Health is one of the main risks of living abroad, and medical insurance addresses it from two sides at once: formally (you won't get a visa or residence permit without a policy) and practically (access to proper healthcare and evacuation if something happens far from home). It makes sense to select a policy at the preparation stage for relocation: program requirements and processing times often turn out to be strict constraints, and searching for insurance at the last moment is risky.
Context: the expat insurance market
The separate expat insurance market grew out of corporate needs: for decades, international policies were issued to diplomats, oil and gas company employees, and those sent abroad by their employers on business trips. In the 2010s, a new audience joined them—relocators and digital nomads who move on their own and buy policies directly. This is how a niche corporate product turned into a mass-market segment with dozens of providers and online enrollment.
There is almost no official market statistics: regulators do not track international private medical insurance separately, so the overall volume is difficult to estimate. However, the largest players are visible. Cigna claims 86 million clients in more than 200 countries and a vast network of clinics and doctors; Bupa Global operates in approximately 170 countries, Allianz Care is represented in more than 200 territories, joined by AXA and BCBS Global (GeoBlue). Competition and online enrollment have made policies accessible not only to corporate clients but also to private relocators and digital nomads.
Concept
For a relocator and digital nomad, health insurance is a mandatory element of relocation on par with a visa and housing. It has two roles: legal (visas and residence permits directly require a policy) and practical (access to quality healthcare abroad and evacuation in an emergency). Two classes of policies coexist in the market—international and local; the choice between them is determined by lifestyle and the requirements of a specific program. It affects both the price and whether the policy will continue to work after the next move.
When insurance is mandatory
A Schengen visa requires travel medical insurance with coverage of at least €30,000: it must include hospitalization, emergency care, and repatriation, including in case of death, be valid in all Schengen countries, and cover the entire duration of the trip. Similar requirements are built into long-stay visas: the Japanese digital nomad visa requires private insurance with coverage from 10 million yen, UAE visas and residence permits require a policy valid in the country. Therefore, it is logical to select insurance immediately according to the requirements of the program under which the application is submitted.
Global or local
An international policy (international private medical insurance) covers treatment in several countries, transfers when relocating, includes medical evacuation and repatriation, provides a choice of clinics, and often direct settlements between the insurer and them. A local policy is tied to a country and a network of medical facilities, costs less, but may not work abroad. For settled residence permits, a local insurance policy recognized by the local program is often sufficient; for a mobile life with frequent moves, an international policy that does not need to be reissued at every border is more practical.
What to look for in a policy
Key parameters are coverage zone (worldwide or worldwide excluding US, since the US dramatically increases the policy cost), overall limit of liability, coverage composition (outpatient and inpatient treatment), attitude toward pre-existing conditions, availability of medical evacuation and repatriation, and the possibility of direct settlements between the insurer and the clinic. For visa purposes, it is additionally verified that the insurer is recognized by the program and that the amount and conditions meet its requirements.
Regulation by country
Specific requirements are set by the entry program, so regulation should be studied before purchasing a policy. A familiar benchmark for everyone is the Schengen minimum of €30,000 under the Visa Code; for long-term residence, countries set their own, significantly stricter conditions, and this is where differences begin.
Two examples are illustrative. Spain for a non-lucrative visa requires full medical insurance from an insurer licensed in the country (DGSFP), with coverage at the level of the state system, without co-payments (sin copago), without waiting periods (sin carencias), and without a sum limit; a regular travel policy is not accepted here. The UAE made health insurance mandatory in all seven emirates from January 1, 2025—without it, a residence visa is not issued or renewed; in Dubai, the requirement has been in effect since 2016, the policy must cover a minimum of 150,000 dirhams per year, and a monthly fine is imposed for an uninsured family member.
How much does it cost
The policy price is made up of several factors. The main one is the age of the insured: the rate grows fastest with years. Next come the coverage zone (the worldwide including US option is noticeably more expensive than worldwide excluding US because American healthcare sets the upper bar for expenses), the level of coverage (from basic inpatient to full outpatient treatment, dentistry, and maternity), and the size of the deductible.
The order of amounts is roughly as follows: basic international plans start from $1,500 per year per adult, full worldwide programs cost $3,000–$8,000 and above, and family policies cost proportionally more (figures are approximate and heavily depend on age and content). A deductible helps reduce the premium: the more expenses a person takes on, the cheaper the policy. Subscription products for nomads are cheaper than full IPMI, but their coverage is more modest, so they are separately checked against visa requirements.
Trends and outlook
The main market backdrop is medical inflation. According to WTW and Aon estimates, the global rate of medical cost growth in 2025 is around 10%, and double-digit growth is projected to continue in 2026; healthcare is becoming more expensive fastest in the Middle East, Africa, and Asia. For a policyholder, this means that the premium will grow year after year even without changes in conditions.
The products themselves are also changing: flexible insurance for digital nomads with monthly payments has appeared, telemedicine and mental health coverage are expanding, insurers more often offer direct settlements with clinics to spare the client from advances. For families with children and affluent clients, demand is growing for premium-level programs with access to the world's best clinics.
This material is for informational purposes only and does not constitute individual legal, insurance, or medical advice.