Health Insurance for British Expats in the USA

Allianz, April MyHealth, Cigna Global, IMG, and Liberty Mutual are the five top insurers catering to the specific health insurance needs of British expats living in the United States. These companies offer a variety of plans suited to obtaining comprehensive healthcare coverage in the US.

What are the best insurance options for long-term coverage for British expats in the States? How does insurance work, given that the US lacks universal public healthcare? And why is international health insurance the right choice for many? This article will answer these questions and more.

Understanding health insurance in the US is crucial because, unlike many other developed countries, the US does not have a universal public healthcare system. Medical care costs here are typically very high, making insurance both essential and costly.

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Overview of the American Healthcare System

The United States public healthcare system primarily consists of programs such as the Medicare program, designed for people aged 65 and older and for those with certain disabilities, and Medicaid, which supports low-income individuals and families.

These programs are primarily federally funded with state-level administration. Other public programs include the Children’s Health Insurance Program (CHIP) and federal healthcare services for veterans.

Healthcare services in the US are delivered by a mixture of hospitals, clinics, and private practices. Hospitals generally provide specialized, inpatient, and emergency care, while general practitioners and specialists see patients in community clinics or private offices.

General practitioners in the US include family practitioners, internists, and pediatricians, and most work in private practice settings, with a third practicing solo.

Rural areas often rely on a network of public and non-profit clinics to serve uninsured or underinsured populations, although access to specialists may be limited compared to urban centers.

Despite advanced technology and quality healthcare institutions, the World Health Organization ranks the overall quality of healthcare in the US lower than in many other developed countries. Issues like access inequity, administrative complexity, and high costs have plagued US healthcare.

Many US healthcare institutions are nationally and internationally recognized for excellence in patient care, research, and medical education. Some of the top hospitals in the United States include:

• Mayo Clinic
• Johns Hopkins Hospital
• Massachusetts General Hospital
• Cleveland Clinic

Health Insurance Requirements for Expats in the USA

Expats in the US, including British nationals, generally need to have health insurance coverage, as healthcare costs are high and uninsured care can be financially devastating.

While the US no longer imposes a federal penalty for lack of insurance, many visa categories and residency statuses require proof of adequate health coverage.

British expats are advised to have comprehensive private or international health insurance during their stay. In some cases, especially for long-term residents or those with work authorization, access to employer-sponsored or government programs may be possible but limited.

Having appropriate health insurance protects British expats from high medical costs and helps them access quality healthcare across the US.

Can British Expats Use Public Healthcare in the USA?

British expats generally have limited access to the US public healthcare system if at all, as eligibility depends heavily on residency and visa status along with social security qualifications.

The US does not offer universal public healthcare, instead providing programs like Medicare and Medicaid for specific groups. To be eligible, applicants must have lawful permanent resident status (Green Card) or be a resident alien for tax purposes.

Furthermore, a minimum of five years’ residency is typically required before qualifying for Medicaid, whereas Medicare is available mainly for those aged 65 or older or those with certain disabilities.

Although emergency care is available regardless of insurance, routine and non-emergency services usually require insurance. British expats planning long-term stays should carefully plan their healthcare insurance arrangements to avoid gaps in coverage.

In general, public healthcare programs are not accessible to non-resident aliens, visitors, and short-term visa holders, and many British expats must secure private or international health insurance to cover their healthcare needs.

British expats applying for Medicaid or Medicare should follow the steps below:

• Check eligibility based on immigration and residency status.
• Gather key documents: passport, visa or residency permit, Social Security Number (SSN), proof of income, and residency (lease or utility bills).
• Apply through state Medicaid offices or the Social Security Administration for Medicare.
• Await application approval and issuance of coverage cards.

Coverage often includes co-payments; out-of-pocket costs vary by program and state.

Private Health Insurance Options for British Expats in the USA

We recommend Allianz, April MyHealth, Cigna Global, IMG, and Liberty Mutual for meeting the health insurance needs of British Expats in the USA.

For British expats living in the US, private health insurance is crucial due to the complexity and high cost of the US healthcare system. While not currently a legal requirement as part of a visa application, securing health insurance is essential to avoid potentially overwhelming medical expenses.

Employers may provide group health insurance, but many expats will need to arrange private coverage independently, especially if self-employed, retired, or ineligible for employer plans.

When choosing private health insurance, British expats can select from local US insurers or international providers:

• Local insurers offer plans that align closely with US healthcare networks and regulations, often providing excellent access to local hospitals and specialists.
• International insurers offer broader coverage that includes global access, emergency evacuation, and repatriation benefits, ideal for expats who travel frequently or may relocate again.

