International Health Insurance: Providers for Germans Abroad Compared
As soon as you move your centre of life abroad, the protection of German statutory health insurance generally ends. Within the EU and in countries with social security agreements, limited arrangements apply; outside that, you are simply uninsured without your own solution.
International health insurance closes this gap. Which provider fits depends on four questions: how long are you staying, in which region, do you want to pay up front, and are you planning to return to Germany?
Travel health insurance or international health insurance?
The terms are often mixed up but mean two different things:
- Travel health insurance: for holidays and short stays, usually a few weeks per trip. Cheap, but unsuitable as soon as you stay longer.
- Expatriate health insurance for long stays: for months to a few years, often with a duration limit of one to five years.
- International health insurance: open-ended, designed for permanent life abroad, with medical underwriting and a lifelong coverage perspective.
The most expensive mistake is starting with a short-term plan and trying to extend it year after year. At some point that stops working – and then your health at that moment decides your cover.
The providers at a glance
- APRIL International – modular building-block system with a zone model, digital claims through the app and 24/7 telemedicine. My Health International open-ended, MyTempoCover up to twelve months.
- BDAE – more than 25 years specialising in emigrants. Expat Infinity without a time limit, Expat Smart for fixed-term stays, plus prospective entitlement and Expat Legal.
- Cigna Healthcare – premium level, a very large worldwide network, selectable areas of cover including or excluding the USA.
- Foyer Global Health – open-ended contracts with a lifelong coverage guarantee and direct billing with clinics.
- PassportCard – cashless payment through a rechargeable card instead of paying up front.
- Care Concept – affordable plans for working holidays, au pairs and students, up to five years.
- HDI Corporate Travel – travel cover, assistance and crisis management for companies and posted employees.
The four decisive questions
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1. How long are you staying?
Up to twelve months with a clear return date: a short-term plan is enough. Several years or an open end: an open-ended solution with medical underwriting is the more solid choice.
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2. Which region?
The USA and Canada are the biggest cost driver. A plan without adequate North America cover is effectively worthless there – and one with an unnecessary USA option costs too much permanently.
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3. Upfront payment or direct billing?
If advancing four-figure sums is a problem for you, direct billing (Foyer, Cigna within its network) or a payment card (PassportCard) matters more than the last percentage point of benefits.
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4. Are you planning to return?
If you held German private health insurance, consider a prospective entitlement to preserve your entry age and state of health. If you were in statutory insurance, know the conditions for re-entry. This question belongs before departure.
Sorted by your situation
If you would rather think in terms of your way of life than by provider: health insurance for expats, for digital nomads, for freelancers abroad, and the overview at health insurance abroad.
Besides health cover, these matter for Germans abroad: international liability insurance, legal protection for expats, accident insurance and retirement planning abroad. The full list is in the emigration checklist.
Planning to emigrate or stay long-term? Write to us on WhatsApp (+49 151 28937141) or via the contact form.
Frequently asked questions about international health insurance
Does my German statutory health insurance still apply abroad?
Usually only to a limited extent. Within the EU and in countries with social security agreements special arrangements apply, but often only for acute treatment and at the local benefit level. If you move your residence permanently, cover generally ends altogether.
What is the difference between travel health insurance and international health insurance?
Travel health insurance is designed for short stays and acute emergencies. International health insurance is open-ended, covers ongoing healthcare and is intended for living abroad. Short-term plans cannot be extended indefinitely.
Are the USA and Canada covered?
That depends on the chosen area of cover. Because of very high cost levels, these countries are priced separately in almost all plans. If North America is relevant to you – even for business trips or stopovers – plan for it from the start.
What is a prospective entitlement and do I need one?
A prospective entitlement (Anwartschaft) lets you suspend existing German private health insurance during your stay abroad instead of cancelling it. It preserves your original entry age and state of health. It is relevant for anyone with private cover who does not rule out returning.
Can I get international health insurance with pre-existing conditions?
Open-ended plans require medical underwriting. Depending on the diagnosis, acceptance, a risk surcharge or an exclusion is possible. What matters is declaring everything in full – incomplete statements are the most common reason for refused benefits.
Am I covered during home visits to Germany?
Most international plans provide home cover with a time limit per year. How long it applies and whether longer stays are included varies considerably, so clarify it before you apply if you return regularly.
Want to know which provider fits your destination and your outlook? Book a free initial consultation or start the insurance check.
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April International
PRO: Digital 24/7 telemedicine & easy app billing.
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Global Health Foyer Group
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Passport Card
PRO: Pay medical bills instantly worldwide without cash.
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Bund der Auslandserwerbstätigen
PRO: Long-term, ideal for genuine emigrants (indefinite).
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Care-Concept
PRO: Affordable rates for work & travel, au pairs & students.
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Cigna Healthcare
PRO: Exclusive, free choice of doctor worldwide (incl./excl. USA).
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HDI Business
PRO: Business, crisis management & evacuation for companies/expats.
Why SpreeFinanz?
We have advised Germans abroad since 1996 – independently and across the whole market. On international health insurance you get a clear recommendation, not a list of providers.
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We are quickly
reachableAbroad, every hour counts. We are available via WhatsApp, video call or phone – across time zones.
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We work
transparentlyYou see area of cover, limits, deductible and duration rules side by side – not just the monthly premium.
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We think
situation-basedSabbatical, emigration, posting or nomadic life lead to different types of plan and different providers.
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We stay with you
after signingOn a change of country, an extension or a return to Germany we accompany the transitions – that is where gaps appear.
