iPMI Magazine Is Proudly Sponsored By:
For a healthier journey.

iPMI Magazine Has Moved

iPMI Magazine successfully rebranded to iPMI Global in 2023 and has moved to a new home on the internet. To visit the brand new international private medical insurance business intelligence platform, please go to

Passportcard's Innovative ASO Solution For Large Customers

International health insurance provider enables full cost control.

PassportCard's payment processing and administration of medical services (ASO solution) is now also used by Lufthansa. More than 20,000 members of its flight staff already benefit from it.

The large company enjoys a comprehensive cost control solution without the need to take out insurance.

The ASO solution enables claims management, cost savings, app usage and PassportCard's innovative card solution - around the clock and around the world.

Eithan Wolf, CEO PassportCard EUROPE told iPMIM, “PassportCard is incredibly proud to service 23000 air crew members of Lufthansa. At the same time it gives us the ultimate proof that we are on the right track on our journey to become the leading IPMI provider in Europe.”

Advantages of the ASO solution

ASO (Administration Services Only) solutions are ideal for large clients where the risk is self-sustaining from an actuarial perspective. In this case, it is more advantageous for companies to be considered "self-pay" in order to receive the full benefits of the insurance but save the insurance margin and the insurer's profit.

In an ASO solution, the claims fund, i.e. the account from which claims are paid, is topped up by the customer. This means that the company itself pays.

On average, the cost saving of an ASO solution compared to full insurance is about 20 per cent.

PassportCard has been managing ASO solutions for government agencies and large corporations for many years.

Effect of ASO solutions

ASO solutions unite the client and the provider. The ASO partner analyses the data every month to track the results and behaviour of the portfolio. Optimising changes can then be made to the performance table, which can be adjusted with the client's approval to achieve better cost containment results.

After one year, there is sufficient data to enter into either the continuation of the ASO solutions or the provision of a full insurance mechanism.

PassportCard is a member of the DavidShield and White Mountains group of companies (NYSE: WTM), which has been a leader in international health and travel insurance since 1999 and serves over two million customers worldwide. The Hamburg-based company has focused on the German market since 2015 and works with Allianz, MGEN and TK. The company is a winner of the German Innovation Award 2021 and belongs to the Leading Employer Top 1%.

Further information:



Allianz Partners Announces Enhanced International Health Insurance Options For Customers

Allianz Partners has announced three significant enhancements to their suite of international health plans, aimed at providing more options to customers with health insurance policies.

Firstly, the new Allianz Summit plan – designed and sold through the company’s international health brand, Allianz Care – offers SMEs increased flexibility when designing their employee health insurance benefits. Secondly, the addition of moratorium underwriting offers faster onboarding when purchasing health insurance for both individuals and SMEs. Thirdly, all customers can now access the hugely popular Wysa app for immediate, confidential and high-quality mental health support, at no additional cost.

Allianz Summit 

The Allianz Summit health plan is a comprehensive international health plan designed for SME groups of up to 100 employees. This product was developed following Allianz Partners’ preferred partnership agreement with Aetna International earlier this year and is modelled on Aetna’s popular Summit product, with a number of enhancements.

Its modular structure and pre-set options offer flexibility, allowing clients to tailor a health plan to the needs of their employees. Members enjoy access to a host of support services, including a 24/7 multilingual helpline, a network of over 1 million medical providers globally, and a range of digital health and wellness tools.

Allianz Summit has launched in English initially, with other languages to follow early next year, and locally compliant plans are available to SMEs across countries in Europe, Asia and the Middle East.

Moratorium underwriting

Individuals and SME customers at Allianz Partners can now opt for moratorium underwriting, or the traditional Full Medical Underwriting (FMU) terms.

With Full Medical Underwriting, customers provide their full medical history and, based on an assessment of that information, there may be specific surcharges applied to their cover from the outset. This form of underwriting is particularly beneficial for those with existing medical conditions.

Moratorium underwriting is a generally faster process than Full Medical Underwriting, as there are no medical forms to complete. Moratorium also takes the recurrence of an illness into account, allowing for more flexibility in the application. It offers the reassurance that as long as the person is symptom-free and has not needed any treatment or medical advice for a pre-existing condition for two consecutive years, cover will begin in the third year of their policy. This is expected to be a popular option amongst SMEs, as the onboarding of employees is much faster.

Moratorium underwriting is available to individuals and small groups with between three and nine members, but is dependent on geographical location and local country regulations.

Wysa Mind Coaching App

The Wysa Mind Coaching App, a chat buddy and human coaching service, is also now available to all Allianz Partners health insurance customers. This is a new support service, following the preferred partnership deal with Aetna International earlier this year.

This app is currently used by 4 million users globally and provides immediate, confidential mental health support at no additional cost. Its aim is to provide early support and intervention for those not yet ready to talk by phone or meet a specialist.

The app centres on Wysa, a conversational chatbot that’s available day and night to listen and chat about whatever’s on someone’s mind in a fully confidential environment. This creates a non-judgmental safe space to vent and be heard, anytime, anywhere. The app also provides a self-care library with over 150 tools and exercises to develop mental strength and resilience to help deal with issues ranging from body image to breakups. All tools are backed by science and handpicked by experts. Additionally, users will have access to a professionally-trained human coach to support them via in-app, text-based chat sessions. If additional support is needed, this will be provided through a 12-week coaching program with a dedicated coach.

Paula Covey, Chief Marketing Officer Health at Allianz Partners, said: “Our new Allianz Summit product and the provision of the Wysa app are both testament to the success of our preferred partnership agreement with Aetna International from earlier this year. Allianz Summit offers increased flexibility for SMEs and enables them to manage costs more efficiently as different options can be selected for different groups of employees. The Wysa app is a multi-award-winning solution, and its availability to all customers at no additional cost highlights the importance that we as a company attach to mental fitness and wellbeing. Meanwhile, the new moratorium underwriting health insurance option we’re providing allows for greater flexibility and a faster onboarding process when buying health insurance. These three new offerings each demonstrate Allianz Partners’ commitment to innovating with purpose, continually improving the range and flexibility of our services to customers.”

To learn more about Allianz Care international health plans, visit:


The Best And Worst Destinations For Living And Working Abroad

The Expat Insider 2021 Survey is out now, and the results reveal the best and worst destinations for living and working overseas.

Ian Youngman, Author of the International Health Insurance 2021 report comments, "Among all the doom and gloom I have heard suggestions that not only were some companies thinking of moving people away from cities into the country but also thinking of moving people abroad. The other vibe is that rather than moving back home - as the media suggests- most expats have opted to stay but perhaps move to the country or move from cities. This is the first time that I have seen any evidence that more people are thinking of moving abroad.

In the UK there is already a trend to move from cities into the country and either work remotely or commute. In my village, every week estate agents ask if I want to sell up - local house prices have shot up over 10% in a few months. So if you think this through globally, with remote work globally being possible and digital nomads becoming a new breed of expats, people are looking to move from cities- and that may mean moving abroad. Nobody can predict figures but I expect expat numbers to increase every year in the next few years - from individuals and companies.

There are now 80 million expatriates, 5 million international students, 4 million temporary foreign workers, and 18 million high net worth individuals of which 2.7 million are ultra high net worth."

RELATED READING: International Health Insurance (IPMI) 2021

The Best Destinations for Living and Working in 2021

1. Taiwan 

Taiwan ranks 1st out of 59 destinations for the third year in a row in the Expat Insider 2021 survey. It also comes first in the Quality of Life and Working Abroad Indices: Most expats are satisfied with their job security (83% vs. 61% globally) and the state of the local economy (85% vs. 62% globally). Additionally, the majority is happy with their job (75% vs. 68% globally) and their life in general (80% vs. 75% globally). Furthermore, 96% of expats rate the quality of medical care positively (vs. 71% globally), and another 94% are satisfied with its affordability (vs. 61% globally). An expat from Chile shares: “The Taiwanese healthcare system truly considers people as human beings instead of mere numbers.” Moreover, not a single expat (0%) feels personally unsafe in Taiwan (vs. 8% globally). An expat from Canada shares: “I can live independently. I feel safe wherever I go, and everything is convenient.” 

Although Taiwan places slightly lower in the Ease of Settling In Index (13th), it is the best-ranking country worldwide in the Friendliness subcategory (1st). Most expats find it easy to make friends there (62% vs. 48% globally) and describe the Taiwanese population as friendly towards foreign residents (96% vs. 67% globally).  

2. Mexico 

Mexico ranks 2nd out of 59 destinations worldwide. It is even rated the best country for expats in the Ease of Settling In Index (1st): 85% find it easy to settle down in Mexico (vs. 62% globally), and 78% say it is easy to make local friends (vs. 44% globally). A US American expat says that “the culture and friendliness of the local people” is their favorite thing about living in Mexico.  

