How PMI Works for Brits Retiring Abroad
As an FCA-authorised broker that has arranged over 900,000 policies, WeCovr helps thousands of people navigate the world of private medical insurance. For Brits planning a dream retirement abroad, understanding your healthcare options is crucial. This guide explains how to secure peace of mind with the right health cover in the UK and beyond.
WeCovr explains PMI for expats in retirement
Swapping grey skies for sunny shores is a retirement dream for millions of Britons. Whether you're picturing a villa in the Algarve, a finca in Andalusia, or a quiet life in rural France, the practicalities of life abroad need careful planning. Chief among them is healthcare.
Many assume their UK health provisions will somehow travel with them, but the reality is quite different. Once you are no longer 'ordinarily resident' in the UK, your access to the NHS is largely cut off. This is where private medical insurance (PMI) becomes not just a luxury, but an essential part of your retirement toolkit.
However, the private health cover that served you well in the UK is not the right tool for the job abroad. You need a specific type of policy designed for an international lifestyle. In this guide, we'll break down everything you need to know, from how state healthcare works for expats to choosing the perfect international health plan for your new life.
Understanding the Healthcare Landscape for UK Expats
Before diving into private insurance, it's vital to understand what, if any, state-provided healthcare you're entitled to as a British retiree living abroad. The answer depends entirely on where you choose to live.
The NHS Stops at the UK Border
This is the most critical fact to understand. The National Health Service (NHS) is a residency-based system. It is funded by UK taxpayers to provide care for people who live in the UK.
Once you move abroad and are no longer considered ordinarily resident, you lose your entitlement to free, routine NHS treatment. You may be able to receive emergency treatment if you visit the UK, but you could be charged for any subsequent hospital admission. You cannot simply fly back to the UK to have a planned operation on the NHS.
What About the S1 Form in Europe?
For those retiring to an EU country, Iceland, Liechtenstein, Norway, or Switzerland, there is a valuable arrangement called the S1 form.
If you receive a UK State Pension, you can apply for an S1 form from the NHS Business Services Authority. This form registers you with the state healthcare system in your new country of residence.
What the S1 form gives you:
- Access to state healthcare: You will be treated on the same basis as a local resident in that country. If healthcare is free for them, it's free for you. If they pay a contribution (a co-payment), you will too.
- Continued UK access: An S1 form also allows you to return to the UK for some NHS treatment. You can use your UK-issued European Health Insurance Card (EHIC) or Global Health Insurance Card (GHIC) when you visit other EU countries on holiday.
The Limitations of the S1 Form:
While the S1 is an excellent benefit, it is not a complete solution.
- No access to private care: It only covers the state system, which in many countries can have long waiting lists for specialist appointments and surgery, just like the NHS.
- Variable quality: The standard of state healthcare can vary significantly from region to region.
- Co-payments: Many European healthcare systems require patients to pay a portion of their treatment costs, which can add up.
The S1 form provides a safety net, but it doesn't offer the choice, speed, or comfort that private medical insurance provides.
Reciprocal Healthcare Agreements Outside the EU
The UK holds Reciprocal Healthcare Agreements with a small number of non-EU countries, such as Australia and New Zealand.
However, these agreements are far more limited than the S1 arrangement. They typically only cover immediately necessary medical treatment that arises during a visit. They are not designed for long-term residents and will not cover:
- Routine monitoring of long-term conditions.
- Planned surgery or treatment.
- The full cost of treatment in all cases.
For popular retirement destinations like Thailand, Canada, the USA, or Turkey, there is no state healthcare provision for British expats. You are entirely responsible for the cost of your own medical care.
What is International Private Medical Insurance (IPMI)?
This is where the distinction becomes vital. The policy you had in London is not the policy you need in Lisbon.
The Key Difference: UK PMI vs. International PMI
A standard UK Private Medical Insurance policy is designed to provide access to private healthcare within the United Kingdom. Its network of hospitals is in the UK, and its terms are based on the UK healthcare system. It will cease to cover you once you move abroad permanently.
International Private Medical Insurance (IPMI), sometimes called international health insurance, is a specialist product designed for people living and working outside their home country. It gives you access to private healthcare facilities across the globe.
Here is a simple breakdown of the differences:
| Feature | Standard UK PMI | International PMI (IPMI) |
|---|---|---|
| Geographical Area | United Kingdom only | A defined region (e.g., Europe) or Worldwide |
| Designed For | UK residents | Expatriates, global nomads, and retirees abroad |
| Network | UK-based private hospitals and clinics | Global network of hospitals and specialists |
| Key Benefits | Fast access to UK specialists, private rooms | Global coverage, medical evacuation, 24/7 multilingual support |
| Currency | Premiums and claims paid in Pounds Sterling (£) | Premiums and claims can be in multiple currencies (£, €, $) |
| Portability | Policy ends when you move abroad | Policy moves with you as you relocate (within your area of cover) |
Essentially, you cannot 'extend' your UK PMI for life abroad. You need to cancel it and take out a new, dedicated IPMI policy.
