Health insurance for US citizens living abroad
Medicare and most US health plans stop at the border. If you live in Portugal, Spain, Mexico or anywhere else outside the United States, you need a plan built for where you actually live. For US citizens that plan is Cigna Global, and we arrange it from quote to claim.
Why your US cover is not enough abroad
Medicare is explicit about it: it usually doesn’t cover health care while you’re outside the U.S., with narrow exceptions, and Medicare drug plans do not cover prescriptions bought abroad. Employer and Marketplace plans are built around US networks and usually treat care abroad as an emergency at best.
Once you live in another country, the question is no longer travel cover for a trip. It is your main health insurance for the year, in the country where you live, with a way back to the United States when you need it.
Why Cigna Global, not Allianz Care
We work with both insurers, but only one of them accepts Americans. Allianz Care does not accept US citizens. Cigna Global does, provided you live outside the United States. So for American families we configure Cigna Global, at the level that fits: Silver, Gold or Platinum.
- Worldwide excluding the USA. Full cover where you live and travel, with emergency hospital treatment in the US included up to €75,000 on Silver and €200,000 on Gold, and paid in full on Platinum.
- Worldwide including the USA. Planned treatment back home as well. It is the most expensive option, and we price it side by side so you can see what the US element really costs.
- Visits home. When the US is inside your area of cover, Cigna covers temporary stays in your country of nationality of up to 180 days per policy year.
Why we ask for your US state
When you select US nationality on our form, it asks for the state where you live or last lived. Cigna needs it for tax purposes when it prepares and documents the policy, so asking at the start saves a round of emails later.
What it costs: a real example
In September 2026 we quoted a US couple aged 67 and 68 who were moving to Portugal, with worldwide cover excluding the USA and no deductible: US$24,597 a year on Silver, US$35,738 on Gold and US$47,963 on Platinum, indicative before underwriting. A deductible, fewer modules or annual payment bring the figure down. More examples are on our international health insurance page.
Residence visas in Portugal and Spain
Most residence routes ask for proof of health insurance. Cigna issues a certificate in English with the insured persons, dates and benefits. Requirements differ by country and visa, so send us the checklist your lawyer or consulate gave you and we make sure the certificate matches it. For Portugal, see also health insurance in Portugal for Americans.
How we work
Both insurers, side by side
Allianz Care and Cigna Global configured on the same terms, with our recommendation in writing.
One adviser, quote to claim
The person who quotes your plan handles the application, the certificate, renewals and claims.
No fee to you
We are paid by the insurer. Quotation, comparison and help with claims cost you nothing.
Get your international health insurance quote
Four details are enough to start. We reply in writing within one working day with Allianz Care and Cigna Global configured for you.
Thank you
We will come back to you in writing within one working day.
Frequently asked questions
Does Medicare cover me if I live abroad?
Usually not. Medicare states that it usually doesn’t cover health care outside the US, with narrow exceptions such as some emergencies where a foreign hospital is closer than the nearest US hospital. Medicare drug plans do not cover prescriptions bought abroad.
Can I have Cigna Global and keep Medicare?
Yes. Cigna Global is independent of Medicare. Whether to keep Medicare Part B while you live abroad is a personal decision with long-term consequences, including possible late-enrolment penalties if you drop it and re-enrol later, so it is worth checking with a US Medicare adviser.
Can the policy include treatment in the United States?
Yes, by choosing worldwide cover including the USA. It is the most expensive area of cover. Plans that exclude the US still include emergency hospital treatment there up to a limit that depends on the level.
Why can’t I have Allianz Care?
Allianz Care does not accept US citizens. That is the insurer’s rule, not ours, which is why we place American clients with Cigna Global.
Do I have to live in Portugal or Spain to work with you?
No. We arrange international cover for US citizens living in any country where Cigna Global is available. We confirm eligibility for your country of residence before we quote.
Related reading
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.