Mexico also does well in the Personal Finance (2nd) and Cost of Living (4th) Indices. In fact, four in five expats (80%) are satisfied with their financial situation (vs. 64% globally), and 90% say their disposable household income is enough or more than enough to cover their living expenses (vs. 77% globally).  

Mexico performs slightly below average in the Quality of Life Index (31st). It comes in 42nd place in the Quality of the Environment subcategory, with 27% of expats being unhappy with the water and sanitation infrastructure (vs. 12% globally). Additionally, Mexico even ends up among the bottom 10 of the Safety & Security subcategory (51st), with 20% of expats concerned about their personal safety (vs. 8% globally). Despite that, 89% of expats in Mexico are happy with their life in general (vs. 75% globally), placing the country first worldwide for personal happiness.  

3. Costa Rica 

Costa Rica places 3rd out of 59 countries in the Expat Insider 2021 survey. It ranks among the top 5 in the Ease of Settling In Index (3rd), with 91% of expats describing the population as generally friendly (vs. 69% globally). Another 87% describe the local residents as generally friendly towards foreign ones (vs. 67% globally), and 70% find it easy to make local friends (vs. 44% globally). “I love the social life and culture,” shares a US American expat. Maybe this is why most survey respondents find it easy to get used to the local culture (82% vs. 65% globally) and feel at home in it too (80% vs. 63% globally).  

Costa Rica performs well in the Quality of Life Index (14th), coming in second place worldwide for personal happiness — just behind Mexico (1st). All things considered, 88% of expats in Costa Rica are happy with their life (vs. 75% globally). The country comes 10th in the Quality of the Environment subcategory, with the majority of expats rating the natural environment (96% vs. 84% globally) and the air quality (91% vs. 66% globally) positively. However, Costa Rica lands in the bottom 10 of the Travel & Transportation subcategory (52nd): 29% of expats are unhappy with the public transportation system (vs. 15% globally). A Canadian expat shares: “Traffic is terrible because of poor drivers, bad roads, and insufficient infrastructure.”  

On the upside, Costa Rica makes it into the top 10 of the Personal Finance Index (7th), with 84% of expats considering their disposable household income enough or more than enough to cover all expenses (vs. 77% globally).  

4. Malaysia 

Ranking 4th out of 59 countries in the Expat Insider 2021 survey, Malaysia ranks above the global average in every index. The country does particularly well in the Ease of Settling In Index (2nd) — as a US American expat puts it: “It is easy to live here, and the people are wonderful.” In fact, most expats find it easy to settle down in Malaysia (77% vs. 62% globally) and to make new friends there (66% vs. 48% globally). It might help that Malaysia ranks first in the Language subcategory: 92% of expats find it easy to live there without speaking the local language (vs. 54% globally), while 45% also consider it easy to learn (vs. 39% globally).  

The country also does exceedingly well in the Cost of Living Index (2nd), where just Vietnam (1st) performs better. In fact, 82% of expats rate the cost of living in Malaysia positively (vs. 48% globally). With the destination ranking 9th in the Personal Finance Index, 73% of expats are satisfied with their financial situation (vs. 64% globally), and 85% say their disposable household income is enough or more than enough to cover their expenses (vs. 77% globally).  

Malaysia does worst in the Working Abroad Index, but it still lands in a slightly above-average 25th place: 72% of expats are satisfied with their working hours (vs. 66% globally), and 69% are happy with their job in general (vs. 68% globally). 

5. Portugal 

Portugal ranks 5th out of 59 destinations in the Expat Insider 2021 survey, performing best in the Quality of Life Index (3rd) — just behind Taiwan (1st) and Austria (2nd). The country ranks third in the Personal Happiness subcategory of this index, with 84% of expats being happy with their life in general (vs. 75% globally). What is more, 87% of expats are satisfied with the local leisure options (vs. 72% globally), and 90% say the same about the climate and weather (vs. 66% globally). “I like the weather and the laid-back lifestyle,” says a French expat.  

Portugal also makes it into the top 10 of the Ease of Settling In Index (9th), coming sixth in the Friendliness subcategory. In fact, 87% of expats find the local residents generally friendly, compared to just 69% globally. Portugal even ranks second worldwide in the Feeling at Home subcategory, where just Mexico (1st) performs better. The majority of expats feels at home in the local culture (83% vs. 63% globally) and finds it easy to settle down in the country (84% vs. 62% globally).  

Portugal receives its worst — but still fairly average — results in the Working Abroad Index (36th). The destination places 44th in the Career Prospects & Satisfaction subcategory, though, with more than half the expats (51%) unsatisfied with the local career opportunities (vs. 33% globally). However, 70% of expats are at least happy with their work-life balance (vs. 66% globally).  

6. New Zealand 

New Zealand almost makes it into the global top 5 of the Expat Insider 2021 ranking, coming 6th out of 59 countries. It performs particularly well for working abroad (2nd): 81% of expats consider their job secure (vs. 61% globally), and 64% feel optimistic about local career options (vs. 45% globally). At the same time, expats enjoy a great work-life balance (83% satisfied vs. 66% globally).  

The country comes in 11th place in the Quality of Life Index, doing especially well in the Digital Life subcategory (5th): 98% are happy with the cashless payment options (vs. 83% globally), and 89% rate the availability of government services online favorably (vs. 63% globally). What is more, New Zealand has the best ratings worldwide for its natural environment (100% positive vs. 84% globally), coming in 6th place in the Quality of Environment subcategory. Last but not least, it is a very safe and stable country to settle down in: 95% of expats describe New Zealand as peaceful (vs. 80% globally), and not one single respondent rates its political stability negatively, compared to about one in six (16%) globally. “I love my peaceful, calm, and safe existence in New Zealand,” a US expat comments.  

The results for the ease of settling in are only slightly worse (16th). Expats find it easy to settle down in New Zealand (77% positive ratings vs. 62% globally), and 82% describe the local residents as friendly (vs. 69% globally).  

7. Australia 

In the Expat Insider 2021 survey, Australia (7th out of 59) lands among the top 10 destinations worldwide. While it ranks sixth in the Quality of Life Index overall, it comes first worldwide for its local leisure activities (87% positive ratings vs. 72% globally). An impressive 97% of respondents also praise the natural environment (vs. 84% globally). “Living in close proximity to nature — close to the beach and the rainforest — is so amazing!”, says a US expat. Lastly, it ranks very well in the Digital Life subcategory (8th) as, for instance, 89% of expats appreciate the availability of government services online (vs. 63% worldwide). However, opinions are divided on the topic of healthcare in Australia: while 88% of expats are satisfied with its quality (vs. 71% globally), just 68% consider it affordable (vs. 61% globally).  

Australia does well in the Working Abroad Index (10th). Expats are especially satisfied with their local career opportunities (60% positive ratings vs. 45% globally) and their work-life balance (76% positive responses vs. 66% globally). Even Australia’s somewhat worse results in the Ease of Settling In Index (18th) still place it in the top 20. Expats find it especially easy to get used to the local culture (76% positive responses vs. 65% globally) and to settle down in Australia (74% vs. 62% worldwide). However, only a slightly above-average 54% find it easy to make new friends there (vs. 48% globally).  

8. Ecuador  

Coming in 8th place out of 59 countries in the Expat Insider 2021 survey, Ecuador performs best in the Personal Finance Index (5th). Close to three in four expats (73%) are satisfied with their financial situation (vs. 64% globally). Moreover, 91% describe their disposable household income as enough or more than enough to cover their expenses (vs. 77% globally). This places the country third for this factor, just behind India (2nd) and Vietnam (1st). Ecuador also lands among the top 10 in the Cost of Living Index (7th), with 78% of expats rating this aspect of life abroad positively (vs. 48% globally).  

In the Ease of Settling In Index (10th), the country ranks sixth in the Feeling at Home subcategory. The majority of expats (82%) finds it easy to settle down in Ecuador (vs. 62% globally), 80% feel at home in the local culture (vs. 63% globally), and 68% find it easy to make new friends in general (vs. 48% globally).  

Ecuador shows a slightly weaker performance in the Quality of Life Index (24th). Still, nearly all expats (96%) rate the country’s natural environment positively (vs. 84% globally), and 85% are satisfied with their socializing and leisure activities (vs. 67% globally). “The nature and scenery are great,” shares a Venezuelan expat. However, in the Digital Life subcategory (45th), Ecuador comes last worldwide (59th) for cashless payment options, with 37% rating this factor negatively (vs. 9% globally).  

