AnkyroWho it’s forMoving abroad
Expat health insurance, sorted before you move.
The NHS and Medicare don’t follow you abroad, and some visas turn down the wrong policy. Here’s what stops when you leave, and what a good expat plan needs.
The facts
The rules and numbers that matter for you.
Checked against official sources and insurers’ own documents on 23 October 2026. Terms change, so the broker confirms them again before you apply.
- UK: the NHS stops when you move for good
The NHS is based on where you live, not your passport. If you move abroad permanently, you are no longer automatically entitled to NHS treatment.
Source: nhs.uk - UK visits: hospital care at 150% of cost
Overseas visitors, which can include former UK residents, are charged 150% of what the NHS treatment costs. A GP visit and A&E stay free, but a hospital stay after A&E can be billed.
Source: gov.uk - US: Medicare doesn’t pay abroad
Medicare usually doesn’t cover care outside the US. The exceptions are narrow, like a ship within 6 hours of a US port, or a foreign hospital closer than the nearest US one that can treat you.
Source: medicare.gov - Spain non-lucrative visa: a Spanish-authorised insurer
The policy must come from an insurer authorised to work in Spain and cover every risk the Spanish public system covers. You also show funds of 400% of the IPREM, plus 100% for each family member.
Source: exteriores.gob.es - Portugal residence visas: medical and repatriation
The official checklist asks for insurance that pays necessary medical costs, urgent care and possible repatriation. A bilateral agreement, like the UK S1, can replace the policy.
Source: vistos.mne.gov.pt - Cigna Global: no upper age to apply
Cigna Global plans start at age 18 with no upper age limit. Each of its 3 levels is sold as worldwide, or worldwide without the USA.
Source: cignaglobal.com - Genki Native: join by 55, keep it for life
New members must be 55 or younger, then there’s no age limit. You pick 182 days or a full year of cover in your country of citizenship, and a deductible of EUR 0, 500 or 1,000.
Source: genki.world
What happens to your home cover when you leave
Most public systems cover you because you live in the country, not because you hold its passport. The NHS says so plainly: move abroad for good and you lose your automatic right to free treatment. The NHS also asks you to tell your GP practice before you go, so you come off their list.
Americans have a different problem. Medicare keeps running, but it almost never pays for a doctor or hospital outside the US. If you retire to Portugal or Mexico on Medicare alone, you’re paying for cover you can only use on trips home.
So the gap usually opens on the day you move, not months later. Start your expat plan on that day, or a few days before your flight.
Expat health insurance vs travel insurance
Travel insurance assumes you have a home to go back to. It pays to stabilise you after an accident and fly you home, and it often leaves out check-ups, maternity and long treatment.
Expat health insurance assumes your new country is home. It pays for the GP, the specialist, the scan, the operation and the follow-up visits, year after year. Most plans let you add outpatient care, dental and maternity on top of hospital cover.
Visa offices know the difference. Spain wants a policy that covers everything its public system covers. Portugal asks for medical costs, urgent care and repatriation. A 30-day trip policy won’t pass either check.
Picking a cover zone: with or without the USA
International plans are priced by where you can be treated. Cigna Global, for example, sells every level as worldwide, or worldwide without the USA. Leaving out the USA is usually the biggest single saving on the quote.
Leave out the USA only if you won’t be treated there. If you have family in the US, ask whether the plan still pays for an emergency during a short visit, and for how many days.
If you live in 1 region, like Southeast Asia or Europe, some insurers sell a regional zone too. Check that your home country sits inside it.
Cover when you go back home
Many expats still see their own doctors, or plan an operation, on visits home. Plans treat this very differently. Genki Native lets you choose 182 days a year in your country of citizenship, or the full year.
Going home without cover is costly for UK expats in particular. Once you no longer live in the UK, a hospital stay can be billed at 150% of the NHS cost. A GP or A&E visit stays free, but what comes after may not.
If you might move back one day, ask what happens to the plan when you do. That matters most if you’re in the middle of treatment.
Age and health: why buying early matters
Age limits for new members vary a lot. Genki Native takes people up to 55. Cigna Global has no upper age to apply. Once you’re in, many plans renew for life, so the age that counts is the age you join.
Your health on the day you apply matters too. Anything diagnosed before you sign up may be excluded, or cost more. A condition that first shows up after you join is usually covered as new.
That’s why moving without a plan and “sorting it out later” is risky. One diagnosis in between can shape your cover for years.
What to look for
4 things that matter most for you.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- The right zone
Worldwide with the USA can cost much more than without it. Pay for the USA only if you’ll really be treated there.
- It meets your visa
Spain wants an insurer authorised in Spain. Portugal wants medical costs and repatriation. Check your exact visa before you pay.
- Days in your home country
Some plans give 182 days a year at home, some a full year, some only emergencies. Match it to how often you go back.
- The age you can join
Limits range from 55 to none at all. If you’re over 50, check the entry age first, then the price.
Common mistakes
3 we see all the time.
- 01Counting on the NHS for treatment on visits home after you’ve moved. Hospital care can be billed at 150% of cost.
- 02Keeping Medicare as your only cover after a move. It almost never pays outside the US.
- 03Buying a plan with a non-Spanish insurer for a Spanish residence visa. The consulate can turn it down.
Questions
People also ask.
Do I need expat health insurance if I move abroad?+
In most cases, yes. Home systems like the NHS stop when you move for good, and Medicare almost never pays abroad. Many residence visas, like Spain’s and Portugal’s, also ask for proof of cover.
Can I still use the NHS if I live abroad?+
You can register with a GP and use A&E for free on a visit. But if you no longer live in the UK, hospital treatment can be charged at 150% of the NHS cost.
Does Medicare cover me if I live overseas?+
Almost never. Medicare covers care outside the US only in rare cases, such as a foreign hospital that is closer than the nearest US hospital during an emergency in the US.
What is the best expat health insurance?+
The one that fits your visa, your age and where you’ll be treated. A 60 year old moving to Spain needs a different plan from a 30 year old in Dubai. Ankyro compares them side by side.
Is there an age limit for expat health insurance?+
It depends on the insurer. Genki Native takes new members up to 55. Cigna Global has no upper age limit. Many plans renew for life once you’re in.
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