Core Benefits of International Health Cover
A good IPMI policy provides comprehensive protection and peace of mind. Key features typically include:
- Choice and Access: You can choose your doctor, specialist, and hospital from a wide network of high-quality private facilities.
- Reduced Waiting Times: Bypass long public queues for consultations, diagnostics, and surgery.
- Direct Payment: The insurer often pays the hospital directly, so you aren't left with a huge bill to pay out-of-pocket (known as a 'cashless' service).
- 24/7 Support: Access to a multilingual emergency helpline, wherever you are in the world.
- Medical Evacuation: This is a crucial benefit. If the necessary treatment is not available locally, your policy can cover the cost of transporting you to the nearest centre of medical excellence.
- Repatriation: Covers the cost of returning you to the UK (or another country of choice) for treatment if desired and medically appropriate.
Critical Information: Pre-existing and Chronic Conditions
This is one of the most important and often misunderstood aspects of private medical insurance.
Crucial Point: Standard private medical insurance, whether for the UK or international, is designed to cover acute conditions that arise after you have taken out the policy. It does not typically cover pre-existing conditions or chronic conditions.
Let's define these terms:
- Acute Condition: A disease, illness, or injury that is new, unexpected, and likely to respond quickly to treatment, leading to a full recovery. Examples include a broken bone, appendicitis, or a cataract.
- Chronic Condition: A condition that is long-lasting and requires ongoing monitoring and management. It cannot be 'cured' in the traditional sense. Examples include diabetes, arthritis, hypertension (high blood pressure), asthma, and heart disease.
- Pre-existing Condition: Any illness, disease, or injury for which you have already experienced symptoms, received medication, or sought advice before the start date of your new policy.
Why are they excluded? Insurance works on the principle of covering unforeseen events. Covering pre-existing or chronic conditions would be like insuring a house that is already on fire. The costs would be immediate and predictable, making premiums unaffordably high for everyone.
When you apply for IPMI, you will go through a process called underwriting. There are two main types:
- Moratorium Underwriting: You don't declare your full medical history upfront. Instead, the insurer automatically excludes any condition you've had symptoms of or treatment for in the last 5 years. If you then go for a set period (usually 2 years) without any symptoms, advice, or treatment for that condition, it may become eligible for cover.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire, declaring all your past conditions. The insurer's medical team assesses your application and will explicitly list any conditions that are excluded from cover from day one. This provides certainty but means those conditions will never be covered.
For retirees, who are more likely to have developed some long-term conditions, this is a vital consideration. You must be completely honest on your application. Hiding a condition can lead to your policy being cancelled and claims being denied.
How to Choose the Right International PMI Policy for Your Retirement
With so many providers and options, choosing the right plan can feel overwhelming. A specialist broker like WeCovr can compare the market for you at no cost. Here are the key factors to consider.
1. Defining Your "Area of Cover"
Insurers don't just offer one "global" policy. They split the world into different geographical areas to manage costs. Common options include:
- Europe: Covers you within all European countries.
- Worldwide excluding USA: Covers you everywhere in the world except for the United States.
- Worldwide: The most comprehensive and expensive option, including the USA.
Why is the USA so expensive? The cost of healthcare in the USA is the highest in the world. A simple doctor's visit can cost hundreds of dollars, and a hospital stay can run into the tens or hundreds of thousands. Including the USA in your cover can often double your premium.
Our Advice: Choose an area of cover that includes your new country of residence, any countries you plan to travel to frequently, and—importantly—the UK. Many expats value the option of being able to return to the UK for private treatment to be closer to family.
2. Understanding Your Policy Options and Add-ons
IPMI policies are modular. You start with a core plan and can add optional benefits to tailor it to your needs and budget.
| Level of Cover | What It Typically Includes | Is It Essential for a Retiree? |
|---|---|---|
| Core / In-patient | Hospital stays, surgery costs, anaesthetist fees, cancer treatment, diagnostic scans (like MRI/CT) related to a hospital stay. | Essential. This is the non-negotiable foundation of any good policy, covering the most expensive medical events. |
| Out-patient | GP visits, specialist consultations, diagnostic tests not requiring a hospital stay, prescription drugs. | Highly Recommended. Without this, you would have to pay for every doctor's visit and pre-hospital test yourself. |
| Dental & Optical | Routine check-ups, fillings, crowns, new glasses and contact lenses. | Optional. Can be good value if you anticipate needing regular dental work, but you can manage these costs 'pay-as-you-go'. |
| Wellness & Wellbeing | Routine health screenings, vaccinations, and sometimes complementary therapies like physiotherapy or osteopathy. | Optional but valuable. Proactive health checks can catch issues early. It's a great 'nice to have'. |
| Evacuation & Repatriation | Medical transport to the nearest suitable hospital or back to the UK. | Essential. Especially if you are retiring to a more remote area or a country with less advanced healthcare facilities. |
3. Managing Your Costs: Excess and Co-insurance
To make your premium more affordable, you can agree to share some of the cost of your care.
