Area of coverage is the plan-design choice that most affects what international health insurance costs, and the one people think about least.
What area of coverage means
International health plans generally ask you to choose where in the world the plan applies. Common options include worldwide (including the United States), worldwide excluding the United States, and in some cases regional plans limited to a part of the world.
The plan pays for eligible care inside the chosen area. Outside it, coverage may be limited to emergencies during short stays, or may not apply at all.
Why the U.S. changes the price
Healthcare in the United States is generally more expensive than almost anywhere else. Plans that include it are priced to reflect that, and the difference can be substantial. For many people living abroad, excluding the U.S. is the single largest available saving.
When excluding the U.S. makes sense
- You have no intention of returning to the U.S. for treatment
- You live somewhere with good private care, or within reach of it
- You are not a U.S. citizen and have no U.S. ties
- Visits to the U.S. are short and infrequent
When it is a mistake
- You would want to come home for a serious diagnosis
- You spend meaningful time in the U.S. each year
- Family members live in the U.S. and would be covered under the plan while there
The hard case is the American abroad who expects never to need U.S. care — until a diagnosis changes that. Decide based on where you would want to be treated for the worst plausible event, not the most likely one.
Check the visit rules
Plans that exclude the U.S. sometimes allow limited emergency coverage during short visits, with day limits and benefit caps. Know them before you travel home.
Living abroad, or about to? Tell us where, for how long, and who is covered. International health overview