As an FCA-authorised expert that has helped arrange over 900,000 policies, WeCovr understands the complexities of private medical insurance for UK citizens. This guide explains what you need to know about international private medical insurance (IPMI) when you decide to live and work abroad.
What Brits abroad need to know about international private medical insurance
Moving abroad is an exhilarating adventure. Whether you're relocating for a career opportunity in Dubai, retiring to the Spanish sunshine, or embracing a digital nomad lifestyle in Southeast Asia, it’s a life-changing step. But amidst the excitement of packing boxes and planning your new life, there's a crucial question every Brit needs to answer: what happens to my healthcare?
The simple truth is that once you are no longer 'ordinarily resident' in the UK, your access to the NHS is significantly restricted, and often ends completely. This is where International Private Medical Insurance (IPMI) becomes not just a safety net, but an essential part of your expatriate toolkit.
IPMI is a specialist type of health insurance designed specifically for people living and working outside of their home country for an extended period. It provides comprehensive cover for medical treatment, from routine GP visits to major surgery, giving you peace of mind and access to high-quality healthcare wherever you are in the world.
Why Your NHS Entitlement Changes When You Move Abroad
A common misconception among British expats is that their UK passport guarantees them free NHS treatment. Unfortunately, this isn't the case. The NHS is a residency-based system, not a nationality-based one.
The key term is 'ordinarily resident'. If you move abroad on a permanent or semi-permanent basis, you are no longer considered ordinarily resident in the UK. This means:
- You lose access to routine NHS treatment. This includes GP appointments, hospital treatment, and prescriptions.
- You may be charged for any NHS hospital treatment you receive during visits back to the UK, typically at 150% of the standard NHS cost.
- Your Global Health Insurance Card (GHIC) or older European Health Insurance Card (EHIC) is for temporary stays (like holidays), not for those who are resident in an EU country. It doesn't provide cover if you've moved there permanently.
According to the latest government guidance, your entitlement to NHS care depends entirely on your legal residency status. For the millions of Brits living abroad, this creates a significant healthcare gap that IPMI is designed to fill.
| Feature | NHS in the UK (for residents) | International PMI (for expats) |
|---|
| Eligibility | Based on being 'ordinarily resident' in the UK. | Available to anyone living outside their home country. |
| Cost | Free at the point of use, funded by UK taxes. | Paid for via monthly or annual premiums. |
| Geographic Cover | UK only. | Your chosen region (e.g., Europe, Worldwide). |
| Choice of Doctor | Limited to your local NHS trust and GPs. | Freedom to choose your own doctors and hospitals. |
| Waiting Times | Subject to NHS waiting lists (can be lengthy). | Swift access to specialists and treatment. |
| Cover Type | Comprehensive, including chronic conditions. | Primarily for acute conditions; chronic care is limited. |
IPMI vs. Travel Insurance vs. Local Health Insurance: What's the Difference?
Understanding the difference between these three types of cover is vital to ensure you're not left dangerously underinsured.
| Insurance Type | Best For... | What It Covers | What It Doesn't Cover |
|---|
| International PMI | Long-term residency abroad (6+ months). | Comprehensive in-patient and out-patient medical care, cancer treatment, emergencies, mental health, wellness. | Generally excludes pre-existing and chronic conditions unless specifically underwritten. |
| Travel Insurance | Short-term trips and holidays (days or weeks). | Medical emergencies, trip cancellation, lost baggage, repatriation. | Routine check-ups, planned treatment, anything outside of an unforeseen emergency. |
| Local Health Insurance | Residents of a single country who do not travel. | Medical care within that specific country's network. Complies with local regulations. | Treatment outside of that one country. May not be portable if you move again. |
In simple terms:
- Travel Insurance is for your suitcase and unexpected holiday mishaps.
- Local Insurance ties you to one country's system.
- International PMI is your global health passport, designed for an expat lifestyle.
The Core Components of an International PMI Policy
An IPMI policy is built from several layers of cover. Understanding these helps you tailor a plan that fits your needs and budget perfectly.
1. In-patient and Day-patient Treatment (Core Cover)
This is the foundation of every IPMI policy. It covers you for treatment that requires a hospital bed.
- Hospital stays: Semi-private or private room costs.
- Surgery: Surgeons' and anaesthetists' fees.
- Cancer Treatment: Chemotherapy, radiotherapy, and other advanced treatments.
- Intensive care: Life support and critical care monitoring.
- Diagnostic tests: MRI, CT, and PET scans performed in a hospital.
2. Out-patient Treatment
This covers medical care that doesn't require a hospital bed. It's often available as a standard benefit or a crucial add-on.
- GP and Specialist consultations: Seeing a doctor or a specialist like a cardiologist or dermatologist.
- Prescription drugs: Medications prescribed by your doctor.
- Physiotherapy: Rehabilitation after an injury or surgery.
