TL;DR
Choosing international private medical insurance (IPMI) is a critical decision for any UK resident living, working, or travelling abroad. As experienced brokers who have arranged over 900,000 policies, our team at WeCovr understands the complex trade-offs between budget-friendly and premium global cover. This guide provides an expert comparison of three market leaders: IMG Global, Bupa Global, and AXA Global.
Key takeaways
- Budget IPMI: Prioritises affordability. It focuses on essential, high-cost medical events like hospitalisation and surgery (in-patient care). You accept higher out-of-pocket costs (excesses) and fewer benefits to keep monthly premiums low.
- Premium IPMI: Aims to provide a 'home-country' standard of care, or better, anywhere in the world. It covers everything from routine GP visits to complex cancer care and maternity, often with little to no financial contribution from you at the point of care.
- Market Position: A strong and respected provider, often seen as the go-to for flexible, cost-effective solutions.
- Best For: Digital nomads, budget-conscious expats, students, and those who need reliable major medical cover without the high cost of a comprehensive plan.
- Insider Insight: IMG excels at providing modular plans. You can start with a core plan and add benefits like dental or terrorism cover as needed. Their plans are often structured in a clear, tiered way (Bronze, Silver, Gold, Platinum) making them easy to compare.
Choosing international private medical insurance (IPMI) is a critical decision for any UK resident living, working, or travelling abroad. As experienced brokers who have arranged over 900,000 policies, our team at WeCovr understands the complex trade-offs between budget-friendly and premium global cover. This guide provides an expert comparison of three market leaders: IMG Global, Bupa Global, and AXA Global.
A practical comparison – what you gain or lose moving from budget-minded global cover to premium international health insurance
Navigating the world of International Private Medical Insurance (IPMI) can feel like comparing a reliable family car to a luxury sports car. Both will get you from A to B, but the journey, features, and cost are vastly different. When you move from a budget-minded plan, often favoured by younger, healthier individuals, to a premium policy, you're not just buying more cover – you're buying convenience, comprehensiveness, and peace of mind.
What is International Private Medical Insurance (IPMI)? IPMI is a specific type of private health cover designed for individuals and families living outside their home country for an extended period (typically more than six months). Unlike a standard UK PMI policy or a travel insurance policy, IPMI provides comprehensive medical cover in your new country of residence and often globally.
- Budget IPMI: Prioritises affordability. It focuses on essential, high-cost medical events like hospitalisation and surgery (in-patient care). You accept higher out-of-pocket costs (excesses) and fewer benefits to keep monthly premiums low.
- Premium IPMI: Aims to provide a 'home-country' standard of care, or better, anywhere in the world. It covers everything from routine GP visits to complex cancer care and maternity, often with little to no financial contribution from you at the point of care.
The fundamental trade-off is clear: saving money now on premiums versus avoiding potentially significant out-of-pocket expenses and gaining access to a wider range of health services later.
Understanding the Tiers: Budget vs. Premium IPMI at a Glance
Before we dive into the specifics of IMG, Bupa Global, and AXA Global, let's establish a clear baseline for what "budget" and "premium" mean in practice. The differences extend far beyond the annual limit.
