As an FCA-authorised broker that has helped arrange over 800,000 policies, WeCovr understands that navigating the world of private medical insurance can be complex. This guide demystifies international private medical insurance (iPMI), offering clear, practical advice for UK citizens living, working, or travelling extensively abroad.
WeCovr's guide to global PMI options for UK expats and frequent travellers
Moving abroad or travelling the world is an exciting prospect, filled with new cultures, opportunities, and experiences. But what happens if you fall ill or have an accident far from the familiar comfort of the NHS? Standard UK private health cover won't stretch across borders, and simple travel insurance often falls short for long-term stays or serious medical needs.
This is where International Private Medical Insurance (iPMI) comes in. It’s comprehensive health cover designed specifically for those living a global lifestyle. This guide will walk you through everything you need to know, from who needs it and what it covers, to how to choose the right policy for your new life abroad.
What Exactly is International Private Medical Insurance (iPMI)?
Think of iPMI as your personal, portable healthcare system. It's an annual health insurance policy that gives you access to private medical treatment and facilities in your chosen country of residence and often across a wider geographical region.
Unlike a UK-only policy, which is geographically limited, iPMI is built for a life without borders. It ensures you can receive high-quality medical care, from routine GP visits to major surgery, wherever your journey takes you.
iPMI vs. Travel Insurance: Understanding the Critical Difference
Many people mistakenly believe that an annual travel insurance policy offers the same protection as iPMI. This is a common and potentially very costly mistake. The two products serve entirely different purposes.
- Travel Insurance is for short trips and holidays. It’s designed to cover unforeseen medical emergencies to get you well enough to travel home. It also covers non-medical issues like lost luggage, cancelled flights, and theft. It is not designed for routine check-ups, ongoing treatment, or elective procedures abroad.
- International Private Medical Insurance (iPMI) is comprehensive health insurance for people living abroad. It covers both emergency and routine healthcare within your chosen area of cover, much like a domestic policy. It's designed for long-term peace of mind and access to quality care without the need to return to the UK.
Here’s a simple breakdown:
| Feature | Travel Insurance | International PMI |
|---|
| Purpose | Short-term travel emergencies | Long-term comprehensive healthcare |
| Duration | Per trip, or up to 365 days (with trip limits) | Annual, renewable contract |
| Medical Cover | Emergency treatment to stabilise you for return home | Emergency, in-patient, out-patient, and routine care |
| Pre-existing Conditions | Generally excluded or very limited | Can sometimes be covered through underwriting |
| Routine Care | Not covered (e.g., GP visits, health checks) | Often covered, especially with out-patient options |
| Cancer Care | Not covered (unless it's a new, acute emergency) | Comprehensive cancer cover is a core feature |
| Maternity Care | Not covered | Can be included as an add-on (with waiting period) |
| Repatriation | Medical repatriation to your home country (UK) | Repatriation or medical evacuation to a centre of excellence |
The bottom line: If you're going on a two-week holiday to Spain, travel insurance is what you need. If you're moving to Spain to live, you need international private medical insurance.
Who Needs International Health Insurance?
If you plan to spend a significant amount of time outside the UK, an iPMI policy is likely essential. Here are the most common groups who benefit from this type of cover.
1. UK Expats and Retirees
Whether you're relocating for a new job in Dubai, retiring to the sunny coast of Portugal, or starting a new life in Australia, you'll be leaving the NHS behind. While some countries have excellent public healthcare, accessing it as a non-national can be complex, involve long waiting lists, or require significant co-payments. An iPMI policy gives you the freedom to choose private facilities, bypass queues, and receive care in your own language.
2. Digital Nomads and Remote Workers
The freedom to work from anywhere is a modern privilege, but it comes with healthcare responsibilities. If you’re a remote worker spending several months in Thailand, then moving to Mexico, a standard insurance plan won't work. iPMI offers flexible, multi-country cover that moves with you, ensuring you're protected no matter which time zone you're working from.