Allianz

Allianz provides internationally recognized health insurance plans with extensive inpatient and outpatient coverage, maternity benefits, and emergency evacuation. Their flexible plan options cater to various expat needs and budgets.

April MyHealth

April MyHealth specializes in customizable expat health insurance plans, including US coverage with comprehensive outpatient, maternity, and emergency services focusing on global flexibility.

Cigna Global

Cigna Global offers tailored plans designed for busy expats with flexible coverage levels, from essential inpatient services to full outpatient and maternity care, plus worldwide evacuation.

IMG

IMG offers comprehensive international health insurance plans with a focus on global expat needs including medical evacuation, maternity, outpatient treatment, and chronic conditions.

Liberty Mutual

Liberty Mutual provides US-based private health insurance products, including options tailored for expats. Coverage emphasizes inpatient care and outpatient services, with options for maternity and evacuation.

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Average Cost of Health Insurance in the USA

When considering health insurance options in the United States, British expats typically evaluate three main types of coverage: public health insurance, private health insurance limited to coverage within the USA, and international health insurance plans.

Public Health Insurance

US public health coverage primarily includes programs like Medicare and Medicaid. These programs serve specific groups such as seniors, low-income individuals, and certain disabled persons.

Public plans are generally more affordable or funded through social contributions but come with limitations and co-payments.

Eligibility criteria are strict, and coverage may not be available to many expats depending on residency status. For most expats, these programs are difficult to access unless they meet residency or visa status requirements.

Private Health Insurance (USA Only)

These plans offer extensive networks of US healthcare providers and cover a full range of medical services within the country, including inpatient, outpatient, maternity, and emergency care.

Premiums for private US-only plans vary, typically higher than public insurance but more accessible to expats on work or long-term visas. Deductibles and co-payments apply, and plans often emphasize access to the broad provider networks available domestically.

International Health Insurance (IHI)

Designed for expats who travel or relocate globally, these plans provide worldwide coverage, including the USA.

International plans usually come at a premium and include benefits such as medical evacuation, repatriation, and maternity. They offer flexibility if expats move frequently but tend to have the highest annual premiums, reflecting the breadth of coverage.

The table below summarizes the important differences between public health insurance in the US, USA-only private health insurance, and international health insurance.

The US has the highest average health insurance premiums globally, with individual IHI plans averaging around GBP £11,545 (USD $15,296) per year and family plans reaching approximately GBP £25,778 (USD $34,152), reflecting both the cost inflation in US healthcare and the broad coverage expats seek.

Higher premiums correspond to extensive benefits, including access to leading American healthcare providers, coverage of pre-existing conditions, and emergency evacuation services.

For British expats, selecting a plan that balances cost with necessary coverage is critical due to the high cost of medical care in the States.

Top Considerations for British Expats in the USA

Moving to the USA and potentially returning to the UK involves careful planning around health insurance to ensure continuous coverage. British expats should take steps to avoid any gaps in their healthcare, whether relying on public or private insurance or a combination of both.

Before arriving in the USA, secure private or international health insurance since eligibility for public healthcare programs like Medicare or Medicaid is generally limited and based on strict residency or visa conditions.

For uninterrupted health coverage during a potential future return to the UK, British expats should consider the timing and coordination of insurance policies.

Moreover, since NHS coverage depends on residency status in the UK, you may have to re-register with the NHS upon return and pay the Immigration Health Surcharge (IHS).

Bridging insurance policies that cover both countries or a seamless transition between private plans can help avoid coverage gaps. Careful management of documentation, keeping track of residency and visa statuses, and consulting insurance experts can mitigate risks.

How to Become Insured and Benefits of Using an Insurance Broker

Whether you choose a public health program or private/international health insurance, to secure health insurance in the US as a British expat you must generally follow the steps as outlined here:

1. Select Your Coverage: Decide whether to apply for public programs like Medicare or Medicaid (if eligible), purchase private health insurance directly from insurers or via the federal/state health exchanges, or purchase international health insurance.
2. Gather Documents: Prepare essential documents including your passport, visa or residency permit, Social Security Number (SSN), proof of address (e.g., lease or utility bill), and proof of income or employment.
3. Apply: For public insurance, applications are made through government portals or offices such as the Social Security Administration for Medicare. For private insurance, applications can often be completed online via insurer websites or insurance marketplaces.
4. Wait for the Decision and Activate Your Coverage: Processing times vary; private insurance often activates upon first premium payment, while public insurance applications may take weeks to process and issue coverage cards.