| Feature | Budget-Minded IPMI | Premium IPMI | What This Means For You |
|---|---|---|---|
| Primary Focus | Emergency & In-patient care | Comprehensive 'whole health' cover | Budget plans protect against catastrophe; premium plans manage your day-to-day health. |
| Out-patient Care | Usually limited, a paid add-on, or not covered. | Almost always included and comprehensive. | With a budget plan, you'll likely pay for GP visits, specialist consultations, and diagnostic scans yourself. |
| Annual Limit | Lower (e.g., £500,000 to £1,000,000) | Very high or unlimited. | A lower limit is sufficient for most issues, but could be tested by complex, long-term treatment in an expensive country like the USA. |
| Excess/Deductible | Higher (e.g., £500 - £5,000+) | Lower or nil. | You'll pay more out-of-pocket on a budget plan before the insurance kicks in, but this significantly lowers your premium. |
| Wellness & Routine Care | Not typically included. | Included (health checks, screenings, vaccinations). | Premium plans actively support preventative health to keep you well. |
| Maternity Cover | Almost never standard; sometimes a costly add-on. | Often included as standard on higher-tier plans (after a waiting period). | If you are planning a family, a premium plan is often the only viable option. |
| Dental & Vision | Not included; sometimes a basic add-on. | Often included or available as a comprehensive add-on. | You'll be self-funding check-ups, fillings, and new glasses on a budget plan. |
Meet the Contenders: A Profile of IMG, Bupa Global, and AXA Global
Each of these global giants has a distinct identity in the IPMI market. Understanding their core philosophy is key to finding the right fit.
IMG (International Medical Group)
- Market Position: A strong and respected provider, often seen as the go-to for flexible, cost-effective solutions.
- Best For: Digital nomads, budget-conscious expats, students, and those who need reliable major medical cover without the high cost of a comprehensive plan.
- Insider Insight: IMG excels at providing modular plans. You can start with a core plan and add benefits like dental or terrorism cover as needed. Their plans are often structured in a clear, tiered way (Bronze, Silver, Gold, Platinum) making them easy to compare.
Bupa Global
- Market Position: The archetypal premium provider, synonymous with high-touch service and comprehensive benefits.
- Best For: Senior executives, high-net-worth individuals, and families who want "best-in-class" cover and are willing to pay for it.
- Insider Insight: Bupa Global's key selling point is service. They offer direct billing with a vast network of hospitals, meaning you rarely have to pay upfront. Their multilingual support and clinical case management for serious conditions provide immense reassurance during stressful times.
AXA Global
- Market Position: A global insurance powerhouse offering one of the widest spectrums of plans, from essential cover to ultra-premium policies.
- Best For: A very broad audience, from individuals needing a plan that sits between IMG's budget focus and Bupa's premium level, to large multinational corporations.
- Insider Insight: AXA's strength is its scale and flexibility. They can cater to almost any need. Their mid-tier plans, in particular, often represent a compelling "sweet spot," providing a good balance of out-patient benefits and manageable premiums.
Core Coverage Compared: What Do You Really Get?
This is where the differences become tangible. Let's compare typical plan structures from each provider, moving from budget to premium.
| Benefit | Budget Tier (e.g., IMG Silver, AXA Standard) | Premium Tier (e.g., Bupa Gold, AXA Prestige Plus) | What You Gain |
|---|---|---|---|
| Overall Annual Limit | £1,000,000 - £2,000,000 | £5,000,000 to 'Fully Covered' | Peace of mind for worst-case scenarios, especially if receiving care in the USA. |
| In-patient & Day-patient | Fully covered (usually) | Fully covered | Little difference here, this is the core of all IPMI. The main variance is in the choice of hospital room (private vs. standard). |
| Out-patient Consultations | Limited to £1,000 - £5,000 or requires an add-on. | Fully covered. | The freedom to see a GP or specialist whenever needed without worrying about the cost. |
| Diagnostic Scans (MRI/CT) | Often requires pre-authorisation; may be covered only if leading to in-patient care. | Fully covered as part of out-patient benefits. | Quicker diagnosis. No need to prove it's for an 'emergency' to get cover. |
| Cancer Treatment | Covered, but may have sub-limits or exclude experimental drugs. | Comprehensively covered, including access to latest approved drugs and treatments. | Access to the very best and latest cancer treatments available globally. |
| Mental Health | Limited in-patient cover; very limited out-patient therapy (£500-£1,000). | Comprehensive cover for both in-patient and out-patient therapy, often up to £10,000+. | Proper, sustained support for mental wellness, not just crisis care. |
| Medical Evacuation | Included, but may have stricter criteria. | Comprehensive cover for evacuation to the nearest centre of excellence. | More choice and support in a critical emergency, ensuring you get the best possible care, not just the nearest. |
The Financials: Premiums, Excesses, and Out-of-Pocket Costs
Your choice has a direct and significant impact on both your monthly budget and your potential financial exposure.
