AnkyroWho it’s forRetiring abroad
Retiring abroad? Get cover you can keep.
Your retirement visa may set a minimum. Insurers set an age limit to join. Medicare stays at home. Here are the rules, country by country.
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.
- Thailand O-A: 3,000,000 THB of cover
A first O-A retirement visa needs a policy worth at least USD 100,000, set at 3,000,000 THB, for the whole stay. A Thai or a foreign insurer is fine, but a foreign one must sign the official certificate form.
Source: longstay.tgia.org - Spain non-lucrative visa: no co-pay, no limit
The policy must come from an insurer authorised in Spain, last 1 year and pay 100% of medical and hospital costs. No deductible, no co-pay, no waiting period, no cover limit. Travel insurance is refused.
Source: exteriores.gob.es - Portugal D7: an S1 can replace the policy
The national visa checklist asks for insurance that pays medical costs, urgent care and repatriation. It says a UK S1 or a similar agreement can waive that.
Source: vistos.mne.gov.pt - Panama Pensionado: a health certificate, not a policy
You need a lifetime pension of at least B/.1,000 a month (B/.750 if you own Panama property worth over B/.100,000). The document list asks for a health certificate, not health insurance.
Source: migracion.gob.pa - Malaysia MM2H: check-up first, insurance at renewal
Main applicants must be 25 or older for Silver, Gold and Platinum. Everyone on the pass has a medical check-up at an approved clinic after approval. Health insurance is on the renewal list.
Source: mm2h.gov.my - Philippines SRRV: from age 40, no policy needed
At 50 or older with a pension of USD 800 a month (USD 1,000 with dependants), the deposit is USD 15,000. The list asks for a medical certificate from the last 6 months, not insurance.
Source: pra.gov.ph - US Medicare: almost nothing abroad
Medicare usually doesn’t pay for care outside the US. The rare exceptions are mostly emergencies where a foreign hospital is closer than the nearest US one. Medicare drug plans don’t cover prescriptions bought abroad.
Source: medicare.gov - UK pensioners in the EU: the S1
If you get the UK State Pension and live in Portugal, an S1 registered locally gives you and your dependants public care on the same terms as Portuguese nationals. You request the form from NHS Overseas Healthcare Services.
Source: gov.uk
Your visa decides the minimum
Retirement visas fall into 2 groups. Some set hard insurance rules. Thailand’s O-A is for people 50 or older and asks for 3,000,000 THB of cover. Spain’s non-lucrative visa wants a Spanish-authorised insurer with no co-pay, no wait and no cap, which rules out most cheap international plans.
Others ask for health papers but no policy. Panama’s Pensionado wants a health certificate. The Philippine SRRV wants a recent medical certificate. Malaysia’s MM2H wants a check-up after approval, then proof of insurance when you renew.
No policy on the visa list does not mean no bills. In those countries you pay every hospital bill yourself unless you buy cover. So the visa sets the floor, and your savings decide how far above it you go.
Age limits: join before the door closes
Each insurer sets a maximum age to join, and they differ a lot. APRIL International takes new customers up to 70. William Russell says you must be under 76 when cover starts, then you can renew for as long as you need. AXA Global Healthcare accepts retirees under 80. Cigna Global says it has no upper age limit for applications.
The age limit to join is not the same as the age limit to stay. William Russell and Cigna both state they keep you after the joining age. Genki Native takes people up to 55, then sets no age limit once you’re in. Ask for this in writing before you buy.
Joining late also limits how your health is checked. AXA only offers moratorium terms to people under 80. William Russell says full medical underwriting is the only choice from 55. So at 65 you will usually fill in a full health form.
Medicare and the S1 stay behind
Americans often assume Medicare follows them. It doesn’t. Medicare.gov says it usually doesn’t pay for care outside the US, and its drug plans never pay for prescriptions bought abroad. Some Medigap policies pay for emergency care on a trip, which helps on holiday but not once you live abroad.
UK state pensioners have a better deal inside the EU. With an S1, the UK pays for your public care in Portugal, Spain and other EU countries on the same terms as locals. Portugal’s visa checklist even lets an S1 replace the private policy.
