Healthcare is often one of the biggest culture shocks when moving abroad, in both good and bad ways. When you’re preparing to move overseas, housing, banking, and getting visas are usually at the top of your list. But there’s one area that catches many people by surprise: Healthcare. Whether you’re planning a short-term stay or a permanent residency, the way healthcare works around the world will affect your day-to-day life more than you might think.
Plan Differences
In the U.S., health insurance is often tied to your job and comes with acronyms like PPO (Preferred Provider Organizations) and HMOs (Health Maintenance Organizations). These plans determine which doctors you can see and how much flexibility you have in choosing your care. Looking abroad, things are very different:
- Public Systems (Europe, parts of Asia, etc): In the case of needing medical attention, you’re usually covered under a national health system (if you qualify), and there’s little to no “plan shopping” required. Receiving care is more standardized.
- Private Insurance (Expats & Visa requirements): Policies are often less complex, but may require up front payments to claim reimbursement later. Some plans may also exclude any pre-existing conditions or limit coverage to certain hospitals.
- International Health Insurance: This plan is designed for expats and nomads who move frequently. These plans usually give you flexibility similar to the U.S. PPO, but at a higher price.
For many expats, the biggest adjustment is realizing that while some countries may offer lower medical costs, not all private or public policies may cover everything automatically.
Insurance Requirements for Visas & Residency
In many countries, proof of health insurance is required if you intend to stay long-term. If you’re applying for a visa in Spain, for example, you need to show private coverage that meets Spanish government requirements. In Germany on the other hand, they usually require you to join either the public insurance system or prove you have equivalent private insurance. Before making the move, be sure to research what your health insurance requirements are in that country. In the chart below, we listed a few of the most popular countries trending and what they require.
| Country/Region | Healthcare Requirement for Expats |
|---|---|
| Germany | Public or Private insurance. Public system is mandatory for employees under a certain income threshold; private insurance allowed if you qualify. Proof is required for residency. |
| Spain | Private health insurance with no co-pays/deductibles is required for long-term visas and residency permits unless you’re employed locally and qualify for public healthcare. |
| France | Public or Private insurance. Application on PUMA, income, and residency documentation required. May purchase supplemental coverage in addition. |
| United States | Not required for visas, but strongly recommended. Without insurance, medical costs are extremely high. International students may be required by their school to show proof of coverage. |
| United Kingdom | Payment of the Immigration Health Surcharge (IHS) is required with most visas, granting access to the NHS. Private insurance is optional. |
| United Arab Emirates | Private health insurance plans. Employers are required to provide coverage for workers, and dependents must also be insured. Proof is needed for residency permits. |
Language Barrier & English-Speaking Doctors
Something to consider when looking for care in your host country is finding a doctor that speaks English fluently. If you were to go to a doctor that speaks the native language of your host country, receiving the correct care could be complicated as the language barrier may prevent clear communication. Some expats keep a list of nearby doctors who speak their language or even use translation apps during visits. Another option is to join international clinics, however, expect to pay the price of convenience.
Preventative Care & Cultural Differences in Medicine
It’s important to note that not every country treats preventative healthcare in the same way. The U.S. emphasizes preventative screenings and checkups to avoid health problems later. In European countries, the focus is more on treatment when it’s needed, rather than before. In Asia, you may find more holistic and alternative practices like acupuncture or herbal medicine integrated into their main healthcare.
Prepare for Care Before the Move
Healthcare abroad, depending on the country, can be better, cheaper, and more accessible – or it can feel complicated and overwhelming. The key is to research before you move, not after. Learn the rules for insurance, understand possible cultural differences, and create a list of local doctor offices to be prepared. Preparing yourself means fewer surprises (financially and physically), and more peace of mind when you settle into your new home.
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