- Diagnostic tests: Blood tests and X-rays done outside of a hospital setting.
3. Optional Add-ons for Comprehensive Cover
These allow you to build a policy that reflects your life and priorities. Common extras include:
- Dental and Optical: Cover for routine check-ups, fillings, new glasses, and more complex dental work.
- Maternity Cover: For pre-natal care, delivery costs, and post-natal check-ups. Note: there is usually a waiting period of 10-12 months before you can claim.
- Wellness Programmes: Proactive health benefits like health screenings, gym membership discounts, and nutrition advice.
- Medical Evacuation and Repatriation: This is a vital benefit, especially if you live in a country with limited medical facilities. It covers the cost of transporting you to the nearest centre of medical excellence or back to the UK for treatment.
The Critical Point: Pre-existing and Chronic Conditions
This is the single most important concept to understand about private medical insurance in the UK and internationally.
Standard IPMI policies are designed to cover acute conditions that arise after your policy has started.
- An acute condition is a disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery (e.g., a broken bone, appendicitis, a chest infection).
- A chronic condition is a long-term illness that cannot be cured, only managed (e.g., diabetes, asthma, hypertension, arthritis).
- A pre-existing condition is any ailment for which you have experienced symptoms, sought advice, or received treatment before you took out the policy.
Standard policies do not cover the routine management of chronic conditions or treatment for pre-existing conditions. An expert PMI broker like WeCovr can help you navigate the underwriting process to find the most suitable solution for your circumstances, but it's crucial to be aware of this fundamental principle.
How to Choose the Right International Health Insurance Policy
With so many options, choosing the right plan can feel overwhelming. Following a structured approach makes it much simpler.
Step 1: Assess Your Healthcare Needs and Lifestyle
Consider your personal situation:
- Who needs cover? Just you, your partner, or your whole family?
- Your age and health: Are you generally fit and well, or do you have a medical history to consider?
- Your lifestyle: Are you an active person who might need sports injury cover? Do you plan on starting a family?
Step 2: Understand Your Destination's Healthcare System
- Is private insurance mandatory? Some countries, like Dubai and Switzerland, require all residents to have private health insurance.
- What is the quality of local care? In some countries, public facilities are excellent, while in others, the private sector is the only viable option for high-quality care.
- What are the costs? Healthcare costs vary dramatically around the world. Treatment in the USA is notoriously expensive, which is why it often requires a specific level of cover.
Step 3: Define Your Area of Cover
Insurers typically offer tiered geographical options. The wider the area of cover, the higher the premium.
- Worldwide: The most comprehensive and expensive option, covering you anywhere.
- Worldwide excluding USA: A very popular and more affordable choice, as it removes the highest-cost country.
- Europe: Covers you across the European continent.
- Specific Regions: Some insurers offer cover for regions like Asia or the Middle East.
Choose an area that reflects where you will live and travel. Remember to include your home country (the UK) if you want the option to return for treatment.
Step 4: Compare Underwriting Options
This determines how the insurer will treat your pre-existing medical conditions.
| Underwriting Type | How It Works | Pros | Cons |
|---|
| Moratorium (Mori) | You don't declare your full medical history upfront. Any condition you've had in the past 5 years is automatically excluded for a set period (usually 24 months). If you remain symptom-free and treatment-free for that condition during the 24-month waiting period, it may become eligible for cover. | Quicker and simpler application process. | Lack of certainty. You may not know if a condition is covered until you make a claim. The "stop-start" nature of some conditions can mean they are never covered. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire, declaring all past and present medical conditions. The insurer assesses your application and states clearly from day one what is covered and what is excluded. | Complete clarity and certainty from the start. You know exactly where you stand. | The application process is longer and more intrusive. Pre-existing conditions will likely be permanently excluded or have a surcharge applied. |
For most people seeking clarity, Full Medical Underwriting is the preferred route.
Key Factors That Influence the Cost of Your IPMI Premium
Your premium is calculated based on a range of risk factors. Understanding them helps you see where you can make savings.
- Age: The primary factor. Premiums increase as you get older.
- Location: Your country of residence significantly impacts cost due to varying local healthcare prices.
- Area of Cover: As mentioned, 'Worldwide including USA' is the most expensive tier.
- Level of Cover: A basic in-patient plan is cheaper than a comprehensive plan with out-patient, dental, and maternity benefits.
- Excess (or Deductible): This is the amount you agree to pay towards a claim before the insurer steps in. Choosing a higher excess will lower your premium.
- Add-ons: Each optional extra (dental, optical, etc.) will increase the price.
An experienced IPMI broker can model different scenarios for you, balancing the level of cover with your budget to find the sweet spot.
The Role of an Expert PMI Broker like WeCovr
Navigating the global health insurance market alone can be a minefield of complex jargon, hidden clauses, and varying regulations. This is where an independent broker provides immense value.