The S1 only covers public care in the EU country you live in. It does not cover Thailand, Panama or Malaysia. And public care can mean waiting lists and doctors who don’t speak English, which is why many S1 holders still buy a private plan on top.
Price goes up with age
International plans charge more as you get older. Genki, for example, states that its Native price depends on your age, the benefits you pick and your deductible. Expect the premium to rise at renewal as you move up an age band, on top of medical inflation.
Two levers bring the price down. A higher deductible, the amount you pay first each year, lowers the premium. So does leaving out the US if you don’t plan to be treated there.
Before you choose, ask the insurer for its price at your age now and in 5 and 10 years. A plan that is cheap at 66 but leaves you unable to afford it at 76 is worse than a dearer one you can keep.
Conditions you already have
At 60 or 70, most people have something on their file: blood pressure tablets, a knee, a heart check. Under full medical underwriting you list it, and the insurer either covers it, excludes it, or covers it at a higher price.
Some insurers now offer cover aimed at older members. Cigna Global, for example, sells a pre-existing condition benefit for people 60 and over on its outpatient option, with a set yearly limit and a waiting period. It is a sourced example, not a recommendation.
Declare everything, even small things. If the insurer finds a missed condition at claim time, it can refuse the claim. Ankyro asks once and shows you how each insurer usually treats your answer before you apply.
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.
- Joining age and staying age
Check both. APRIL stops new customers at 70, William Russell at 75, AXA at 79. Cigna sets no limit. Staying should have no limit at all.
- It meets your visa’s exact rule
Spain needs a Spanish-authorised insurer with no co-pay. Thailand’s O-A needs 3,000,000 THB and a signed form. Match the wording, not just the amount.
- Chronic care, not just flare-ups
Some plans only pay when a long-term illness suddenly gets worse. At 70 you want monitoring, check-ups and medicines paid too.
- Evacuation and cover back home
Away from capital cities, serious care may mean a flight. Check evacuation is included, and how many weeks a year you’re covered at home.
Common mistakes
3 we see all the time.
- 01Waiting until 76 or 80 to shop. Some insurers close the door at 70, and options shrink every birthday after.
- 02Counting on Medicare abroad. It almost never pays outside the US, and its drug plans never do.
- 03Treating the S1 as worldwide cover. It pays for public care in the EU country you live in, nowhere else.
Questions
People also ask.
Can I get international health insurance after 70?+
Yes. AXA Global Healthcare accepts retirees under 80, and Cigna Global says it has no upper age limit. Others stop earlier, like APRIL at 70. You will usually need to fill in a full health form.
Does Medicare cover me if I retire abroad?+
Almost never. Medicare usually doesn’t pay for care outside the US, apart from rare cases, like an emergency where a foreign hospital is closer than any US one. Its drug plans don’t cover prescriptions bought abroad.
What insurance do I need for a Thailand retirement visa?+
For a first O-A visa, cover of at least 3,000,000 THB (USD 100,000) for the whole stay, from a Thai or foreign insurer. A foreign insurer must sign the official certificate form.
Can a UK pensioner use the S1 in Spain or Portugal?+
Yes. With the UK State Pension you can register an S1 and use public healthcare on the same terms as locals. Portugal’s visa list accepts it instead of private insurance.
Why does expat health insurance cost more over 65?+
Insurers price by age, so the premium rises as you move into older age bands. You can lower it with a higher deductible or by leaving the US out of your cover area.
Also on Ankyro
Not quite you?
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.
02Remote workersMost “nomad insurance” is travel cover you can renew. Spain won’t accept that for its nomad visa, and Thailand’s DTV asks for nothing. Here’s how to pick.
03Families abroadMaternity cover starts 10 to 12 months after you buy, and a newborn has to be added within weeks. Here are the real rules from insurers’ own pages, and how to plan around them.
05Health conditionsDiabetes, asthma, a past operation. How the insurer checks your health decides what it pays. Here is how the 2 main methods work, with real wording.
06Students abroadAustralia wants OSHC, the UK a £776 surcharge, Germany a public fund until 30. Each country has its own rule. Here they are, side by side.