9. Canada 

Making it into the top 10 out of 59 destinations, Canada (9th overall) performs well in most indices of the Expat Insider 2021 survey. The country ranks best in the Quality of Life Index (5th), with the majority of expats finding it easy to get high speed internet at home (92% vs. 79% globally) and to pay without cash (96% vs. 83% globally). Additionally, 86% are happy with the availability of government services online, compared to 63% globally. Most expats are also satisfied with the affordability of healthcare in Canada (85% vs. 61% globally) and the country’s political stability (90% vs. 64% globally). “Healthcare is a basic right, and the quality of life is very good in Canada,” says a US American expat.  

Canada also performs well in the Working Abroad and Ease of Settling In Indices (12th for both). It even lands in the top 10 of the Feeling at Home subcategory (7th), with 73% of survey respondents feeling at home in the local culture (vs. 63% globally). In terms of work, close to two out of three expats (64%) rate the career opportunities positively (vs. 45% globally).  

On the other hand, Canada ends up among the bottom 10 of the Personal Finance Index (50th). Nearly a third of expats (32%) say their disposable income is not enough to cover all their living expenses (vs. 23% globally). An expat from Mexico shares that “the best cities are really expensive. It is hard to become a homeowner with an average income.”  

10. Vietnam  

Coming in 10th place out of 59 countries in the Expat Insider 2021 survey, Vietnam ranks first in both the Personal Finance and Cost of Living Indices. The majority of expats (85%) rates the cost of living positively (vs. 48% globally), and 78% are satisfied with their financial situation (vs. 64% globally).  

Vietnam also does well in the Working Abroad Index (9th), with the vast majority of expats (86%) expressing overall job satisfaction (vs. 68% globally). Placing 25th in the Ease of Settling In Index, Vietnam does especially well in the Finding Friends subcategory (9th). According to 63% of expats, making local friends is easy (vs. 44% globally), and another 67% find it easy to make new friends in general (vs. 48% globally). What is more, the majority (81%) considers the local residents generally friendly (vs. 69% globally).  

Despite its great performance in the overall ranking, Vietnam ends up among the bottom 10 in the Quality of Life Index (53rd). More than three in five expats (63%) rate the air quality in Vietnam negatively (vs. 20% globally), and 42% are unhappy with the water and sanitation infrastructure (vs. 12% globally). A Swiss expat shares: “Plastic pollution is a major problem, especially along the coast.” However, 85% of expats in Vietnam are still generally happy with their life (vs. 75% globally).  

The Worst Destinations for Living and Working in 2021 

59. Kuwait 

For the seventh time in eight years, Kuwait (59th out of 59 countries) comes in last place in the Expat Insider 2021 survey. The country ranks last in the Quality of Life Index (59th), with especially poor results in the Leisure Options, Personal Happiness, and Travel & Transportation subcategories (59th for all). In fact, 58% of expats in Kuwait are unhappy with the local leisure options (vs. 14% globally), and 50% rate the climate and weather negatively (vs. 17% globally). Additionally, 29% state that they are generally unhappy (vs. 10% globally).  

Kuwait comes last in the Ease of Settling In Index (59th), with 46% of expats not feeling at home in the local culture (vs. 20% globally) and 45% finding it difficult to settle down in this country (vs. 22% globally). Moreover, 51% have trouble finding new friends (vs. 32% globally), and 62% find it difficult to make local friends in particular (vs. 36% globally). The country ranks last for friendliness (59th) as well: 36% of expats rate the general friendliness of the population negatively (vs. 16% globally), while another 44% describe the people as unfriendly towards foreign residents (vs. 18% globally).  

Placing 56th in the Working Abroad Index, Kuwait performs poorly in both the Work & Leisure (58th) and the Career Prospects & Satisfaction (57th) subcategories. More than three in ten respondents (31%) are dissatisfied with their job in general (vs. 16% globally), and 34% are unhappy with their work-life balance (vs. 17% globally).  

58. Italy 

Coming in 58th place in the Expat Insider 2021 survey, Italy is the second-worst country for expats — ranking only ahead of Kuwait (59th). In the Personal Finance Index (59th), the Southern European country even lands in last place worldwide: 30% of expats are dissatisfied with their financial situation (vs. 19% globally), 14% even very much so, twice the share of the global average (7%). Furthermore, one in three expats (33%) says their disposable household income is not enough to cover their expenses (vs. 23% globally).  

Italy also performs poorly in the Working Abroad Index (58th), only ahead of Turkey (59th), coming last in the Career Prospects & Satisfaction subcategory (59th). More than half the expats (56%) rate their local career opportunities negatively (vs. 33% globally), and 31% are dissatisfied with their job (vs. 16% globally). An Iranian expat shares: “Finding a job is not easy for foreigners, not even for the well-educated ones.”  

Within the Quality of Life Index (42nd), Italy ranks worst in the Digital Life subcategory (51st): 23% of expats find it difficult to get high-speed internet access at home (vs. 12% globally), 18% consider it difficult to pay without cash (vs. 9% globally), and 40% are unhappy with the availability of government services online (vs. 21% globally). Overall, there are only few upsides about expat life in Italy, such as the climate and weather (71% happy vs. 66% globally) and the travel opportunities (88% happy vs. 84% globally). 

57. South Africa 

Coming in 57th place out of 59 destinations in the Expat Insider 2021 survey, South Africa ends up in the bottom 3 — only ahead of Italy (58th) and Kuwait (59th). It performs worst in the Personal Finance Index (55th): over one-third of expats in South Africa (34%) do not consider their disposable household income enough to cover all their expenses (vs. 24% globally), and just 57% of expats in South Africa are satisfied with their financial situation (vs. 64% globally).  

South Africa also ends up among the bottom 10 of the Working Abroad Index (54th), coming last worldwide in the Economy & Job Security subcategory (59th). Only 47% of expats are satisfied with their job security (vs. 61% globally), and less than a third (31%) are happy with the state of the local economy — exactly half the global average (62%).  

Ranking among the bottom 10 in the Quality of Life Index (52nd), South Africa ranks last worldwide in the Safety & Security subcategory (59th). More than one-third of expats (34%) do not consider South Africa a peaceful country (vs. 9% globally) and just about one in four (24%) feel safe there (vs. 84% globally). An Ethiopian expat even says: “You are not able to walk around safely.” However, South Africa does well in the Leisure Options subcategory (15th), with 87% of expats rating the climate and weather favorably (vs. 66% globally). The majority (95%) is also satisfied with the natural environment (vs. 84% globally). “I like the climate, the diverse coastlines, and South Africa’s natural beauty,” summarizes a German expat. 

56. Russia 

Out of 59 countries in the Expat Insider 2021 survey, Russia (56th) lands in the bottom 10. It performs worst in the Working Abroad Index (52nd): Close to one in four expats (24% each) rate the state of the local economy negatively (vs. 19% globally) and are unhappy with their job security (vs. 20% globally).  

Narrowly escaping the bottom 10 in the Quality of Life Index (49th), Russia performs especially poorly in the Quality of the Environment subcategory (49th). Expats are unhappy with the air quality (31% vs. 20% globally), the water and sanitation infrastructure (21% vs. 12% globally), and the natural environment (14% vs. 8% globally). “I do not like the lack of any meaningful efforts or policies to reduce environmental pollution and to support basic recycling,” shares a US American expat.  

With Russia coming in 48th place in the Ease of Settling In Index, 29% of respondents find it difficult to settle down in this country (vs. 22% globally). What is more, Russia ends up in the bottom 10 of the Language subcategory (58th), only ahead of Japan (59th). Nearly half the expats (48%) find it difficult to live in Russia’s cities without speaking the local language (vs. 29% globally), and two-thirds (67%) find it difficult to learn Russian (vs. 42% globally). Russia receives its best result in the Cost of Living Index (25th): 49% of expats rate the cost of living positively, which is, however, still just one percentage point above the global average (48%). 

55. Egypt  

Egypt (55th out of 59) also ranks the bottom 10 of the Expat Insider 2021 survey. The country performs worst in the Quality of Life Index (57th), where only India (58th) and Kuwait (59th) do worse. In fact, 39% of expats in Egypt rate the water and sanitation infrastructure negatively (vs. 12% globally), and 48% give the air quality a negative rating (vs. 20% globally). “The air quality is bad, and there are only few green spaces,” shares an Afghan expat. Landing at the very bottom, Egypt performs even worse in the Digital Life subcategory (59th). Exactly three in five expats (60%) rate the availability of government services online negatively (vs. 21% globally), 34% find it difficult to get high-speed internet access at home (vs. 12% globally), and 32% consider it hard to pay without cash (% vs. 9% globally).  

