Leaving the U.S.? International Health Insurance

When local health insurance won't cover you due to age restrictions or insufficient benefits, international travel medical insurance works for short stays…

Moving abroad or planning an extended stay overseas is exciting Until you hit that wall trying to secure health insurance. Maybe you're over 65 and local insurers won't touch you. Perhaps the destination country's coverage is bare-bones at best. Or you're stuck in that frustrating gap between visa approval and residency status where nobody wants to insure you. I've been there, and I'm here to help you navigate these choppy waters. Why Local Insurance Isn't Always the Answer Let's be honest: not every country rolls out the welcome mat when it comes to healthcare for newcomers. Some common roadblocks include: Age restrictions – Many countries cap enrollment at 60, 65, or 70 years old Pre-existing conditions – Local policies often exclude coverage for anything diagnosed before you arrived Waiting periods – Some systems make you wait 6-12 months before coverage kicks in Coverage gaps – Basic plans might cover emergencies but leave you on the hook for routine care, prescriptions, or specialist visits Language barriers – Understanding what's actually covered can be a nightmare Short-Term Visa Stays: Your Best Options 1. Travel Medical Insurance (Up to 12 Months) For tourist visas, work permits, or sabbaticals, travel medical insurance is your friend. These aren't your typical "lost luggage" travel policies—they're serious medical coverage designed for extended stays. Top providers: GeoBlue Voyager – Excellent for Americans abroad, offers plans from 5 days to 1 year SafetyWing Nomad Insurance – Popular with digital nomads, monthly subscription model ($40-50/month) IMG Patriot Travel Medical – Solid coverage, accepts applicants up to age 79 Seven Corners RoundTrip – Good for longer stays, renewable up to 12 months What to look for: Coverage amounts of at least $100,000 (preferably $250,000+) Emergency medical evacuation included Direct billing to hospitals (not just reimbursement) 24/7 assistance hotline in your language 2. Schengen Visa Insurance (For Europe) If you're headed to Europe's Schengen Zone, you'll need proof of insurance just to get your visa. The minimum requirement is €30,000 ($32,000) coverage, but many of the providers above exceed this easily. Pro tip: Don't just buy the cheapest policy to satisfy the visa requirement—you might actually need to use it. Permanent Immigration: Long-Term Solutions Once you're settling in for the long haul, you need something more robust than travel insurance. 1. International Private Medical Insurance (IPMI) This is the gold standard for expats. These plans work globally or regionally, cover pre-existing conditions (sometimes with waiting periods), and grow with you as you age. Leading providers: Cigna Global – The heavyweight champion, comprehensive coverage, accepts members up to age 74 (some plans to 80) Aetna International – Strong network, particularly good in Asia and Middle East Allianz Care – Flexible plans, available worldwide, accepts new members up to age 74 Bupa Global – Excellent customer service, strong in Europe and Asia, some plans accept up to age 80 William Russell – UK-based, great for those aging in place, accepts members up to 75 What you'll pay: Expect $200-$800/month depending on age, coverage level, and whether you include the US in your coverage zone (which dramatically increases premiums). 2. Regional Expat Plans If you know you're staying in one region long-term, regional plans can save you money: Pacific Prime – Excellent for Asia-Pacific residents April International Expat – Strong in Africa and francophone countries Integra Global – Good for Latin America 3. Medicare Supplement Plans (For US Citizens 65+) Here's something many people don't know: If you're a US citizen collecting Social Security abroad, you're eligible for Medicare—but it generally doesn't work outside the US. Solutions: Medicare Supplement Plan F or G – Won't work abroad, but useful when you return to the US for care Medjet Assist – Not insurance, but provides emergency medical transport back to the US ($300-400/year) GeoBlue Xplorer – Designed specifically to work alongside Medicare for international coverage Special Situations: When Age or Health Issues Complicate Things You're Over 70 and Getting Declined Don't panic. Options still exist: IMG Global Medical Insurance – Accepts applicants up to age 99 (seriously) Allianz Care Senior Plans – Designed for older expats, up to age 85 International Citizens Insurance – Specializes in "uninsurable" cases Local private hospitals – Many offer direct membership programs that bypass traditional insurance You Have Significant Pre-Existing Conditions Most IPMI providers will cover pre-existing conditions, but with catches: Waiting periods – Usually 12-24 months before pre-existing conditions are covered Moratorium periods – Coverage excluded for conditions treated in the 2-5 years before enrollment Full medical underwriting – Some plans will cover everything immediately, but charge accordingly Best bet: Apply with multiple providers and compare what each will actually cover for YOUR specific conditions. Your Budget Is Tight If premium IPMI is out of reach: Catastrophic-only plans – Cover emergencies/hospitalization only, much cheaper Local private insurance – Even if public insurance won't take you, private insurers might Health tourism – Combine travel to countries with excellent affordable care (Thailand, Mexico, Costa Rica) Direct primary care abroad – Pay cash for routine care, insure only for emergencies Red Flags: Insurance to Avoid Not all international insurance is created equal. Watch out for: Coverage caps under $50,000 – A single hospital stay can exceed this Reimbursement-only policies – You pay upfront, fight for repayment later Policies that exclude your destination country – Read the fine print Annual aggregate limits – They pay up to $X total per year, even for separate issues Plans from non-rated or sketchy companies – Stick with A-rated insurers My Recommended Path Forward Here's what I'd do in your shoes: For short stays (under 1 year): Start with SafetyWing or GeoBlue Voyager—affordable, reputable, easy to manage online. For permanent moves (under age 65): Get quotes from Cigna Global and Aetna International. Compare coverage for your specific needs and destination. For retirees (65+): Contact William Russell and Allianz Care Senior plans. If you're US-based, keep Medicare Part B and add GeoBlue Xplorer. If you're on a tight budget: IMG's catastrophic plans or direct private hospital memberships in your destination country. One More Thing: Don't Wait The worst time to shop for international health insurance is after you've already been declined or after a medical emergency. The second-worst time is when you're rushing to meet a visa deadline. Start the process at least 2-3 months before you need coverage. Get multiple quotes. Read the actual policy documents, not just the marketing materials. And if you're not sure what you need, talk to an insurance broker who specializes in expat coverage—they work with multiple insurers and can find the best fit for your situation.