Understanding international health insurance: your financial shield worldwide
23.04.25
12
Minutes
Katrin Straub
Managing Director at nextsure
A medical emergency abroad can hit your finances hard. Overseas medical insurance protects you from unexpectedly high costs. Discover how this cover works and what you should look out for.
The topic in brief and concise terms
Travel health insurance is essential for any trip abroad, as statutory health insurance often provides only insufficient cover, especially outside Europe.
The cost of an annual policy is low (often starting at ten euros for individuals), but if you do not take one out it can lead to potentially life-threatening costs abroad, especially due to repatriation.
When choosing your plan, pay attention to the area of cover, the maximum trip duration, the definition of medically appropriate repatriation and the provisions regarding pre-existing conditions.
Key aspects of travel health insurance at a glance
Travel health insurance covers medically necessary treatment during your trips abroad. These costs can quickly run into several thousand euros, depending on the destination. It protects you against financial risks in the event of illness or accident. Annual policies for individuals are often available from as little as ten euros. Families can usually get cover for under forty euros per year. Cover generally applies worldwide, although trips to the USA and Canada often attract higher premiums. The maximum trip duration per journey for annual policies is usually limited to six to eight weeks.
Scope of cover in focus: When does the insurance pay out?
Overseas health insurance covers the costs of outpatient and inpatient medical treatment abroad. This includes visits to the doctor, hospital stays and necessary medication. A skiing accident in Austria involving a torn cruciate ligament, for example, can result in treatment costs of over 8,000 euros, which are covered. Pain-relieving dental treatment and simple fillings are usually covered too. A key benefit is medically appropriate repatriation of the patient, which can quickly amount to five- or six-figure sums. The insurance does not pay for treatment that was the sole reason for the trip or that had already been planned before departure. Find out about suitable overseas health insurance for your needs.
Statutory protection versus private provision: recognising the gaps
Statutory health insurance (GKV) provides cover within the EU and in countries with social security agreements. However, reimbursement is based on the usual local rates in the destination country. This means that often only part of the actual costs is reimbursed. Many doctors in holiday regions also bill on a private basis, which can lead to significant out-of-pocket costs. Medical repatriation to Germany is generally not included in the scope of benefits of statutory health insurance. You must also cover treatment in private clinics or customary local co-payments yourself without a private travel health insurance.
Identifying the optimal tariff: key selection criteria
When choosing your international health insurance, several factors are decisive. The length of your trip is an important factor; annual policies usually cover trips of up to 56 days. For longer stays, such as a semester abroad, you need a long-term international health insurance. Pay attention to the area of cover: worldwide, or excluding the USA/Canada, which is often cheaper. An important point is the clause on medical repatriation: it should be defined as „medically reasonable and justifiable“, not only as „medically necessary“. Our expert tip: Check the terms regarding pre-existing conditions carefully; unexpected worsening should be covered. Also clarify whether search and rescue costs are covered up to at least EUR 5,000.
You should consider the following points when choosing a plan:
Maximum trip duration per trip (e.g. 42, 56 or 70 days)
Area of cover (worldwide, with/without USA/Canada)
Rule on medical repatriation (reasonable vs. necessary)
Coverage for pandemics and travel warnings
Amount of the benefit limits for individual services
Exclusion or limitation for pre-existing conditions
Excess (plans without an excess are often only slightly more expensive)
Benefits for travelling children (e.g. rooming-in)
Careful review of these aspects will ensure you have optimal protection.
Calculating costs: These are the expenses to expect
The cost of overseas health insurance varies depending on the provider and the scope of cover. Affordable annual policies for individuals are available from around ten to twenty euros. Families pay between twenty and 35 euros per year for comparable cover. For longer stays abroad of, for example, three months, costs can be around 200 euros. Trips to North America (USA/Canada) are more expensive due to the high treatment costs there; for three months, charges of 300 to 500 euros may apply. A full year abroad costs between 400 and 900 euros (excluding North America); with North America cover, it can be 600 to 2,000 euros. People over 65 often have to expect surcharges. The exact cost also depends on the level of cover you want. You can find more information about the costs in our article How much does overseas health insurance cost?.
Emergency management abroad: your action checklist
In the event of illness or an accident abroad, quick and correct action is important. Inform your insurer as promptly as possible. Have your policy number and the insurer’s emergency number ready. Check directly with the insurer which documents are required for reimbursement of costs. Request invoices for treatment in English or German where possible; they should include the name, diagnosis and type of treatment. For larger and more expensive treatments, you should discuss these with the insurer in advance. Keep all original receipts carefully. For a smooth process, it is helpful if you know whether your health insurance also applies abroad.
Here is a short checklist for emergencies:
Have the insurer’s emergency number and your policy number ready.
Contact the insurer immediately, especially before larger treatments.
Collect all receipts and invoices in original form.
Ideally, have invoices issued in German or English (with diagnosis).
In the case of inpatient stays, request daily cost reports, if possible.
Request a cost coverage declaration from the insurer for the hospital.
These steps help to speed up later reimbursement of costs.
Contributions to overseas health insurance can, under certain circumstances, be claimed for tax purposes as tax-deductible precautionary expenses. This depends on your individual tax situation. For precise advice, you should consult a tax adviser. In addition to overseas health insurance, other travel insurance policies may also be worthwhile. These include, for example, travel cancellation insurance or trip interruption insurance. Travel baggage insurance may also be worth considering depending on the type of trip and destination. Before you travel, please also check the scope of your private liability insurance. At nextsure, we will be happy to advise you on comprehensive insurance solutions for your travels. A question that often arises is whether overseas health insurance can be deducted from tax.
Request an individual risk analysis now: Have your insurance situation reviewed free of charge and receive specific suggestions for improvement.
More useful links
Federal Foreign Office provides comprehensive information on travel and safety, including important health advice for travellers.
Federal Foreign Office provides detailed country-specific health advice that should be consulted before travelling.
Wikipedia offers an informative overview of the topic of travel health insurance.
Federal Statistical Office (Destatis) provides official data and statistics on healthcare expenditure in Germany.
World Health Organization (WHO) publishes global travel recommendations and health warnings.
Federal Ministry of Health provides information on health insurance for travel abroad and the benefits of statutory health insurance abroad.
FAQ
Do I need travel health insurance if I’m covered by statutory health insurance?
Yes, absolutely. Statutory health insurance (GKV) often only covers part of the costs abroad and never a medical repatriation. Outside Europe, GKV usually provides no cover at all.
What happens if I fall ill abroad and don’t have travel health insurance?
You must pay all treatment costs incurred, including any expensive repatriation that may be necessary, entirely yourself. This can quickly amount to very high sums.
How long is an annual overseas health insurance policy valid for?
An annual policy covers any number of trips within a year, with each individual trip usually limited to a certain duration (e.g. six or eight weeks).
Are pre-existing conditions covered by overseas health insurance?
That depends on the plan. Acute, unforeseeable worsening of a chronic condition is often covered. Planned treatments or treatment for conditions that already required treatment before the start of the trip are usually not covered. Please check the terms carefully.
Does overseas health insurance also cover a coronavirus infection?
Most insurers provide cover in the event of a Covid-19 illness. However, it is important to check the exact policy conditions, particularly with regard to travel warnings issued by the Foreign Office.
What should be considered when travelling to the USA and Canada?
Medical costs in the USA and Canada are extremely high. Many standard tariffs exclude these countries or charge high surcharges. Choose a tariff that explicitly covers these regions if you travel there.
