Moving abroad as an American comes with endless new experiences—but one of the most important (and overlooked) decisions is securing the right health insurance.
Domestic plans like Medicare or ACA marketplace policies typically don’t extend outside the U.S., and relying on local systems can be risky, especially if you don’t speak the language or face long wait times. Emergency travel insurance may cover short trips, but it isn’t designed for long-term expat living or chronic care.
If you’re planning to live overseas for more than a few months, you’ll need a health insurance plan that can support your lifestyle across borders—one that covers doctor visits, emergency care, and the occasional trip home to the U.S.
This guide breaks down the top expat health insurance options for Americans living abroad in 2025. Whether you're a digital nomad, retiree, family, or working professional, you’ll find side-by-side comparisons to help you choose the best plan based on your needs, travel habits, and budget.
What Makes an Insurance Plan Expat-Friendly?
Not all international health insurance is designed for long-term living abroad. Many policies marketed to travelers are meant for short stays, covering emergencies only—and leaving out essentials like follow-up care, prescriptions, or mental health support. For American expats, a truly expat-friendly plan should be built around mobility, long-term stability, and global access.
Here’s what to look for:
Global Coverage
Your plan should provide comprehensive care in multiple countries—not just for emergencies. If you relocate, travel regionally, or split time between countries, your policy should follow you without lapses or re-approval processes.
Local and U.S. Care
Some expat plans exclude the U.S. entirely or charge more for including it. If you plan to visit home regularly, look for policies with built-in U.S. coverage or flexible add-ons for temporary visits.
Telemedicine and Mental Health
Long-term living abroad often brings logistical and emotional challenges. Access to remote consultations, therapy, and mental health services in your native language can be essential—especially in regions where local mental healthcare is limited.
Preventive and Chronic Care
Expat life isn't just about emergencies. You'll want coverage that includes checkups, prescriptions, diagnostics, and ongoing treatment if you manage any chronic conditions.
Flexible Billing and Enrollment
Look for providers that allow enrollment from abroad, monthly payments, and easy cancellation or plan adjustments. Plans that require long-term contracts or U.S. addresses are often built for travelers, not expats.
Choosing the right expat health insurance as an American means thinking beyond short-term trips. The best policies support your healthcare needs across time zones, regions, and phases of life.
Key Considerations for American Expats
If you're an American planning to live abroad, your health insurance needs are fundamentally different from those of short-term travelers. Beyond basic coverage, you’ll need to navigate gaps in U.S.-based systems and understand how international insurance integrates with your lifestyle overseas.
1. Medicare Doesn’t Apply Abroad
If you’re over 65, it’s important to know that Medicare does not provide coverage outside the United States. Even if you continue paying into the system, benefits generally stop at the border—making international coverage essential.
2. ACA Plans Aren’t Built for Expats
U.S.-based health plans from the Affordable Care Act marketplace typically require residency and terminate if you live outside the country for extended periods. They also offer no support for care overseas, unless it’s during short travel.
3. Some Countries Require Proof of Insurance
If you’re applying for a long-term visa or residence permit, many countries require you to show valid health insurance. This often means coverage that is not only international but compliant with local regulations.
4. Cross-Border Access Is Key
Single-country insurance may seem appealing if you’re based in one place—but it can become a limitation if you travel regionally or relocate. A true expat policy should cover care across multiple countries without requiring policy changes.
5. Consider Mental Health, Maternity, and Ongoing Conditions
If you rely on regular therapy, medication, or medical monitoring, check how each plan handles non-emergency care. Some budget policies exclude chronic conditions, while more comprehensive options offer long-term support.
Being insured while abroad isn’t just about protecting against the unexpected—it’s about maintaining access to care wherever life takes you.
Top Health Insurance Providers for U.S. Expats
Not all international health insurance providers are created equal. Some offer barebones emergency coverage, while others provide full-service healthcare networks that mirror what you’d expect from a premium plan in the U.S. The providers below are consistently rated among the best for Americans living abroad—each with different strengths depending on your budget, lifestyle, and coverage needs.
SafetyWing
SafetyWing was originally built for digital nomads, but it’s become a popular choice for expats seeking affordable, location-flexible coverage.
Pros: Low monthly pricing, enrollment while abroad, coverage in most countries, option to add U.S. coverage temporarily
Cons: Limited outpatient and mental health benefits, lower coverage ceilings
Best for: Younger expats, digital nomads, budget-conscious individuals
IMG Global
IMG offers a range of plans for expats, from basic travel medical to comprehensive global coverage, including modular add-ons for dental, maternity, and more.
Pros: Customizable plans, optional U.S. coverage, strong international provider network
Cons: Claims process can be slower, complex pricing structure
Best for: Families, retirees, long-term expats needing tailored care
Cigna Global
Cigna is one of the most widely recognized names in international healthcare, offering fully customizable plans for individuals and families living overseas.
