International Health Insurance for Expats, Anywhere in the World
Moving from Mexico to the Philippines, from London to Dubai, from Texas to Lisbon? International private medical insurance (IPMI) follows you, not your postcode. We are an EU-regulated broker appointed by Allianz Care, Cigna Global and APRIL International, three established international health insurers. Tell us four things and we come back in writing with the plans that fit you, configured side by side.
Key facts
- Insurers: Allianz Care, Cigna Global and APRIL International, compared on the same terms.
- US citizens living abroad: Cigna Global (Allianz Care does not accept US citizens).
- Eligibility: you live outside your country of nationality; the policy follows your main country of residence.
- To quote: full name, date of birth, nationality and country where you will live (plus US state for US nationals).
- Real 2026 premiums: from €5,241 a year (64, Europe, hospital only) to €39,634 (family of five, worldwide excl. USA, top level).
- No fee to you; written reply within one working day; EU-regulated broker, ASF no. 425591790/3.
What international health insurance is
International health insurance is private medical cover for people who live outside their country of nationality. Instead of a single national hospital network, you choose a geographic area — Europe, worldwide excluding the United States, or worldwide including it — and you can be treated at recognised hospitals and doctors anywhere inside it. Planned hospital treatment is normally pre-authorised and paid directly by the insurer, and the policy stays with you when you move country again.
It is not travel insurance. Travel insurance covers emergencies on a trip and ends when you go home. An international health plan is your main health insurance for the year: hospital stays, surgery, cancer treatment, specialists, and — if you choose them — out-patient care, dental, maternity and medical evacuation.
Who it is for
If your life is spread across more than one country, a domestic policy covers only part of it. These are the people we arrange international cover for every week.
Families relocating abroad
One contract for parents and children, a cover area that matches where you live and where you travel, and continuity if the next posting is in another country.
Remote workers and digital nomads
People who live in one country for most of the year and work from several. The insurer bases the policy on your main country of residence — the place where you spend most of the year.
Retirees living abroad
Cover that does not depend on a local public system you may not yet be entitled to, with the option of treatment back home or at a specialist centre within your area of cover.
US citizens overseas
Americans living abroad are placed with Cigna Global, which accepts US citizens resident outside the United States. We price worldwide cover with and without the US so you can see what the US element really costs.
Executives and high-net-worth families
High annual limits, private rooms, second medical opinions and evacuation — arranged and serviced by one adviser who knows the file.
Students and children at school abroad
Cover that works where the child actually lives, coordinated with the parents’ plan. See health cover for children at school abroad.
How an international plan is built
Every international plan is assembled from the same five decisions. Getting them right matters more than the brand on the card.
- Area of cover. Europe, worldwide excluding the US, or worldwide including the US. Including the United States is the single biggest driver of price.
- Core level. The hospital side of the plan: in-patient and day-patient treatment, surgery, intensive care, cancer care, and the annual limit that applies.
- Optional covers. Out-patient consultations and diagnostics, dental and optical, medical evacuation and wellbeing, added only if you will use them.
- Deductible. How much you pay yourself before the insurer pays. A higher deductible lowers the premium and suits people who want protection against large bills only.
- Underwriting. You declare your medical history and the insurer sets your terms. Pre-existing conditions may be covered, excluded or covered with a loading. Declaring everything is what protects a future claim.
Allianz Care, Cigna Global and APRIL International
We are appointed by Allianz Care, Cigna Global and APRIL International, so we do not have to sell you any one of them. They are built differently, and the better choice depends on your family, your area of cover and your medical history. The table sets the three side by side.
| Point of comparison | Allianz Care | Cigna Global | APRIL International |
|---|---|---|---|
| Core levels | Base, Enhanced, Signature | Silver, Gold, Platinum | Explore, Essential, Extensive, Elite |
| Hospital, private room | Included in every plan | Included in the core cover | Semi-private on Explore; standard private room on Essential, Extensive and Elite |
| Medical repatriation / evacuation | Repatriation built into every plan | Optional Medical Evacuation module | Included in every plan |
| Out-patient care | Optional addition | Optional International Outpatient module | Optional |
| Dental and optical | Optional addition | Optional Vision and Dental module | Optional |
| Maternity | Enhanced and Signature, after 12 months | Gold and Platinum, after 12 months | Essential, Extensive and Elite, after 12 months |
| Area of cover | Europe-only option, plus worldwide options | Worldwide excluding the US, or including it | Worldwide excluding the US, or including it |
| Main premium levers | Plan level, area and optional covers | Deductible, cost-share, area and modules | Plan level, deductible up to €/US$5,000, out-patient co-payment and area |
| US citizens living abroad | Not accepted | Accepted | No nationality restriction in the terms |
| Best known for | A complete core plan and strong claims service | Flexibility: build exactly the cover you want | Four hospital levels, direct billing and the Easy Pay Card |
Benefit limits, waiting periods and exclusions vary by plan level and are set out in each insurer’s table of benefits, which we send with every comparison. For the full analysis read Allianz Care vs Cigna Global.