- Excess (or Deductible): This is a fixed amount you agree to pay towards a claim each year. For example, if you have a £500 excess and your hospital bill is £10,000, you pay the first £500 and the insurer pays the remaining £9,500. Choosing a higher excess will significantly lower your annual premium.
- Co-insurance: This is where you agree to pay a percentage of the cost of every claim, for example, 10% or 20%, up to a certain annual limit. This also reduces your premium.
Finding the right balance between a manageable premium and an affordable excess is key.
Real-Life Scenarios: How IPMI Works in Practice
Let's look at how this works for two fictional retirees.
Scenario 1: Arthur, 68, Retires to the Algarve, Portugal Arthur has his S1 form, giving him access to the Portuguese National Health Service. He also takes out an IPMI policy with WeCovr, choosing 'Europe' as his area of cover and including an out-patient module.
Six months into his retirement, he develops severe hip pain. His Portuguese GP refers him to a specialist through the state system, but the waiting list for an appointment is 9 months, and the wait for surgery could be another 18 months.
Using his IPMI, Arthur:
- Calls his insurer's 24/7 helpline.
- They provide a list of approved private orthopaedic surgeons near him.
- He sees a top surgeon within a week. An MRI scan confirms he needs a hip replacement.
- The insurer pre-authorises the surgery, which is scheduled for the following month at a modern private hospital. The insurer pays the hospital directly.
- His policy also covers a course of private physiotherapy to get him back on the golf course quickly.
Scenario 2: Brenda, 65, Retires to Chiang Mai, Thailand Thailand has no state healthcare for British expats. Brenda knows she needs comprehensive cover. She takes out a 'Worldwide excluding USA' IPMI policy, which includes medical evacuation.
While exploring a market, she slips on a wet floor and fractures her ankle badly.
Using her IPMI, Brenda:
- Is taken by private ambulance to a top international hospital in Chiang Mai.
- Her IPMI provider is contacted and guarantees payment for her emergency surgery.
- She has the operation and recovers in a private room.
- If her injury had been more complex (e.g., a serious spinal injury) and the local hospital wasn't equipped to handle it, her policy's medical evacuation benefit would have covered the cost of flying her to a specialist centre in Bangkok or Singapore.
Wellness and Health Tips for a Happy Retirement Abroad
Your health insurance is a safety net, but the best strategy is to stay as healthy as possible. Retiring abroad is a fantastic opportunity to build healthy habits.
- Embrace the Local Diet: Many popular retirement spots, particularly in the Mediterranean, boast incredibly healthy diets rich in fresh fish, olive oil, fruit, and vegetables. Explore local markets and learn to cook with fresh, seasonal ingredients.
- Stay Active: Your new location offers new ways to move. Whether it's swimming in the sea, walking in the hills, joining a local bowls club, or taking up tai chi in the park, find an activity you love and stick with it.
- Prioritise Sleep: A change in climate and lifestyle can disrupt sleep patterns. Establish a relaxing bedtime routine and ensure your bedroom is cool, dark, and quiet to promote restorative sleep.
- Build Your Social Network: Loneliness and social isolation are significant health risks. Make an effort to connect with other expats and locals. Join clubs, take language classes, or volunteer. A strong social life is a powerful tonic for mental and physical wellbeing.
To help you on your wellness journey, WeCovr provides all our health and life insurance clients with complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. It's a simple way to stay mindful of your diet as you explore the new culinary world around you.
Why Use a Specialist Broker Like WeCovr?
The international private medical insurance market is complex, with dozens of providers all offering slightly different products. Trying to compare them yourself is time-consuming and confusing.
A specialist broker works for you, not the insurance company.
- Expert Advice: We live and breathe this market. We understand the nuances of different policies and which ones are best suited for retirees in specific countries.
- Market Comparison: We use our expertise and technology to compare policies from a wide range of leading international insurers, finding the perfect balance of cover and cost for your unique circumstances.
- No Cost to You: Our service is completely free. We receive a commission from the insurer you choose, which is already built into the premium. You pay the same price as going direct, but with the added benefit of our expert, impartial advice.
- Your Advocate: We help you with the application process and are here to offer support if you ever need to make a claim. We also offer discounts on other policies, like travel or life insurance, when you purchase your PMI through us. Our consistently high customer satisfaction ratings reflect our commitment to our clients.
