Expat Healthcare Checklist: What to Sort Before You Move Abroad

Healthcare is one of the most significant practical concerns for anyone moving abroad. Leaving the NHS — the only healthcare system most UK residents have ever used — requires building a new framework from scratch. This guide sets out the healthcare checklist every expat should work through before they relocate, covering NHS departure steps, international insurance, vaccinations, medication, dental and eye health, mental health, and the specific considerations for families.

1. Make the Most of the NHS Before You Leave

The NHS provides free at the point of need care for UK residents. Once you have been non-resident for a qualifying period (the rules are complex — residency, not nationality, determines entitlement), you lose free access to NHS care. Before you leave:

Complete any outstanding medical appointments. Schedule a general health check with your GP. Address anything you have been putting off — specialist referrals, minor procedures, chronic condition management reviews. This is the time to be proactive.

Repeat prescriptions. Request a longer supply of any regular medications before departure. UK GPs can typically supply two to three months of prescription medication. Some medications are unavailable abroad, available under different brand names, or require a local prescription. Research this for your specific medications.

Dental. Book a full dental examination and treatment before leaving. Dental treatment abroad varies enormously in cost and quality; some countries have excellent affordable dentistry (Spain, Portugal, Hungary), others are very expensive (USA, Switzerland, Australia). Starting abroad with a clean bill of dental health avoids urgency and unexpected cost.

Eye tests and glasses/contact lenses. Update your prescription and obtain a copy of it. Stock up on contact lenses and obtain a spare pair of glasses. Optician services are widely available internationally but your UK prescription in hand speeds up the process.

Vaccinations. Review your vaccination status with your GP or a travel health clinic. Some destinations require or strongly recommend vaccinations not routinely given in the UK — hepatitis A/B, typhoid, Japanese encephalitis (for some Asian destinations), rabies, yellow fever. Allow adequate time — some courses take multiple doses over weeks or months.

Collect medical records. Request a summary of your GP records, particularly relevant for any chronic conditions, allergies, or previous serious medical events. Having this available in English (and translated if needed) is invaluable when registering with doctors abroad.

NHS-prescribed items. Compression stockings, orthotics, CPAP supplies, and similar prescription items may be harder to access or more expensive abroad. Stock up or identify equivalent suppliers internationally.

2. Sort Out International Health Insurance

The NHS does not follow you abroad. For most destinations, you will need health insurance from day one of residency. Your options:

International Private Medical Insurance (IPMI). A globally portable health insurance plan that covers you anywhere in the world (or within a defined region). IPMI is the gold standard for expats — it provides continuity of cover as you move between countries, covers emergency repatriation to the UK if needed, and can be tailored to include or exclude the USA (which significantly affects premiums).

Leading IPMI providers as of 2026 include Cigna Global, AXA – International, Allianz Care, Bupa Global, Aviva International, and William Russell. Compare on:

• Annual maximum benefit (look for at least USD 1–2 million per year minimum)
• Out-patient vs in-patient cover (out-patient — GP visits, tests — is significantly more expensive to include)
• Pre-existing condition terms (most plans have waiting periods or exclusions)
• Geographic scope (worldwide including USA vs worldwide excluding USA — latter is 30–50% cheaper)
• Emergency medical evacuation cover (essential — this alone can cost USD 50,000–200,000 without insurance)
• Dental and optical add-ons

Local health insurance in the destination country. Some countries require a local plan (UAE, for example, requires employers to provide local health insurance). These often have limitations — low annual limits, restricted networks, no cover outside the country. Layer IPMI on top if employer cover is mandatory but insufficient.

European Health Insurance Card (EHIC) / Global Health Insurance Card (GHIC). UK nationals are entitled to a UK Global Health Insurance Card (GHIC), which covers medically necessary treatment in EU countries at the same level as a local resident. This is useful for short trips back to Europe but does not substitute for comprehensive IPMI as a resident.

Apply for your IPMI before you leave. Most insurers require a cooling-off period and some have specific application timing rules relative to departure date.

