How Insurance Works When You're Working Abroad

There’s a lot to think about when you’re moving overseas, and health insurance belongs near the top of that list. Not only is it required in some countries, getting sick or injured while uninsured can be nothing short of financially disastrous. Figuring out how to get insured when you’re abroad lets you avoid the gamble.

Health insurance varies country by country, and frankly, it can get complicated. This guide is meant to get you started, no matter where you’re going or how long you’ll be there. Keep reading to learn more about how insurance works when you’re abroad, the questions you need to ask, and where to look for answers.

As mentioned above, different countries take different approaches to health care. Writer T.R. Reid broke them all into four basic systems in the book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care (via an excerpt on PBS.org).

One system centers on the government – it both provides and finances health care through taxes. Under another, the government pays for care through taxes, but there are private-sector providers. In yet another, employers and employees share the cost by paying into group funds. Finally, in the fourth, medical expenses have to be paid out-of-pocket and you get the care you can afford it.

Having four systems seems straightforward enough, but some countries don’t use just one. They might have aspects of more than one, as is the case in the United States. You’ll want to figure out which specific system or systems are in place in the country where you’ll be working.

There are several different ways to get health insurance while working abroad. We've broken down the most common ones below. You might find that you are eligible for one (or more) of these depending on which country you're working in.

Employer-Based Insurance

Given that many countries have health care systems that include some form of employer-based insurance, your hunt should start here if you have a job offer. Find out what benefits are included with your job.

If your employer does indeed have an insurance plan, the company will be able to help you get on it. It’s also important to find out what exactly what the policy covers, especially if you’re already managing an illness. If you need more coverage, you’ll want to see what supplemental insurance options are available to you.

Public and/or Private Insurance

Employer-based insurance isn’t an option for everyone, of course. It might not be common in the country where you’ll be working, or perhaps you plan to move before you secure a job. Either way, you’ve still got options.

One key issue will be your country of residence. Residence-based health care systems are common, meaning that many countries require non-citizens to establish and maintain residency in order to access services such as public health insurance. Do your research on the specific country where you’ll be living and working and determine if you’ll meet the requirements to enroll in the local health care system and obtain public and/or private insurance.

Another option is to look at the coverage offered in your home country. In the United States, you’re eligible for health insurance through the Health Insurance Marketplace as long as you are considered a U.S. “resident” for tax purposes, according to HealthCare.gov. That would give you the option to be covered by a plan with international coverage. It’s important to know, though, that not all of them offer it.

If you currently have a domestic plan, call your provider to find out if you’re covered for medical emergencies that occur overseas. It’s okay if you don’t know already. A 2017 study by InsureMyTrip found that one in three Americans are in that same boat, according to Forbes. You can find out the specifics of your plan by calling your insurer and asking about coverage abroad.

Travel Health Insurance

If you find yourself without adequate coverage or you find that there may be gaps, you can sign up through a travel health insurance provider like World Nomads. These policies tend to have flexible start and end dates, which is good considering that you should be insured for the entirety of your time abroad. Disaster and illness can strike at any time, after all.

It’s worth stating again: health insurance can be complicated. Not all plans are created equal. As the U.S. State Department puts it, “Travel insurance varies widely and one should carefully read the terms of an insurance policy to make sure it fits the needs of the traveler.”

When looking at policies, there are numerous factors you’ll want to weigh. Perhaps the most important is location. You’ll want to make sure you’re covered in all regions where you’ll travel, otherwise your health insurance could end up being essentially worthless. Beyond that, the State Department advises that you consider the plan’s financial coverage limits, if it covers preexisting conditions, if there are exclusions, and more.

Some plans might require you to pay hospital bills abroad upfront. That can understandably be a challenge, so the Centers for Disease Control and Prevention recommends finding out if your insurer will pay the hospital directly rather than reimbursing you. You should also think about whether the local health care system is equipped to treat serious injuries and purchase medical evacuation insurance if not.

Just in case you didn’t already have enough to think about, there are other types of insurance it can pay to have. Before you move abroad, it’s worth looking into other areas in which you might want to protect yourself. There are multiple kinds of insurance – some related to travel and some not – and again, the options vary by country.

In addition to travel health insurance and medical evacuation insurance, there’s trip cancellation insurance. This allows you to protect pre-paid non-refundable trip costs before you leave. If, for example, you couldn’t move abroad due to serious illness, you could get your money back on your flight.

As for non-travel-related insurance, you can consider homeowner’s or renter’s insurance to protect your property; these are actually required in some countries, so make sure you find out what you’re obligated to have. Auto insurance is another big one, as it can protect you and other drivers if car-based commuting is part of your life abroad. Further options include life insurance and long-term disability insurance should something horrible happen.

Finding insurance while working overseas can be overwhelming, but the process of selecting the right plan is still a lot easier than not having one when you need it. As horrible as it is to get hurt or sick, it’s a lot worse when you have to worry about how to pay for it. Doing the work now could save you in the long run.