International Health Insurance: Who Needs It and How It Works

Who needs international health insurance

• Expatriates living abroad for work, retirement, or family.
• Retirees who spend much of the year outside the U.S., where Medicare generally doesn’t pay.
• Students and teachers on long programs abroad.
• Remote workers on long-stay or digital nomad visas that require health coverage.
• Employees on overseas assignments whose employer plan doesn’t cover them fully abroad.

How it works

You choose a plan level, a coverage area, and a deductible. The insurer reviews your health history, then accepts, accepts at a higher rate, or declines the application. Once covered, you can usually see doctors and hospitals in many countries, sometimes with direct billing through the insurer’s network, and renew each year.

Pre-existing conditions are often covered after a waiting period. BCBS Global Solutions, for example, applies up to six months on its Worldwide Premier plan without prior coverage, reduced by months of prior coverage.

Example plans

BCBS Global Solutions’ long-term plans are for people who live outside their home country at least three months a year. Its plan page lists Worldwide Premier for individuals and families, Worldwide Education for students and teachers, Worldwide Crew for maritime crews, and Worldwide Non-Profit for mission, volunteer, and humanitarian workers. Coverage is underwritten, so an application can be accepted, accepted at a higher rate, or declined, and plans without U.S. coverage are also available.

Pre-existing condition waiting periods apply: up to six months on Worldwide Premier without prior coverage, and 12 months on the Crew, Education, and Non-Profit plans, reduced month for month by prior coverage.

Source: Cigna Global benefits page, October 2026. Deductible options run from $0 to $10,000, with 0% to 30% cost share. The customer guide controls.

International health versus travel medical

Summary only. The plan documents control coverage, limits, and exclusions.

Coverage in the United States

Many plans let you choose whether to include the U.S. Including it costs more, but matters if you will return for care or visit often. Cigna Global offers worldwide coverage including or excluding the U.S., and notes that excluding it still allows limited emergency hospital care on brief visits. BCBS Global Solutions also offers plans with and without U.S. coverage.

Medicare and living abroad

Original Medicare generally does not pay for care outside the United States. Medicare.gov lists three narrow exceptions for foreign hospital care: an emergency that happens in the U.S. when a foreign hospital is closer than the nearest U.S. hospital that can treat you; an emergency while driving the most direct route between Alaska and another state through Canada; and living in the U.S. when a foreign hospital is closer to your home than the nearest U.S. hospital that can treat your condition.

Medicare Part D drug plans do not cover prescriptions you buy outside the U.S. On a cruise ship, Part B may pay for medically necessary care only if the ship is in a U.S. port or no more than six hours from one when you get care.

Some Medigap plans add a foreign travel emergency benefit. Plans C, D, F, G, M, and N pay 80% of billed charges for medically necessary emergency care that begins in the first 60 days of a trip, after a $250 yearly deductible, up to a $50,000 lifetime limit. Plans C and F are available only to people eligible for Medicare before 2020. Some Medicare Advantage plans cover emergencies abroad, but not all do, so check your plan's evidence of coverage for the words “foreign” or “worldwide.”

Why your home coverage may not travel

The U.S. Department of State says the U.S. government does not pay medical costs for citizens traveling abroad, and that Medicare and Medicaid do not pay for medical care outside the United States. It recommends asking your U.S. health insurer what it covers overseas, buying travel health insurance if it does not, and buying medical evacuation insurance for trips to higher-risk areas or places with limited medical care.

The department also notes that trip cancellation insurance usually does not pay for medical costs abroad, and that some travel medical policies pay hospitals directly instead of reimbursing you later.

Existing conditions and trip plans

Most travel policies exclude pre-existing conditions unless you qualify for a waiver. Squaremouth’s October 2026 guidance says a waiver typically requires buying within 14 to 21 days of your first trip payment, insuring the full trip cost, and being medically able to travel when you buy. Insurers usually look back 60 to 180 days before the purchase date to decide what counts as pre-existing.

Travel medical plans differ. BCBS Global Solutions’ Single Trip Platinum covers pre-existing conditions for U.S. residents who keep a qualifying primary health plan, while its Single Trip Gold plan does not.

Questions to ask before you apply

• Which countries are included, and is the U.S. optional?
• How long are waiting periods for pre-existing conditions and maternity?
• Is evacuation included or an add-on?
• Can the plan pay hospitals directly in my country?
• What happens to coverage if I move to another country?

Checking a plan and insurer

• Who issues the plan. Find the insurer’s legal name on the quote, not just the brand or website.
• License. Confirm the insurer and agent are licensed in your state through your state insurance department or the NAIC’s company and producer searches.
• Pre-approval rules. Ask whether you must call the assistance line before treatment or evacuation, since some plans reduce or deny benefits if you don’t.
• Direct billing. Ask whether the plan can pay hospitals directly or whether you pay first and file a claim.
• Exclusions. Read the exclusions for pre-existing conditions, hazardous activities, alcohol, and travel to countries under government warnings.

What an independent agency does

An independent insurance agency is licensed to sell policies from several insurance companies. Instead of quoting one company's products, an independent agent can compare options from the insurers the agency represents, explain the differences in coverage, and help you re-shop at renewal. The insurance company, not the agent, makes underwriting and claim decisions.

Blake Insurance Group is an independent agency. We work with clients by phone, email, and online in states where we are licensed, and we will tell you which insurers we can quote for your situation.

How we work

Blake Insurance Group serves clients by phone, email, and online in states where we are licensed. The insurers and plans we can offer depend on our appointments and your location; a company named on this page may not be available through us.

How to verify an insurer or agency

Before buying through any website or app, confirm who is selling you the policy and who will issue it:

1. Find the licensed agency or insurer named in the site's footer, terms, or license page.
2. Look up the agency or producer on your state insurance department's license search, or through the National Insurance Producer Registry (NIPR).
3. Look up the insurer on your state insurance department's company search to confirm it is authorized in your state.
4. Save the insurer's name and policy number once issued, since that is who handles claims.

A legitimate service will make this information easy to find. Be cautious if you cannot identify the licensed entity.

Sources

We checked the facts on this page against the sources below in October 2026. Plans, prices, and rules change, so confirm current terms before you buy.

• BCBS Global Solutions: Long-term plans for living abroad
• Cigna Global: Plans and benefits
• Medicare.gov: Travel outside the U.S.
• AARP: Does Medicare cover me outside the U.S.?
• U.S. Department of State: Insurance coverage overseas
• 22 CFR 62.14: Exchange visitor insurance requirements
• Squaremouth: What is a pre-existing conditions exclusion waiver?
• BCBS Global Solutions: Single Trip plans

What to have ready for an international health quote

These details help an agent quote accurately.

1. Traveler details. Names, dates of birth, and citizenship.
2. Where you will live. Country of residence and how long you will stay.
3. U.S. coverage needs. Whether you need coverage during visits home.
4. Health history. Long-term plans are medically underwritten.
5. Budget. Preferred deductible and annual maximum.

International health insurance FAQs

Related guides

• International health insurance plans
• Expat insurance
• Cigna Global insurance
• Travel medical insurance
• Medical evacuation and repatriation

Partner quote options

Your next step

Request a quote, and a licensed agent will compare options available to us for your trip or situation.