International Health Insurance for US Retirees
Medicare stops at the US border. That gap doesn't have to mean going uninsured — the right international plan covers your routine care, emergencies, and hospitalization wherever you land.
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Which Type of Insurance Do You Actually Need?
International insurance isn't automatically the right answer. If you're fully settled in one place, local private insurance is often cheaper and does the job. The right call depends on how you're actually living your life abroad.
Fully settled in one country
Local insuranceYou've picked your country and you're staying. Most destination countries have affordable local private insurers — often $80–150/month — that cover you within that country. Combined with the local public health system, this is often all you need.
Note: local plans don't cross borders. A weekend in Spain or a flight home to the US isn't covered.
Traveling frequently or splitting time
International insuranceYou're based abroad but traveling around Europe, visiting the US, or haven't fully committed to one country yet. International insurance covers you across borders, includes medical evacuation, and can include US coverage — it moves with you.
This is what the plans below cover.
For country-specific guidance on local insurance options — costs, providers, and how they interact with the public health system — see our Portugal guide.
What Actually Matters When Choosing a Plan
US coverage included
If you're splitting time or visiting family, you'll want coverage that works in the US too. Not all plans include it — and those that do often charge more or limit US coverage.
Pre-existing conditions
Most plans impose a waiting period (6–24 months) before covering pre-existing conditions — some exclude them entirely. If you have ongoing health needs, this is the first thing to check, not the last. Being upfront during the application process protects you from claim denials later.
Medical evacuation
A medical evacuation back to the US can cost $50,000–100,000+. It's often a separate add-on — make sure it's included, not assumed. This is one of the highest-cost exposures of living abroad and the easiest to eliminate with a line item on your policy.
Renewal age limits
Some plans stop accepting new enrollees at 65–70. Others allow you to start at any age but price you out by 75+. You want a plan you can actually keep — check the long-term renewal terms, not just the entry price.
Plans Worth Considering
Prices vary significantly by age, destination, deductible, and coverage level. The ranges below are estimates for a 65-year-old — get a quote for your specific situation.
IMG® (International Medical Group)
~$150–280/monthat age 65, varies by plan and destination
Multiple plan tiers — from basic to comprehensive
Medical evacuation included on most plans
US coverage available as an add-on
Designed specifically for expats and international retirees
Pre-existing conditions: 12-month waiting period on most plans
Worth considering if: you want flexible plan options and strong international coverage
Get a Quote from IMG →Also worth getting a quote from:
Cigna Global
Large provider network, strong in Europe and Latin America
Allianz Care
Modular plans, strong European coverage
AXA Global Healthcare
No upper age renewal limit, strong mental health coverage
Get a Quote That's Actually Useful
Insurance quotes are only as good as the inputs. Walk in with these four things decided and you'll get a number you can actually compare.
Your destination country.
Where you're living drives the premium more than anything else. European countries cost more than Southeast Asia or Latin America — sometimes by a factor of two.
Whether you need US coverage.
If you're visiting family or splitting time, you need a plan that covers the US — not just your destination country. Not all plans include it; those that do charge more. Decide this upfront.
Your pre-existing conditions.
Every insurer will ask — and they'll find out regardless. Being upfront means your policy actually covers you when you need it. Know what you have before you fill out the form.
Get at least two quotes.
Pricing varies more than you'd expect for nearly identical coverage. There's no single right answer — comparison is the only way to know what you're overpaying.
Thinking about Portugal?
Our Portugal guide covers exactly how insurance fits into the broader picture — SNS access, D7 visa requirements, what local vs. international plans each cover, and the Social Security tax reality.
Read the Portugal Guide →