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US Citizens Living Abroad: Expat Health Insurance

Thousands of Americans realize their lifelong dreams and move overseas to chase these dreams. From experienced executives looking for new business ventures, a retired couple longing to explore new cultures, to spirited students on a gap year hoping to gain some work experience, becoming an American expat has no age limits. However, living abroad comes with a set of challenges. Moving to a new country means adapting to things you are not used to, which can be stressful. In your environment, you'll find yourself worrying about things such as understanding highway signboards, where to find an internet provider, or interpreting different dishes on the menu. While these challenges are easy to embrace, one main challenge stands out; expat health insurance. Here, we discuss everything you need to know about expat insurance for Americans living abroad.

How to Manage Social Security for American Expat and His Family Abroad 

The amount of Social Security benefits you receive depends on your earning history and how old you started making contributions. Although these benefits don't provide a comfortable life, they are vital in supplementing your income, other pensions, and retirement accounts. If you live in the country, managing your Social Security is straightforward. But if you live abroad and qualify for Social Security, there's much you need to know about these benefits.  

While it's possible to receive your payments while living in most countries, the US Treasury Department prohibits Social Security from sending money to American expats living in Cuba and North Korea. However, anyone affected by the sanction can recoup their benefits after relocating.  

American expats living in the following eight countries- Moldova, Azerbaijan, Belarus, Turkmenistan, Kyrgyzstan, Kazakhstan, Tajikistan, and Uzbekistan- can only receive their Social Security payments under the condition that they show up in person at a U.S embassy or consulate after every six months. 

Common Issues You May Receive When Collecting Your Social Security Benefits Abroad 

Other than the conditions set for the above countries, you are free to receive your Social Security benefits when living as an expat in any other country. However, there are specific issues that you and your spouse are likely to encounter when receiving these benefits.

Bi-Lateral Social Security and Totalization Agreements 

Suppose you worked less than 40 quarters under Social Security in the United States and contributed to an equivalent in a foreign country. In that case, you can still receive your Social Security benefits under the bilateral agreements known as the Totalization Agreement 

The Totalization Agreement aims at: 

  • Eliminating dual Social Security taxation, which occurs when you are an American expat working abroad and are required to pay social insurance taxes for both countries.  
  • Filling gaps in benefit protection for workers who have divided their careers between the United States and another country. The benefits gap occurs if you are an expat in a country without a Totalization Agreement. 

Receiving U.S Social Security for Foreign Spouses 

Your foreign spouse may be eligible for social security benefits but must meet certain conditions. For instance, if your spouse is not a U.S citizen or a green card holder, their Social Security payments will stop if you have not been in the country for six consecutive months.  

However, there are certain exceptions to this rule. First, your foreign spouse may receive social security benefits abroad if you lived with them in the United States for at least five years as a married couple. Second, your foreign spouse can receive the benefits if they are residents or citizens of a country with bilateral social security agreements. In both cases, the foreign spouse will receive Social Security survivor benefits. 

Effects of Windfall Elimination Provision on Social Security Benefits 

The Windfall Elimination Provision (WEP) may affect you as an American expat who has earned a pension with a foreign government but is also eligible for U.S Social Security benefits. For example, this happens if you are an expat working for a foreign employer but contributed to the U.S Social Security System in the past.  

WEP controls the situation where you might be double-dipping by reaping benefits from both plans. The system helps determine the benefits on record for the primary beneficiary and auxiliaries. WEP minimizes your Social Security benefits, but the reduction cannot be more than 50%. 


Types of Medical Insurance Available for American Expats Abroad 

There are numerous risks associated with moving abroad without medical coverage. For example, you may incur massive medical bills or experience limited access to medical care in a foreign country. Since you never know when you may get sick, it's wise to get an expat's health insurance when working or living abroad.  

Getting health insurance coverage when moving abroad saves you the trouble of finding immediate medical attention in case of an emergency. In addition, it helps you meet the requirements by the US Department of State that requires all US expats to purchase health insurance before traveling.  

When moving abroad, you have three medical insurance options, depending on the country you're relocating to: 

International Private Healthcare Insurance 

If you're relocating to a foreign country without an exemplary public healthcare system, rely on international private insurance. You might want to seek medical attention in private hospitals in such a country since they are well-equipped and provide better services than public hospitals. However, access to these quality medical services is too costly to pay out of your pocket. 

National Public Insurance

There are countries with reliable state-run public health insurance schemes. If you work in such a country, you will be automatically enrolled by paying monthly contributions, similar to taxes. As a result, you will access affordable healthcare services in public hospitals and clinics.  

Combination of Public and Private Health Insurance  

Some foreign countries offer good quality public healthcare. However, the waiting time and crowding in the clinics are a turn-off. In that case, you may prefer additional private healthcare insurance to complement the public insurance, giving you access to private hospitals and clinics. 

Medical System in Europe and the Costs of Service for Expat Health Insurance 

Almost all European countries offer a public healthcare system that ensures easy access to healthcare. As an American expatriate working in European countries, the local insurance may not be sufficient health cover. It's therefore essential to consider other options such as Expat Health Insurance or European Health Insurance.  

You can purchase the European Health Insurance if: 

  • You're an American expat, digital nomad, or a globally mobile citizen living in a European country for a long time.  
  • You live in a European country for a year or more. 
  • You live with your family, are an entrepreneur or a student in a European country, and wish to live without the stress of accessing quality medical services.  

By getting European health insurance, you get access to: 

  • Easy and quick claim procedure via an online portal 
  • Second medical opinion from medical experts from all over the world 
  • Transparent communication and clear information 
  • Medical assistance benefits in case of emergencies 
  • 24/7 teleconsultation services at no extra cost.


Planning to Move Abroad as an Expatriate? Familiarize With Expat Health Insurance 

When living abroad as an American expat, you never know when you might get sick or injured. Moreover, depending on which country you're living in, you might only access quality health services from private hospitals, which charge you an arm and a leg for the services. For that reason, it's advisable to get expats health insurance before relocating. Hopefully, this guide has provided enough information on the types of medical insurance options you have.

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