Choosing expat health insurance with repatriation cover comes down to a handful of decisive criteria: the geographic area covered, reimbursement limits, the exact conditions of medical repatriation, and the quality of the assistance service. These elements vary considerably from one policy to the next and can make all the difference on the day you actually need them.
Why expat health insurance is different from standard cover
When you leave France to settle abroad for the long term, French state health cover no longer applies to medical care received locally. In many countries, medical bills can reach eye-watering amounts with no local safety net. International health insurance fills that gap: it covers consultations, hospital stays, medication and, in most cases, medically supervised repatriation.
To understand how this type of policy differs from short-term travel cover, read our article on the differences between travel insurance and health insurance.
Get my expat insurance quoteEssential cover to check before you sign
Medical expenses and hospitalisation
This is the foundation of any expat policy: cover for consultations, tests, treatment and hospital stays. Compare the annual limits per category (hospitalisation, routine care, dental, optical) and the overall policy cap. For a stay in a country with high medical costs, unlimited or very high limits for hospitalisation are strongly recommended.
Medical repatriation
Repatriation cover pays for medically supervised transport from your country of residence to a suitable hospital or back to France in the event of a serious medical emergency or accident. It typically includes transport by air ambulance or adapted commercial flight, medical supervision during the transfer where needed, the return of accompanying family members, and repatriation of remains in the event of death.
Before signing, read the activation conditions carefully: triggering a repatriation requires a medical assessment and usually involves contacting the assistance centre beforehand, which then evaluates the situation with local doctors. Also check that the assistance line is available 24 hours a day, seven days a week.
Direct billing and international medical network
A solid policy includes access to a network of partner medical providers for direct billing. This avoids having to pay large sums upfront in an already stressful situation. The quality of the multilingual assistance service is another differentiating factor, particularly in non-French-speaking countries.
The 4 criteria for choosing an expat policy
1. Geographic coverage area: this is the first filter. Some policies exclude costly destinations or cover them under separate pricing tiers. Check that your country of residence, your usual transit countries, and the United States if you travel there are all included.
2. Exclusions: undisclosed pre-existing conditions, chronic illnesses, high-risk sports, conflict zones or embargoed territories – these situations are frequently excluded depending on the policy. Disclose your full medical history at the point of application to avoid any dispute when making a claim.
3. Waiting periods: certain benefits (maternity, serious conditions) only activate after several weeks or months. Plan your departure in advance to avoid a gap in cover at the start of your assignment.
4. Cover during visits back to France: expats regularly return home for medical appointments or family visits. Check whether the policy reimburses costs incurred in France and what limits apply.
Repatriation insurance: not the same as short-trip travel assistance
The repatriation cover included in a long-stay expat policy is different from the repatriation assistance bundled into a standard travel insurance policy: its limits are calibrated for potentially very high intercontinental medical transport costs, and its logistics are designed around permanent residency abroad. For shorter trips or round-the-world journeys, other forms of cover exist: see our guide on how to insure yourself during a round-the-world trip.
To explore the different plans available and the key organisations for French nationals living abroad, our dedicated article on expat insurance makes a useful companion read.
How to handle a claim abroad
The order of steps is often decisive when it comes to getting reimbursed:
- Contact the assistance centre before any non-urgent medical visit, planned hospitalisation or evacuation. Prior approval is often a contractual condition for cover to apply.
- Keep all supporting documents: prescriptions, invoices, medical reports, even if they are written in a foreign language.
- File within the timeframe set out in your policy. Missing these deadlines can result in a claim being refused.
- For repatriation, do not make any arrangements yourself without the insurer’s agreement: costs incurred without prior authorisation are generally excluded from cover.
FAQ
Am I still covered by French state health insurance if I move abroad?
Not for medical care received abroad during a long-term stay. Your entitlements remain active only during temporary visits back to France, and depending on your status (posted employee, applicable bilateral social security agreement). International health insurance takes over to cover costs on the ground.
Is repatriation cover always included in an expat health policy?
Not automatically. Some policies offer it as an optional add-on or include it only in premium tiers. Read the general conditions carefully and check the benefit limit allocated to this cover: an intercontinental medical repatriation can run to tens of thousands of pounds depending on the destination and the transport required.
What does medical repatriation cover exactly?
It covers medically supervised transport (air ambulance, adapted commercial flight or ground ambulance depending on the situation) from your country of residence to a suitable hospital or back to France. It may also include medical supervision during the transfer, the return of accompanying family members, and sometimes accommodation costs related to the evacuation. Activation conditions vary between policies.
Can you combine expat insurance with the CFE?
Yes. The CFE (Caisse des Français de l’Étranger) maintains basic health cover for voluntary expats, but its reimbursements are indexed to French social security rates, which are often far below actual costs abroad. International supplementary insurance is therefore recommended to bridge that gap, depending on your destination and personal profile.
What exclusions should you watch out for in an expat health policy?
The most common exclusions relate to undisclosed pre-existing conditions, high-risk sports activities, geographic areas under embargo or in armed conflict, and certain benefits subject to a waiting period (maternity cover in particular). Disclose your full medical history at the point of application to avoid any dispute further down the line.