- Premium: The fixed monthly or annual amount you pay.
- Excess (or Deductible): The amount you must pay towards a claim before the insurer contributes. This is the single most effective tool for managing your premium. A plan with a £2,000 excess will be substantially cheaper than one with a £250 excess.
- Co-insurance: A percentage of the claim you pay after the excess has been met. For example, a 10% co-insurance on a £10,000 bill would mean you pay £1,000. This is less common on UK-style plans but prevalent in budget or US-centric policies.
The Cost-Benefit Trade-Off
| Factor | Budget Plan Approach | Premium Plan Approach | Practical Implication |
|---|---|---|---|
| Monthly Premium | As low as possible. | Higher, reflecting the broader cover. | A 40-year-old expat might pay £150/month for a budget plan but £500+/month for a premium one. |
| Excess Strategy | High Excess (e.g., £2,500). You are self-insuring for smaller issues. | Low or Nil Excess (e.g., £0 - £250). The insurer covers nearly everything. | In a year with multiple GP visits and a scan, you could pay £3,000 out-of-pocket on the budget plan, but £0 on the premium plan. |
| Geographic Scope | Often "Worldwide excluding USA" to reduce cost. | "Worldwide" cover is more common. | Including USA cover can increase premiums by 50-100% due to the high cost of American healthcare. |
Expert Tip: When choosing an excess, pick the highest amount you could comfortably pay tomorrow without financial distress. This will give you the most efficient premium for your risk appetite. A WeCovr adviser can model these costs for you.
Underwriting & Pre-existing Conditions: The Non-Negotiable Rules
This is the most misunderstood area of private medical insurance, and the rules are strict.
Crucially, standard private medical insurance, whether for the UK or international, is designed to cover new medical conditions that occur after your policy begins.
It is not designed to cover:
- Pre-existing Conditions: Any illness or injury you have (or have had symptoms of) before the policy start date.
- Chronic Conditions: Long-term conditions that require ongoing management rather than a cure, such as diabetes, asthma, or high blood pressure.
There are two main ways insurers handle this:
- Full Medical Underwriting (FMU): You provide a detailed health history. The insurer then gives you a firm decision upfront, which might be to accept you unconditionally, accept you with specific exclusions for your pre-existing conditions, or in some cases, decline cover. This provides certainty.
- Moratorium Underwriting: You don't complete a full health questionnaire. Instead, the policy automatically excludes any condition you've had symptoms of, or sought advice for, in the 5 years before your policy started. These exclusions can be lifted, but only if you remain completely treatment-free and symptom-free for that condition for a continuous 2-year period after your policy begins.
What you gain with premium IPMI: While the core rule remains, the most exclusive, top-tier plans from providers like Bupa Global or AXA Global may offer some level of cover for the management of pre-existing conditions, but this is:
- Only available on their most expensive plans.
- Always subject to Full Medical Underwriting.
- Often has a separate, lower annual limit.
- Very rare and should not be assumed.
Practical Scenarios: How Your Choice Plays Out in Real Life
Theory is one thing; real-world application is another. Let's see how these plans perform.
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Scenario 1: The Digital Nomad in Thailand
- Profile: A healthy 28-year-old web developer.
- Choice: An IMG Silver plan with a £2,000 excess to keep costs low.
- Event: A scooter accident results in a broken leg requiring surgery and a 3-night hospital stay. Total cost: £15,000.
- Outcome: The plan covers the £13,000 after the £2,000 excess is paid. It works perfectly for its intended purpose – covering a major medical event. For a subsequent ear infection, they pay the £80 GP fee and prescription cost out-of-pocket.