Also ending up among the bottom 10 of the Working Abroad Index (53rd), Egypt receives extremely poor results in the Career Prospects & Satisfaction (55th) and Economy & Job Security (53rd) subcategories. A quarter of expats (25%) are dissatisfied with their job in general (vs. 16% globally), and 46% rate the local career opportunities negatively (vs. 33% globally).  

The country performs better in the Cost of Living (19th) and Ease of Settling In (30th) Indices: 61% of expats rate the cost of living positively (vs. 48% globally) and 57% find it easy to make local friends (vs. 44% globally).  

54. Japan 

Japan ranks 54th out of 59 countries featured in the Expat Insider 2021 survey. Performing particularly poorly in the Ease of Settling In Index (58th), Japan only ranks better than Kuwait (59th). Just 36% of expats find it easy to settle down in Japan (vs. 62% globally), and a mere 45% feel at home in the local culture (vs. 63% globally).  

In the Working Abroad Index (50th), 30% of expats are unhappy with their work-life balance (vs. 17% globally). A US American expat living in Hashimoto even says that “the work-life balance here is atrocious”. Japan also receives poor results in the Personal Finance Index (54th), with 26% of expats dissatisfied with their financial situation (vs. 19% globally).  

On the upside, Japan has an above-average performance in the Quality of Life Index (21st). With the country coming 12th for the quality of the environment, 94% of expats rank the water and sanitation infrastructure positively, compared to 77% globally. Additionally, nearly all expats rate Japan positively for personal safety (97% vs. 84% globally) and peacefulness (95% vs. 80% globally). A Brazilian expat shares: “In Japan, there is a low crime rate throughout the country. It is very safe to walk on the streets at any time.” And a South African expat says: “Japan offers a safe environment, and most things are done properly with respect for others in mind.”  

53. Cyprus 

Cyprus lands in the bottom 10 overall, coming 53rd out of 59 destinations in the Expat Insider 2021 survey. It places 57th in the Working Abroad Index — just ahead of Turkey (59th) and Italy (58th). Close to half the expats (49%) are dissatisfied with the local career opportunities (vs. 33% globally), and more than a third (34%) rate the job security negatively (vs. 20% globally). A Nepalese expat shares: “It is difficult to find work, so I cannot afford college or my living expenses.” In fact, Cyprus also places in the bottom 10 of the Personal Finance Index (57th) and comes last for the disposable household income (59th). Close to two in five expats (39%) say their disposable household income is not enough to cover their expenses abroad (vs. 23% globally).  

Cyprus performs best in the Ease of Settling In Index (28th), with 66% feeling at home in the local culture (vs. 63% globally) and 70% describing the local population as generally friendly towards foreign residents (vs. 67% globally). Furthermore, 80% of expats find it easy to get around without knowing the local language(s) (vs. 54% globally).  

With Cyprus placing 34th in the Quality of Life Index, the majority of expats (89%) is happy with the local climate and weather (vs. 66% globally) — ranking the destination 5th worldwide for this factor. However, while 70% of respondents are happy with the air quality in Cyprus (vs. 66% globally), 14% rate the water and sanitation negatively (vs. 12% globally).  

52. Turkey 

Overall, Turkey (52nd out of 59) lands among the bottom 10 destinations in the Expat Insider 2021 survey. Ranking last worldwide in the Working Abroad Index (59th), Turkey ends up in the bottom 10 for every single subcategory: Career Prospects & Satisfaction (56th), Economy & Job Security (58th), and Work & Leisure (59th). In fact, expats in Turkey are dissatisfied with their working hours (32% vs. 16% globally), their job in general (29% vs. 16% globally), and their job security (30% vs. 20% globally). A British expat shares that “for expats, it is extremely difficult to get a work permit”.  

Turkey places 32nd in the Ease of Settling In Index, with more than half the expats (53%) finding it easy to make local friends (vs. 44% globally). Most expats consider the local residents to be friendly towards foreign ones (72% vs. 67% globally), and they are happy with the general friendliness of the population too (72% vs. 69% globally). “There is a general warmth and hospitality among the people around me,” shares a Russian expat.  

Coming in 35th place in the Quality of Life Index, Turkey ranks among the bottom 10 in the Digital Life subcategory (50th), though: 16% of expats find it difficult to get a local mobile phone number (vs. 7% globally), and 21% have trouble getting high-speed internet at home (vs. 12% globally). The country also lands in the bottom 10 for political stability (54th), with more than a third of expats (35%) rating this factor negatively (vs. 16% globally).  

51. India 

Coming in 51st place out of 59 countries, India also ranks among the bottom 10 of the Expat Insider 2021 survey. Despite the poor result overall, the country ranks fourth worldwide in the Personal Finance Index: 82% of expats in India are satisfied with their financial situation (vs. 64% globally), and 89% say their disposable household income is enough or more than enough to cover their expenses (vs. 77% globally). Additionally, India places 13th in the Cost of Living Index (69% positive ratings vs. 48% globally).  

India performs slightly below average in the Ease of Settling In Index (34th). More than three in five expats (62%) feel at home in the local culture (vs. 63% globally), and 79% say the local population is generally friendly towards foreign residents (vs. 67% globally). However, over half the expats (51%) find it difficult to settle down in India, compared to 22% globally.  

India receives the second-worst results worldwide in the Quality of Life Index (58th) — only ahead of Kuwait (59th) — and performs worst in the Quality of Environment subcategory (59th): 67% of expats rate the air quality negatively (vs. 20% globally), and more than half (54%) are unhappy with the water and sanitation infrastructure (vs. 12% globally). The overall quality of life is also lowered by India’s poor performance in the Safety & Security subcategory (56th). Just 29% are satisfied with the country’s political stability (vs. 64% globally) and just 72% feel safe in India’s cities (vs. 84% globally). 

50. Malta 

Malta comes in 50th place out of 59 countries in the Expat Insider 2021 survey, performing worst in the Quality of Life Index (54th). It ends up among the bottom 10 in the Quality of the Environment and Travel & Transportation subcategories (56th for both). More than half the expats in Malta (51%) are unhappy with the transportation infrastructure (vs. 15% globally), and 11% rate their travel opportunities negatively (vs. 7% globally). “There is no nature at all, no green spaces, poor infrastructure for children, and too much traffic and pollution,” shares an Italian expat. In fact, 38% of expats in Malta are unhappy with the natural environment (vs. 8% globally). Moreover, 35% rate the air quality negatively (vs. 20% globally), and 25% are dissatisfied with the water and sanitation infrastructure (vs. 12% globally). On the upside, Malta ranks 7th worldwide for its local climate and weather (92% positive ratings vs. 66% globally).  

Malta receives below-average results in the Cost of Living and Ease of Settling In Indices (35th for both). In fact, 20% of expats rate the friendliness of the local population towards foreign residents negatively (vs. 18% globally). Additionally, 37% of expats find it difficult to make local friends in Malta (vs. 36% globally).  

Expat Life during the COVID-19 Pandemic 

On a global scale, 45% of survey respondents say that COVID-19 had an impact on their current stay abroad or their relocation plans: the share of expats who say so (37%) either decided to not move back home in the near future (18%), planned to move to another country but had to change these plans (8%), will move to another country due to the pandemic (6%), or will move back home sooner than originally planned (5%).  

The share of local respondents whose relocation plans were affected by COVID-19 (61%) is a lot higher: some of them were living abroad but moved home sooner than planned (18%), others were planning to move abroad but had to change their plans (35%), and about one in ten have now decided to move abroad because of the pandemic (9%).  

The Pandemic’s Impact on Everyday Life 

Of course, COVID-19 has not only disrupted the relocation plans of expats worldwide. When asked where they see the biggest impact of the pandemic on their personal life right now, the survey respondents point out its effects on personal travel (25%), social life (23%), and their work or business (16%) in particular. In the long run, respondents are still concerned about the impact of COVID-19 on their social life (17% of all respondents), and there are also considerable worries regarding personal travel (22%).   

How Expats Stay Informed on COVID-19 

Expats across the world mostly rely on official government channels (48%), local news (47%), and social media (40%) for news on the COVID-19 situation and the related regulations in their country of residence. Considering the importance of government channels, just how satisfied are expats with the official communication regarding COVID-19 and related regulations? Worldwide, not quite two-thirds (66%) rate this factor positively, with close to a quarter (24%) saying they are completely satisfied. The main complaint among expats who are not satisfied with the official communication on the pandemic is that the information is unclear, confusing, and/or contradictory (67%).  

For further information on the global impact of COVID-19 on expat life, please take a look at the full press release in the download center of our e-mail.  