3. Frequent Business Travellers
For those who live out of a suitcase, flying between international offices, corporate travel insurance might not be sufficient. It's typically designed for short-term emergencies. If you develop a condition that requires ongoing consultations or diagnostic tests while abroad for an extended project, iPMI provides the necessary continuity of care.
4. Students Studying Abroad
Spending a year or more studying in another country is a formative experience. An iPMI plan ensures that students have access to reliable healthcare, from minor illnesses to more serious issues, without the worry of navigating an unfamiliar public system or facing huge medical bills. It also provides peace of mind for parents back in the UK.
How International PMI Works: A Step-by-Step Guide
Securing global health cover is more straightforward than you might think, especially with an expert broker like WeCovr to guide you.
- Choose Your Area of Cover: Insurers typically offer different geographical tiers. A "Worldwide" policy provides the most comprehensive cover, while a "Worldwide excluding USA" plan is a popular, more affordable option (as US healthcare is the most expensive in the world). Other options might include "Europe only" or specific regions.
- Select Your Level of Cover: You can tailor your plan to your needs and budget.
- Core Cover (In-patient): This is the foundation of every policy, covering costs for hospital stays, surgery, and major treatments like cancer care.
- Out-patient Add-on: This covers consultations, diagnostic tests, physiotherapy, and other treatments that don't require a hospital stay.
- Optional Add-ons: You can further enhance your policy with dental and vision care, maternity cover, wellness checks, and repatriation benefits.
- Complete the Underwriting Process: This is how the insurer assesses your medical history to determine the terms of your policy. We’ll cover this in more detail below.
- Receive Your Policy Documents: Once approved, you'll get your documents and membership card. You're now covered!
- Making a Claim: When you need treatment, the process is simple. For major planned procedures, you'll contact your insurer for pre-authorisation. Many hospitals have direct billing agreements with insurers, meaning the provider settles the bill directly. For smaller claims like a GP visit, you may need to pay upfront and claim the cost back.
The Critical Rule: Acute vs. Chronic and Pre-existing Conditions
This is the single most important concept to understand about all private medical insurance, both in the UK and internationally.
PMI is 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, pneumonia).
- A chronic condition is a disease, illness, or injury that has one or more of the following characteristics: it needs long-term monitoring, has no known cure, is likely to recur, or requires ongoing management (e.g., diabetes, asthma, arthritis, hypertension).
- A pre-existing condition is any ailment you had, received treatment for, or had symptoms of before you took out the policy.
Standard iPMI policies do not cover chronic or pre-existing conditions. Treatment for these remains the responsibility of your local state healthcare system or must be self-funded. However, some insurers may offer cover for pre-existing conditions after a specific assessment, which we explore in the underwriting section.
Key Features to Look For in a Quality iPMI Policy
When comparing plans, certain features are non-negotiable for robust protection. At WeCovr, we help you find policies that include:
- Comprehensive In-patient & Day-patient Cover: Full cover for hospital stays, including surgeons' fees, anaesthetists' fees, and hospital accommodation.
- Emergency Medical Evacuation: This is vital. If local facilities are inadequate for your condition, this covers the cost of transporting you to the nearest centre of medical excellence.
- Repatriation: Covers the cost of returning you to your home country for treatment if medically necessary.
- 24/7 Multilingual Assistance Helpline: Immediate access to medical advice and support, no matter where you are or what time it is.
- Comprehensive Cancer Care: This should include diagnosis, surgery, chemotherapy, radiotherapy, and monitoring.
- Mental Health Support: Access to counsellors and therapists is an increasingly important feature for expats dealing with the challenges of relocation.
- Out-patient Options: The flexibility to add cover for GP visits, specialist consultations, and diagnostic scans.
- Wellness Benefits: Proactive benefits like health screenings, vaccinations, and sometimes even gym memberships.
