Best Health Insurance for US Expats (2026): SafetyWing vs Cigna vs GeoBlue vs IMG vs Allianz

Short answer: there are two kinds of cover, and most Americans need both at different stages. To satisfy a visa's €30,000 insurance rule and stay flexible while you settle in, SafetyWing Nomad Insurance is the best self-serve pick — you can buy it from abroad, month to month. Once you're a long-term resident, switch to a full international health plan: Cigna Global (most comprehensive), GeoBlue (best for US citizens), IMG (best value) or Allianz Care (best for pre-existing conditions).

What's the difference between travel-medical and international health insurance?

Travel-medical insurance is short-term, emergency-focused cover — hospitalisation, urgent care and repatriation — sold month to month and accepted for visa applications. International (private medical) health insurance is comprehensive annual cover, including routine outpatient care, specialists and often maternity, designed for people who actually live abroad. You typically start with the first and move to the second.

• Moving / applying for a visa: a travel-medical or "nomad" policy that meets the €30,000 rule.
• Living abroad long-term: a full international health plan with outpatient cover.
• Short scouting trips: ordinary travel insurance is enough.

How much health insurance do you need for a visa?

At least €30,000 of cover for any Schengen visa. The EU Visa Code requires travel-medical insurance of at least €30,000, valid throughout the Schengen area, covering emergency treatment, hospital care and medical repatriation (including death) for your whole stay. This applies to Portugal and most of Europe, and the minimum is unchanged for 2026.

Best health insurance for US expats, compared (2026)

Two travel-medical options for the visa stage, four international health plans for residents. Prices are starting points and move with age and country — get a live quote before you buy.

Best for the visa & flexibility: SafetyWing

SafetyWing's Nomad Insurance is the easiest way to get covered while you move. Unlike most insurers, you can buy or extend it while already abroad, it runs as a monthly subscription, and the certificate meets the €30,000 Schengen requirement. The Essential plan includes up to $100,000 in medical evacuation and covers one young child (under 10) free per adult.

The trade-offs are real, so know them: it excludes pre-existing conditions, maternity and cancer treatment, and home-country (US) cover is limited to 15 days per 90 unless you pay the US add-on. SafetyWing also raised its prices in 2026 — for ages 10–39 the Essential plan is now about $62.72 per 4 weeks, with the US add-on around $48 more. It's emergency cover, not a substitute for a resident health plan.

Disclosure: the SafetyWing links above are affiliate links — we may earn a commission at no extra cost to you. See our affiliate disclosure. SafetyWing is our pick for the visa/nomad stage on the merits above; the international health insurers below are honest recommendations and are not affiliate links.

Best international health insurance for residents

Once you're settled, you need real cover — outpatient visits, specialists, prescriptions — not just emergencies. These four are the plans US expats most often choose, each with a clear strength.

🥇 Most comprehensive: Cigna Global

Cigna Global is the most-purchased international plan among US expats, thanks to US-based English-language service, broad worldwide cover and high tier limits. It's fully customisable — choose inpatient-only or add outpatient, evacuation, deductibles and copays — which also makes it one of the pricier options if you load it up.

🇺🇸 Best for US citizens: GeoBlue

GeoBlue (Blue Cross Blue Shield Global) is built for Americans abroad, with an unlimited medical maximum on premier plans and access to the BCBS network if you travel home. It sits between Cigna's Gold and Platinum tiers on coverage and is often more affordable for the same level.

💸 Best value: IMG Global

IMG offers comprehensive plans that are typically cheaper than Cigna or GeoBlue, with lots of customisation. One caveat: many IMG plans use lifetime rather than annual coverage limits, so a major illness can erode your maximum over time — check the limit type.

🩺 Best for pre-existing conditions: Allianz Care

Allianz Care has a reputation for taking on chronic-condition expats other insurers reject: many conditions are covered after underwriting with a surcharge, rather than simply excluded. It's also strong for families and employer group plans.

How much does expat health insurance cost in 2026?

Budget two separate numbers. Travel-medical cover for the visa stage starts around $62 per 4 weeks (ages 10–39). Comprehensive international health insurance is quote-based and depends heavily on your age and country: third-party comparisons report premiums from roughly $69/month with Cigna and $90/month with IMG, rising to several hundred dollars a month for top-tier GeoBlue plans or older applicants.

Rule of thumb: a healthy American in their 30s should expect $1,500–$4,000 a year for a solid international plan abroad — far less than equivalent US cover, and a fraction of a single uninsured hospital stay.

Does Medicare cover you abroad, and what about retirees?

No — Medicare almost never pays for care outside the US. Medicare generally does not cover healthcare received abroad, so American retirees need a separate international health plan in their new country. Many keep Medicare Part A (it's free) for trips home and buy an expat plan — Cigna, GeoBlue or Allianz — for day-to-day care where they live.

Frequently asked questions

Related guides

Sources

• EU Visa Code (Regulation 810/2009): travel-medical insurance requirement
• AXA Schengen: €30,000 coverage explained
• SafetyWing: Nomad Insurance policy & pricing
• Medicare: coverage outside the US
• International Insurance: best international health plans 2026