Insurer guides: Allianz Care international health insurance · Cigna Global international health insurance · APRIL International international health insurance
Often Allianz Care
A family whose life is mainly in Europe or Asia, that wants hospital, private room and repatriation built in from the start, and values a consistent claims experience.
Often Cigna Global
Someone who wants to design the plan module by module, or who wants catastrophic protection with a high deductible and pays routine care out of pocket.
Often APRIL International
Someone who wants to choose a precise level of hospital cover with a deductible of up to €/US$5,000, a French national contributing to the CFE, or anyone who values direct billing and a payment card for costly out-patient care.
Always Cigna Global
US citizens living outside the United States. Allianz Care does not accept US citizens, so for American families Cigna Global is the plan we configure.
For everyone else with a medical history, or who needs the United States in the area of cover, we price more than one: the same profile can receive different terms and very different premiums from each insurer.
Can I get international cover where I live?
In most countries, yes. Both insurers write international cover for expatriates around the world, but every international plan has three rules worth knowing before you apply. We check all three on day one, so you never waste time on a plan you cannot buy.
1. You live outside your country of nationality
International plans are designed for expatriates. A Portuguese citizen living in Portugal, or a German citizen living in Germany, is normally not eligible. Dual nationals should tell us both nationalities.
2. Your main country of residence counts
The policy is based on where you spend most of the year, not where you are registered. If you split 160 days in one country and 205 in another, the second one is your country of residence.
3. Some countries require local insurance
A small number of countries require residents to hold cover from a locally licensed insurer — for example Brazil, Saudi Arabia, the United Arab Emirates and mainland China — and US residents need US-compliant cover. Where that applies we tell you, and explain the alternatives.
Destinations and profiles
Guides for the situations we quote most often.
Why arrange it through us
You can buy international health insurance from the insurer’s website or from a large online broker. Here is what changes when you come to us.
Three insurers, side by side, in writing
We configure Allianz Care, Cigna Global and APRIL International on the same assumptions — area, deductible, optional covers — so you compare like with like, with our recommendation in writing.
One adviser, not a call centre
The person who quotes your plan is the person who handles the medical application, the policy certificate, the renewal and the claim. You have a name and a direct line.
Regulated in the European Union
Adler & Rochefort is the brand of Ownizo, Unipessoal Lda., an insurance intermediary registered with Portugal’s supervisory authority (ASF) under no. 425591790/3, bound by EU insurance distribution rules.
Underwriting done properly
Most claim disputes start with an incomplete application. We help you declare your history clearly, and we explain the insurer’s decision before you accept it.
On your side at claim time
Pre-authorisations, direct billing with hospitals, refused or delayed claims: we deal with the insurer for you and keep you informed.
No fee to you
We are paid by the insurer. There is no charge for the quotation, the comparison, the application or the help with claims.
What our clients say
TrustScore 4.3/5 on Trustpilot · 8 reviews, October 2026. Reviews of our service across all lines of insurance, as published.
Great for this US expat with ‘vacation’ property awaiting my relocation
I was drawn to Adler & Rochefort because they were comfortable with English communication … and worked with second/vacation home owners. It was reassuring that I was asked for specific information about the property and my needs, with follow-up, before a quote was obtained. … Coverage is a clear match for my needs.
Hugo provided excellent detailed and…
Hugo provided excellent detailed and thorough service in the transition from our old policy to a new and better policy that served our needs. We highly recommend him and Adler & Rochefort for their professionalism and attentiveness.
Amazing service - highly recommend
Amazing service. Hugo was hugely knowledgeable and gave us quotes incredibly fast. He was always at the end of the phone answering questions and was very diligent in getting the right insurance for us. Highly recommend.
What international health insurance costs: real quotes
The premium depends on age, area of cover, plan level, options and medical underwriting, so there is no useful average. These are real quotes we obtained for clients in September and October 2026, anonymised. All have no deductible and are indicative until the insurer has underwritten the application.
| Profile | Area of cover | Insurer | Annual premium, entry to top level |
|---|---|---|---|
| One person, 64, living in Portugal | Europe | Allianz Care | €5,241 (Base, hospital only) to €14,027 (Signature, with out-patient) |
| One person, 43, living in Portugal | Worldwide | Allianz Care | €8,818 (Base) to €16,641 (Signature), with out-patient and dental |
| Couple, 55 and 59, living in Portugal | Worldwide excl. USA | Cigna Global | €15,951 (Silver) to €31,904 (Platinum), all modules, monthly payment |
| Family of five: two adults around 40, three children under 8 | Worldwide excl. USA | Cigna Global | €19,769 (Silver) to €39,634 (Platinum), all modules |
| US couple, 67 and 68, moving to Portugal | Worldwide excl. USA | Cigna Global | US$24,597 (Silver) to US$47,963 (Platinum) |
How to bring the premium down. Leave the United States out of the area of cover, which is the single biggest saving. Add a deductible: Cigna Global offers hospital deductibles from €275 to €7,400 and out-patient deductibles from €110 to €1,100. Choose hospital-only cover, or a Europe-only area with Allianz Care. Pay annually: Cigna Global gives 10% off compared with monthly payment.
Examples only. Your premium is set by the insurer on your own details, after medical underwriting, and is confirmed in writing before you commit.