Choosing the Right iPMI Provider: A Comparison of Global Leaders
The international private medical insurance UK market features several world-renowned providers, each with its own strengths. Choosing between them depends on your destination, budget, and specific health needs.
As an independent PMI broker, WeCovr works with these leading insurers to find the perfect fit for you, at no extra cost.
Here is an illustrative comparison of some top-tier global providers:
| Provider | Key Strengths | Best For... | Typical Add-ons |
|---|
| Bupa Global | Premium service, extensive direct billing network, strong mental health support. | Executives and families seeking top-tier, comprehensive cover. | Dental, vision, wellness checks, repatriation. |
| Cigna Global | Highly flexible modular plans, allowing you to build your own policy. | Digital nomads and those needing customisable, budget-friendly options. | Out-patient, dental & vision, medical evacuation. |
| AXA Global Healthcare | Strong global presence, straightforward policies, excellent customer service. | Expats and students looking for reliable, well-rounded cover. | Out-patient, dental, medical evacuation. |
| Aetna International | Focus on wellness and preventative care, large US network. | Expats in the USA or those who prioritise proactive health management. | Dental, vision, wellness, repatriation. |
This table is a starting point. The best way to find the ideal policy is to speak with a specialist who can compare the fine print and match insurer benefits to your personal circumstances.
Understanding the Costs of International Health Cover
The premium for an iPMI policy is influenced by several key factors. Understanding these will help you manage your budget and choose wisely.
- Your Age: This is the most significant factor. Premiums rise with age as the statistical likelihood of needing medical care increases.
- Area of Cover: "Worldwide including USA" is the most expensive tier due to the high cost of American healthcare. Excluding the US can reduce premiums by 30-50%.
- Level of Cover: A basic in-patient only plan will be much cheaper than a comprehensive plan with out-patient, dental, and maternity benefits.
- The Deductible (or Excess): This is the amount you agree to pay towards a claim before the insurer covers the rest. A higher excess (£500, £1,000) will lower your annual premium.
- Underwriting Method: The way your medical history is assessed can impact the price.
Illustrative Monthly Premiums
To give you an idea, here are some example monthly premiums. These are for illustrative purposes only and will vary based on your exact profile and choices.
| Profile | Area of Cover | Excess | Illustrative Monthly Premium |
|---|
| 30-year-old remote worker in Spain | Europe | £500 | £90 – £150 |
| 45-year-old family of four in Dubai | Worldwide excl. USA | £250 | £450 – £700 |
| 65-year-old retiree in France | Worldwide excl. USA | £1,000 | £350 – £550 |
| 35-year-old executive in New York | Worldwide | £0 | £600 – £900+ |
Navigating Pre-existing and Chronic Conditions
As we've established, standard policies exclude pre-existing conditions. However, insurers use two main methods of underwriting, which determine how your past health is handled.
1. Moratorium Underwriting (Mori)
This is the most common and simplest option. You don't have to declare your full medical history on the application form. Instead, the policy automatically excludes any condition you have had symptoms of, or received advice or treatment for, in a set period before the policy starts (usually the last 5 years).
These conditions can become eligible for cover later, but only if you remain completely treatment-free and symptom-free for that condition for a continuous period after your policy starts (usually 2 years).
- Pros: Quick and simple application.
- Cons: Lack of certainty. A claim might be rejected if the insurer discovers it relates to a pre-existing condition, causing stress when you are unwell.
2. Full Medical Underwriting (FMU)
With FMU, you provide your complete medical history on the application form. The insurer's underwriting team will review it and make a clear decision from day one. They might:
-
Cover you in full with no exclusions.
-
Cover you but apply a premium loading (a higher price) to reflect the increased risk.
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Cover you but place a permanent exclusion on the specific pre-existing condition and any related ailments.
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Decline to offer cover (this is rare).
-
Pros: Complete clarity and certainty from the start. You know exactly what is and isn't covered.
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Cons: Longer, more detailed application process.
