{"id":3899,"date":"2023-11-26T16:05:00","date_gmt":"2023-11-26T21:05:00","guid":{"rendered":"https:\/\/startabroad.com\/?p=3899"},"modified":"2026-05-14T08:59:50","modified_gmt":"2026-05-14T12:59:50","slug":"international-health-insurance-for-americans-and-canadians","status":"publish","type":"post","link":"https:\/\/startabroad.com\/es\/international-health-insurance-for-americans-and-canadians\/","title":{"rendered":"International Health Insurance for Americans & Canadians: What I Learned Using Cigna, Aetna, and GeoBlue"},"content":{"rendered":"
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Note: This blog is our personal view on the best service providers for expats. We make no money on referring customers to these services.<\/em><\/p>

As a long-term expat who has switched among multiple international jobs, being a student, and being self-employed, I\u2019ve had just about every type of health insurance you can get as an American abroad. I have also spent a ridiculous amount of time researching all of the possibilities, trying out the insurance that I thought would be best for me, and then changing my mind based on lived experience (multiple times). Hopefully you can learn from my mistakes and make your international health insurance decisions more easily!<\/p>

Disclaimer:<\/strong> I am a (fairly) young, healthy person, who has had limited health insurance needs. Most of my claims are for wellness visits and a birth control prescription. I have also gotten into a couple of bad accidents requiring ER visits abroad. My experience is very different from someone who is navigating a serious or chronic illness. That said, there are a couple of takeaways below that I think could be helpful regardless of your health circumstances.<\/p>

Top Takeaways<\/h3>

Experts who are in your corner can be very useful<\/b><\/p>

For my most recent health insurance purchase I worked with International Insurance<\/a>, a reputable insurance broker specializing in American expats. I told my broker my situation and what has frustrated me with international insurance before, and he quickly steered me away from the (more expensive) company I thought I wanted toward GeoBlue Xplorer. I highly<\/strong> recommend talking to an insurance broker. They can help you choose the best plan for you, and do it efficiently. Many brokers (including International Insurance) do not increase your premiums at all. Their commission is taken exclusively from the insurance company.<\/p>

Think carefully about needing U.S. coverage<\/b><\/p>

Most international insurance companies have an option for \u201cworldwide coverage excluding U.S.\u201d and another option for \u201cworldwide coverage including U.S.\u201d Adding the U.S. to your coverage will usually raise your premiums by a shocking amount. Before purchasing a plan, you should ask yourself, do you really need U.S. coverage?<\/p>

When I was living in East Africa my answer was yes. Due to relatively weak health infrastructure in the countries where I was living, I wanted to be able to receive specialist care back in my home country \u2013 and I did. After a pretty terrible bike accident I received great ER care in Rwanda, but wanted to get follow-up care that was not available in the country. Conversely, now that I\u2019m living in Costa Rica I don\u2019t really need U.S. care. There are plentiful specialists and procedures available here. I feel comfortable relying on the Costa Rican health infrastructure.<\/p>

If you\u2019ll be splitting your time between the U.S. and other countries, one option is to maintain your current coverage in the U.S. If you have affordable U.S. insurance through your employer, Medicare, or healthcare.gov, this may be more cost-effective than adding U.S. care to an international plan.<\/p>

If you\u2019ll be splitting your time but will mostly use health services abroad, some plans allow you to add on basic U.S. care to cover you during trips home (typically emergency cover only). That said, if you won\u2019t be spending much time in the U.S., it\u2019s probably more affordable to take out trip insurance to cover your trip dates, rather than add this to your annual plan.<\/p>

International insurance plans are not governed by the ACA<\/b><\/p>

If you\u2019ve had U.S. health insurance over the past 8 years, you may have gotten used to certain standards. For example: maternity cover upon enrollment, coverage of pre-existing conditions, and prescription coverage. None of these international health insurance plans have to be ACA compliant, and most are not. Read the fine print to be sure you understand the limitations and\/or ask your broker!<\/p>

It can be a pain to file claims in the U.S.<\/b><\/p>

Depending on which insurance company you choose, it can be a hassle to get your doctor\u2019s office to bill your insurance company. Particularly if you go with a plan from a company based in the U.K. (e.g. Aetna International) or Ireland (e.g. Allianz International), don\u2019t expect for direct billing to work. You can try, but it may make more sense to pay expenses out of pocket and then file for reimbursement. This includes doctors offices that are \u201cin network\u201d for your insurance plan.<\/p>

Plans I Have Used, and When I\u2019d Recommend Them<\/h3>

Cigna Silver<\/b><\/p>