The Complete Insurance Guide for Expats 2026
Insurance is rarely the most exciting topic in personal finance, but for expats it deserves serious attention. The comfortable assumption that "the NHS will cover me" — or that existing UK policies will still apply abroad — is wrong in both cases. And the consequences of being uninsured or underinsured as an expat can be severe.
This guide covers the five types of insurance every expat should consider, explains the difference between products that sound similar, and provides practical guidance on how to make sensible choices.
1. International Private Medical Insurance (IPMI)
This is the most urgent insurance decision when moving abroad. The NHS is a UK institution. It covers UK residents while they are in the UK; it does not cover British nationals while they live in other countries. European Health Insurance Cards (EHICs, now replaced by Global Health Insurance Cards for British nationals) provide access to state healthcare in some EU countries, but on a temporary basis — they are not a substitute for health insurance for long-term residents.
What is IPMI? International Private Medical Insurance (IPMI) is a health insurance policy designed specifically for people living outside their home country. Unlike a standard UK private health policy, IPMI provides coverage across a defined region (Europe, worldwide excluding USA, worldwide) and continues regardless of where you are living.
What does it typically cover? A comprehensive IPMI policy typically covers inpatient and day-patient treatment, outpatient consultations, specialist referrals, diagnostic tests, emergency dental treatment, emergency evacuation, maternity (as an optional module), and mental health treatment. Some policies also cover routine GP visits and prescription medication.
What it does not cover. IPMI policies exclude pre-existing conditions for new policyholders (or offer them at significantly higher premiums). Cosmetic treatment, experimental treatments, and conditions arising from substance misuse are typically excluded.
How to compare policies. Key variables are: coverage area (worldwide is more expensive than Europe-only), inpatient vs outpatient scope, deductible/excess level, insurer's network strength in your country of residence, claims process, and premium level. Comparison brokers (Cigna, Allianz Care, Aetna International, AXA Global Healthcare, and Bupa International are among the major providers) can help — but ensure you use an independent broker who compares multiple providers rather than one tied to a single insurer.
Cost. IPMI premiums vary significantly with age, coverage area, and excess chosen. A healthy 45-year-old covering Europe might pay £1,500–2,500 per year for a comprehensive policy; worldwide coverage adds a meaningful premium. Premiums rise with age; it is generally better to buy early and maintain the policy continuously.
2. Life Insurance for Expats
UK life insurance policies present a significant problem when you emigrate: many policies have residency requirements, and the insurer may cancel the policy or void claims if you move abroad without notifying them. Some policies continue to operate for UK nationals living in EU countries, but this varies by policy and insurer.
The practical issue. You may have a UK term life policy that you have held for years. When you move abroad, you should check the policy terms carefully. Failing to notify your insurer of an address change, and then suffering a claim that is rejected on the basis of breach of residency terms, would be a catastrophic outcome.
International universal life insurance. The standard solution for expats is to replace (or supplement) a UK life policy with an international universal life (IUL) policy, typically issued in the Isle of Man, Guernsey, or Cayman Islands. An IUL policy:
- Has no residency requirement — it covers you wherever you live
- Has an investment element (a cash value) that grows alongside the death benefit
- Is portable — you can move countries without the policy being affected
- Can be written in trust for IHT planning purposes
The trade-off is that IUL policies are more complex than simple UK term policies, and the costs (mortality charges plus investment charges) can be higher. For younger policyholders with long-term needs, a well-structured IUL can offer excellent value. For those over 60, the cost of life cover is significantly higher.
Sum assured. Consider what you actually need the life insurance to do. If the primary purpose is mortgage protection, insure the mortgage value. If it is income replacement for a spouse, consider 10 times salary. If it is IHT planning, the sum assured might be designed to cover the estimated IHT liability on your estate.
3. Critical Illness Cover
Critical illness insurance pays a lump sum if you are diagnosed with one of a specified list of serious conditions — typically including most cancers, heart attack, stroke, and certain other major illnesses. The payment is made on diagnosis, not on death, and you can spend it however you need.
Why it matters for expats. In the UK, a serious illness diagnosis — however devastating personally — typically means access to the NHS, sick pay from an employer, and various state benefits. An expat without critical illness cover faces the same medical bills (if their IPMI does not cover the full cost of treatment), loss of income (if they cannot work), and potentially the need to return to the UK for care — which comes with its own significant costs.
