TL;DR
As a UK expat, securing robust private medical insurance is non-negotiable. At WeCovr, with our experience in advising on thousands of policies, we find AXA Global is a top contender. This guide demystifies AXA's worldwide cover, US options, and common pitfalls to help you make an informed choice for your health and peace of mind abroad.
Key takeaways
- Global or Regional Coverage: Policies are designed to cover you in your new country of residence and often a wider region, or even worldwide.
- Higher Overall Limits: IPMI policies typically have much higher annual limits (often £1 million or more) to account for the potentially high cost of healthcare in other countries, especially the USA.
- Expat-Specific Benefits: Many plans include benefits crucial for expats, such as medical evacuation, repatriation, and cover for compassionate travel for a relative.
- Portability: A good IPMI policy is portable, meaning you can take it with you if you move from one country to another without needing a new medical assessment each time (subject to terms).
- Vast Global Network: AXA boasts an extensive network of hospitals, clinics, and medical professionals across the globe. This facilitates direct billing, meaning the insurer pays the hospital directly, so you aren't left with a hefty bill to settle yourself.
As a UK expat, securing robust private medical insurance is non-negotiable. At WeCovr, with our experience in advising on thousands of policies, we find AXA Global is a top contender. This guide demystifies AXA's worldwide cover, US options, and common pitfalls to help you make an informed choice for your health and peace of mind abroad.
How AXA Global works for expats – residency rules, emergency vs full cover, US cover differences, direct billing, claims process and renewal considerations
Navigating international private medical insurance (IPMI) can feel like a labyrinth of complex terms, regional variations, and hidden clauses. For British expats moving abroad, understanding how a leading provider like AXA Global structures its plans is the first step towards securing the right protection.
This comprehensive guide breaks down every critical component of an AXA Global health plan, from the moment you apply to the point of making a claim and renewing your policy. We’ll provide the expert insight you need, drawing on our experience as specialist PMI brokers, to ensure you avoid common mistakes and select a policy that truly meets your needs.
What is International Private Medical Insurance (IPMI)?
Unlike standard UK private medical insurance (PMI), which is designed for treatment within the UK, International PMI is specifically built for those living and working abroad.
Key characteristics of IPMI include:
- Global or Regional Coverage: Policies are designed to cover you in your new country of residence and often a wider region, or even worldwide.
- Higher Overall Limits: IPMI policies typically have much higher annual limits (often £1 million or more) to account for the potentially high cost of healthcare in other countries, especially the USA.
- Expat-Specific Benefits: Many plans include benefits crucial for expats, such as medical evacuation, repatriation, and cover for compassionate travel for a relative.
- Portability: A good IPMI policy is portable, meaning you can take it with you if you move from one country to another without needing a new medical assessment each time (subject to terms).
Crucially, like its UK counterpart, IPMI is designed for new, eligible medical conditions that arise after you take out the policy. It does not typically cover pre-existing or chronic conditions.
Why UK Expats Choose AXA Global Health Insurance
AXA is a global insurance titan with a formidable reputation. For UK expats, their international health insurance arm, AXA Global, offers a compelling package built on a foundation of experience, a vast network, and comprehensive support.
Key reasons AXA stands out:
- Vast Global Network: AXA boasts an extensive network of hospitals, clinics, and medical professionals across the globe. This facilitates direct billing, meaning the insurer pays the hospital directly, so you aren't left with a hefty bill to settle yourself.
- 24/7 Multilingual Support: Living in a different time zone is no issue. AXA's global service centre provides round-the-clock support for medical emergencies, claims assistance, and pre-authorisation.
- Digital-First Approach: The "MyGlobe" member portal and app allow you to find doctors, submit claims, and manage your policy from anywhere in the world.
- Comprehensive Plan Options: AXA offers a tiered system of plans, allowing you to balance your budget against the level of cover you need – from essential inpatient treatment to comprehensive plans covering dental, optical, and wellness checks.
- Strong Financial Backing: As part of the wider AXA Group, the policies are underwritten by a company with immense financial strength and stability, providing peace of mind that they can and will pay claims.
Understanding AXA's Residency Rules for UK Expats
This is a critical area where many expats get confused. Your country of residence is the primary factor that determines your premium and the terms of your policy.
- Defining Your Country of Residence: This is the country where you intend to spend more than 183 days (six months) in a policy year. You must declare this accurately when you apply.
- Cover in Your Home Country (UK): Most AXA Global plans for UK expats provide cover for trips back to the UK. However, this is typically limited to a certain number of days per year (e.g., 90 days) and is intended for temporary visits or specific elective treatments, not for re-establishing residency.
- Post-Brexit Considerations: For expats in the EU, relying on a GHIC card is insufficient. It only provides state-level emergency care, not comprehensive private treatment, planned surgery, or medical evacuation. An IPMI policy like AXA's is essential to bridge this significant gap.