3. Pre-Existing Conditions — Plan Carefully

IPMI underwriting for pre-existing conditions is one of the most complex aspects of expat health planning:

• Most plans will exclude pre-existing conditions for a defined period (often two years) before covering them, or may permanently exclude them.
• Some plans use "moratorium underwriting" — conditions not treated in the two to five years preceding the policy start date may be covered after a further two-year claim-free period.
• Full medical underwriting at inception is more transparent — the insurer reviews your medical history and specifies what is included and excluded from day one.

Disclose fully and accurately. Non-disclosure of material medical information can invalidate claims — not merely the excluded condition, but potentially the entire policy.

If you have a significant pre-existing condition, specialist medical insurance advisers can help identify the most favourable underwriting terms across the market.

4. Medications Abroad — A Checklist

Research availability. The same drug may be sold under a different brand name, be unavailable, or be prescription-only where it was over-the-counter in the UK. Websites such as the International Society of Travel Medicine, the MASTA clinic, and WHO provide guidance. Your pharmacist can also advise on equivalents.

Carry a letter from your doctor. For any prescription medications, carry a letter from your UK GP (on headed paper, dated, with your name and date of birth) explaining your condition and the medication. Many countries require this for importing prescription drugs through customs.

Check customs rules. Some medications are controlled substances that cannot be imported into certain countries. Pain medications, ADHD medications (e.g., Adderall, Ritalin), sleeping aids, and some antidepressants face import restrictions in countries including Japan, the UAE, Indonesia, and several others. Research your specific destination carefully.

Travel with adequate supply. Carry at least three months' supply in your hand luggage (not checked bags — luggage can be lost). For long-term relocation, establish a local prescription relationship as soon as possible after arrival.

5. Mental Health Provision

Mental health support is often overlooked in pre-relocation healthcare planning. Relocation is stressful — even to a desirable destination. The psychological challenges of uprooting your life, leaving social networks, adjusting to a new culture, and (for accompanying partners) losing professional identity are real and significant.

Before you leave:

• If you currently see a therapist or counsellor, have a conversation about transitioning — many therapists now work online internationally.
• Research English-language therapists and mental health support in your destination city. Expat communities (Facebook groups, InterNations) are often the best source of personal recommendations.
• Check that your IPMI plan includes mental health cover — many basic plans exclude or limit psychiatric and psychological treatment. This is worth upgrading for.

6. Family Healthcare Considerations

Children's healthcare. Research how children's healthcare works in your destination. Are paediatric GP services in English available? Where is the nearest reputable children's hospital? Do school-age children need to show evidence of vaccinations to enrol in school?

Vaccinations for children. Check your children's vaccination record and ensure it is up to date before departure. Some destination schools require specific vaccination records. Carry certified copies of vaccination certificates.

Pregnancy and maternity. If you are pregnant or planning to become pregnant, research maternity care carefully before committing to a destination. Healthcare quality for maternity varies enormously; some destinations (particularly in the developing world) have significant gaps. Your IPMI plan's maternity cover terms are particularly important here.

Elderly dependants travelling with you. If you are relocating with elderly parents or in-laws, their healthcare needs are more complex. IPMI premiums rise significantly with age (above 65 and particularly above 75). Pre-existing conditions in older individuals can make comprehensive cover expensive or unavailable. Plan well in advance.

7. Register Quickly on Arrival

On arrival in your new country, registering with local healthcare is a priority:

• Register with a GP/family doctor as soon as you have your local residence documentation.
• Register with dentist and optician.
• Activate your IPMI plan and confirm the card is valid.
• If the country has a national health registration process (France's CPAM, Spain's tarjeta sanitaria, Australia's Medicare), complete this promptly.
• Save emergency service numbers — these are not 999 in most countries.

How Global Investments Can Help

Healthcare planning is one element of the broader pre-relocation financial checklist. Global Investments works with clients to ensure their international insurance arrangements — health, life, and income protection — are structured appropriately for their destination and circumstances. We can refer clients to specialist IPMI brokers and provide guidance on how healthcare costs interact with overall financial planning for an internationally mobile life.

This guide is for general information only. Healthcare rules, insurance terms, and visa requirements change frequently. Always seek professional medical advice before making changes to your health management and consult a qualified insurance adviser before selecting cover. Investments can fall as well as rise in value.