Accessing Long-Term Healthcare Abroad: What Are My Options?

Having long-term access to healthcare abroad is not only a requirement for some visa holders, but it’s invaluable for your peace of mind. Those who know they’re going to be well taken care of if anything happens to them away from home are much more likely to feel settled and carefree in their new country of residence.

However, accessing long-term healthcare abroad is often easier said than done when each country has a different healthcare system, different visa requirements, and different insurance options. While the obvious choice is buying international health insurance, it’s by no means the only one. In this article, we cover it all. From reciprocal agreements to paying out of pocket, read on to find out exactly what your options are based on which country you’re moving to, so that you can create a personalized healthcare plan abroad and enjoy your stay to the full.

Public Healthcare Access

Some countries have what’s called a “reciprocal healthcare agreement,” which allows their citizens to receive free healthcare benefits in participating countries and vice versa. While these agreements typically only cover urgent care and not elective treatments, they can provide great peace of mind and reduce medical expenses if you’re in a reciprocating country.

Therefore, checking your country’s reciprocal healthcare agreements is a useful place to start when learning how to access healthcare wherever you plan to move. To get you started, here’s a summary of the countries and regions that offer some form of reciprocal healthcare agreement (spoiler none apply to US citizens, so if that’s you, keep scrolling):

The United Kingdom:
UK citizens are fortunate enough to have agreements with dozens of countries around the world. European Health Insurance Card (EHIC) holders have access to free urgent healthcare within the EU, while the UK Global Health Insurance Card (GHIC) includes some non-EU countries and British territories. The UK also holds reciprocal agreements with several other countries, including the US, Canada, Australia, New Zealand, Japan, and Barbados, that offer free or reduced-cost healthcare for those paying social security contributions.

European Union Nations:
Like the UK, EU countries use the European Health Insurance Card (EHIC) system, which allows citizens to receive free or reduced-cost urgent healthcare in other EU countries, as well as several non-EU countries, including Norway, Iceland, and Switzerland.

Australia:
Australia’s Reciprocal Health Care Agreements (RHCA) allow citizens to receive free emergency healthcare in 11 countries, including Finland, Italy, Belgium, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden, and the UK.

Scandinavia:
Nordic countries, including Denmark, Finland, Norway, Sweden, and Iceland, have one of the most comprehensive reciprocal healthcare agreements in the world, offering full medical care to participating nations. This means citizens from Denmark have the same level of access to Norway’s healthcare system as Norwegian citizens, from elective treatments to emergency care. However, this system is technically for short-term stays, so those planning to reside longer may have to register with a local healthcare provider to continue access.

United States:
The US does not have broad reciprocal healthcare agreements comparable to those in the UK, EU, or Australia. In most cases, US citizens are not entitled to free or reduced-cost public healthcare abroad. Medicare typically does not provide coverage outside the United States, except in very limited circumstances. As a result, Americans living or traveling abroad usually need to rely on private or international health insurance to access care.

Local National Health Systems for Residents

If you obtain legal residency in a new country, you may qualify for its national healthcare system. To do so, you’ll need to obtain your residency permit, tax or national ID number, and register your home address. The local government might automatically prompt you to sign up for its healthcare services once you obtain these, or you might have to proactively register at a local clinic.

Depending on the type of healthcare system in your new country of residence, you might be asked to pay monthly contributions to have continued access to the healthcare system, or you might be required to purchase an approved insurance plan. Exceptions are made in tax-funded healthcare systems provided by countries such as the UK, Canada, and Sweden. Bear in mind there may be a waiting period after you register for local healthcare while the application is processed, or in case the country requires a backlog of financial contributions, in which case consider private coverage for the interim.

Buying International Health Insurance

For most expats, remote workers, and long-term travelers, purchasing an international health insurance policy is the easiest and most secure way to gain full access to the local healthcare system abroad. Most policies work on a price-access basis, meaning the more you pay, the greater coverage you benefit from. Generally, however, you can expect your international health insurance policy to cover inpatient and outpatient care, mental health support, and emergency care with diagnostic tests. This means that whether you’re suffering from the flu or you’ve been involved in an accident, you’ll have immediate access to treatment. For additional services like maternity care, specialist care such as cancer treatment, and dental care, a more comprehensive insurance plan might be necessary.

What Is the Difference Between International Health Insurance and Travel Insurance?

When looking into an insurance policy that covers healthcare abroad, you might get confused by the use of two seemingly interchangeable terms “travel insurance” and “international healthcare insurance.” To make it clear, travel insurance is a policy for short-term travel that includes but is not limited to foreign healthcare, whereas international healthcare insurance is a healthcare-specific insurance policy for expats, remote workers, and long-term travelers.

What Are the Benefits of International Health Insurance?