About the InterNations Expat Insider 2021 Survey  

For its annual Expat Insider survey, InterNations asked 12,420 expats representing 174 nationalities and living in 59 countries or territories to provide information on various aspects of expat life, as well as their gender, age, and nationality. Participants were asked to rate up to 37 different aspects of life abroad on a scale of one to seven. The rating process emphasized the respondents’ personal satisfaction with these aspects, considering both emotional topics and more factual aspects with equal weight. The respondents’ ratings of the individual factors were then bundled in various combinations for a total of 13 subcategories, and their mean values were used to draw up five topical indices: Quality of Life, Ease of Settling In, Working Abroad, Personal Finance, and Cost of Living. The first four of these indices were further averaged together with expats' general satisfaction with their life in order to rank 59 expat destinations around the world. In 2021, the top 10 are Taiwan, Mexico, Costa Rica, Malaysia, Portugal, New Zealand, Australia, Ecuador, Canada, and Vietnam. Moreover, expats were asked about how COVID-19 has impacted their life abroad; however, these responses did not influence the overall ranking.  

For a country to be featured in the indices and consequently in the overall ranking, a sample size of at least 50 survey participants per destination was necessary. 


iPMI Magazine Speaks with Antony Brown MBE, Head of Africa, Aetna International

In this exclusive iPMI Magazine interview, Christopher Knight, CEO, iPMI Magazine, met with Antony Brown MBE, Head of Africa at Aetna International. They discussed in detail the international private medical insurance market in Africa, and the Sanlam Pan Africa and Aetna International Global Health Plan.

Please introduce yourself and background in the international private medical insurance (IPMI) market:

After 10 years with Her Majesty’s UK Foreign Office, I started the African subsidiary of InterGlobal Private Medical Insurance in 2008, as a member of the Executive Management team, and with overall responsibility for the Africa region as Regional General Manager, I later accepted the role of Head of Business in Africa for Aetna International following the acquisition of Interglobal by Aetna.

I have traveled extensively across the continent and I have a thorough understanding of the key insurance services required in local markets. I am also very well-versed in the regulatory requirements needed by insurers looking to operate stand-alone insurance businesses or partner with local insurance entities, in the region.

Sanlam Pan Africa and Aetna International have joined forces to deliver Africa’s “most comprehensive health care solution”. Can you walk us through the features and benefits of the new IPMI plan for Africa?

This offering has been created in partnership with Sanlam Pan Africa to address the healthcare needs of both local and expatriate nationals, on an international basis, across all market segments in 20 countries in Africa. Global Health offers a broad range of benefits, an extensive direct billing medical network and an enhanced member experience with local in-country service. The Global Health Plan reflects the needs and concerns of our clients and members across Africa, by giving them access to quality health care in a cost-effective way.

Through this partnership, we bring together the Africa-specific experience of Sanlam Pan Africa with the global expertise of Aetna International to deliver Africa’s most comprehensive and locally compliant health care solution with broad international access.

The Global Health proposition provides four plan levels — Value, Essential, Plus and Premium — with coverage ranging from US$100,000 to US$5,000,000. Depending on the tiers, the plans offer a host of health and well-being benefits, including cancer care, inpatient psychiatric treatment or psychotherapy, HIV or AIDS, terminal care, dental, optical and emergency treatment outside the area of cover.

With pre-authorised inpatient care across all of Africa and outpatient direct billing across the 20 Africa markets, Global Health offers members access to one of the widest medical networks locally and globally, as well as a 24/7 multilingual call centre for emergency and evacuation immediate assistance.

Who is the target market for the Global Health plan and why?

The Global Health Plan addresses the needs of the local market in 20 countries across Africa, for all employee levels: administrative, management and executive. Depending on the choice of cover, it offers access to health care in the country of residence but also abroad, for cases where medical expertise is not available locally or where the member is travelling. 

Geographically speaking, which countries does the new Global Health Plan cover?

Global Health is sold in 20 countries across the continent including Angola, Benin, Burkina Faso, Cameroon, Congo Brazzaville*, Gabon, Guinea Conakry*, Ivory Coast, Mali, Madagascar, Morocco, Niger, Nigeria, Senegal, Togo, Kenya, Rwanda, Uganda, Zambia and Tanzania. Members in these countries can choose one of four variants of area coverage:

Area 1: Worldwide Inc. US

Area 2: Worldwide Excl. US

Area 3: Europe Inc. Africa, India, Pakistan, Sri Lanka, Lebanon & Bangladesh

Area 4: Africa, India, Pakistan, Sri Lanka, Lebanon & Bangladesh

* Subject to OFAC regulations

Regarding access to healthcare across Africa, and the medical network, what are the options?

Members have access to an extensive direct billing medical network across the continent and beyond with more than 8,000 directly contracted providers in Africa and over 1.3 million health care professionals globally.

Emergency and non-emergency evacuation remain a critical feature of any IPMI plan. What options are available?

All four variants of the plan — Value, Essential, Plus and Premium — offer medical evacuation and in-patient cover as standard, but the coverage limits vary depending on the plan tier. For members under the Platinum plan, the cover is 100% of the medical evacuation costs.

What currency and billing options are available for insureds seeking access to healthcare under the Global Health plan?

Whether it is choice of medical provider or level of benefits, flexibility is a key value proposition of the plan and the same is true for billing.

For plan sponsors, premiums can be invoiced centrally in USD, or in the local currency of each respective country, subject to local laws and regulations.  

For members, Global Health offers outpatient treatment from within the available network on a direct billing basis in each of the 20 countries — the medical provider invoices us, as the insurer, directly without the need for the member to pay at the point of service. Inpatient treatment is required to be pre-authorised beforehand, and arrangements will be made by us, as the insurer, for the medical provider to bill us directly without the member having to pay. 

Can you please give us some more background on Sanlam Pan Africa?

Sanlam Pan Africa is the Sanlam Group’s business cluster that manages financial services in the emerging markets in Africa (excluding South Africa). Africa is a fundamental component of the Sanlam Group’s vision, which is the strategic mission of Sanlam Pan Africa — to build a leading pan-African financial services group.

Founded in 1918 as a life insurance company, Sanlam has become the largest non-banking financial services group in Africa, through its global diversification strategy and an unmatched

Pan-African footprint in more than 30 countries. Over the years, Sanlam has established itself as a financial services leader in the emerging markets in Africa and Asia.

What opportunities exist in the African market for international private medical insurance? Africa is a challenging geography – what issues on the ground, are expats and travelers facing when it comes to accessing high quality healthcare?

Africa is certainly challenging; its sheer size and diversity means that it is impossible to make broad generalisations on healthcare across the continent. Each country has its own strengths and weaknesses when it comes to accessing healthcare in any situation. For example, while coverage of healthcare can be patchy in rural areas, the quality of service in urban areas is certainly improving and often the challenge can be in arranging and funding care. In this respect, many parts of Africa are leading the way technologically when it comes to seamlessly booking appointments and minimising the use of cash, and Kenya is a great example of this.  We expect this capability to expand and, as the use of technology becomes a norm, insurance companies and medical providers will have to be ready with digital offerings, like telehealth services, to meet the demands of their members. 

The diversity of the countries in terms of language, currencies, cultures, and service expectation is also a challenge. We believe we have managed to address these aspects by making our plans as locally relevant as possible — the plans offer cover to local nationals, all documentation is available in the primary language of the country, we offer local invoicing and currency payment options, access to primary care on a direct billing basis, and local in-country representation. 

In 5 years’ time how will the international private medical insurance market look in Africa?

In recent years we have seen employers across Africa pivot from traditional offshore international medical insurance providers to local ones. However, few local providers have the capacity to offer international cover, which in Africa, where certain forms of treatment are not always available locally, is essential. Combining the expertise and capabilities of Aetna and Sanlam not only solves for such issues but offers access to a world-class comprehensive healthcare service. 

Furthermore, as a result of the global pandemic, we are seeing employers across the globe re-think their strategies when it comes to sending their staff on expat assignments, meaning that we expect a pivot towards more local hiring. Africa is no exception, particularly as the local workforce becomes more skilled and self-sufficient. What this means is potentially less demand for the traditional, high-cost fully international plans, which are the norm today, and an uptick in demand for plans that are more focused on regional cover, with comprehensive yet affordable benefits. This is exactly where we position Global Health; fit for today’s market and yet future-proofed for the changes ahead.



International Health Insurance (IPMI) 2021

Leading international private medical insurance publisher iPMI Magazine is excited to announce the launch of the “International Health Insurance 2021" IPMI market report written by leading insurance and healthcare analyst Ian Youngman.