How it works
- Send four details. Your name, date of birth, nationality and the country where you will live. US citizens add their state.
- We confirm eligibility and quote. We check the three rules above and ask Allianz Care, Cigna Global and APRIL International for quotes on matching terms.
- You choose, with our advice in writing. We explain the differences that matter for you, and you decide. Add your family and the cover area you want at this stage.
- Medical application and policy. We guide the application, the insurer underwrites it, and your policy and certificate of insurance are issued — useful for visa and residence applications. Claims, renewals and changes of country then go through us for the life of the policy.
Get your international health insurance quote
Four details are enough to start. We reply in writing within one working day with Allianz Care, Cigna Global and APRIL International configured for you.
Thank you
We will come back to you in writing within one working day.
Frequently asked questions
What is international health insurance?
International health insurance, or international private medical insurance (IPMI), is private medical cover for people who live outside their country of nationality. You choose an area of cover — Europe, worldwide excluding the United States, or worldwide — and can be treated at recognised hospitals and doctors anywhere inside it. The policy is your main health insurance for the year and continues if you move to another country.
How much does international health insurance cost?
There is no meaningful average. The premium depends on the ages of the people insured, the area of cover, the core level, the optional covers, the deductible and the outcome of medical underwriting. Including the United States in the area of cover is the single biggest cost driver. The only reliable figure is a quotation on your own details, which we provide free of charge for Allianz Care, Cigna Global and APRIL International.
Can I buy international health insurance if I live in my own country?
Normally not. International plans are designed for expatriates, so a citizen living in their country of nationality is usually not eligible — a Portuguese national living in Portugal, for example, cannot take Cigna Global. If you hold two nationalities, tell us both: dual nationals often qualify.
Which insurer is best for US citizens living abroad?
Cigna Global. It accepts US citizens who live outside the United States, with worldwide cover excluding or including the US. Allianz Care does not accept US citizens. For Americans we also ask for the state where you live, because it matters for tax purposes.
Which country counts as my country of residence?
The country where you spend most of the year. Insurers look at where you actually live, not only where you are registered. If you spend 160 days in one country and 205 in another, the second is your main country of residence.
Are there countries where international cover is not available?
Yes. Sanctioned countries are excluded, and some countries require residents to hold cover from a locally licensed insurer — for example Brazil, Saudi Arabia, the United Arab Emirates and mainland China. Each insurer also has its own list. We confirm availability for your nationality and country of residence before we quote.
Are pre-existing conditions covered?
Not automatically. International plans are individually underwritten: you declare your medical history and the insurer sets your terms, which can be cover as standard, an exclusion or a premium loading. Allianz Care, Cigna Global and APRIL International can reach different decisions on the same history, which is why we present more than one. Declaring everything is what protects a future claim.
Is international health insurance the same as travel insurance?
No. Travel insurance covers emergencies during a trip and stops when the trip ends. International health insurance is annual, comprehensive health cover for where you live, including planned treatment, specialists, cancer care and, if you choose them, out-patient, dental and maternity.
Will the policy be accepted for my visa or residence permit?
Allianz Care and Cigna Global issue a certificate of insurance in English showing the insured persons, the dates and the benefits, which is the document most consulates and immigration services ask for. Requirements differ by country and visa type, so check the checklist for your application and we will make sure the certificate matches it.
Do you charge a fee?
No. We are paid a commission by the insurer. There is no fee for the quotation, the comparison, the application or our help with claims.
Who is Adler & Rochefort?
Adler & Rochefort is the brand of Ownizo, Unipessoal Lda., an insurance intermediary registered with Portugal's Autoridade de Supervisão de Seguros e Fundos de Pensões (ASF) under no. 425591790/3, with its head office in Lisbon. We are appointed by Allianz Care, Cigna Global and APRIL International for international health insurance and are not a tied agent of any insurer.
Related reading
Allianz Care vs Cigna Global
Plan levels, modules, maternity, US cover and underwriting, compared in detail. Read the comparison
Living in Portugal?
When an international plan earns its premium for residents in Portugal, and when a Portuguese policy is the better answer. International health insurance in Portugal
Living in Spain?
Private and international health cover for residents and residence-visa applicants in Spain. Health insurance in Spain
Medical evacuation
Why frequent travellers should read the evacuation and repatriation wording before they rely on a policy. Read the guide
Children at school abroad
How to cover a child who lives in another country from the rest of the family. Read the guide
Pre-existing conditions
How underwriting works and what to declare. Read the guide
Adler & Rochefort is the commercial brand of Ownizo, Unipessoal Lda., an insurance broker registered with the Autoridade de Supervisão de Seguros e Fundos de Pensões (ASF) under no. 425591790/3, authorised to carry on insurance mediation in the life and non-life branches, and not a tied agent of any insurer. We are appointed to distribute the international health plans of Allianz Care, Cigna Global and APRIL International. Availability depends on your nationality, your main country of residence and local law, and is confirmed before any quotation. This page is general information, not advice on a specific case, and not an offer of insurance. Acceptance, cover, limits, exclusions and premium are determined by the insurer following medical underwriting and are governed exclusively by the policy conditions issued.