Better Prepared: The essential guide to understanding international health insurance

Finding the right health care looks different depending on where you are in the world. Some countries, like the United Kingdom, primarily rely on public health care that is free at the point of use. Others depend entirely on private health care, where you need to pay for care yourself. In some cases, people use a combination of public and private care to access care faster or receive specialised care.

When using private health care, health insurance can ease the burden of paying for that care. Health insurance education is a vital step in understanding how it works, ultimately helping you feel confident managing your health care, wherever you are in the world.

Our Cigna Healthcare International Health 2026 Global Well-Being Survey found that, among 12,000 respondents worldwide, only 34% said they understand health insurance terms [1]. The underlying cause is rarely a lack of interest. More often, it reflects a gap in health insurance knowledge.

What is private health insurance?

At its simplest, health insurance is a safety net. You pay a regular fee, known as a premium, to keep your coverage active. In return, when you get sick or injured, your insurer steps in to help pay for any treatments included in your policy.

Coverage often falls into two main categories:

• Individual/family plans: You buy the plan and pay the full premium yourself.
• Employer-provided plans: Your workplace offers insurance as a job benefit, often paying for some or all of the premium. You may contribute to the cost through payroll deductions.

If you are moving or living abroad, domestic health insurance often falls short. International health insurance is built specifically for expats, digital nomads, and students studying abroad. Unlike short-term travel insurance, it provides long-term, comprehensive care across multiple countries, depending on your plan, and is often a mandatory requirement for obtaining work or study visas.

For people relocating abroad, understanding how health care works in a new country can feel overwhelming. Navigating unfamiliar health care systems, local regulations, and coverage requirements often adds to the challenge. Our Cigna Healthcare International Health 2026 Globally Mobile Study found that nearly three in four globally mobile people wished for more support with international relocation, a process often marked by acute stress [2].

How does private health insurance work?

While every insurance plan has its own processes, how you use it generally follows these three steps:

1. Check your coverage Before you book an appointment, contact your insurer. They can confirm if your chosen doctor, hospital, or clinic is covered and, in many cases, help you find the best care available.
2. Get treatment Once you’ve confirmed coverage, you can proceed with your care. Depending on your plan, you may be asked to pay a portion of the cost directly to the provider.
3. Submit a claim Depending on your insurer and health care provider, either you or the provider may need to submit a claim so that eligible costs can be processed. Claims typically include details about the treatment, when it took place, and how much it cost. If you need to pay upfront, you can submit the required documents to your insurer for reimbursement.

In an emergency: Always prioritise your health and seek immediate medical treatment first. You or a family member can contact your insurer to sort out the paperwork as soon as it is safe to do so.

What are “out-of-pocket” costs?

Even with insurance, you may be responsible for a share of your medical bills. These are called "out-of-pocket" costs. Here are three common types:

Deductible

A set amount you must pay first each year before the insurance provider begins to pay anything.

Co-pay

A small, flat fee (like £20) you pay every time you use specific services, such as routine doctor’s visits.

Co-insurance

Your share of the bill written as a percentage (like paying 20% of a treatment bill while the insurer pays 80%).

Most policies include an out-of-pocket maximum. This means that, once you spend a certain amount of your own money in a year, your insurer will pay 100% of your remaining medical bills for that year.

How do I choose a plan?

Most insurers offer a range of cover levels and benefits to help you find the right fit for your needs and your wallet. When comparing plans, ask yourself these four questions:

• What is my budget? Balance what you want to pay monthly or annually (your premium) against what you will have to pay out-of-pocket when you get treatment.
• What are my health needs? Do you need regular check-ups, ongoing prescriptions, or specialised care for an existing condition?
• What coverage do I need? Do you need cover across multiple countries, or will a plan covering your current country of residence do?
• Are my preferred providers included? Ensure your local hospitals and doctors are part of the insurer’s network.

Ready to get started? Gather your basic details, including your residency or visa status, a brief medical history, and a list of any regular medications you take. Having this information ready makes it easy to compare plans and secure the coverage you need.

Want to learn more? Our Better Prepared series of short videos is designed to explain key health insurance concepts in clear, accessible language, helping you better understand your coverage and make more informed health care decisions.

Sources

1. Cigna Healthcare International Health. (2026). Cigna Healthcare International Health Study. https://www.cignaglobal.com/global-well-being-and-vitality
2. Cigna Healthcare International Health. (2026). Cigna Healthcare International Health 2026 Globally Mobile Edition. https://www.cignaglobal.com/global-well-being-and-vitality/turning-global-mobility-into-performance-edge