There are now 80 million expatriates, 5 million international students, 4 million temporary foreign workers, and 18 million high net worth individuals of which 2.7 million are ultra high net worth. All of these are targets for international private medical insurance.

International health insurance for expats, third country nationals, domestic nationals and global nomads is a 3 volume iPMI market report updated in 2021 with even more companies and more countries.


Expats and local workers of global companies and HNW individuals may no longer have the option of flying home or another country for medical treatment so may have to rely on local healthcare.

Global insurers have national and international healthcare networks that have a better capability for telemedicine than local insurers.

In almost every country the state healthcare network is under never before experienced pressure so access to private healthcare is increasingly essential. In some countries, expats will be at the back of the queue for state healthcare. In some countries, even access to private healthcare may be strained and hospitals may have to prioritise healthcare for long-term partners such as insurance companies over one-time private patients.

An increasing number of insurers are moving from being health insurers to healthcare providers protected by health insurance. With a linked move to Artificial Intelligence and teleconsultation, the world of IPMI is changing.

The fragile and volatile state of global stock markets is of concern to insurers who may already be vulnerable while offering opportunities to potential buyers of insurers and health insurance books of business. The environment for mergers and acquisitions among health insurers remains favourable as they continue to seek out diversification and growth opportunities.

The iPMI 2021 report includes 3 volumes:

  • Volume 1 Overview - 395 pages
  • Volume 2 Companies - 129 Company Profiles
  • Volume 3 Countries - 176 Country Profiles

Table Of Contents

1. Introduction

  • Overview
  • Growth of need for IPM
  • Health insurance definitions
  • Expatriate definitions
  • Voluntary health insurance
  • Why IPMI and PMI are no longer separate
  • Social and technological disruption
  • Duty of care
  • Why insurers are moving into IPMI
  • The changing insurance ecosystem
  • Customer centricity
  • Blockchain
  • Emerging markets
  • Belt and Road initiative
  • Middle East and North Africa outlook
  • Asian health
  • IPMI must cover more than insurance
  • The future
  • Merging health insurance and healthcare
  • Swiss Re forecast
  • Changing how we work
  • Ageing workforce
  • Health insurance for older workers
  • Global mobility changes

2. International Health Insurance Numbers

  • Global premium figures
  • Onshoring and offshoring
  • Premium retention in countries
  • Premiums and local taxes
  • Local partnerships
  • Muddying the waters
  • It is not health insurance

3. Health insurance

  • Compulsory health insurance
  • Compulsory travel health insurance
  • Health insurance market potential
  • Global medical price trends
  • Health insurance pricing trends
  • Global health insurance costs and trends
  • Health insurance and universal healthcare global health benefits
  • Digital transformation
  • Dental and vision care

4. Healthcare

  • Health at a Glance Europe 2019
  • Global healthcare
  • Healthcare in 2040
  • Future health, care and wellbeing by 2040Re-Opening the World - Life After COVIDUniversal healthcare
  • Health at a glance in LatAm and CaribbeaHealthcare in UAE

5. International Health Insurance Market

  • Buying the market overseas
  • Distribution
  • Healthcare or health insurance
  • History
  • Market potential
  • Hospitals offering health insurance
  • Numbers of insurers
  • Insurance companies
  • Latin American healthcare potential
  • Lloyd’s of London
  • Lloyds’ brokers
  • Managing general agents
  • Third party administrators
  • Insurance brokers
  • Financial advisors
  • Insurance agents
  • Banks
  • Health insurance trade bodies
  • Health insurance comparison sites
  • Micro-insurance
  • Mobile devices
  • Self- insurance
  • Smartphones
  • Social media
  • Videos

6. International Health Insurance Products

  • Cover
  • International insurance versus domestic insurance
  • IPMI in 2021

7. Expatriate numbers

  • Expatriate figures
  • Global numbers of expatriates
  • Global population
  • Expatriates, migrants and refugees
  • Global mobility
  • Expatriate population as % of the worldwide population
  • Expatriate or international migrant
  • International students
  • Migrant workers
  • Cross border workers
  • Digital nomads
  • Diasporas
  • Migration and health

8. Customers

  • Target markets for insurers
  • What is an expatriate?
  • Expatriate characteristics
  • Expatriate salaries and benefits
  • Buyers
  • Dependants
  • Emerging markets middle class
  • Generation Y
  • High net worth
  • How people choose the international health insurance
  • Indian companies
  • Maritime
  • Mining
  • More than one product
  • Music industry
  • NGOs
  • Need
  • Oil and gas
  • Older workers
  • Overseas employees need support
  • Pilots
  • Questions potential customers ask
  • Retirees
  • Self-employed
  • Short assignments
  • Short-term cover
  • Singles
  • Students
  • Target ages
  • Teachers
  • Wealthy expatriates
  • Who can be covered?
  • Why companies buy it
  • Why individuals buy it
  • Why needs are changing
  • Why not just buy cover locally
  • Women

9. The product

  • Addiction treatment
  • Admitted policies
  • Apps
  • Big data
  • Budget covers
  • Cancer
  • Chatbots
  • Choice of cover or set packages
  • Claims
  • Compliance with local law
  • Co-payments
  • Critical illness
  • Currency
  • Danger zones
  • Diabetes treatment
  • Diaspora insurance
  • Duty of care
  • Emergency assistance
  • Emergency evacuation
  • European Air Medical Institute
  • Fertility treatment
  • Fraud
  • Funeral plans
  • Global cover
  • Helplines
  • Income protection
  • Insurers rethink of health insurance
  • International medical accreditation
  • Medical evacuation and repatriation
  • Medical tourism and insurance
  • Medical travel insurance
  • Mental health
  • Micro health insurance
  • Obesity treatment
  • Organ transplants
  • Passive war
  • Political risks
  • Pricing
  • Price regulation
  • Pricing on group schemes
  • Private repatriation
  • Risk management
  • Second medical opinion
  • Security and travel advice
  • Takaful
  • Takaful health
  • Telehealth
  • Term life
  • Top-up covers
  • Trauma
  • Travel insurance
  • Underwriting
  • Virtual doctors
  • War risks
  • Wearables

10. Conclusion

  • Conclusion
  • Database


  • Base country
  • HQ
  • Ownership
  • Overview
  • Structure
  • Insurance
  • Healthcare
  • Customer numbers
  • Strategy
  • 2020 results
  • 2021 results
  • 2021 forecasts
  • Buying businesses
  • Selling businesses
  • Failed deals
  • Partnerships
  • Sponsorships
  • Micro health
  • Special products
  • Apps
  • Marketing
  • Technology
  • Start-ups, accelerators and labs

Companies Profiled

  • A Plus
  • Abacare
  • Achmea
  • Adelaide
  • Aetna
  • Ageas
  • AIA
  • AIG
  • Alan
  • Allegiant Global Partners
  • Alliance Group International
  • Allianz
  • Amariz
  • Amazon
  • Antae
  • Anthem
  • AON
  • Apple
  • Arabia Insurance
  • Ardonagh
  • Arma Insurance
  • Aviva
  • Axa
  • Bahrain National Life
  • Bellwood Prestbury
  • Berkshire Hathaway
  • Blue Cross
  • Blue Cross Blue Shield
  • Bupa
  • CCW
  • Centene
  • Chubb
  • CIG Group
  • Cigna
  • Clements Worldwide
  • CMIG International
  • Collinson Group
  • Combined Insurance
  • CVS Health
  • Daman
  • DavidShield
  • DFV
  • Discovery
  • Doha Insurance
  • ERGO
  • Euroins
  • Exclusive Healthcare
  • Expacare
  • Expatriate Group
  • Fairfax
  • Fosun International
  • Freedom Health
  • FWD
  • Gallagher
  • General & Medical
  • Generali
  • GeoBlue
  • Global Benefits Group
  • Global Risk Partners
  • Global Underwriters
  • Globality Health
  • Great Eastern
  • Great West Lifeco
  • Gulf Insurance Group
  • HealthCare International
  • Henner Group
  • Howden
  • Humana
  • IMG
  • Integra Global
  • Irish Life Health
  • Jubilee Holdings
  • JW Seagon
  • Liberty Health
  • Liberty Mutual
  • Lloyd’s of London
  • Lockton
  • Malakoff Humanis
  • Manulife
  • Marsh McLennan
  • Medgulf
  • Medibank
  • Medicover
  • Met Life
  • MGEN
  • Millennium Insurance Brokers
  • Momentum Metropolitan
  • Morgan Price
  • MSH International
  • Munich Re
  • Mutua Madrilena
  • National Life and General
  • New India
  • nib
  • NN Group
  • NowCompare
  • Now Health International
  • Nugent Sante
  • Old Mutual
  • Oman Insurance
  • Orient Insurance
  • Pacific Cross International
  • Pacific Prime
  • Pan-American Life
  • PIB Group
  • PICC
  • Ping An
  • Primary Group
  • PZU
  • QBE
  • QLM
  • RBI Premium
  • Regency Assurance
  • Sanlam
  • Seguros 360
  • Seven Corners
  • Siaci Saint Honore
  • SiriusPoint
  • Sompo
  • Starr International
  • State Life
  • Status Global
  • Swiss Global
  • Swiss Life
  • SwissCare
  • Tokio Marine
  • Union Insurance
  • UnitedHealth
  • VHI
  • Verlingue
  • Vienna Insurance Group
  • Vitality
  • VUMI
  • VYY
  • WAFA Assurance
  • WellAway
  • William Russell
  • Willis Towers Watson
  • Zhong An
  • Zurich Insurance


