Our insurance policies for expatriates

Expatriate insurance: what do you need to know before moving abroad?

Moving abroad is a major undertaking that requires you to plan ahead for a number of issues, to ensure your move goes as smoothly as possible: accommodation, administrative procedures, employment, schooling, and also social security. Your health is your most precious asset, so you must ensure you are fully protected when you move. Depending on your destination country and your status, your healthcare costs may not necessarily be covered by the local system.

Therefore, if you do not have access to a comprehensive local social security scheme, taking out a good expatriate insurance policy is essential for living abroad with complete peace of mind. Expatriate insurance provides health cover tailored to a long-term stay abroad. Whether it’s hospitalisation, doctor’s appointments, medication, maternity care or assistance: the cover provided varies depending on the policy and should be chosen based on your destination, your family situation and your needs, both now and in the future.

A specialist in international mobility since 1979, ACS offers a range of lifelong, flexible and customisable health insurance policies for expatriates, with a choice of cover: from the first euro, from the first dollar, or as a supplement to the Caisse des Français de l’étranger (CFE). The aim? To enable you to build a level of cover that is consistent with your plans and the healthcare system in your host country.

What is expat health insurance?

Expatriate health insurance is a form of medical cover designed for people who are moving to another country on a long-term basis, i.e. for one or more years.

It may cover all or part of the medical expenses incurred abroad, subject to the conditions, cover and limits set out in the policy. Unlike cover designed for a one-off trip, it can cover both day-to-day medical care and hospitalisation.

However, the cover provided depends on the policy you choose: you should check which treatments are covered, the geographical area, the financial limits and any exclusions before taking out a policy.

Depending on the policy chosen, international health insurance for expatriates may cover, amongst other things:

• consultations with a general practitioner or specialist;
• examinations, tests and medical imaging procedures;
• prescribed medicines;
• hospitalisation;
• dental and optical care;
• maternity;
• medical assistance and repatriation.

Some cover is included, such as cover in the event of hospitalisation, whilst other cover is optional. Maximum limits, excesses, waiting periods or exclusions may also apply. It is therefore essential to check the terms and conditions of the policy before taking out cover.

What is the difference between travel insurance and expat insurance?

Travel insurance mainly covers unforeseen events during a temporary stay, whilst expat insurance can cater for healthcare needs associated with a long-term move.

Travel insurance is generally designed for a temporary stay and primarily covers unforeseen or urgent events (a new illness, an accident, hospitalisation) occurring whilst abroad.

Expatriate health insurance is a comprehensive health cover designed to meet the day-to-day and long-term needs of someone living in a new country. Depending on the policy chosen, it may include routine medical care, regular check-ups, maternity cover, and even dental and optical care. The difference therefore also lies in the nature of the care covered, not just the length of the stay.

The right policy depends, amongst other things, on the length of your stay, your status, your destination and the nature of your medical needs.

Why take out health insurance for your time living abroad?

Expatriate health insurance can help keep your healthcare costs abroad down when the cover you have leaves you liable for some of the expenses.

When you move abroad, your social security cover changes. If you move abroad to work as an expatriate, you will generally no longer be covered by the French social security scheme and will instead be covered by the statutory scheme in your new country of residence. However, the rules vary depending on your status, your destination and whether there is a social security agreement with France. 

Health insurance for expatriates can supplement the reimbursements available or cover the treatment specified in the policy from the very first euro, in order to limit the out-of-pocket expenses you would otherwise have to pay.

The local scheme may offer adequate cover, but it may also involve waiting periods for enrolment, limited reimbursements, restricted access to certain healthcare facilities or a significant out-of-pocket cost. In some countries, private healthcare, specialist examinations or hospitalisation can be very expensive. Before you travel, the official advice from France Diplomatie, the website of the Ministry for Europe and Foreign Affairs, can help you identify the key points to check.

Health insurance tailored to expatriates can therefore offer:

• to supplement the cover provided by the local scheme or the CFE;
• to be covered from the very first euro, depending on the policy;
• to access a network of healthcare professionals or healthcare facilities;
• to limit the out-of-pocket costs in the event of expensive treatment;
• to benefit from the support services provided for in the contract.

The aim is not to automatically choose the most comprehensive cover, but rather the cover that truly matches the risks, healthcare costs and requirements in your country of residence.

What social security cover is available to an expatriate?

An expatriate’s social security cover depends on their status, their country of residence and the applicable social security agreements.

Before choosing health insurance for your time abroad, start by determining which scheme you will be covered by. An employee temporarily seconded by their employer may, under certain conditions, remain covered by the French scheme. An expatriate worker is, in principle, covered by the social security scheme of the country in which they are working. As you will have realised, it is important to distinguish clearly between secondment and expatriation.

