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iPMI, COVID-19 And Global Mobility 2021 Featured

iPMI, COVID-19 And Global Mobility 2021

Ian Youngman, author of the market leading iPMI report, International Health Insurance (IPMI) 2021, looks at the latest developments in global mobility and international private medical insurance during the global COVID-19 pandemic.

Expats are staying put, going back abroad, planning to go back, or going abroad for the first time.

Aetna survey

Over the years Aetna surveys have tended to be reliable and informative- with the minimum of spin.

The latest one says that most expats want to continue living and working abroad. Three quarters of expats are looking forward to things getting back to normal.

In an original survey, Aetna International asked expats in four popular locations around the world (Germany, Singapore, UAE and Mexico) to discover:

  • How they are feeling about the return of international travel;
  • How their priorities have changed;
  • What their plans are for the future;
  • Are they feeling confident.

With restrictions and isolation on arrival still being a factor when travelling to many countries in 2021, it would not be a surprise if interest in expat experiences had significantly dipped, but the opposite seems to be true. 75% of expats said they are still very or fairly confident about continuing with their way of life.

Of the regions surveyed, there seems to be a correlation between how the pandemic was handled and increased expat confidence. The most confident responses came from Singapore (88%) and UAE (87%), while countries that felt a greater impact of the pandemic had comparatively lower levels of confidence from expats looking to continue their way of life (Germany 64%, Mexico 70%). Even in these cases, over two-thirds of expats remain confident about living and working abroad.

This confidence is closely related to the perceived safety of their chosen country. While 54% of expats surveyed moved back to their home country at some point, this number was far lower for expats based in Singapore and the UAE than those in Germany or Mexico.

Confidence by country


Confident to continue living as an expat (very and fairly confident)









Due to the pandemic, considerations around well-being have become even more of a focus, allowing existing expats to further enhance their lifestyle.

The combination of feeling happy and safe while living abroad, along with improved health and lifestyle, has contributed to the feeling of confidence - with 75% of those surveyed saying they were confident in their decision to continue living as an expat.

While it will vary from industry to industry, skilled expats are generally in a strong position to find well-paid jobs with significant benefits and support as result.

Expats have traditionally found it difficult to get permanent residence. That has now changed as the government seeks to boost economic recovery and growth with a range of inviting new pro-expat policies and revised residency laws. To encourage their return, skilled expats are now able to apply for citizenship. As UAE nationals have visa-free travel between Gulf States and can buy property anywhere, these measures provide a level of security for the future of the individual and their family.

Many countries are still trying to encourage expats to return. As economies look to bounce back, the need for skilled workers could result in a range of opportunities for expats whose skills line up to their host nation’s needs.

When considering a job opportunity abroad, family health and well-being benefits were considered important by 87% – more than the financial package or even which country the family would have to move to (both picked by 85%).

Protection of both family and individual health is a key consideration for employees. By acknowledging this and adapting to support these expectations with revised employee packages, that extend to protecting the health of their family, businesses can reassure expats that their families will have support available if it is needed.

Even though pandemic restrictions are easing in some countries, uncertainties about the future remain and may be making people think that moving abroad for work is not a risk worth taking yet. But with countries actively looking to encourage expat arrivals with improved policies, businesses providing staff with more support for family health and well-being, and opportunities for improved health and well-being, now could be the right time for expats to return to the lifestyle they fell in love with.

Another survey

The latest Internations Expat Insider Survey also confirmed Aetna International's findings on traveller confidence as it stated that seven in ten expats whose plans for moving to another foreign country were thwarted by COVID are still looking to move abroad within the next two years.

Aetna comments

Damian Lenihan, executive director of Europe at Aetna International, "In what has been a difficult and uncertain time, confidence is key, especially for those planning and trying to build a life in another country. Whatever their motivations for moving abroad, expats play an important role for both local and global communities. Returning to some sort of ‘normality' is what everyone is hoping for but feeling safe with access to quality health care is paramount to this becoming a reality. Wherever we are in the world. There have always been many factors for expats to consider. The resultant restrictions and challenges of the pandemic have only complicated decision-making. In some cases, like the widespread border restrictions and closures related to Coved, expats may feel like they had no choice.  Clear, informative communications are key to  helping expat communities continue in their desire to live and work abroad. Authorities and employers need to provide reassurances that the health and wellbeing interests of expats and their families are being looked after. This will hopefully start to encourage existing and wannabe expats to resume their plans when the time is right, and it is safe to do so.” 

Digital nomads

Traditionally digital nomads were people who moved around from country to country every few months, usually staying on tourist visas. With the evolution of new technologies many more people have become remote workers, able to take their jobs anywhere.

This means that countries across the world have been competing to attract remote workers and digital nomads, offering them the chance to legally stay and work for a period of more than just a few months.

So we have a new class of expat for anything from 3 to 18 months.

A digital nomad is someone who lives a nomadic lifestyle and uses telecommunications technology to work remotely while outside their country of permanent residence.

Over 20 countries have or plan a digital nomad visa. A digital nomad visa gives someone the legal right to work remotely while residing away from their country of permanent residence.

There are usually restrictions on income, where the business is based, what they do and insurance.

Some countries require them to have international health cover- in a vague way. Others demand they join the national health insurance scheme. Most are in limbo as not citizens, not tourists, and not expats. The question of paying for healthcare may not even be thought of until the digital nomad needs healthcare.

This must be a new source of business for IPMI – with a special short-term policy between student and expat.

Travel restrictions

Even for somebody like me who looks at piles of information on changing regulations each day it is a nightmare trying to keep up with who can leave or enter a country and what rules are on testing, regulation, and quarantine.

In theory this is driven by science but in the real world it is more about international and domestic politics – such as the love-hate relationship between British and French politicians (although the French and British are united in their contempt for their own politicians!),

The good news, particularly for fully vaccinated travellers is that – even with setbacks- borders are opening and 2022 will bring a return to normality.

However wonderful Zoom is, the pandemic has brought home that for business there is no real substitute for actually going to a country.


With all the above, it seems that in most countries the need for PMI and IPMI is increasingly understood and business figures from insurers suggest sales are increasing.

But just as we have people refusing to be vaccinated on the grounds that it is some sort of conspiracy there is still a belief by a large number of expats that they do not need IPMI.

Insurers and brokers tend to market in a nice way – and while it would be unethical to advertise IPMI on a “, Buy it or you will either die or be broke” basis- the pandemic should teach us new ways of promoting IPMI just as governments are trying new ways to get people vaccinated.

Perhaps to the younger generations the message needs to be more direct, more humorous and less long-winded.

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