  • 2021 population
  • 2030 population estimate
  • 2020 UN international migrants IN
  • 2020 UN international migrants OUT
  • 2020 UN refugees
  • Global diaspora
  • Expats in country
  • Healthcare
  • Healthcare for expatriates
  • Healthcare regulators
  • Healthcare regulation
  • Healthcare price regulation
  • State health insurance
  • State health insurance top-up
  • Compulsory health insurance for locals
  • Compulsory health insurance for expatriates
  • Compulsory health insurance for overseas students
  • Compulsory travel health insurance for visitors
  • Health insurance for locals overseas
  • Private health insurance
  • Micro health insurance
  • Insurance company and broker regulators
  • Foreign insurance companies
  • Health insurance regulation
  • Health insurance price regulation
  • Countries where expats come from
  • Leading local health insurers
  • Head office of leading health insurers and brokers
  • International health insurers/ brokers/agents activity

Country Profiles

  • Abu Dhabi
  • Afghanistan
  • Albania
  • Algeria
  • Andorra
  • Angola
  • Antigua
  • Argentina
  • Armenia
  • Aruba
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Bermuda
  • Bolivia
  • Bosnia
  • Botswana
  • Brazil
  • British Virgin Islands
  • Brunei
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cayman Islands
  • Chile
  • China
  • Colombia
  • Congo
  • Costa Rica
  • Croatia
  • Cuba
  • Curacao
  • Cyprus
  • Czechia
  • Denmark
  • Dominica
  • Dominican Republic
  • Dubai
  • Ecuador
  • Egypt
  • El Salvador
  • Estonia
  • Eswatini
  • Ethiopia
  • Fiji
  • Finland
  • France
  • Georgia
  • Germany
  • Ghana
  • Gibraltar
  • Greece
  • Grenada
  • Guam
  • Guatemala
  • Guernsey
  • Guinea
  • Guyana
  • Haiti
  • Honduras
  • Hong Kong
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Ivory Coast
  • Jamaica
  • Japan
  • Jersey
  • Jordan
  • Kazakhstan
  • Kenya
  • Kosovo
  • Kuwait
  • Kyrgyzstan
  • Laos
  • Latvia
  • Lebanon
  • Lesotho
  • Libya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macau
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Malta
  • Mauritius
  • Mexico
  • Micronesia
  • Moldova
  • Monaco
  • Mongolia
  • Montenegro
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Nigeria
  • North Macedonia
  • Norway
  • Oman
  • Pakistan
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Puerto Rico
  • Qatar
  • Romania
  • Russia
  • Rwanda
  • Saint Kitts And Nevis
  • Saint Lucia
  • Saudi Arabia
  • Senegal
  • Serbia
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Somalia
  • South Africa
  • South Korea
  • Spain
  • Sri Lanka
  • St Vincent
  • Sudan
  • Suriname
  • Sweden
  • Switzerland
  • Syria
  • Taiwan
  • Tanzania
  • Thailand
  • Trinidad And Tobago
  • Tunisia
  • Turkey
  • Turks And Caicos
  • UAE
  • Uganda
  • Ukraine
  • United Kingdom
  • Uruguay
  • US Virgin Islands
  • USA
  • Uzbekistan
  • Venezuela
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe

How To Buy International Health Insurance (IPMI) 2021

We are selling the report on Research and Markets for £3600 for all 3 volumes. However, if you are an advertiser or iPMI Magazine subscriber, we are offering the report at a reduced price. To take advantage of this offer please complete the form here, or write to ipmi[at]

About The Author

Ian Youngman is a writer and researcher specialising in insurance. He writes regularly for a variety of magazines, newsletters, and on-line services. He publishes a range of market reports and undertakes research for companies and has London market management experience with brokers and insurers. 




The Instrumental Role Of Telemedicine During And After The Pandemic

In this exclusive iPMI Magazine article, Damian Lenihan, Executive Director for Europe at Aetna International, talks about how telemedicine is positively impacting access to high quality healthcare, during a global pandemic.

With record numbers of employees working from home and facing new and evolving health pressures, employers have also begun to embrace telemedicine as a way to roll out effective health and well-being strategies.

Telemedicine is easing the burden of new employee health pressures

A survey we conducted with 4,000 global office workers last September shows just how much workers’ mental health has been impacted by the pandemic. From worrying about juggling work and home-schooling, to concerns over being furloughed (not to mention fears over contracting the virus or caring for those who have), lockdown truly tested our emotional resilience.

With social restrictions limiting access to sports facilities, as well as eliminating the commute, most employees have also been moving and exercising less. Add to this the fact that most hospitals and health care centres have been overwhelmed with Covid-19, and businesses are facing a perfect storm: their employees’ health is under more pressure than ever before, but regular health tests and screenings, and even treatment appointments, have largely been postponed unless crucial.

That is why employer-provided access to virtual consultations and health and well-being support during this time has been so important. It has helped to address a clear gap, giving people the much needed opportunity to speak to their GP or other health care professionals, all from the comfort and safety of their own home.

Virtual health for a new type of workplace

As hybrid and flexible working models become a more permanent fixture of working life, employers need to be mindful of the impact this could have on employee experiences and expectations. Our ongoing research into the views of global employees and HR Directors indicates that 3 in 5 UK HR decision makers recognise that expectations around employer-provided health support have changed dramatically since the beginning of the pandemic. For instance, employees say they now want access to more digital health solutions.

Although not completely new, the provision of health benefits through virtual means has accelerated and employee usage is increasing as well. At Aetna International, for example, we saw a 180% increase in global utilisation of vHealth, our virtual telemedicine service, between April 2019 and April 2020, with some regions more than doubling their usage during this time. More generally, the use of virtual health platforms has increased by 200-300% across the globe, showing the increasing demand for such services.

As many firms announce the implementation of hybrid working models, providing health support for teams through digital means, underpinned by a clear internal communications strategy, will be key to ensuring employees can take care of their health and well-being – no matter where they are. 

Employee appetite for digital health solutions in the workplace

The role technology has played in keeping the world connected over the last year has shown just how easy it is to take care of everyday tasks virtually, whether conducting meetings via Zoom or participating in virtual events.  

Previous research we conducted found that 69% of global workers think access to physical health services through their phone would help them better manage their physical health, whilst over three quarters said the same about convenient access to exercise or health appointment options online. It’s clear that even though our lives have been dominated by technology during the past year, employees view health and well-being services through technology as a positive and are keen to see more of it.

Harnessing digital solutions, including telemedicine, will allow employers to more easily cater to the hybrid workforce, as well as help them tackle the long-lasting mental and physical effects caused by the pandemic. In addition, anonymised employee health data could help companies to adapt their digital health benefits and make them more personalised. In fact, our research found that 80% of people would willingly share their anonymised health data if it would help to improve their health and well-being benefits at work. Of course, employees must also feel reassured that their data is secure and won’t be used for purposes outside their consent.

Building the future of virtual solutions and telemedicine

Although telemedicine has been available for some time, the pandemic has helped to establish it as a practical and convenient health care solution. The increased use of telemedicine has changed the way people think about access to health care, and people are now more likely to expect easy digital access to general health information, e-prescriptions in some cases, as well as convenient appointments and quick advice about condition management, for example.

The benefits of telemedicine go beyond this though, and as its role in our everyday lives increases, so will awareness of the benefits it can bring. For instance, dealing with health issues can be stressful and scary, but services such as Aetna International’s vHealth give patients the opportunity to store and access all health documents in one place, making communications between the patient and health care professionals more streamlined and connected. What’s more, employers with workers based in various locations needn’t worry about a service only benefitting some employees, as many services are offered around the world, and in multiple languages.

