International vs local vs travel insurance: what's the difference?

International vs local vs travel insurance: the short answer

When you move abroad, three kinds of cover compete for your attention: international health insurance, local health insurance and travel insurance. They can look similar on a website, but they are built for very different situations.

• Travel insurance protects you during a trip, mainly against emergencies and travel problems.
• Local health insurance covers you in the country where it is sold, often through a set network of local hospitals.
• International health insurance is long-term medical cover for people who live abroad, and it can follow you when you move.

Choosing the wrong one is rarely a problem until the day you need treatment. This guide explains what each type does well, where it falls short and how to decide.

What is travel insurance designed for?

Travel insurance is made for people who live in one country and travel for a limited time. Its main purpose is to deal with the unexpected during a trip: an accident, a sudden illness, a cancelled flight or lost luggage.

For someone who has moved abroad, it has clear limits:

• It is built for trips. Many policies have a maximum trip length and may require you to have a home country you return to.
• It focuses on emergencies. Routine check-ups, ongoing treatment and follow-up care are often excluded.
• Chronic and pre-existing conditions are frequently excluded or very limited.
• Maternity, dental and preventive care are usually not part of it.

Travel insurance is a good tool for a holiday or a short business trip. It is not a substitute for health insurance if you live, work or retire abroad.

What does local health insurance offer?

Local health insurance is sold by an insurer based in your country of residence and designed for people living there. In some countries it is the standard option, and in a few it is compulsory for residents or for certain visas.

Its strengths are real:

• Price: it can cost less than an international plan, because cover is limited to one country.
• Local know-how: insurers know the local hospitals and often have direct billing agreements with them.
• Compliance: where a local plan is required by law, it may be the simplest way to meet the rule.

Its limits matter for expats:

• Cover usually stops at the border. If you need treatment in another country, or you move, you may have to start again.
• Medical evacuation to another country is often not included.
• Choice of hospital may be restricted to a local network.
• Documents and customer service may only be available in the local language, depending on the insurer.

What makes international health insurance different?

International health insurance is designed for people whose life is not tied to one country. Its main advantages are:

• Portability: you stay covered if you move, within your chosen area of cover.
• Choice: many plans let you be treated in private hospitals in your country of residence or abroad, depending on the plan.
• Medical evacuation: most plans can include transport to a suitable hospital when the right care is not available locally.
• Long-term cover: plans are renewed each year and can include outpatient care, maternity, dental and wellness as options.
• Service in English and, often, other languages.

The trade-off is cost. A plan that covers you in many countries, with evacuation and a wide hospital choice, usually costs more than a single-country plan. You can control the price with your area of cover, your deductible and the options you pick. Our complete guide to international health insurance for expats explains these choices in detail.

The three types side by side

Travel insurance

• Best for: holidays and short trips.
• Where: your trip destinations.
• Routine care: usually not covered.
• Long-term residence abroad: usually not suitable.

Local health insurance

• Best for: people settled in one country for the long term, or where local cover is required.
• Where: mainly the country where it is sold.
• Routine care: often available, depending on the plan.
• Moving country: cover usually does not follow you.

International health insurance

• Best for: expats, families, retirees and remote workers living abroad.
• Where: the area of cover you choose, for example worldwide excluding the USA.
• Routine care: available as an option on most plans.
• Moving country: cover can follow you within your area of cover.

Can you combine local and international insurance?

Yes, and sometimes you have to. In some places, residents must hold a local or approved plan. The health insurance rules in some UAE emirates are a well-known example. Expats in that situation often keep the required plan and add an international one for wider hospital choice, evacuation or cover when they travel. Rules change, so always check the latest official requirements for your country.

Another common question is whether you still need travel insurance once you have an international plan. Your medical needs while travelling are often already covered inside your area of cover. Travel insurance may still be useful for non-medical risks such as cancelled flights or lost baggage, which health plans do not cover.

Which one is right for you?

A simple way to decide:

• You live at home and travel for a few weeks: travel insurance.
• You live in one country, plan to stay, and are happy with its local hospitals: local insurance may be enough, or may be required.
• You live abroad, move between countries, have a family, or want access to private care and evacuation: international health insurance is usually the better fit.

Not sure where you stand? Our advisors can look at your situation and compare options from 20+ international insurers, free of charge. You can also browse our FAQ, or simply get an instant quote and receive a personalised comparison by e-mail in about 2 minutes.

Useful resource: World Health Organization: universal health coverage