Group vs Individual Expat Health Insurance: Which Is Better?

If your employer offers a group health plan abroad, it can be cheaper and more generous than anything you could buy alone. But it usually ends when the job does. This guide compares group and individual expat health cover and shows what to check before you rely on either.

This guide is general information, not personal advice. Plans differ by insurer, so read the policy documents.

The short answer

Group plans are bought by an employer for a set of staff. Individual plans are bought by you, for you and your family. Group cover is often cheaper and can be easier to get if you have a health condition. Individual cover is yours to keep when you change job or country. Many expats need to think about both, because the group plan stops when the employment does.

How the two types work

Group plans. An employer, or a company you own, arranges one policy for several people. Some providers describe a minimum of two employees on overseas assignments, though rules vary. The employer chooses the benefits, the areas covered and the limits, and staff join the plan as part of the job.

Individual plans. You apply for yourself and your family. The insurer asks about your health and decides what it will cover, exclude or charge extra for. You pay the premium and you choose the plan.

Side by side

• Cost. Group plans spread risk across many people, so providers say they are often cheaper than comparable individual plans. The employer may also pay some or all of the premium.
• Health questions. Group plans can accept people with less underwriting, which means conditions you already have may be covered. Individual plans are usually underwritten, and existing conditions may be excluded or priced in.
• Exclusions. Group plans can have broader terms and fewer exclusions. Individual plans tend to be more restricted, and some risks, such as war or terrorism, may be excluded.
• Portability. An individual plan is yours and can follow you if you change country, depending on the policy. A group plan stays with the employer.
• Control. In a group plan the employer picks the benefits. In an individual plan you do.
• Admin. A group plan is arranged for you. An individual plan is something you arrange and renew.

Treat the claims about group plans as typical features, not guarantees. Insurers set their own rules, so check the actual policy.

Pre-existing conditions

This is often the deciding factor. An individual policy usually asks about your medical history, then uses a moratorium or full medical underwriting to deal with conditions you already have. Our guide to pre-existing conditions and expat health insurance explains both methods.

A group plan can be more flexible, because the insurer is pricing the group rather than each person. Some group plans accept existing conditions from the start. Ask whether this applies to you, and whether it applies to your family as well as to you.

What happens when the job ends

A group plan usually ends when you leave the employer or when the employer stops the plan. That can leave you with no cover at a bad moment. Before you rely on one, ask:

1. Can I continue the cover for a period after I leave?
2. Can I convert to an individual plan, and will that need new medical underwriting?
3. What happens to cover for my partner and children?
4. Are there notice periods or gaps in cover?
5. If I fall ill while covered, does treatment continue after the job ends?

If conversion without new medical checks is available, it can be very valuable. If it is not, a condition that develops while you are in the group plan could be excluded when you buy individual cover later.

Cover for your family

Check who is covered and for how long. Some group plans include a partner and children, some charge extra and some limit the age of children. Pregnancy and maternity may have waiting periods, so ask early if you plan a family. A move back to the UK is also worth discussing in advance, because the plan may stop covering you there.

The self-employed and contractors

If you run your own company or work as a contractor, you may not have an employer plan to join. There are two options:

• an individual plan, which is simpler and does not depend on a company
• a group plan for your own company, which some providers offer if the company has the required number of covered people

A company plan can change the tax and reporting position in the country where you live. Take advice from an accountant who knows the local rules. If your income is irregular, our guide to income protection for expat contractors covers the other half of the risk.

When a group plan makes sense

A group plan tends to suit you when:

• your employer pays all or part of the premium
• you have a condition that an individual insurer would exclude
• you expect to stay with the employer for several years
• you want a simple plan with little paperwork

When an individual plan makes sense

An individual plan tends to suit you when:

• you are self-employed, a contractor or between jobs
• you want cover that stays with you if you change employer
• you want to choose the benefits, hospital network and limits
• the group plan is weak on the benefits you care about

A worked example

This example is illustrative.

A 48-year-old engineer is posted to Singapore with an employer-paid group plan that includes his family and accepts his asthma without exclusions. Three years later the employer ends the posting. He asks the insurer about conversion and learns that an individual plan would need full medical underwriting, which would probably exclude the asthma.

Because he asked before the posting ended, he has time to compare quotes, and he decides to take out an individual plan while still covered by the group plan. A short overlap costs a few months of premium. Leaving it until after the job ended could have meant a gap in cover and an exclusion for his condition.

Planning the switch

If you move from group to individual cover, avoid a gap. A sensible order is:

1. Get quotes while you are still on the group plan.
2. Answer health questions fully and keep copies of your answers.
3. Ask whether the new insurer will count time you have already been covered.
4. Start the new plan before the old one ends.
5. Confirm the start date in writing.

The NHS is not a fallback

Some people assume that, if cover lapses, they can use the NHS. In practice, free hospital treatment depends on being ordinarily resident, not on being British. Our guide to expat health insurance vs the NHS explains the rule, and why it matters before you cancel any private cover.

Common mistakes

• Assuming the group plan will continue after you leave the job.
• Not asking about conversion rights until after the notice period starts.
• Forgetting that cover for your partner and children may differ from yours.
• Choosing on price alone and missing exclusions.
• Cancelling the old plan before the new one is confirmed.

Health cover is one layer

Health cover pays for treatment. It does not replace income or pay a lump sum. See critical illness cover abroad for lump-sum protection. If you own a business, read about key person insurance for expat business owners.

For options and providers, see our expat insurance hub and our page on expat health insurance.

Frequently asked questions

Is group or individual expat health insurance better?

Neither is better for everyone. Group plans are often cheaper and easier with existing conditions, while individual plans stay with you when the job ends.

What happens to my group health cover if I leave my job?

It usually ends. Ask in advance whether you can continue it or convert to an individual plan, and on what terms.

Does group cover include pre-existing conditions?

Some group plans do, but terms vary. Ask the insurer and get the answer in writing.

Can a self-employed expat get a group plan?

Sometimes, if the provider allows a company plan for a small group. Many self-employed expats choose an individual plan instead.

Should I overlap my old and new plans?

Yes, briefly. Start the new plan before the old one ends so there is no gap.

This article is for information only and is not financial advice. Insurer terms differ and can change. Read the policy documents and take advice from an independent broker before acting.