TL;DR
Moving to Europe is an exciting chapter, but navigating healthcare can be complex. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr specialises in finding the right private medical insurance for UK citizens, ensuring you have peace of mind wherever you settle in the EU.
Key takeaways
- Waiting Lists: Just like the NHS, state systems in Europe can have long waiting lists for specialist consultations and non-urgent surgery. The British Social Attitudes survey consistently shows that quick access to treatment is a primary driver for people buying PMI in the UK.
- Choice and Comfort: PMI offers you the choice of hospital, specialist, and surgeon. You can also secure a private room for greater comfort and privacy during your recovery.
- Access to English-Speaking Doctors: Navigating a complex medical issue is stressful enough without a language barrier. International PMI providers often have extensive networks of English-speaking medical professionals.
- Gaps in State Cover: State systems may not cover certain treatments, advanced drugs, or dental and optical care. PMI can fill these crucial gaps.
- Medical Repatriation: If you become seriously ill, you may wish to be treated back in the UK, closer to family. This is rarely covered by state systems but is a common feature of international PMI policies.
Moving to Europe is an exciting chapter, but navigating healthcare can be complex. As an FCA-authorised broker that has helped arrange over 900,000 policies, WeCovr specialises in finding the right private medical insurance for UK citizens, ensuring you have peace of mind wherever you settle in the EU.
Providers, challenges, and cross-border claims tips for EU-bound UK citizens
The dream of a new life in sunny Spain, historic Italy, or vibrant France is a reality for over a million British citizens. According to the ONS, an estimated 1.3 million UK-born people lived in the EU in 2022. But since Brexit, the rules around healthcare access have changed significantly.
This guide provides an authoritative overview of securing private health cover as a British expat in Europe. We'll explore the leading providers, demystify the challenges, and offer practical tips for managing your health and your insurance policy across borders.
Understanding Your Healthcare Options in Europe After Brexit
Before Brexit, the European Health Insurance Card (EHIC) provided a straightforward safety net. Now, the landscape is more fragmented. Understanding your baseline state-provided healthcare rights is the first step before considering private options.
The Global Health Insurance Card (GHIC)
The GHIC has replaced the EHIC for most UK citizens. It allows you to access state-provided healthcare in EU countries at the same cost as a local resident.
Key Facts about the GHIC:
- It's not insurance: The GHIC doesn't cover private medical costs, medical repatriation to the UK, or rescue services.
- It's for necessary care: It covers emergency treatment and care for pre-existing conditions that become necessary during a temporary stay. It is not designed for people who have moved permanently.
- Country-specific agreements: The level of care varies. In some countries, state healthcare is free at the point of use; in others, you may need to pay a portion of the cost (a co-payment) and claim it back later.
For permanent residents, you will typically need to register with the local state healthcare system in your new country. This process varies and often depends on your employment status, residency permit, and whether you are a pensioner. The GHIC is not a substitute for local registration or private cover.
Why Do Expats Need Private Medical Insurance (PMI)?
While state systems in countries like France and Germany are excellent, they have limitations that make private health cover a vital consideration for many expats.
- Waiting Lists: Just like the NHS, state systems in Europe can have long waiting lists for specialist consultations and non-urgent surgery. The British Social Attitudes survey consistently shows that quick access to treatment is a primary driver for people buying PMI in the UK.
- Choice and Comfort: PMI offers you the choice of hospital, specialist, and surgeon. You can also secure a private room for greater comfort and privacy during your recovery.
- Access to English-Speaking Doctors: Navigating a complex medical issue is stressful enough without a language barrier. International PMI providers often have extensive networks of English-speaking medical professionals.
- Gaps in State Cover: State systems may not cover certain treatments, advanced drugs, or dental and optical care. PMI can fill these crucial gaps.
- Medical Repatriation: If you become seriously ill, you may wish to be treated back in the UK, closer to family. This is rarely covered by state systems but is a common feature of international PMI policies.
What is International Private Medical Insurance (iPMI)?
