After you buy international health insurance: claims, renewal and your next move.
Cover is chosen once and used for years. Whether it pays is decided mostly before a claim: what needs approval, what changes at renewal, and what a move does to your policy.
In brief
What happens after you buy international health insurance?
Three things decide how it works in use: approvals before treatment, the yearly renewal, and what a move does to your cover.
- Before treatment: planned hospital stays and evacuation often need approval first.
- At renewal: premiums and benefits can change; renewal is usually automatic.
- When you move: residence rules decide whether the policy continues.
What needs approval before you need it.
The approval rules sit in the terms, not the brochure. This is what the documents we read say for five of the seven ranges, checked on 2026-09-06 and 2026-10-13. Your own policy’s terms are the ones that apply.
| Insurer | What the documents say |
|---|---|
| APRIL International | Planned hospital stays need pre-approval and a facility in the network for your level. Without pre-approval the terms apply a 50% penalty, and care outside the network a 40% co-payment, except in a medical emergency. |
| Cigna Global | Optional International Medical Evacuation module, subject to medical assistance approval and terms. |
| Allianz Care | Included in the described core range, with medical necessity and insurer arrangement requirements. |
| Global Health (Foyer) | Included on all four levels after written pre-approval, when the treating doctor prescribes it and it is medically necessary. Transport stays within the selected area, to a place the insurer considers suitable for treatment. |
| MSH International | Standard assistance, included with hospitalisation, covers emergency transport to the nearest facility with appropriate care and return to your country of residence. Europ Assistance decides whether, where and how; conditions treated in hospital in the six months before a request are excluded. |
An emergency can be treated differently from planned care. Read your plan’s row, then ask the insurer in writing.
What the documents say about renewal.
Seven ranges, in the order of the selection guide. Renewal is usually automatic. Premiums and benefits can change, and what carries over depends on your own terms.
| Insurer | Renewal, as the documents describe it |
|---|---|
| Cigna Global | The CGIC February 2024 example protects against claims-based non-renewal, subject to clause 7, while renewal is offered on stated terms. Check the rules for your issuer. |
| Allianz Care | Automatic subject to plan availability, residence, payment and other terms. Benefits and premiums can change; new-condition protection has disclosure and cover-increase conditions. |
| Bupa Global | The brochure lists automatic renewal and no cancellation based on claims history. Read the membership guide for contractual conditions and changes at renewal. |
| AXA Global Healthcare | Obtain the current policy terms and renewal quotation. A benefits summary alone does not establish continuity after a move or switch. |
| APRIL International | Twelve-month membership renewed automatically unless either party terminates at the anniversary. Premiums can change with age, residence, medical inflation and the insured group’s claims. The product page says “for as long as you want”, but the terms do not establish a lifetime guarantee; check the written terms. |
| Global Health (Foyer) | Twelve months, renewed tacitly if neither party opposes renewal. Continuing after a move home needs the insurer’s approval, and cover ends after five years for temporary residents of Germany. Check the written terms. |
| MSH International | Annual membership renewed automatically unless either party terminates. Group premium rates may be reviewed each 1 January, and membership ends on a permanent return to your country of origin. Check the written terms. |
A renewal notice is a reason to check the policy, not an automatic reason to replace it. A new policy can bring fresh health questions, different exclusions and new waiting periods.
A move is a question for the policy.
Residence is a rule of the policy, not a detail of the application. In the documents we read, continuing after a move home needs the insurer’s approval (Global Health (Foyer)), membership ends on a permanent return to your country of origin (MSH International), and the terms cover your declared country of residence and a zone (APRIL International).
That is why we plan for the second move at the first consultation: it is far cheaper to plan for than to fix. If you are already insured and a move is coming, a second opinion reads the cover you hold against the move before you go.
Country by country, the public rules and the private cover are on the destination pages; the journal has the moves people ask about most.
What we do, and what we cannot.
Before a renewal, a move or a change of insurer, we read the cover you already hold and give you written findings and a reasoned recommendation, including when keeping it makes sense. The second opinion is that service; the consultation is free and lasts 45 minutes by video.
Once cover is placed through us, Robert or Nicole help you through a claim. The insurer decides application and claim outcomes: we cannot decide a claim, guarantee that an insurer will accept an application or bind it to cover a condition. Eight questions to ask any adviser includes this one, with our answers.
After you buy: your questions.
Do I need approval before going to hospital?
For planned stays, often yes. In the documents we read, APRIL International says: Planned hospital stays need pre-approval and a facility in the network for your level. Without pre-approval the terms apply a 50% penalty, and care outside the network a 40% co-payment, except in a medical emergency. Evacuation has its own conditions in the documents we read, such as approval by an assistance provider or medical necessity. In an emergency the rules can differ, so read the row for your plan.
What happens to my premium at renewal?
It can change. For example, APRIL International: Twelve-month membership renewed automatically unless either party terminates at the anniversary. Premiums can change with age, residence, medical inflation and the insured group’s claims. The product page says “for as long as you want”, but the terms do not establish a lifetime guarantee; check the written terms. Allianz Care: Automatic subject to plan availability, residence, payment and other terms. Benefits and premiums can change; new-condition protection has disclosure and cover-increase conditions.
Can I keep my policy if I move country?
Residence is a rule of the policy, so check it before you go. In the documents we read, Global Health (Foyer): Twelve months, renewed tacitly if neither party opposes renewal. Continuing after a move home needs the insurer’s approval, and cover ends after five years for temporary residents of Germany. Check the written terms. MSH International: Annual membership renewed automatically unless either party terminates. Group premium rates may be reviewed each 1 January, and membership ends on a permanent return to your country of origin. Check the written terms.
Will you help me if I have to make a claim?
Yes. Once cover is placed through us, Robert or Nicole help you through a claim. The insurer decides whether it is paid: we cannot decide a claim, guarantee that an insurer will accept an application or bind it to cover a condition.
Who decides whether a claim is paid?
The insurer decides application and claim outcomes. We cannot decide a claim, guarantee that an insurer will accept an application or bind it to cover a condition.
The arrangement, in plain words.
Expat Savvy is an advisory practice and holds no insurance licences of its own. International cover is placed through SIP Medical Family Office. Availability depends on your residence, the product and the relevant SIP entity; we check the placement route before arranging cover.
We hold no exclusive arrangement with any insurer, and no insurer owns part of this business. That does not mean every insurer or product is available to every client. The scope of a recommendation depends on the cover we can consider and arrange for your circumstances.
International cover is placed on a courtage basis: the insurer pays a percentage of the premium when a policy is placed. A higher premium can mean higher remuneration; this payment model does not remove that potential conflict. Our written report sets out the reasons for a recommendation, the alternatives considered and whether keeping existing cover is appropriate. There is no fee for the review or written report, whether or not you arrange cover through us.
Ask us to explain the remuneration attached to a proposed placement. You can read the reasoning before deciding, ask why an alternative was left out, or take the report to another adviser.
These register entries identify the relevant SIP companies, not Expat Savvy: FINMA intermediary register — Switzerland, SIP Switzerland AG registration F01111824 · FMA register — Liechtenstein, SIP Europe AG licence 10116 · FCA register — United Kingdom, SIP MFO Ltd firm reference 989310. The entities and their terms of business are on our about page.
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