To save on premiums, you may elect to:

• Choose regional plans if you plan to stay long term in a specific state.
• Select reasonable deductibles to trade off between monthly premiums and out-of-pocket costs.
• Avoid overlapping coverage if you already have travel insurance.
• Consider international plans if you may relocate again; international health insurance helps avoid re-underwriting, preventing premium spikes if your health changes.

One key advantage of international health insurance is its portability. It often offers continuous coverage across countries without needing to reapply or undergo new health assessments—a big benefit if you develop health issues or plan future moves.

Why You Should Engage a Broker

While you can purchase insurance on your own, working with an experienced insurance broker offers significant benefits, including wider plan selection, expert guidance, ongoing support, and enhanced peace of mind. Moreover, using a broker typically does not lead to higher costs:

• Broader Access to Plans: Brokers provide access to multiple insurers and plan options, saving time and ensuring a well-rounded comparison.
• Expert Guidance: Their knowledge of expat insurance products helps in choosing plans tailored to individual health needs, travel frequency, and budget.
• Cost Efficiency: Brokers are usually compensated by insurers, so their advice and services typically come at no additional cost to the client.
• Ongoing Support: Brokers assist with policy renewals, changes, and claims, helping expats navigate complex paperwork and advocate for fair settlements.
• Peace of Mind: Knowing a trusted professional supports your insurance journey reduces stress and confusion, especially when adapting to healthcare systems abroad.

Frequently Asked Questions

Are British expats eligible to use the public healthcare system in the USA, and what are the main requirements?

British expats may access public healthcare programs like Medicare or Medicaid only if they meet specific criteria such as lawful permanent residency or specific visa types. Eligibility often requires residency of several years and proof of social security status.

Which are the top health insurance providers recommended for British expats in the USA?

Leading insurers for British expats in the USA include Allianz, April MyHealth, Cigna Global, IMG, and Liberty Mutual. These companies offer a variety of plans, covering inpatient and outpatient care, maternity, and emergency evacuation, tailored to the unique needs of expats.

What key features should retired British expats consider when choosing health insurance in the USA?

Retirees should prioritize comprehensive coverage, including inpatient treatment, outpatient services, prescription drugs, and chronic disease management. Special attention should be on maternity coverage if applicable, flexible deductibles, and access to broad hospital and specialist networks.

Why is direct billing an important aspect of health insurance for expats in the USA?

Direct billing eliminates the need for expats to pay healthcare providers upfront, reducing out-of-pocket financial stress. It simplifies the claims process since insurers pay providers directly, which is crucial in a complex system like the USA, enhancing smoother access to medical treatment.

How critical is medical evacuation coverage for British expats living in the USA?

Medical evacuation coverage is vital as it ensures that expats can be transported to appropriate medical facilities domestically or internationally if local care is insufficient. This protects expats from significant unexpected emergency medical transport costs, providing peace of mind.

What are the main benefits of using an insurance broker for health insurance as a British expat in the USA?

Insurance brokers offer a wide selection of plans from various insurers, expert advice tailored to individual needs, and ongoing support with claims and renewals. Their services usually come at no extra cost and help expats navigate complex healthcare systems more efficiently.

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Conclusion

British expats in the USA have both public and private health insurance options. For even better protection and added flexibility, many choose to complement their public coverage with private insurance. Moreover, many opt for international health insurance for the most complete level of security.

Regardless of whether you select travel insurance, expat health insurance, or international health insurance, professional assistance is available from us to help tailor a plan that aligns with your needs, budget, and expectations for value.

Moreover, expert advice and ongoing support are provided at no cost to you. Feel free to reach out for consultations, quotes, or a complimentary, no-obligation comparison of plans.

If you are also considering other countries like Italy or Canada alongside the US, be sure to read our detailed guides on health insurance options for British expats in Italy and in Canada too.

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Martin Lee

Content Creator at Pacific Prime

Martin is a writer and translator with over 10 years of experience. He writes articles and blog posts, creates infographics and videos, translates between Chinese and English, and more. Skilled at explaining complicated concepts in layman’s terms, Martin believes the gold standard of translation is attained when the translated text is not only accurate, but also reads like an original text. Martin holds a degree in Economics from the University of London, UK.

Since joining Pacific Prime, Martin has become even more aware of the gap between the true value of insurance products and most people’s appreciation of it, and developed a passion for demystifying and simplifying matters, so that more people get the protection they need at a cost they can easily afford.

In his free time, Martin attends concerts of various genres, and plays the violin with piano accompaniment he pre-recorded himself or played live by his niece.

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