It's essential to distinguish between standard UK PMI and International PMI (iPMI).
- UK PMI: Designed for residents of the UK to access private healthcare within the UK. It typically does not provide cover if you move abroad permanently.
- International PMI (iPMI): Specifically designed for people living and working outside their home country. These policies are global or regional in scope and built to handle cross-border healthcare needs.
Think of it this way: your UK car insurance won't cover you if you permanently export your car to France. Similarly, your UK PMI policy is not designed for an expatriate lifestyle. You need a policy built for your new circumstances.
Key Features of an iPMI Policy
| Feature | Description | Why it Matters for Expats |
|---|---|---|
| Area of Cover | Defines the geographical region where you are covered (e.g., Europe only, Worldwide excluding USA, Worldwide). | You must ensure your country of residence and any countries you travel to frequently are included. |
| Direct Billing | The insurer pays the hospital directly, so you don't have to pay large sums out-of-pocket. | Hugely important for managing cash flow during a medical emergency. Not all providers have direct billing networks everywhere. |
| 24/7 Multilingual Helpline | A support line to help you find a doctor, get pre-authorisation for treatment, and handle emergencies. | Invaluable when you're in a new country and unsure of how the local system works. |
| Medical Evacuation & Repatriation | Covers the cost of moving you to the nearest centre of medical excellence or back to the UK if necessary. | Provides a crucial safety net if local facilities are inadequate for your condition. |
| Modular Plans | Core inpatient cover with optional add-ons for outpatient care, dental, optical, and wellness. | Allows you to tailor the policy to your specific needs and budget. |
A Crucial Note on Pre-existing and Chronic Conditions
This is one of the most misunderstood aspects of private medical insurance.
Standard private medical insurance, whether for the UK or for expats, is designed to cover acute conditions that arise after your policy begins.
- Acute Condition: 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).
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is recurrent, or requires palliative care (e.g., diabetes, asthma, hypertension, arthritis).
- Pre-existing Condition: Any medical condition for which you have experienced symptoms, received medication, advice, or treatment before the start date of your policy.
Insurers will not cover the routine management of chronic or pre-existing conditions. For these, you will need to rely on the state healthcare system in your new country of residence. An iPMI policy may cover an acute flare-up of a chronic condition, but this varies significantly between insurers and policies.
It is vital to declare your full medical history during the application process. Non-disclosure can lead to your policy being voided and claims being rejected.
Top Providers of International PMI for British Expats in Europe
The iPMI market is competitive, with several major global players offering excellent plans for British expats. A specialist PMI broker like WeCovr can help you compare these providers impartially to find the best PMI provider for your specific situation.
Here is a comparison of some leading options:
| Provider | Key Strengths | Best For | Potential Considerations |
|---|---|---|---|
| Bupa Global | Extensive direct billing network, premium service, comprehensive wellness benefits. | Expats seeking top-tier, comprehensive cover with a strong brand reputation. | Generally one of the more expensive options on the market. |
| AXA Global Healthcare | Flexible modular plans, excellent customer service, strong digital tools (virtual doctor service). | Those who want to tailor their policy precisely to their needs and budget. | Area of cover can be less flexible on lower-tier plans. |
| Cigna Global | Highly customisable plans, good value for money, strong focus on mental health support. | Budget-conscious expats who still want robust and flexible cover. | The direct billing network may be less extensive than Bupa's in some rural areas. |
| Aviva | Strong UK brand recognition, often good for those who may return to the UK, integrated health pathways. | Expats who value a well-known UK insurer and may want seamless cover if they move back. | International proposition is not as long-standing as dedicated global players like Bupa or Cigna. |
This table is for illustrative purposes. The best provider for you depends on your age, location, health status, and desired level of cover.
How to Choose the Right Expat Health Insurance Policy
With so many variables, choosing a policy can feel overwhelming. Break it down by considering these key factors.
1. Define Your Area of Cover
Are you planning to stay exclusively in your new country, or will you be travelling frequently across Europe or even globally?