Using a specialist broker like WeCovr offers several advantages:
- Expert Guidance at No Cost: Our service is free to you. We are paid a commission by the insurer you choose, which does not affect the price you pay.
- Whole-of-Market Comparison: We compare policies from the world's leading IPMI providers—like Bupa Global, AXA, Cigna, and Allianz—to find the best fit for your specific needs, saving you hours of research.
- Help with Complex Applications: We assist you with the paperwork, especially for Full Medical Underwriting, ensuring your application is presented clearly to the insurer.
- Ongoing Support: Our relationship doesn't end once the policy is sold. We are here to help with queries or provide assistance if you need to make a claim.
- Exclusive Benefits: When you arrange your PMI through WeCovr, you also get complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to support your health goals. Furthermore, our clients often receive discounts on other insurance products like life or income protection cover.
With high customer satisfaction ratings and deep market knowledge, WeCovr acts as your advocate, ensuring you get the right protection at a competitive price.
Wellness and Staying Healthy Abroad: Tips for UK Expats
Your health insurance is your safety net, but the best strategy is to stay healthy in the first place. Living abroad presents new challenges and opportunities for your wellbeing.
- Adapt Your Diet Sensibly: Exploring local cuisine is one of the joys of expat life. Embrace new foods, but be mindful of portion sizes and ingredients. Try to replicate healthy home-cooked meals using fresh local produce.
- Prioritise Mental Health: Culture shock and homesickness are real. Schedule regular video calls with family and friends. Join local expat groups or clubs to build a new support network. Don't be afraid to use the mental health support services often included in modern IPMI plans.
- Stay Active: Your UK gym routine might not be possible, so adapt. Explore local parks for running, find a nearby yoga studio, or take up a new sport popular in your host country, like paddleboarding in Spain or cycling in the Netherlands.
- Manage Sleep: Jet lag and new daily rhythms can disrupt your sleep. Establish a consistent sleep schedule, create a relaxing bedtime routine, and make your bedroom a dark, quiet sanctuary.
- Schedule Health Screenings: Don't neglect preventative care. Many IPMI policies include benefits for routine health checks. Use them to stay on top of your health and catch any potential issues early.
Real-Life Scenarios: When International PMI is a Lifesaver
Scenario 1: The Retiree in Portugal
David, 68, retired to the Algarve. He developed severe chest pains and was diagnosed with an acute coronary blockage. His IPMI policy allowed him to bypass the local waiting list and be treated by a leading private cardiac surgeon within days. His policy covered the €30,000 cost of the surgery and hospital stay.
Scenario 2: The Young Family in the UAE
The Smith family moved to Dubai for work. Their four-year-old daughter developed a severe respiratory infection. Their IPMI plan gave them immediate access to a paediatric specialist at a top private hospital, ensuring she received prompt and effective treatment without them having to worry about the substantial out-of-pocket cost.
Scenario 3: The Digital Nomad in Mexico
Chloe, 29, was working remotely from Playa del Carmen when she fell and sustained a complex wrist fracture. Her 'Worldwide excluding USA' policy covered her emergency treatment, surgery with a specialist orthopaedic surgeon, and subsequent physiotherapy sessions, allowing her to make a full recovery.
Do I still need IPMI if my new country has a free public healthcare system?
Yes, it is highly recommended. Even in countries with good public healthcare (like Spain or France), IPMI offers significant advantages. These include skipping long waiting lists for specialist appointments and surgery, gaining access to a wider choice of doctors and hospitals (including private facilities), and ensuring you are covered for treatments that may not be available on the public system. It also provides cover for medical evacuation if the best care is located elsewhere.
What is the difference between moratorium and full medical underwriting?
These are two ways insurers assess your health history. With **Moratorium underwriting**, you don't declare your medical history upfront, but any condition you've had in the last 5 years is automatically excluded for an initial period (usually 2 years). With **Full Medical Underwriting (FMU)**, you declare your full history on an application form, and the insurer tells you from the start precisely what is and isn't covered. FMU provides much greater certainty and is often recommended for peace of mind.
Does international PMI cover me when I visit the UK?
Most IPMI policies offer cover for trips back home as a standard feature or an optional add-on. This is an important benefit, as you will likely no longer be entitled to free NHS treatment as a non-resident. It allows you to receive private medical care in the UK should you fall ill or have an accident while visiting friends and family. Always check the terms of your specific policy for details on home country cover.
How can WeCovr help me find the best international private medical insurance?
As an expert, independent private medical insurance broker, WeCovr simplifies the entire process. We use our market knowledge to compare leading global insurers and find the policy that best matches your needs, destination, and budget. We explain the options in plain English, help with the application, and provide support for the life of your policy—all at no cost to you.
Ready to secure your health and peace of mind for your new life abroad? The expert team at WeCovr is here to help. We'll compare the best international private medical insurance UK providers to find a plan that's right for you.
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