Can I keep my UK private medical insurance policy when I move abroad?
Will my S1 form be enough for healthcare in Europe?
What happens to my pre-existing health conditions when I apply for new cover?
Can I get medical treatment back in the UK with my international policy?
Ready to Plan Your Healthy Retirement Abroad?
Planning your retirement abroad is an exciting time. Securing the right health insurance is the most important step you can take to protect your health and finances, ensuring your new life is as stress-free as possible.
Let the experts at WeCovr help. We'll take the time to understand your plans and your health needs, then compare the market to find you the best international private medical insurance at the most competitive price.
[Get Your Free, No-Obligation IPMI Quote from WeCovr Today]
Related guides
Why private medical insurance and how does it work?
What is Private Medical Insurance?
Private medical insurance (PMI) is a type of health insurance that provides access to private healthcare services in the UK. It covers the cost of private medical treatment, allowing you to bypass NHS waiting lists and receive faster, more convenient care.How does it work?
Private medical insurance works by paying for your private healthcare costs. When you need treatment, you can choose to go private and your insurance will cover the costs, subject to your policy terms and conditions. This can include:• Private consultations with specialists
• Private hospital treatment and surgery
• Diagnostic tests and scans
• Physiotherapy and rehabilitation
• Mental health treatment
Your premium depends on factors like your age, health, occupation, and the level of cover you choose. Most policies offer different levels of cover, from basic to comprehensive, allowing you to tailor the policy to your needs and budget.
Questions to ask yourself regarding private medical insurance
Just ask yourself:👉 Are you concerned about NHS waiting times for treatment?
👉 Would you prefer to choose your own consultant and hospital?
👉 Do you want faster access to diagnostic tests and scans?
👉 Would you like private hospital accommodation and better food?
👉 Do you want to avoid the stress of NHS waiting lists?
Many people don't realise that private medical insurance is more affordable than they think, especially when you consider the value of faster treatment and better facilities. A great insurance policy can provide peace of mind and ensure you receive the care you need when you need it.
Benefits offered by private medical insurance
Private medical insurance provides numerous benefits that can significantly improve your healthcare experience and outcomes:Faster Access to Treatment
One of the biggest advantages is avoiding NHS waiting lists. While the NHS provides excellent care, waiting times can be lengthy. With private medical insurance, you can often receive treatment within days or weeks rather than months.
Choice of Consultant and Hospital
You can choose your preferred consultant and hospital, giving you more control over your healthcare journey. This is particularly important for complex treatments where you want a specific specialist.
Better Facilities and Accommodation
Private hospitals typically offer superior facilities, including private rooms, better food, and more comfortable surroundings. This can make your recovery more pleasant and potentially faster.
Advanced Treatments
Private medical insurance often covers treatments and medications not available on the NHS, giving you access to the latest medical advances and technologies.
Mental Health Support
Many policies include comprehensive mental health coverage, providing faster access to therapy and psychiatric care when needed.
Tax Benefits for Business Owners
If you're self-employed or a business owner, private medical insurance premiums can be tax-deductible, making it a cost-effective way to protect your health and your business.
Peace of Mind
Knowing you have access to private healthcare when you need it provides invaluable peace of mind, especially for those with ongoing health conditions or concerns about NHS capacity.
Private medical insurance is particularly valuable for those who want to take control of their healthcare journey and ensure they receive the best possible treatment when they need it most.
Important Fact!
We can look at a more suitable option mid-term!
Why is it important to get private medical insurance early?
👉 Many people are very thankful that they had their private medical insurance cover in place before running into some serious health issues. Private medical insurance is as important as life insurance for protecting your family's finances.👉 We insure our cars, houses, and even our phones! Yet our health is the most precious thing we have.
Easily one of the most important insurance purchases an individual or family can make in their lifetime, the decision to buy private medical insurance can be made much simpler with the help of FCA-authorised advisers. They are the specialists who do the searching and analysis helping people choose between various types of private medical insurance policies available in the market, including different levels of cover and policy types most suitable to the client's individual circumstances.
It certainly won't do any harm if you speak with one of our experienced insurance experts who are passionate about advising people on financial matters related to private medical insurance and are keen to provide you with a free consultation.
You can discuss with them in detail what affordable private medical insurance plan for the necessary peace of mind they would recommend! WeCovr works with some of the best advisers in the market.
By tapping the button below, you can book a free call with them in less than 30 seconds right now:
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WeCovr is an insurance specialist for people valuing their peace of mind and a great service.👍 WeCovr will help you get your private medical insurance, life insurance, critical illness insurance and others in no time thanks to our wonderful super-friendly experts ready to assist you every step of the way.
Just a quick and simple form and an easy conversation with one of our experts and your valuable insurance policy is in place for that needed peace of mind!