- Europe Only: The most cost-effective option if you don't plan to travel further afield.
- Worldwide excluding USA: A popular choice, covering you globally except for the USA, where medical costs are exceptionally high.
- Worldwide: The most comprehensive and expensive option, necessary if you travel to the USA.
2. Choose Your Level of Cover
Most iPMI plans are modular. You start with a core plan and add benefits.
- Inpatient Cover (Core): This is the foundation of any policy. It covers costs associated with a hospital stay, such as surgery, accommodation, and specialist fees.
- Outpatient Cover (Add-on): Covers consultations, diagnostic tests (like MRI scans), and therapies that don't require a hospital stay. Highly recommended for comprehensive cover.
- Dental and Optical (Add-on): Covers routine check-ups, treatments, glasses, and contact lenses.
- Wellness and Prevention (Add-on): A growing area, covering health screenings, vaccinations, and sometimes even gym memberships.
3. Understand Underwriting Options
This determines how the insurer treats your pre-existing conditions.
- Full Medical Underwriting (FMU): You complete a detailed health questionnaire. The insurer assesses your medical history and may exclude certain conditions from cover permanently. This provides certainty from day one about what is and isn't covered.
- Moratorium Underwriting: You don't declare your medical history upfront. Instead, any condition you've had in a set period (usually the 5 years before the policy starts) is automatically excluded for an initial period (usually 24 months). If you remain symptom-free and treatment-free for that condition during the initial period, it may become eligible for cover. This is simpler upfront but creates uncertainty.
4. Check the Excess/Deductible
The excess (or deductible) is the amount you agree to pay towards a claim before the insurer contributes. A higher excess will lower your premium. Consider what amount you could comfortably afford to pay in the event of a claim.
Navigating Cross-Border Claims: A Step-by-Step Guide
Making a claim in a foreign country can be daunting. Here’s how to ensure the process is as smooth as possible.
Real-Life Example: David, a 55-year-old British expat living in the Algarve, Portugal, develops severe abdominal pain. He suspects it might be his appendix.
Step 1: Contact Your Insurer Immediately Before seeking treatment (unless it's a life-threatening emergency), call your insurer's 24/7 helpline. David calls his provider. They confirm his cover and, using their network, recommend a private hospital in Faro with English-speaking staff.
Step 2: Get Pre-Authorisation For any planned inpatient treatment or expensive diagnostic test, you need pre-authorisation. The insurer needs to confirm the treatment is medically necessary and covered by your policy. David's insurer liaises with the hospital in Faro to pre-authorise the consultation with a surgeon and a potential appendectomy.
Step 3: Understand the Payment Process
- Direct Billing: The ideal scenario. The hospital sends the bill directly to the insurer. The insurer pre-authorised David's surgery, so the hospital bills them directly. David only has to pay for personal items like TV or phone calls.
- Pay and Claim: For smaller outpatient costs or if you use a provider outside the insurer's network, you may need to pay upfront and claim the money back. Keep all receipts and medical reports.
Tips for a Smooth Claims Process:
- Keep Your Policy Number Handy: Save your insurer's helpline and your policy number in your phone.
- Ask for a "Guarantee of Payment": This is the document the insurer sends to the hospital confirming they will cover the costs.
- Keep All Paperwork: Store all invoices, medical reports, and prescriptions securely. Take photos as backups.
- Submit Claims Promptly: Insurers have deadlines for claim submissions, often 90 or 180 days after treatment.
- Use Your Insurer's Network: Sticking to approved hospitals and clinics makes direct billing more likely and simplifies the process.
The Role of a Specialist Broker like WeCovr
Navigating the complexities of iPMI alone can be tough. A specialist broker acts as your expert guide.
- Market Expertise: An independent broker understands the nuances of policies from dozens of insurers. WeCovr's experts can quickly identify which providers offer the best terms for your destination country and personal circumstances.
- No Extra Cost to You: Brokers are paid a commission by the insurer you choose. Their service and advice are provided at no cost to you, and the premium is the same as going direct.