The lump sum from critical illness cover can fund treatment costs not covered by medical insurance, replace income during recovery, adapt accommodation, fund return to the UK if needed, or simply provide the financial flexibility to manage a deeply difficult period without financial pressure.
Key considerations. Cover levels typically start at £100,000 and can go significantly higher. The list of covered conditions varies between policies — compare carefully, particularly if there are conditions in your family history. Premiums increase with age; ideally buy cover when younger.
UK vs international. As with life insurance, UK critical illness policies may have residency terms. International policies from Isle of Man or Guernsey providers are generally more appropriate for long-term expats.
4. Income Protection
Income protection (also known as permanent health insurance) pays a replacement income if you are unable to work due to illness or injury. Typically, it pays up to 60–70% of your pre-disability income, after a deferred period (typically 3–6 months), until you recover, reach retirement age, or die.
Why it matters for expats. Without the NHS safety net, recovery from a serious illness or injury is more financially exposed. Employment and support from employers varies enormously between countries. For self-employed expats in particular — a very common situation, given that many internationally mobile professionals work as contractors or run their own businesses — there is no employer sick pay to fall back on.
Income protection is often described as the most important but least-purchased insurance product for the self-employed. For expats with ongoing financial commitments — a mortgage, school fees, a dependent spouse — it provides a foundation of financial security.
5. Travel Insurance vs IPMI — Not the Same Thing
This distinction causes significant confusion. Many expats who have a travel insurance policy believe they are covered for healthcare abroad. They may not be.
Travel insurance is designed for temporary travel — trips of a few days to a few weeks. It typically covers emergency medical treatment, trip cancellation, baggage loss, and similar travel-specific risks. It is not designed to cover ongoing healthcare needs, chronic conditions, or the full medical costs of a long-term resident.
Most travel insurance policies have a duration limit (typically 60–90 days per trip) and specifically exclude claims arising from conditions that existed before the trip started. They also typically exclude treatment that is not immediately necessary and could wait until you return home.
IPMI is designed for people who live abroad. It covers ongoing and planned medical care, specialist treatment, and potentially routine healthcare — not just emergencies.
If you live abroad, you need IPMI as your primary medical cover. Travel insurance can supplement IPMI for trips back to the UK or onward journeys, but it should not be the primary cover for someone resident overseas.
The Five Insurance Products Every Expat Should Have
To summarise, most expats benefit from having in place:
- IPMI — for day-to-day and significant healthcare
- Life insurance — international policy, written in trust, to protect dependants and address IHT
- Critical illness — lump sum protection against serious diagnosis
- Income protection — especially if self-employed
- Travel insurance — for trips, particularly back to the UK
The specific products, sum assured levels, and providers will depend on your age, health, family circumstances, country of residence, and budget. An independent financial adviser with experience in the expat insurance market can help you assess priorities and identify the most suitable policies.
How to Compare International Insurers
When comparing IPMI providers in particular:
- Check the insurer's financial strength. Look for a credit rating from Moody's, S&P, or Fitch. An insurer with a weak balance sheet may not pay claims reliably.
- Look at the claims process. How do you make a claim? Is there a 24-hour helpline? Do they pay the hospital directly or do you pay and claim reimbursement?
- Check the network. Does the insurer have direct billing relationships with hospitals in your country of residence? This avoids having to pay upfront and wait for reimbursement.
- Read the exclusions carefully. Pre-existing conditions, mental health, and specific treatments vary significantly between policies.
- Use an independent broker. A broker who compares multiple IPMI providers is better placed to find suitable cover than going direct to a single provider.
This article provides general information only and does not constitute financial advice. Insurance products, terms, and regulations change. Always read the policy documentation before purchasing and seek independent advice on suitability. Global Investments does not underwrite insurance products.
How Global Investments Can Help
Global Investments can provide independent advice on insurance as part of a broader financial plan, working with specialist insurance advisers to identify appropriate IPMI, life, critical illness, and income protection solutions for your specific circumstances. We do not receive commission on insurance products — our advice is objective. Contact us to arrange a conversation.
This article is for general information only and does not constitute financial, legal or tax advice. Rules, prices and regulations change; verify current requirements with a qualified adviser before acting.