Insider Tip: Be completely honest about your intended country of residence. If you state you're living in Spain but spend most of your time in the USA (a much higher-cost country), your insurer could refuse to pay your claims or even void your policy for non-disclosure.
AXA Global's Core Plans: A Breakdown
AXA structures its offering around several core plans, allowing you to tailor your cover. While exact names and benefits can be updated, they generally follow a tiered structure. Below is a simplified overview of a typical structure.
| Feature / Plan Level | Foundation | Standard | Comprehensive | Prestige |
|---|---|---|---|---|
| Main Purpose | Essential Inpatient Cover | Solid All-Round Cover | Extensive Cover | Premium, High-End Cover |
| Annual Limit | ~£1,000,000 | ~£1,500,000 | ~£2,000,000 | ~£3,000,000+ |
| Inpatient & Day-patient | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover |
| Outpatient Treatment | ❌ Not standard | ✅ Full Cover (up to annual limit) | ✅ Full Cover | ✅ Full Cover |
| Medical Evacuation | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover |
| Cancer Care | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover | ✅ Full Cover |
| Dental & Optical | ❌ Optional Add-on | ❌ Optional Add-on | ✅ Included | ✅ Included (higher limits) |
| Maternity Cover | ❌ Optional Add-on | ❌ Optional Add-on | ❌ Optional Add-on | ✅ Included (after waiting period) |
| Wellness & Health Checks | ❌ No | ❌ No | ✅ Included | ✅ Included (higher limits) |
Key Terms Explained:
- Inpatient: Treatment that requires admission to a hospital bed overnight.
- Day-patient: Treatment that requires a hospital bed for the day but not an overnight stay (e.g., minor surgery).
- Outpatient: Treatment that doesn't require a hospital bed, such as a GP visit, specialist consultation, or diagnostic scan.
Choosing the right level is a balance of risk and budget. A broker like WeCovr can model the costs and benefits for you, ensuring you don't pay for cover you don't need or, more dangerously, end up underinsured.
Worldwide Cover vs. Worldwide Excluding the US: The Key Difference
This is perhaps the single most important decision you will make when choosing your AXA Global policy. It has a monumental impact on your premium.
- Worldwide Excluding USA: This is the most common choice for UK expats. It provides cover anywhere in the world except for the United States. Healthcare costs in the US are exceptionally high, so excluding it can reduce your premium by 30-50% or even more.
- Worldwide Including USA: This option provides global cover, including within the US. It is significantly more expensive and essential for anyone who will be residing in the US or spending a substantial amount of time there.
Common Pitfall: Many expats assume "Worldwide" cover automatically includes emergency treatment in the US. This is incorrect. If you have a "Worldwide Excluding USA" policy, you will generally have no cover for treatment in the US, even for a medical emergency during a short holiday. You would need separate travel insurance for that trip.
The US Cover Conundrum: Navigating AXA's Options
If you need cover in the United States, your policy becomes more complex and costly. This isn't an AXA-specific issue; it's a market-wide reality driven by the US healthcare system.
Why is US Cover So Expensive?
- No National Price Regulation: Unlike the NHS or other state-run systems, US hospitals can charge vastly different and often exorbitant prices for the same procedure.
- High Administrative Costs: The complex billing and insurance system adds significant overhead.
- Litigious Environment: The risk of medical malpractice lawsuits drives up costs for practitioners, which are passed on to patients and insurers.
How AXA Handles US Cover:
When you opt for Worldwide cover including the US, AXA provides a more structured solution than simply paying any bill.
- Network Management: AXA works with specific PPO (Preferred Provider Organisation) networks in the US. You are strongly encouraged or required to use doctors and hospitals within this network.
- Negotiated Rates: By directing you to their network, AXA can leverage pre-negotiated rates that are lower than what an individual would be charged.
- Higher Deductibles/Excesses: Policies with US cover often come with a higher mandatory deductible (the amount you pay first) to help manage costs.
- Stricter Pre-authorisation: For any significant treatment in the US, you will almost certainly need to get pre-authorisation from AXA. This involves them reviewing the proposed treatment plan and costs before agreeing to cover it.
An expert adviser is crucial here. WeCovr can help you understand the specific US network AXA uses and confirm it has good coverage in the state you'll be living in.
The Claims Process Explained: Direct Billing and Reimbursement
AXA aims to make the claims process as smooth as possible for expats, who may be navigating an unfamiliar medical system. There are two primary methods for settling a bill.
-
Direct Billing (Cashless Service) This is the most convenient method. For planned inpatient treatment, and often for major outpatient procedures like an MRI scan, AXA can arrange to pay the hospital or clinic directly.
- Process:
- Pre-authorisation: You or your doctor must contact AXA before the treatment is scheduled.
- Guarantee of Payment (GOP): AXA assesses the request. If the treatment is covered, they send a "Guarantee of Payment" to the hospital.