- Personalised Advice: A broker takes the time to understand your needs, budget, and health profile to recommend the most suitable options, saving you hours of research.
- Claims Advocacy: If you run into any issues with a claim, a good broker can act as your advocate, liaising with the insurer on your behalf.
- Ongoing Support: Your needs may change. A broker can help you review your policy annually to ensure it remains fit for purpose.
With high customer satisfaction ratings, WeCovr prides itself on providing clear, impartial advice to the UK expat community.
Wellness and Staying Healthy in Your New European Home
Your health insurance is a safety net, but the best strategy is to stay healthy. Embracing a new lifestyle in Europe is a fantastic opportunity to boost your wellbeing.
Embrace the Mediterranean Diet
If you're moving to Spain, Italy, Greece, or the south of France, you're in luck. The Mediterranean diet, rich in fresh vegetables, fruits, olive oil, fish, and whole grains, is consistently ranked as one of the healthiest in the world. It's linked to lower rates of heart disease and improved longevity.
Stay Active
Your new home offers new ways to be active. Explore local hiking trails, join a cycling club, or take up swimming in the sea. Regular physical activity is proven to reduce stress, improve sleep, and lower the risk of chronic illness.
Manage Your Nutrition and 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 monitor your diet and make healthier choices as you explore new cuisines.
Prioritise Mental Health
Moving abroad is a major life event and can be stressful.
- Build a social network: Join local expat groups, take a language class, or get involved in community activities.
- Stay connected: Schedule regular video calls with family and friends back home.
- Seek support: Many iPMI policies now include excellent mental health support, including access to counselling and virtual therapy sessions.
Save More with WeCovr
When you arrange your private medical insurance UK or international policy through us, you can also benefit from exclusive discounts on other types of cover you might need, such as life insurance or travel insurance, helping you protect your family and your finances more affordably.
Cost of International PMI: What Influences Your Premiums?
The cost of iPMI can vary significantly, from under £100 to over £1,000 per month. The key factors influencing your premium are: (illustrative estimate)
- Age: Premiums increase with age as the statistical risk of needing medical care rises.
- Area of Cover: A worldwide policy will cost substantially more than a Europe-only policy.
- Level of Cover: The more comprehensive the plan (e.g., including outpatient and dental), the higher the cost.
- Excess/Deductible: A higher excess will lower your premium.
- Your Medical History: If you have pre-existing conditions, an insurer may charge a higher premium (a "loading") or apply exclusions.
Sample Monthly Premiums for a British Expat in Spain
The table below provides an estimated monthly cost for a mid-range iPMI policy (inpatient and outpatient cover, €1,000 excess, Europe-wide cover). These are for illustrative purposes only.
| Age | Estimated Monthly Premium |
|---|---|
| 35 | £120 – £180 |
| 45 | £180 – £270 |
| 55 | £280 – £450 |
| 65 | £450 – £700 |
Your actual quote will depend on the specific provider and your individual circumstances. The best way to get an accurate figure is to compare quotes from a range of insurers.
Do I still need travel insurance if I have international PMI?
Can I add my family to my expat health insurance policy?
What happens to my policy if I move back to the UK?
Moving to Europe is the start of an incredible journey. Ensuring you have the right health insurance in place is one of the most important steps you can take to protect your health and financial wellbeing. It removes the uncertainty of relying on unfamiliar state systems and provides fast access to high-quality care when you need it most.
Ready to explore your options? Get a free, no-obligation quote from WeCovr today. Our expert advisors will compare the market for you and help you find the perfect private health cover for your new life in Europe.
Sources
- NHS England: Waiting times and referral-to-treatment statistics.
- Office for National Statistics (ONS): Health, mortality, and workforce data.
- NICE: Clinical guidance and technology appraisals.
- Care Quality Commission (CQC): Provider quality and inspection reports.
- UK Health Security Agency (UKHSA): Public health surveillance reports.
- Association of British Insurers (ABI): Health and protection market publications.