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Scenario 2: The Expat Family in Dubai
- Profile: A 45-year-old manager, her 46-year-old partner, and their two children (8 and 11).
- Choice: A comprehensive Bupa Global Gold plan.
- Events: Over the year, they have six GP visits for the kids, annual dental check-ups for everyone, a specialist consultation for a skin allergy, and a full health screening for both adults.
- Outcome: The Bupa Global plan covers everything with no excess. The direct billing network means they show their insurance card and never see a bill. The total value of benefits used is over £4,000. The peace of mind and convenience are the primary value.
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Scenario 3: The Executive Relocating to the USA
- Profile: A 55-year-old CEO moving to New York.
- Choice: An AXA Prestige Plus plan with Worldwide cover.
- Event: Develops severe chest pains. An ambulance is called, and they undergo emergency heart surgery. The total bill is £250,000.
- Outcome: The plan covers the entire cost. The high annual limit and comprehensive US cover are essential. A budget plan with a £1m limit and no specific US network might have led to complications and significant out-of-pocket expenses.
WeCovr's Expert Verdict: Finding the Sweet Spot for You
There is no single "best" international health insurance provider, only the one that is best for your specific circumstances.
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IMG Global is an excellent choice for: The budget-conscious, younger individuals, and those who need robust, reliable cover for major medical events but are happy to self-fund routine care. Its flexibility is a major advantage.
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AXA Global is the versatile all-rounder: Its wide range of plans offers a solution for almost everyone. Their mid-tier options often provide the ideal balance of comprehensive benefits and manageable cost, making them a fantastic "sweet spot" for many families and professionals.
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Bupa Global is the premium benchmark: For those who want the highest level of service, the most comprehensive benefits, and the ultimate peace of mind, Bupa Global is unparalleled. It's an investment in seamless, worry-free global healthcare.
The wisest decision is not to guess, but to get expert advice. At WeCovr, we are independent, FCA-regulated brokers. We can compare these plans and many others across the market, tailoring a solution to your specific needs, destination, and budget – all at no cost to you.
As a WeCovr customer, you also gain complimentary access to our AI-powered calorie tracking app, CalorieHero, and can benefit from discounts when you take out other policies like life insurance.
Ready to find the perfect global cover?
Does international health insurance cover pre-existing conditions?
Generally, no. Standard International Private Medical Insurance (IPMI) is designed for acute medical conditions that arise after your policy starts. Pre-existing and chronic conditions are typically excluded. Some very high-tier, premium plans may offer some cover for management of pre-existing conditions, but this is rare, expensive, and always requires a full medical declaration (Full Medical Underwriting).
Is IPMI much more expensive than UK private medical insurance?
Yes, IPMI is significantly more expensive than domestic UK PMI. This is because it needs to account for the potentially high cost of healthcare in different countries (especially the USA), currency fluctuations, and the inclusion of high-cost benefits like medical evacuation and repatriation. The global nature and complexity of the cover command a higher premium.
Do I need IPMI if my new country has a free public health system?
It is highly recommended. Even in countries with good public healthcare, expats often face long waiting lists, may not be eligible for all services, and can encounter language barriers. IPMI guarantees you access to private hospitals and doctors, allowing you to bypass waiting lists, choose your specialist, and receive care in a familiar language, which is invaluable during a stressful medical situation.
What is the difference between 'medical evacuation' and 'repatriation'?
They are both crucial benefits, but serve different purposes. Medical Evacuation involves transporting you from your current location, if it has inadequate medical facilities, to the nearest 'centre of medical excellence' to receive appropriate treatment. Repatriation is the process of transporting you back to your home country (e.g., the UK) to receive treatment or for recuperation once you are stable enough to travel.
Finding the right balance between cost and cover is a personal choice. Don't make it alone. Contact WeCovr today for a free, no-obligation quote and let our expert advisers build a personalised comparison of IMG, Bupa Global, AXA, and more, ensuring you have the perfect protection for your life abroad.