Pros: Global access, strong customer service, wide provider network, plans tailored by region or need
Cons: Higher cost, requires more upfront research to choose modules
Best for: Professionals, families, expats managing chronic health needs
GeoBlue (for U.S. citizens)
GeoBlue is backed by Blue Cross Blue Shield and offers expat health plans with familiar U.S.-style coverage and standards.
Pros: Premium care abroad, includes U.S. visits, highly rated service
Cons: More expensive than most, U.S. citizenship or residency required
Best for: Americans who want U.S.-style support and access while living abroad
Insured Nomads
A boutique option with high-end features and concierge-style services, Insured Nomads blends health insurance with travel and crisis support tools.
Pros: Mental health coverage, global assistance platform, includes tech and lifestyle services
Cons: Higher pricing, newer to the market
Best for: Expats wanting premium support, solo professionals, frequent movers
Each of these providers offers a different balance of cost, flexibility, and benefits. Your ideal choice depends on how long you’ll be abroad, how often you return to the U.S., and what level of care you expect day to day.
Price Comparison and What to Expect
Health insurance for American expats can vary widely in cost depending on your age, coverage level, region of residence, and whether or not you include U.S. coverage. Understanding the price ranges helps avoid surprises—and ensures you don’t underinsure yourself while chasing the lowest premium.
General Monthly Price Ranges (2025 estimates):
- Ages 25–35: $45–$150/month
- Basic emergency coverage (e.g. SafetyWing) starts around $45
- More comprehensive plans with outpatient care and mental health support range from $90–$150
- Ages 40–60: $120–$300/month
- Costs increase with age and coverage complexity
- Chronic condition support, preventive care, and U.S. visit coverage push plans toward the higher end
- Families: $250–$800/month
- Family coverage depends on the number of dependents, maternity coverage, and whether everyone is covered globally or regionally
- Including U.S. Coverage: Add ~$100–$200/month
- Some plans let you include short-term U.S. visits at an additional cost
- Full U.S. coverage significantly increases premiums
Optional Add-Ons and Their Typical Costs:
- Outpatient care: $40–$80/month
- Mental health or therapy access: $20–$60/month
- Maternity coverage: Often requires a 12-month waiting period, adds $50–$150/month
- Dental and vision: Typically offered as separate modules
To stay within budget, many expats choose a core plan with emergency and inpatient care, then selectively add benefits like outpatient or mental health coverage. If you’re healthy and need lower premiums, lean toward plans like SafetyWing. If you expect to use care regularly or want U.S. access, consider IMG, Cigna, or GeoBlue.
How to Choose the Right Plan for Your Needs
The best expat health insurance for Americans living abroad depends less on the “top-rated” plan and more on what matches your actual lifestyle, health needs, and travel patterns. Here’s how to narrow it down:
1. Are you relocating long-term or moving often?
If you’re settling in one country for several years, you might benefit from region-specific coverage or plans that integrate with the local system. If you’re frequently on the move, choose a plan with truly global coverage that doesn’t penalize you for crossing borders.
2. Will you return to the U.S. regularly?
If you visit home once or twice a year, consider a plan that includes short-term U.S. coverage. Some expat plans offer up to 30–60 days of U.S. coverage annually. If you expect longer stays, you may need a supplemental U.S. policy or a more premium global plan.
3. Are you insuring just yourself, or your partner or family?
Some insurers offer attractive rates for individuals but scale up quickly for families. If you need maternity care, pediatric support, or spousal coverage, look for modular plans that allow you to tailor benefits by person.
4. What level of care do you expect?
If you only want protection against major emergencies, a basic plan may be enough. But if you require therapy, prescriptions, or treatment for an ongoing condition, invest in a policy that covers outpatient care and ongoing treatment without heavy exclusions.
5. Where will you be based?
The quality and cost of local healthcare vary widely by country. In regions like Southeast Asia, private care is accessible and relatively affordable, so basic coverage might be enough. In Europe or Latin America, public systems may exist—but may not cover you as a non-resident. Match your plan to local realities.
Use your current habits and foreseeable needs—not just pricing—as your filter. A slightly higher monthly premium can save you thousands later if your plan is actually usable when you need it.
Final Thoughts and Recommendations
Choosing the right expat health insurance as an American living abroad isn’t just about cost—it’s about access, reliability, and peace of mind in unfamiliar systems. While some U.S. citizens try to get by with emergency-only travel insurance or depend on local care, these approaches often fall short when it matters most.
If you’re young, healthy, and moving often, SafetyWing offers affordable, flexible coverage that’s easy to manage from anywhere. For those settling down, traveling with family, or managing long-term health concerns, IMG or Cigna Globalprovide more comprehensive care with tailored plan options. If you want U.S.-style support and the ability to return home without gaps, GeoBlue remains one of the most dependable premium choices.
There’s no single best option—only the one that fits your location, life stage, and healthcare expectations. Choose coverage before you need it, read the fine print, and revisit your plan as your circumstances evolve.
Expat life can be unpredictable. Your healthcare shouldn’t be.