freedom's wording answers who you actually pay: the excess is deducted from the first valid invoice and any after it until used up, and you then pay that amount to the provider, not the insurer (Freedom Elite Policyholder's Guide to Cover, April 2025, page 31, read 4 September 2026).

"Where an excess is chosen, you must pay your excess for eligible treatment up to your chosen level per Policy year before we provide benefit. Where Shared Responsibility (co-payment) has been selected, you must pay 25% of claims for eligible treatment up to your chosen level of Shared Responsibility."

— WPA's Complete Health Insurance Product Information Document (November 2025), page 2, read 4 September 2026.

That is co-insurance on a UK policy: a quarter of each eligible claim, up to a ceiling you choose. On an international plan the ceiling is the figure to look at, because a percentage of a hospital bill in an expensive country is a different sum from a percentage of one at home.

Out-patient limits are the dial people underestimate: the same WPA document caps out-patient consultations with a specialist at £250 a policy year as standard, extendable with its Extra Out-patient Consultations option (page 1), and Aviva's shows that a lower limit can carry consequences elsewhere in the policy.

"If you have chosen a reduced out-patient limit of £500 or £1,000 you are not covered as an in-patient, day-patient, or out-patient for treatment for: complications of pregnancy and childbirth, or surgical procedures on the teeth performed in a hospital"

— Aviva's Healthier Solutions terms and conditions (April 2025 issue), page 8, read 4 September 2026.

The lesson transfers: when an international price list offers a cheaper tier with a lower out-patient figure, read the clause for what else moves with it.

Underwriting and pre-existing conditions on an international policy

Full medical underwriting is the norm on international cover: you complete a health questionnaire and the insurer sets terms before the policy starts. The outcomes are acceptance on standard terms, an exclusion for a named condition and anything related to it, a loading, meaning a higher premium to cover it, or a decline. Some international insurers also offer a moratorium, which asks no questions and excludes recent conditions instead; ask which basis a quote is on, because quotes on different bases are not comparable.

Be realistic about serious existing conditions. Diabetes, dialysis and current cancer treatment all appear in the searches behind this page, and the position is the same for each: ongoing treatment of an existing condition is the hardest thing to insure anywhere, and on an international policy there is no NHS behind it. Expect an exclusion rather than a loading, sometimes a decline, and plan on that basis. Where international cover differs from a UK policy in your favour is on conditions that arise after the start date: many international plans cover a chronic condition diagnosed once you are a member, where a UK policy typically would not, so read the chronic-conditions wording before you buy.

Whatever the condition, disclose it. An insurer that finds an undisclosed condition at claim time can void the policy, and you would be abroad, uninsured and already in treatment.

Common questions

Is international health insurance expensive?

Compared with a UK policy for the same person, usually, because it has no NHS underneath it and pays private prices in countries where they can be higher than the UK's. The gap between a regional in-patient plan with a large deductible and a worldwide comprehensive one is enormous.

Does international health insurance cover dental?

Routine dental is not normally in a core international plan; it is sold as an optional module, often with a waiting period and an annual limit, and it adds to the premium. Emergency dental after an accident is sometimes in the core plan, so check the wording for which it is.

Do I need international health insurance when I move abroad?

For most people living abroad, yes: a UK policy stops paying when you leave, your NHS entitlement rests on living in the UK, and your new country's public system will usually treat you as a newcomer with little or no entitlement at first. Some employers provide it, and some residence visas require it.

Can I use the NHS if I live abroad and come back for treatment?

Generally not for planned hospital treatment, because entitlement rests on being ordinarily resident in the UK and a permanent move usually ends that, though A&E and GP consultations remain free. There are specific exceptions, including UK state pensioners in the EU, EEA or Switzerland with a registered S1, so confirm your position through GOV.UK rather than assuming.

Can I buy international health insurance for one week or one month?

That is travel insurance, a different and cheaper product; international health insurance is an annual contract for people who live abroad. If you move between countries with no fixed base, say so when you ask for a quote, because insurers price on a country of residence and some will not write a policy without one.

What if I have diabetes, need dialysis, or am being treated for cancer?

Declare it and expect the condition to be excluded, or in some cases the application declined; the rest of the policy still covers you for everything unrelated. If an employer's group scheme is open to you, ask whether it accepts members on a medical-history-disregarded basis, which some do.

My employer provides international cover. Is that enough?

Often, but check the area of cover, whether your partner and children are included, what happens on the day the job ends, and whether you can convert to an individual policy without new underwriting when it does.

Which companies sell international health insurance?

The names a UK reader is most likely to be offered include Bupa Global, AXA Global Healthcare, Cigna Global, Allianz Care, April International, William Russell and Now Health International, among others. IMG and GeoBlue, which also appear in the searches behind this page, are American-market names written mainly for people from the United States.

I am coming to the UK from abroad. What changes?

The NHS is residence-based, so most people arriving on a longer-stay visa pay the immigration health surcharge with their visa application and then use the NHS as residents do, while short-stay visitors are charged for hospital treatment and need travel or visitor cover. A US citizen who wants the option of treatment at home needs the United States in the area of cover, which is the expensive version.

The next step is a quote with the dials set for your own move. Fill in the form on this page and a broker will call you back to price it across several international insurers in one go. It costs nothing to ask, and you will have a real figure instead of a guess.