Telemedicine will never be able to fully replace traditional health systems (and nor should it) but it will certainly be an essential part of them; increasing their scope and easing the burden on currently overtaxed systems. As we move into the next normal, I’m confident that digital health solutions are here to stay, and will only become more embedded in day-to-day life. Employers will need to ensure these are part and parcel of their health and well-being strategies, to help their employees achieve the best possible health outcomes.



UnitedHealthcare Global Launches Expatriate Insurance in the Netherlands

  • New BeHealthy proposition launch gives local businesses access to international healthcare plans;
  • Partnering with Dutch insurer ONVZ gives members local healthcare plans in the Netherlands alongside their international BeHealthy plans;
  • New market entry builds on UnitedHealthcare Global’s continued commitment to expand across Europe, following successful UK launch in 2018.

UnitedHealthcare Global is entering the Netherlands market by providing local businesses access to internationally recognised health, wellness, assistance and security programmes, through its global BeHealthy expatriate insurance plans. The launch follows the success of UnitedHealthcare Global’s entry into the European market in the United Kingdom in 2018.

To ensure that the offering is tailored to the specific needs of the local Dutch market, UnitedHealthcare Global has partnered with ONVZ, an independent Dutch insurer, to provide locally compliant plans as an integral part of its BeHealthy insurance package. UnitedHealthcare Global’s commitment to health and wellbeing aligns closely with that of ONVZ. A local team in the Netherlands and across Europe will be dedicated to providing a personalised service to ensure intermediaries, clients and members have access to the advice and local support they need.

BeHealthy, focuses on a whole-person approach to wellbeing, helping to identify health risks before they happen. The plans offer globally mobile employees a personalised digital experience that inspires and motivates healthier habits. This helps them better manage their international assignments by prioritising their mental, emotional and physical health.

UnitedHealthcare Global’s BeHealthy includes:

  • Access to UnitedHealthcare Global’s worldwide medical network of more than 1.4 million care providers
  • Comprehensive health and wellness benefits, including Employee Assistance Programme (EAP), Optum My Wellbeing app, a wellness coaching resource, Health Management Programme and preventive health screenings
  • In-house global assistance and security benefits embedded across all plan levels

“Our UnitedHealthcare Global proposition, coupled with our new local partnership of health plans through ONVZ, will provide organisations with a comprehensive offering for their expatriate populations in the Netherlands,” said Janette Hiscock, CEO of UnitedHealthcare Global Solutions, Europe. “We are delighted to be entering this key European market, following our successful launch in the UK, and I am particularly proud of our proactive wellbeing programmes embedded into all of our international healthcare plans.”

“We are very pleased with this collaboration and we are looking forward to partnering with UnitedHealthcare Global as it enters the Dutch market,” said Jean-Paul van Haarlem, Chairman of the Board at ONVZ. “UnitedHealthcare’s unparalleled global network makes this an exciting prospect for businesses and the Dutch international workforce. Our shared mission to promote health and wellbeing will be a significant benefit to both businesses and employees. Additionally, our combined expertise in national and international healthcare will be a significant advantage in helping to keep our customers healthy, particularly those placed overseas. We’re excited to be able to offer our customers the tools they need to work towards their organisation’s wellbeing goals, especially during a time when workforces are continuing to manage the challenges of the pandemic. Protecting and supporting workplace wellbeing has never been more critical, whether that’s whilst employees continue to work from home, transition back to the workplace or travel abroad.”

The Central Bank of Ireland authorised UnitedHealthcare Global a license to conduct business across the European Economic Area (EEA) countries on a freedom of services basis. The Netherlands was chosen as the next market for United Healthcare Global’s European expansion to support the high number of globally mobile families based in the Netherlands and will also give the large number of Dutch employees being sent on assignments abroad access to comprehensive health and wellbeing coverage.



FBNInsurance Partners With Collinson To Launch International Health Insurance Plan

FBNInsurance, a Nigerian life insurer and a member of the SANLAM group, has partnered with Collinson to launch SmartHealth International, a market specific international health insurance product for critical medical conditions. 

Addressing the health insurance gap in the Nigerian market between domestic and international health insurance products, FBNInsurance and Collinson have collaborated on the design of SmartHealth International, which will deliver a suite of new affordable health insurance products aimed at Nigerian employers desirous of protecting and giving peace of mind to its employees and their families.

NAICOM approved, SmartHealth International, is designed to complement local healthcare cover by providing cover for treatment abroad should an employee or family member develop a critical medical condition that cannot be adequately treated in Nigeria.

FBNInsurance, a leader in Life insurance in the country, delivers products that help customers enjoy the peace of mind that comes from managing the risks of everyday life and the introduction of a health insurance proposition complements its portfolio strategy. With national presence in strategic geographical locations across the country, FBNInsurance will market SmartHealth International across Nigeria, whilst partnering with Collinson to leverage its in-house international insurance and assistance expertise to provide international access to an extensive network of Collinson certified medical providers.

Understanding the drivers for affordability, and at a time when provision for adequate healthcare and peace of mind has never been more top of mind, SmartHealth International is an affordable solution for the treatment of complex and critical care treatments. The proposition has been designed to cater for  specific critical complex medical events such as cancer and those requiring renal, orthopaedic and neurosurgery, as well as serious trauma injuries sustained in road traffic accidents. These collectively are the primary medical conditions for which Nigerians are currently leaving the country to seek medical care abroad.

Each case will be individually case managed and assessed, working closely with attending doctors in conjunction with Collinson’s expert international medical team. Depending on the level of cover purchased, eligible policyholders will be flown to South Africa, India or the UK, and even North African countries, where Arabic speaking is required.  

Speaking about the Launch, the Managing Director/CEO of FBNInsurance, Val Ojumah said “At FBNInsurance, one of our primary objectives is to help people, businesses and communities get back on their feet when the unexpected happens and it has never been more pertinent than now to offer our customers more choice and peace of mind when it comes to their healthcare. We are delighted to be launching this proposition in partnership with Collinson. Our teams have collaborated to develop a unique and affordable international healthcare solution that not only caters for critical medical conditions that cannot be adequately cared for in Nigeria, but also delivers innovation locally across health insurance product design”.

In addition, Lawrence Watts, Head of Insurance at Collinson, commented “Our health and the health of our loved ones has never been more top of mind and so Collinson is proud to be partnering with FBNInsurance to give their Nigerian clients access to optimum international healthcare whilst maintaining value for money. At a time when the demands of even the best of healthcare systems globally are under pressure, it’s vital to provide healthcare alternatives to consumers, particularly in markets where we have identified a gap between domestic and international cover.”



Aetna International Announces Product Upgrades And Updates To COVID-19 Coverage

Aetna International, a leading provider of global health benefits, has announced updates to its cover for communicable diseases, including COVID-19, all aimed at supporting the physical health of its members in an ever-evolving international landscape.

The changes to its Summit plans will offer better flexibility for business clients, allowing them to tailor coverage based on local market and member needs. The updates will allow members to access a COVID-19 test if they have no symptoms. This type of testing could help businesses to mitigate the risk of transmission.

After a qualifying period, individual members with Pioneer 2500 to 5000+ plans will benefit from outpatient tests and diagnostic procedures for communicable diseases (including COVID-19) when they do not have symptoms.

Additionally, to further support members’ physical health during this challenging time, Aetna International is also adding vaccinations as a stand-alone benefit to its range of COVID-19 cover for both Summit and Pioneer plans. 

Damian Lenihan, Executive Director Europe at Aetna International said: “Our aim is to support businesses and individuals by ensuring they have access to cover that is tailored to today’s unique challenges. Countries around the world are facing a range of infection rates and restrictions and are tackling these with vastly different healthcare systems and strategies.”

“This means our cover needs to be flexible and adaptable as we all continue to navigate the new routines created by the pandemic. We want to ensure businesses and their employees have access to appropriate COVID-19 testing, whenever they need it and wherever they are.”

Recognising the ongoing impact of the pandemic, the temporary extension of COVID-19 testing coverage will continue. Up to and including 31 March 2021, Aetna International members will be covered for one test per calendar month if they are asymptomatic and classified as high-risk* – as referred by a medical practitioner and when testing takes place in an appropriate medical facility.

While reimbursements for COVID-19 testing won’t be offered as standard for all policies, plan sponsors will have the flexibility to add this cover to Summit plans, without increasing premiums for those who do not want or need this benefit (for example, in areas where free local testing is already available.

*Refer to for full details

Subscribe to this RSS feed

Expatriate Health Insurance

Compare Expatriate Health and Medical Insurance Plans, Coverage, Quotes and Companies, with iPMI Magazine. iPMIM represents leading providers of expat medical, health and travel insurance plans. Find the right and most appropriate Expatriate Health Insurance for overseas travel, global mobility and relocation