- Treatment & Settlement: You receive your treatment, sign any necessary forms, and leave. AXA settles the eligible bill directly with the provider. You only pay for your deductible/excess or any non-covered items.
- Best for: Major, planned procedures and treatment at network hospitals.
- Process:
-
Pay and Claim (Reimbursement) For smaller, routine costs like a GP visit or buying prescription drugs, it's often simpler to pay yourself and claim the money back.
- Process:
- Pay: You pay the doctor, clinic, or pharmacy at the time of service.
- Collect Paperwork: Always get a detailed invoice and a receipt showing proof of payment.
- Submit Claim: You submit the claim through the MyGlobe online portal or app, uploading photos or scans of your documents.
- Reimbursement: AXA processes the claim and reimburses the funds to your nominated bank account, minus any applicable excess.
- Best for: Routine outpatient visits, prescriptions, and non-network providers.
- Process:
Underwriting Options: Moratorium vs. Full Medical Underwriting
When you first apply for an AXA Global policy, you must choose an underwriting method. This determines how they assess your pre-existing medical conditions.
| Underwriting Method | How it Works | Pros | Cons |
|---|---|---|---|
| Moratorium (MORI) | You don't declare your full medical history upfront. Instead, the policy automatically excludes treatment for any condition that existed in the 5 years before your policy started. Cover for these conditions may be added later, but only after you complete a set period (usually 2 years) without any symptoms, treatment, or advice for that condition. | Quicker application process. Less initial paperwork. | Lack of certainty. A condition you thought was minor could be excluded. Claims can be delayed while AXA investigates your medical history. |
| Full Medical Underwriting (FMU) | You provide your full medical history on the application form. The insurer assesses your health status and decides what they will cover. They might accept you on standard terms, add an exclusion for a specific condition, or charge a higher premium. | Provides complete certainty from day one. You know exactly what is and isn't covered. Smoother claims process. | Longer application process. Requires you to gather medical information. Potential for specific exclusions to be applied to your policy permanently. |
Expert Advice: For most people, especially those with any past health issues, Full Medical Underwriting (FMU) is the superior choice. The upfront effort is worth the peace of mind of knowing exactly where you stand. A moratorium can lead to nasty surprises at the point of a claim, which is the worst possible time.
Common Pitfalls to Avoid with Your Expat Health Policy
- Underestimating Outpatient Costs: Choosing an "inpatient-only" plan to save money can be a false economy. In many countries, the cost of consultations, diagnostic scans, and tests can add up to thousands of pounds a year.
- Ignoring the Waiting Period: Most policies have waiting periods for certain benefits. For example, maternity cover often has a 10-12 month waiting period, meaning you must have the policy for that long before conception for the costs to be covered.
- Forgetting About Medical Inflation: Your renewal premium will increase each year due to two factors: your age (you move into a more expensive age bracket) and medical inflation. Medical inflation is the rate at which healthcare costs are rising, which is almost always higher than standard inflation. Expect your premium to rise by 8-12% per year, even without claiming.
- Not Checking the Dental/Optical Sub-limits: Plans that include dental and optical cover will have specific sub-limits for different types of treatment (e.g., £500 for routine dental, £1,500 for major restorative work). Don't assume everything is covered in full.
Renewal Considerations for Your AXA Policy
Your AXA Global policy is an annual contract. At renewal, you have a few options:
- Accept the Renewal: If you are happy with the cover and the new premium, you can simply accept the renewal terms.
- Adjust Your Cover: You can look at reducing your cover or increasing your excess/deductible to make the premium more affordable. However, be cautious about downgrading your cover, as you cannot easily add it back without fresh medical underwriting.
- Re-broke the Market: This is where a specialist broker adds immense value. At each renewal, WeCovr can compare your AXA renewal offer against the entire market. If another insurer like Bupa Global, Cigna, or Allianz can offer equivalent cover for a lower premium, we can help you switch seamlessly. Switching on an FMU basis can ensure your existing conditions remain covered.
Remember, when you have an IPMI policy, you receive complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to support your wellness goals. Furthermore, clients who take out a health or life insurance policy with us often receive discounts on other types of cover they may need.
Frequently Asked Questions (FAQ)
Does AXA Global cover pre-existing conditions for UK expats?
Can I use my AXA Global policy for treatment back in the UK?
What is the difference between an excess and a co-payment on an AXA policy?
Get Expert Advice on Your AXA Global Health Insurance
Choosing the right international health insurance is one of the most important decisions you'll make as an expat. The options are complex, and the consequences of getting it wrong can be financially devastating.
At WeCovr, we are FCA-regulated experts in the UK and international PMI market. We take the time to understand your unique needs, travel plans, and budget. We will compare AXA's options against other leading providers to find the optimal solution for you, at no cost to you.
Contact WeCovr today for a free, no-obligation quote and let our experts guide you to the right cover for your life abroad.