The rules vary depending on your destination and the applicable agreements. To find out which rules apply to your situation, please consult the CLEISS guide on moving abroad and the ‘Social Protection’ page on the France Diplomatie website.

The host country’s healthcare system

Depending on local legislation and your status, enrolment in the country’s public or private healthcare scheme may be compulsory. The level of cover varies considerably from one destination to another: some schemes cover a large proportion of healthcare costs, whilst others leave a significant portion of the costs to be borne by the insured person. In particular, check the conditions of enrolment, the waiting periods before cover begins, the healthcare facilities available, the treatments covered and the cover provided for your spouse or children.

The Fund for French Nationals Abroad

For French expatriates, the Caisse des Français de l’étranger (CFE) offers the option of voluntarily taking out cover modelled on the French system. The CFE provides several separate insurance schemes, including health, occupational risks and pensions. Enrolment in health insurance does not therefore automatically entail paying pension contributions.

The CFE reimburses medical treatment in accordance with its own scales, which depend, amongst other things, on the nature of the expenses and, in some cases, on the country where the treatment is provided. If local medical fees exceed the amounts covered, you may still be liable for the balance.

Membership of the CFE does not exempt you from contributing to the compulsory scheme in your country of residence where local legislation requires it. Supplementary health insurance for expatriates may cover costs after the CFE has reimbursed you, thereby reducing the amount you are left to pay, up to the limits of the cover taken out. Depending on the policy, it may also include repatriation assistance, which is not covered by the CFE.

Supplementary expatriate insurance to the CFE

Supplementary expatriate insurance, which complements the CFE, comes into effect after the CFE has made its reimbursement, in order to cover all or part of the remaining costs for which you are liable, subject to the terms and limits set out in the policy. It works in a similar way to supplementary health insurance in France: the CFE provides the basic cover and the insurance policy supplements this cover.

Depending on the plan chosen, this expatriate health insurance can provide enhanced cover for hospitalisation, doctor’s appointments, medication, dental or optical care, and maternity care. It may also include cover or services not provided under the CFE’s health insurance scheme, such as repatriation assistance or personal liability cover, depending on the policy.

This solution is aimed in particular at expatriates who wish to maintain a link with the French system whilst adapting their level of cover to the cost of healthcare in their country of residence. To assess the cost, however, you must take into account the CFE contribution, the supplementary insurance premium and, where applicable, compulsory contributions to the local scheme.

Expatriate insurance covering claims from the very first euro or dollar

An expatriate insurance policy covering from the first euro (or dollar) pays for covered expenses from the very first euro or dollar spent, without requiring prior reimbursement from the CFE. It operates independently, in accordance with the limits, excesses, cover percentages and exclusions set out in the policy.

This solution may be suitable for expatriates who do not wish to, or are unable to, join the CFE, as well as for those seeking international health insurance managed by a single organisation. However, it does not replace any compulsory membership of the local scheme.

In summary, the local scheme depends on the rules of the host country and your status. The CFE reimburses according to its own scales, which may leave you with some costs to pay; supplementary insurance can then top up these reimbursements. Insurance that covers costs from the very first euro or dollar pays out directly for covered expenses, without requiring prior reimbursement from the CFE. Before making a choice, check your obligations regarding enrolment in the local scheme, the total cost of cover and the limits of the cover provided.

CFE, supplementary cover or ‘first-euro’ insurance: what are the differences?

The CFE reimburses in accordance with its scales; a supplementary insurance policy supplements this cover; and ‘first-euro’ insurance covers the guaranteed expenses without the need for prior reimbursement from the CFE.

No one solution is universally better than another. Your choice of expatriate insurance depends on your country of residence, your status, the composition of your household, your medical needs and the level of continuity of cover you wish to maintain with France. In all three cases, enrolment in the local scheme may remain compulsory.

What cover should you choose for expat insurance?

Start by comparing hospitalisation cover, then routine medical care, cover that is useful for your family, and assistance, depending on your circumstances.

Not all expat insurance policies offer the same cover. Before taking out a policy, it is important to compare the areas of healthcare that are truly important to you, so that you can choose the option that best suits your circumstances. Hospitalisation warrants particular attention given the high costs it can entail.

Routine healthcare, dental care, optical care and maternity cover depend more on your personal and family circumstances. Finally, assistance and cover whilst travelling warrant separate consideration: these cannot be deduced solely from the level of reimbursement for medical expenses.

Hospitalisation and direct payment

Hospitalisation is the minimum and most important form of cover, as it can result in high costs. Check the annual limit, the reimbursement percentage, any excesses and whether the insurer offers direct payment. Prior authorisation may be required, except in emergencies.

