22 June 2022 · Packing Up and Landing Smooth · Global
Travel Insurance vs Expat Health Insurance: Your Step-by-Step Safety Net for Moving Abroad
“The only thing more expensive than good insurance is no insurance.”
— Every relocation coach, ever
If you’re reading this, chances are your Pinterest boards are filled with dreamy street-market photos and your bookmarks overflow with visa requirements. Yet there’s one tab you keep skipping: health coverage.
I get it. Comparing travel insurance with expat (a.k.a. international private medical) insurance feels like pitting a Swiss Army knife against a surgical tool—both sharp, but built for different situations. As your virtual relocation coach, I’ll walk you through:
- The practical differences between the two policies
- A pre-move checklist to lock coverage before wheels-up
- Arrival-week must-dos that protect both wallet and well-being
- Budget techniques for those make-or-break first 30 days
- My favourite tools and local intel that keep clients healthy on the go
By the end, you’ll know exactly which insurance suits your journey—and have a clear plan to implement it.
1. Travel Insurance vs Expat Health Insurance: The Quick-Start Overview
| Feature | Travel Insurance | Expat Health Insurance |
|---|---|---|
| Intended duration | Trips up to ~180 days (varies by provider) | Long-term stays (6 months – multi-year) |
| Core focus | Emergency medical + trip mishaps (delays, lost luggage) | Comprehensive, ongoing healthcare (GP visits, chronic care, maternity) |
| Portability | Follows you per trip | Follows you globally or in chosen regions |
| Underwriting | Often “instant issue” with fewer health questions | Detailed medical questionnaire; pre-existing conditions assessed |
| Cost structure | Low upfront, may have per-claim excess; renew each trip | Higher annual premium, but predictable monthly cost |
| Good for… | Backpackers, business travellers, short-term nomads | Expats, cross-border families, remote workers settling abroad |
👉 Rule of thumb:
If you can still remember where you left your return ticket, travel insurance probably does the trick. If your return date is “someday, shrug emoji,” move on to expat health insurance.
2. Pre-Move Preparation Checklist
Think of this as packing cubes for your peace of mind. Tackle each item 4–6 weeks before departure (sooner if you have pre-existing conditions that need underwriting).
2.1 Map Your Medical Risk Profile
- List previous diagnoses, medications, or ongoing therapies.
- Check your destination’s healthcare costs—an ER visit in the U.S. can flatten a savings account faster than you can say House, M.D.
- Examine visa requirements; some countries (e.g., Thailand’s O-A long-stay visa) mandate specific insurance limits.
2.2 Choose Your Policy Type
• Short sabbatical (<6 months): Get a robust travel insurance policy with at least USD 1 million in medical coverage, plus evacuation.
• Long-term relocation: Collect quotes from expat insurers (Cigna Global, Allianz Worldwide Care, April International). Compare not just premiums but network quality in your future city.
2.3 Confirm Region & Exclusions
Many expat plans let you exclude the United States to drop your premium by 30–50 %. Double-check whether neighboring countries you plan to visit are still covered.
2.4 Align Coverage Start Dates
Synchronize coverage with:
• Termination of your domestic plan (if U.S.-based, note ACA 60-day special enrollment windows)
• Flight departure time—insurance nerds know policies start at 00:01 local time, not take-off.
• Accommodation lease; accidents often spike in the frantic move-in phase.
2.5 Gather Documentation
Keep digital copies of:
• Policy certificate & emergency hotline numbers
• Vaccination records (COVID, yellow fever, etc.)
• Prescriptions with generic drug names (brand names differ abroad)
Throw them in an encrypted cloud folder and a USB key—belt and suspenders.
3. Arrival Week Must-Dos
You’ve landed, bleary-eyed but thrilled. While the instinct might be to Instagram that first pastry, spend Day 1-7 ticking off these tasks.
3.1 Register with Local Healthcare (if relevant)
Countries like Spain require expat residents to sign up for the padrón (municipal registry) before they can access public clinics or even open a bank account. Your private expat insurance does not exempt you—you still need the paperwork.
3.2 Locate In-Network Providers
Log into your insurer’s app and bookmark:
• Nearest emergency hospital
• English-speaking GP (ask expat Facebook groups if directories look bare)
• 24/7 pharmacies (farmacia de guardia in Spain, Apotheken-Notdienst in Germany)
3.3 Set Up Direct Billing
Nothing ruins a honeymoon phase like paying €5,000 upfront for appendicitis. Contact the clinic’s billing desk to place your insurer’s guarantee of payment on file. Most do it within 24 hours by email.
3.4 Understand Evacuation Scenarios
Expat plans usually cover medical evacuation to the nearest center of excellence, not necessarily “home.” Memorize the hotline protocol; evac decisions are doctor-led, not customer-led. (Pro tip: Add the hotline as an ICE contact in your phone.)
3.5 Keep Receipts, Always
Whether you’re filing a digital claim for a sprained ankle or a lost Kindle, insurers want original receipts. I recommend the free app GENICON to snap and auto-back up.