Whether country-hopping year-round or moving permanently abroad, international health insurance allows you to access healthcare in foreign countries without the worry of having to foot a huge bill at the end. Policies tend to range from 1 to 3 months to 12+ months, targeting long-term travelers, remote workers, and expats. The greatest benefit to buying an international health insurance plan is that it gives you access to private healthcare, which is invaluable in countries where the public healthcare system isn’t up to par.

How Does International Health Insurance Work?

When taking out a policy, the insurance provider will ask for your chosen area of coverage such as Europe only, worldwide excluding the US, or worldwide including the US, and the level of coverage you want. This is where you assess how fit, healthy, and active you are. Those with minimal health risks might prefer basic coverage, while those who are accident-prone or have high-risk conditions may consider more extensive coverage.

In the event you require some form of treatment abroad, the hospital will need to be paid for its services through your insurance. Some hospitals can bill insurance companies directly, while others require upfront payment from the patient, who can later submit reimbursement claims.

What Are the Best International Health Insurance Providers on the Market Right Now?

International Citizens Insurance (ICI)

International Citizens Insurance helps expats compare international health insurance plans, offering expert guidance to navigate coverage options and find a plan suited to your destination, lifestyle, and healthcare needs abroad.

Cigna Global
Cigna Global is one of the more affordable insurance providers on the market right now, with policies starting around $150 per month. Unlike other providers, Cigna Global focuses solely on international health insurance, making them specialists in the field. Its basic policy includes hospital charges, cancer care, mental health care, unlimited telehealth appointments, and account management.

Bupa Global
Bupa Global is an international health insurance provider under the parent company Bupa Ltd, a multinational British private healthcare and insurance company. Its policies start around $185, and coverage is wide. It includes a €2.5 million allowance to use on a wide range of health benefits, including private facilities, coverage for chronic and hereditary conditions, and 24-hour access to an online doctor.

Allianz Care
Allianz Care is a strong and reliable healthcare provider, averaging around $200 per month for its popular worldwide Care Enhanced plan. This includes coverage for surgery, private rooms, medical repatriation, emergency treatment, preventative treatment, and congenital conditions. For an extra $150 per month, you can also receive a comprehensive outpatient plan, which includes GP visits, diagnostic tests, vaccinations, and more.

APRIL International
APRIL International is a trusted international health insurance company focused specifically on providing healthcare solutions for long-term residents abroad. At $190 per month, their basic International package includes only inpatient treatments and hospital services, which is ideal for those living a healthy, low-risk lifestyle. For extra peace of mind, the $300 per month International Plus plan also provides outpatient care, mental health support, routine dental treatment, and well-being care.

Paying Out of Pocket and Local Insurance

Before purchasing international healthcare, check the affordability of private healthcare options in the country you’re planning to reside in. In a surprising number of cases, paying out of pocket for routine outpatient healthcare may work out cheaper than adding it to your international health insurance plan.

Bear in mind that hospital care costs for serious illness, injury, or medical evacuation remain extremely high wherever you go, so it’s always best to have insurance for inpatient care. However, foreign residents of certain countries may be eligible to purchase national private health insurance, which is often cheaper than international options.

KEY TAKEAWAYS

What are the main healthcare options for expats abroad?

Expats can access healthcare through public systems, international insurance, local private insurance, or by paying out of pocket depending on the country and residency status.

Can I use public healthcare in another country?

Some countries offer reciprocal healthcare agreements that allow limited access to public healthcare, usually for urgent or emergency treatment only.

Do US citizens get free healthcare abroad?

No, US citizens generally do not have access to free public healthcare abroad and must rely on private or international insurance options.

What is the best option for long-term healthcare abroad?

International health insurance is the most reliable option for long-term stays, offering access to both routine and emergency care across multiple countries.

What’s the difference between travel insurance and international health insurance?

Travel insurance is short-term and includes limited healthcare coverage, while international health insurance is designed for long-term living abroad with comprehensive medical benefits.

Can I use a country’s national healthcare system as a resident?

Yes, once you obtain legal residency, you may qualify for local healthcare systems, often requiring registration, contributions, or approved insurance plans.

Is it cheaper to pay for healthcare out of pocket abroad?

In some countries, routine care can be cheaper out of pocket, but serious medical treatment or emergencies can be very expensive without insurance.

If you’re considering traveling or moving abroad, be sure to explore your healthcare options. Visit International Citizens Insurance to learn more and get a free quote.

About the Author

Emily Draper is an experienced travel and lifestyle writer and editor from the UK who has written for brands including Culture Trip, Hidden Compass, and tourism boards in Greenland, Luxembourg, and Copenhagen. She has travelled to over 70 countries across all seven continents, now calling Morocco her home.

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