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If you have employees who live abroad, are posted overseas on assignment, or travel for work regularly enough that they’d struggle without local medical cover, you need to think about how their healthcare is provided.
International Group Health Insurance for employees is cover arranged and paid for by you as the employer, for a defined group of employees based outside their home country. It’s different from the personal international Health Insurance an individual might buy for themselves; this guide is about the version you provide as part of your benefits programme.
You don’t always need a completely separate policy for this. Some UK Group Health Insurance schemes let you add an international travel option for specific employees, rather than running two policies side by side. Which route makes sense depends on how many people you have abroad, where they’re based, and how long they’ll be there.
International Group Health Insurance (also known as Group International Private Medical Insurance (IPMI)) provides cover for the cost of medical expenses incurred while abroad. This could be anything from emergency treatment to routine GP appointments (or overseas equivalents), as well as dental checkups and maternity care.
A typical policy includes:
Most International Group Health Insurance Plans contain a number of standard exclusions, which are usually:
What your employees will be covered for will also depend on the type of medical underwriting you choose for your policy, whether that’s Moratorium, Full Medical Underwriting, Continued Personal Medical Exclusion, or Medical History Disregarded. Read more about the different types of Health Insurance underwriting.
International Health Insurance tends to be more comprehensive than its domestic, UK-only counterpart. UK Group Health Insurance works alongside the NHS, designed to give employees faster access to the things the NHS covers well but slowly (elective surgery, consultant appointments, diagnostics) while leaving emergency care, most GP visits, chronic condition management and maternity care to the NHS as normal.
Employees outside of the UK don’t have that safety net. In most countries, there’s no free-at-the-point-of-use system to fall back on, so an international policy has to stand in for everything the NHS would otherwise provide. That’s why international policies typically cover a wider range of treatment than its UK equivalent; emergency care, routine GP-equivalent appointments, dental and optical, and maternity are usually included as standard.
If your employees live abroad for work or simply spend a great deal of time travelling, then it’s likely you’ll need to provide them with some element of Health Insurance overseas to cover their travels. This is in case they fall sick while abroad.
This is because the health systems in other countries aren’t like the NHS, where treatment is free at the point of use. In many countries you may have to live in the country for a certain period of time to qualify for state-backed healthcare or commit to paying into the system for a set time before you get access to it.
Of course, that’s if access to state healthcare is available at all. In countries such as the US, there’s little to no state-funded healthcare and almost everything medically must be taken care of privately.
The cost of healthcare abroad varies depending on the country and the medical care needed.
For example, breaking an arm in France could cost up to £1,000¹, and a single day in intensive care in most European countries is typically £5,000².
Though most countries’ healthcare costs pale in comparison to the US, where a broken leg could cost as much as £36,000¹, and a heart attack could see you spending anywhere between £50,000–£200,000¹ on treatment.
The costs of healthcare abroad can be financially crippling, making International Health Insurance for employees an important consideration if they’re going to be living or working overseas.
No, Travel Insurance is not a substitute for Group IPMI, and this is something that often catches employers out.
Travel Insurance is built for short trips and emergencies, covering travel-specific benefits such as cancellations and loss of baggage/passport, etc. It typically excludes pre-existing conditions, routine checkups and maternity care, and most policies stop covering someone after 30 days continuously abroad. It’s the wrong tool for employees who are based overseas rather than travelling through it.
Where Travel Insurance does something employee IPMI often doesn’t is emergency evacuation and repatriation. Group IPMI usually only covers this if the treatment an employee needs genuinely isn’t available where they are; which can mean an employee is stuck in a hospital abroad rather than flown home, if adequate local treatment exists (even if it’s not what they’d get in the UK).
Many employers choose to cover travelling staff with both products: Group IPMI for ongoing healthcare needs, and a travel policy specifically for evacuation and repatriation. The two are complementary rather than alternatives.
If you want to give your travelling employees comprehensive cover, consider offering Travel Insurance as well to plug the gaps that worldwide healthcare coverage can’t.
Nadeem Farid
Head of Health & Wellbeing Benefits
The cost of International Health Insurance varies depending on a number of factors. Cost depends heavily on where your employees are based or travel to most often. Cover is usually sold in geographic tiers, from cheapest to most expensive:
The US drives cost more than any other single factor, because healthcare there is dramatically more expensive than almost anywhere else in the world. A single hospital admission or a serious procedure in the US can run into tens of thousands of pounds; costs that simply don’t exist at the same scale in most other markets, including much of Europe.
Beyond geography, age and prior medical history affect price in the same way they would for a domestic scheme.
Given how much premiums can vary by country coverage and by individual circumstances, it’s worth getting advice on the right tier and structure for your specific group, rather than defaulting to the broadest (and most expensive) option “to be safe.”
Our consultants work with businesses of all shapes and sizes, helping them set up and manage the competitive rewards packages for their diverse teams. Call 02074425880 for a free, no-obligation consultation, or submit an enquiry to discuss your options.
Given the huge number of variations when it comes to setting up a policy, we recommend seeking advice before going forward to ensure the policy you choose is the most appropriate for your circumstances.
Joseph Toft
Senior Employee Benefits Consultant
If you’re providing healthcare cover for a handful of employees in one country, a single policy is usually straightforward to arrange.
If you’re covering employees across several countries, there’s more to think about; such as admitted insurance rules, and how to handle countries where you have no registered entity. See our full guide: International Employee Benefits: A Guide for Employers.
The tax position of Group International Health Insurance is broadly similar to UK Group Medical Insurance, with one extra consideration for anyone taxed outside the UK.
Whether you need a separate policy or extended UK scheme depends on the situation. For a small number of employees travelling for short periods, many UK group PMI schemes offer a travel extension that’s simpler and cheaper than a standalone policy. For employees genuinely based overseas long-term, you need dedicated group international cover; a travel extension isn’t designed for that.
Group International Health Insurance is arranged and paid for by the employer, covering a defined group of employees under one set of terms. Personal expat Health Insurance is bought by an individual for themselves. If you’re an employer setting up cover for your staff, Group International Health Insurance is the product you want.
Employees’ families can often be included in International Group PMI policies. Many plans olicies allow dependents to be added, particularly for employees genuinely relocated abroad rather than just travelling frequently. This is worth specifying when you set the policy up rather than assuming it’s automatic.
Healthcare costs in North America are significantly higher than in most of the rest of the world, for both routine and emergency treatment. Insurers price this into the “worldwide including North America” tier specifically, which is why it sits well above the other geographic bands.
You may still need travel insurance for employees to cover evacuation and repatriation. Group IPMI generally only pays for evacuation if adequate treatment isn’t available locally at all, which is a narrower trigger than most travel policies use. Many employers run both for staff who travel or work abroad regularly.
Our specialists are available to help you find the most suitable Employee International Health Insurance that will give both your team and your business the most suitable protection.
To learn more about worldwide health cover for employees and compare quotes from across the market, get in touch with our specialists on 02074425880.
If you’re setting up group international cover for the first time, or reviewing what you already have in place, we’re happy to talk through what makes sense for your specific group; with no obligation at the end of it.
Employee benefits can be a headache. But our specialists do this day-in, day-out, offering first class service when you need it most. Here’s why you should talk to us:
¹https://www.admiral.com/travel-insurance/cost-of-getting-ill-abroad
²https://www.postoffice.co.uk/travel-insurance/guides/getting-sick-on-holiday