Choosing between Mori and FMU is a crucial decision. A WeCovr advisor can help you decide which path is best for your personal health history.
Wellness and Health Tips for a Global Lifestyle
Staying healthy abroad is about more than just having the right insurance. It's about adapting your lifestyle to thrive in a new environment.
- Embrace Local Cuisine Wisely: Explore new foods, but be mindful of hygiene standards. Eat at busy, popular restaurants. Balance rich new dishes with fresh fruits and vegetables. To help you stay on track, all WeCovr health and life insurance clients receive complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app.
- Prioritise Sleep: Jet lag can disrupt your body clock for days. When you arrive, try to adapt to the local time zone immediately. Avoid long daytime naps and get exposure to natural daylight in the morning.
- Stay Active: Walking is one of the best ways to explore a new city and stay fit. If you're settling long-term, find a local gym, a hiking group, or a sports club to build a routine and meet new people.
- Manage Your Mental Health: Moving abroad is a major life change. It's normal to feel lonely or experience culture shock. Stay connected with loved ones back home, build a local support network, and don't hesitate to use the mental health support services included in your iPMI policy.
Why Use a Specialist Broker Like WeCovr?
Choosing an international health insurance plan is a significant financial and personal decision. You could spend weeks researching different providers, but a specialist broker does the hard work for you.
- Expert, Impartial Advice: We are experts in the private medical insurance UK and global markets. We are not tied to any single insurer, so our advice is always 100% impartial and focused on your best interests.
- No Cost to You: Our service is completely free for you to use. We receive a commission from the insurer you choose, which is already built into their standard pricing. You won't get a cheaper price by going direct.
- Market-wide Comparison: We have access to plans and rates from all the leading global providers, saving you the time and hassle of getting multiple quotes yourself.
- Personalised Service: We take the time to understand your unique needs, travel plans, and health profile to recommend the most suitable options.
- Ongoing Support: Our relationship doesn't end when you buy the policy. We're here to help with renewals, claims queries, and any other questions you may have.
- Exclusive Benefits: When you arrange your PMI or life insurance with us, we offer discounts on other insurance products, from home to travel cover, as well as complimentary access to our CalorieHero wellness app. Our high customer satisfaction ratings reflect our commitment to putting clients first.
What is the difference between international health insurance and travel insurance?
Travel insurance is for short-term holiday emergencies, designed to get you stable enough to return to the UK. International private medical insurance (iPMI) is comprehensive annual health cover for people living or working abroad long-term. It covers both emergency and routine medical care in your country of residence, similar to a domestic private health plan.
Do I still need iPMI if my new country has a public healthcare system?
Yes, it is highly recommended. Even in countries with good public healthcare, expats may face restricted access, long waiting lists for specialist treatment, language barriers, and significant out-of-pocket costs. iPMI gives you access to private facilities, allows you to bypass queues, and ensures you can be treated by a medical professional who speaks your language, providing crucial peace of mind.
How does international PMI handle pre-existing conditions?
Standard international PMI policies, like UK PMI, are designed for new, acute conditions and do not cover pre-existing or chronic conditions. However, you have two main underwriting options. 'Moratorium' underwriting automatically excludes recent conditions for a set period (e.g., 2 years). 'Full Medical Underwriting' involves declaring your health history, after which the insurer may offer to cover certain conditions, sometimes for a higher premium, or exclude them permanently. It is vital to be honest, as non-disclosure can invalidate your policy.
Can I cover my family on one international health insurance policy?
Yes, absolutely. All major international health insurance providers offer family plans. You can typically include your partner and dependent children on a single policy, which is often more convenient and can be more cost-effective than arranging separate individual plans.
Your health is your most valuable asset, especially when you're thousands of miles from home. Don't leave it to chance.
Ready to explore your options? Get a free, no-obligation quote from a WeCovr international health insurance specialist today and take the first step towards global peace of mind.