Routine care and medicines

This cover may include general practitioner appointments, specialist consultations, tests, diagnostic imaging and prescribed medicines. Check whether the policy provides cover from the very first euro, has a maximum limit per treatment or per year, and specifies any excess you are required to pay.

Dental and optical

Dental and optical cover is sometimes offered as an optional extra or subject to specific limits. If you wear glasses, are undergoing dental treatment or are travelling with children, these cover options may be important to consider when comparing policies.

Maternity

A planned pregnancy should be anticipated. Insurance policies may include a waiting period, a specific cover limit and special conditions relating to antenatal care and childbirth. It is advisable to check these terms and conditions before the start of the pregnancy.

Assistance, evacuation and repatriation

Under the terms of the policy, repatriation assistance may arrange for transfer to a suitable facility or repatriation where the medical situation warrants it. This cover should be distinguished from the reimbursement of medical treatment: the conditions under which it applies, the geographical scope of cover and the relevant medical criteria are set out in the policy.

Stays in France and travel outside one’s country of residence

If you are planning to return to France or travel to other countries, check whether your expat insurance covers medical treatment received during these stays, for how long and under what conditions. The area of cover may also include or exclude certain countries, particularly destinations where medical costs are particularly high.

How do you choose the right expat insurance?

When choosing an expat insurance policy, compare the cover and limits offered by different policies with your actual needs, rather than focusing solely on the price.

Several factors have a direct impact on the quality of your cover: the country where you will be living, access to healthcare, your family’s needs and how often you travel.

Next, check what the policy actually covers and what you’ll have to pay yourself, rather than just looking at the advertised maximum cover. Also bear in mind the steps you need to take before being admitted to hospital and to claim a refund.

Your destination and your coverage area

The level of cover for medical expenses, the quality of the public healthcare system and the conditions for accessing private healthcare vary from country to country. You should also check whether your travel outside your country of residence and your temporary stays in France are covered, and under what conditions.

Your personal and family circumstances

A young, single professional, a family with children, a self-employed person and an expatriate pensioner do not all have the same needs. Age, household composition, the frequency of medical care and any plans for having children must be taken into account.

Maximum limits, excesses and reimbursement rates

An attractive premium alone is not enough to assess an insurance policy. Check the annual limit, the sub-limits per cover category, the excess, the reimbursement rate and the maximum amount you will have to pay out of pocket.

Exclusions and waiting periods

Certain pre-existing conditions, scheduled treatment, high-risk sports or specific treatments may be excluded or subject to specific conditions. Waiting periods may also apply, particularly for maternity, dental or optical cover.

Management of healthcare and reimbursements

Find out about the steps you need to take before being admitted to hospital, the options for direct payment, reimbursement timescales, the supporting documents required and how to contact the assistance service from abroad.

How much does expat health insurance cost?

The cost of health insurance for expatriates depends, amongst other things, on age, destination, the number of people covered and the cover chosen.

Two policies with similar premiums may have very different maximum cover limits, excesses or out-of-pocket costs. To properly assess the cost of an expat insurance policy, compare the premium with the actual costs you might incur in the event of a doctor’s appointment, hospitalisation or ongoing treatment.

A personalised quote remains the most reliable way to get a price tailored to your circumstances.

The cost of health insurance for expats depends mainly on:

• the age of the insured persons;
• the country of residence and the area of cover;
• the number of people to be insured;
• the level of cover chosen;
• reimbursement limits;
• of any excess;
• selected support staff, for example in dental, optometry or maternity departments;
• the choice between cover from the first euro and supplementary cover under the CFE.

Insurance for a single person living in a country where healthcare is moderately expensive will not cost the same as family cover in a country where medical costs are recognised as being high. If you choose a supplementary policy alongside the CFE, add the CFE contribution to the cost of the insurance to work out the total cost of your cover.

When should you take out expat insurance?

It is best to take out expat insurance before you leave to avoid any gap in cover whilst you are settling in abroad.

Check the end date of your current cover and the start date of your new policy. You should also factor into your schedule the time it takes to complete the enrolment process, any waiting periods and the conditions governing the reimbursement of treatment that has already been arranged. Planning ahead allows you to compare cover options at your leisure, without finding yourself without cover when you move in.

It is possible to take out cover once you are in your country of residence abroad, but this may result in a waiting period, a gap in cover or the exclusion of an event that has already occurred. If you are considering joining the CFE, please also find out about its enrolment deadlines and the time it takes for cover to come into effect.

Request your quote for expat insurance online and find out how much your cover will cost

Are you looking for expat insurance that covers you from the very first euro, or supplementary cover to complement your CFE? You can get a personalised quote online to find out about the options and prices that suit your destination, your age, your family situation and your needs.

Are you unsure which plan to choose? ACS advisers can help you compare levels of cover and identify the expat health insurance policy best suited to your plans.