Health Insurance for Expats: Why Global Cover Matters
October 2026
The Safety Net You Lose When You Leave
Most people never think about health insurance because it comes with where they live. Then they move abroad, and it quietly stops.
Public health systems are tied to residence. In many countries, public cover ends when you deregister and leave, and the country you move to may not let you in until you have lived and paid there for a while, if at all. Private policies from home usually cover trips of a few weeks, not a life abroad. Travel insurance assumes you have a home you are going back to.
So the moment you build a life between countries, you are uninsured unless you deliberately fix it. For most expats it is the single most important thing to get right, and the easiest one to postpone.
What Can Actually Happen
None of these are rare. They are the situations international health insurance exists for. (Illustrative examples, not client stories.)
- An accident abroad. A scooter crash, a fall on a hike, a car accident. Private hospitals in many popular expat destinations ask for a payment guarantee or a deposit before they treat you. Without an insurer who pays the hospital directly, that is your credit card.
- An emergency operation. Appendicitis, a burst gallbladder, a broken hip. Not planned, not cheap, and not something you can fly home for.
- A diagnosis that doesn’t go away. Diabetes, an autoimmune disease, a heart condition. Travel insurance pays for the first emergency, then treats it as a pre-existing condition. You need cover for the years of treatment that follow.
- Cancer. Months of treatment, specialists, scans and medication, often with the wish to be treated at home, near family.
- A mental health crisis. Burnout, anxiety, depression. Common among people far from their usual support network, and excluded by most travel plans.
- Starting a family. Pregnancy and birth abroad, with the waiting periods that come with any plan.
- Getting older. The longer you wait, the more likely it is that something already shows up in your health history. Insurers then exclude it or charge more. Joining young and healthy is the cheapest protection you can buy.
The financial risk isn’t the doctor’s visit. It’s the one large event that costs more than you can comfortably pay, and the long-term treatment after it.
Why Travel Insurance Isn’t Enough
Travel medical insurance is good at one thing: an unexpected emergency on a trip. For a life abroad it falls short in predictable ways.
- It covers emergencies, not health care. No check-ups, no ongoing treatment, no chronic conditions.
- It runs out. Many plans stop after 12 months, or require you to return home regularly.
- It excludes what you already have. Anything that started before the policy is usually off the table.
- Home visits are limited. Often emergencies only, and only after a waiting period.
If you live abroad for the long term, you need international health insurance: full cover for doctors, hospitals, medication and long-term treatment, wherever you live, including when you visit home.
What to Protect Against, and What to Check
Before choosing any plan, check these points. They decide whether a policy works when it counts.
- Medical limit: high enough for a serious illness, not just an emergency. Look for at least €1 million a year.
- Deductible: how much you pay yourself per year, and whether it applies to hospital stays.
- Chronic conditions and cancer: covered for the long term, not just the first treatment.
- Your home country: how long you can be treated there, and under which conditions.
- The USA: full cover in the US is expensive. Most expats outside the US only need emergencies there.
- Direct billing: whether the insurer pays hospitals directly, so you don’t have to.
- Contract length: whether you can cancel monthly, or are locked in for a year.
- Entry age and health questions: how old you can be when you join, and how existing conditions are handled.
- Local rules: if you still live in a country with compulsory health insurance, a private international plan usually doesn’t replace it.
The Plan We Recommend: Genki Native
For expats who live abroad for the long term, we recommend Genki Native. It is built for exactly this situation, and it ticks the points above better than anything else we’ve looked at for people under 55.
Genki is an insurance agency based in Cologne. The insurer behind Genki Native is Squarelife Insurance AG in Liechtenstein, and MCI Assist handles hospital guarantees and emergencies. Genki pays hospitals directly.
| Genki Native Basic | Genki Native Premium | |
|---|---|---|
| Price example | From €189 a month (age 24, no deductible) | From €285 a month (age 24, no deductible) |
| Annual limit | €1 million | €3.5 million |
| Hospital and doctor visits | Included | Included |
| Medication, chronic conditions, cancer | Included | Included |
| Home country | Up to 182 days per stay, after 91 days abroad | Unrestricted |
| USA | Emergencies only, up to €250,000 a year | Emergencies only, up to €500,000 a year |
| Check-ups, dental, glasses | Not included | Included, with waiting periods |
| Therapy | In hospital only | Included, with prior approval |
| Pregnancy | Not included | Included after 12 months |
| Deductible | €0, €500 or €1,000 a year, never on hospital stays | €0, €500 or €1,000 a year, never on hospital stays |
| Contract | Monthly, cancel any time after the first month | Monthly, cancel any time after the first month |
Price example
- Genki Native Basic
- From €189 a month (age 24, no deductible)
- Genki Native Premium
- From €285 a month (age 24, no deductible)
Annual limit
- Genki Native Basic
- €1 million
- Genki Native Premium
- €3.5 million
Hospital and doctor visits
- Genki Native Basic
- Included
- Genki Native Premium
- Included
Medication, chronic conditions, cancer
- Genki Native Basic
- Included
- Genki Native Premium
- Included
Home country
- Genki Native Basic
- Up to 182 days per stay, after 91 days abroad
- Genki Native Premium
- Unrestricted
USA
- Genki Native Basic
- Emergencies only, up to €250,000 a year
- Genki Native Premium
- Emergencies only, up to €500,000 a year
Check-ups, dental, glasses
- Genki Native Basic
- Not included
- Genki Native Premium
- Included, with waiting periods
Therapy
- Genki Native Basic
- In hospital only
- Genki Native Premium
- Included, with prior approval
Pregnancy
- Genki Native Basic
- Not included
- Genki Native Premium
- Included after 12 months
Deductible
- Genki Native Basic
- €0, €500 or €1,000 a year, never on hospital stays
- Genki Native Premium
- €0, €500 or €1,000 a year, never on hospital stays
Contract
- Genki Native Basic
- Monthly, cancel any time after the first month
- Genki Native Premium
- Monthly, cancel any time after the first month
Prices and benefits as published by Genki in October 2026. Prices depend on your age and the deductible you choose.
Basic or Premium?
Basic covers what can ruin you financially: hospitals, doctors, chronic illness and cancer. Premium adds the everyday and life-stage parts: check-ups, dental, glasses, therapy and pregnancy, plus unlimited cover in your home country. If you are planning a family or spend a lot of time at home, Premium is the one.
Joining works online. You answer health questions and get an instant decision: accepted, accepted with an exclusion, accepted with a surcharge, or declined. You can join up to age 55.
What to Know Before You Sign Up
No plan covers everything. With Genki Native, keep these points in mind:
- It’s not for life in the USA. US cover is emergencies only. If you live there, you need a US plan.
- It doesn’t replace compulsory insurance. If you are still registered in a country where health insurance is mandatory, Genki Native doesn’t replace it. Deregister properly first.
- Entry is up to age 55. After that, you’ll need a different insurer.
- Plan larger outpatient treatment. Outpatient treatment costing €2,000 or more has to be announced 5 days ahead, otherwise only half is paid.
- Read the conditions once. They decide claims, not the plan page.
Bottom Line
Leaving your home country means leaving its health system. The risk isn’t a cold or a doctor’s visit; it’s the accident, the diagnosis or the long treatment that costs more than you can carry. International health insurance is what turns that from a financial disaster into an inconvenience.
Sort it out before you need it, while you’re young and healthy. For most expats under 55, Genki Native is the simplest way to do that.
Check your price
Your price depends on your age, where you live and the deductible you choose. Genki shows your exact quote before you sign up.