4. Budgeting Tips for the First Month
Health costs may feel abstract until they ambush you. Here’s how to keep control:
4.1 Forecast Your Premiums
• Travel insurance: Pay once pre-trip; renew only for extra side journeys.
• Expat health: Annual premium, but most providers allow monthly payment with a 3–5 % surcharge. Set up auto-debit on your new bank account to avoid lapses.
4.2 Build a “Healthcare Buffer” Fund
Allocate the equivalent of one policy excess (deductible) + USD 500 for out-of-pocket meds and consults. Park it in a high-yield account or local fintech wallet—think of it as self-insurance for minor hiccups.
4.3 Leverage Local Rates
In many countries, paying cash for simple care can be cheaper than traveling to an in-network hospital. Example: A GP visit in Lisbon runs ~€40. Your expat plan might have a €50 deductible per visit. Choose wisely—just keep receipts for potential reimbursement.
4.4 Don’t Forget “Invisible” Costs
• Vaccination boosters not covered by private plans
• Translation fees for medical reports
• Courier charges for prescription refills from home
Tracking these on a spreadsheet early helps you refine next year’s budget.
5. Tools and Local Resources to Keep You Healthy
Below are my staple recommendations, field-tested with clients on five continents.
5.1 Digital Swiss Army Knives
• GeoBlue Member Hub / Cigna Wellbeing App – file claims, find doctors, request telemedicine.
• Air Doctor – book same-day appointments, upfront pricing.
• Wise – pay foreign medical bills minus bank fees.
• BorderPilot’s Time-Zone Planner – pairs perfectly with our guide on managing time zones when working remote so late-night calls don’t torpedo your immune system.
5.2 Local Expat Groups
Search “Expats in ___ (city)” on Facebook or Meetup. Besides social events, these communities maintain living Google Sheets of recommended dentists, physiotherapists, even pet vets.
5.3 Multilingual Emergency Lines
Program into your phone:
• European Union: 112
• Thailand Tourist Police: 1155
• Australia Poisons Information: 13 11 26
Your insurer’s hotline often three-way calls with local operators to smooth language barriers.
5.4 Cultural Health Nuances
Cross-cultural couples in particular discover how differently nations think about preventive care (hello, dental coverage gap in France!). If that’s you, bookmark our piece on where cross-cultural couples can build a life for more on balancing healthcare expectations.
6. FAQ: Rapid-Fire Clarifications
Q: Can I start with travel insurance and “upgrade” mid-year?
A: Generally, yes—but you’ll need to disclose any claims made while travelling, and waiting periods (especially for dental or maternity) reset with the new expat plan.
Q: Are pandemics covered now?
A: Most insurers learned their lesson in 2020 and include COVID-19 like any other illness, but read the fine print about government advisories.
Q: What about mental health?
A: Expat policies increasingly include tele-psychology sessions. Travel insurance rarely covers non-emergency mental health; if that’s a priority, go expat.
Q: My credit card offers “free” travel insurance. Good enough?
A: Fine for flight delays, rarely adequate for medical claims above USD 100k. Always check caps and pre-existing condition exclusions.
7. Decision Time: Which Insurance Should You Choose?
Use this mini-flowchart:
- Duration: >6 months abroad? → Jump to Step 2, else travel insurance.
- Access to Public Healthcare: Will you have immediate local coverage (e.g., EU Blue Card holders)? If yes, consider a minimal top-up. If no, go comprehensive expat plan.
- Pre-Existing Conditions: Significant history? Start underwriting early, or you might have gaps.
- Future Mobility: Planning multi-country hops? Travel insurance works short-term, but an expat plan’s portability may save headaches when you swap continents.
Still torn? BorderPilot’s relocation engine can model premium scenarios side-by-side using real-time cost data—no phone sales pitch required.
8. Case Study: Sofia & Kenji’s Two-Phase Move
Sofia (a Mexican UX designer) and Kenji (a Japanese data analyst) took a 90-day Iberian road trip before settling in Berlin. They:
- Bought a 3-month travel policy covering Spain & Portugal.
- Applied for German freelance visas; underwriting for an expat plan ran concurrently.
- Activated their expat health insurance the day they crossed into Germany, ensuring zero gap.
- Saved €420 by excluding U.S. coverage and redirecting that cash toward language classes.
Moral: Flexibility + timelines = happy wallet.
9. Final Thoughts
Relocating is equal parts exhilaration and admin. Choosing between travel insurance and expat health insurance is non-negotiable adulting—but it doesn’t have to feel like pulling teeth (which, by the way, is covered on most top-tier expat plans).
With the step-by-step prep above, you’re ready to pack, jet, and land smooth—fully insured from day one.
Ready to see how coverage fits into your broader relocation budget?
Create your free, personalised relocation plan with BorderPilot and let data do the heavy lifting while you focus on the adventure ahead.