Health insurance for global citizens registered in no country
Deregistration ends more than a tax residence — it usually ends your place in a health system, as a side effect nobody mentions at the counter. The life is legal and livable. The cover has to be built deliberately, because nothing catches you by default.
What deregistration actually does
The exit is an afternoon. Re-entry is a rulebook.
Three structural facts about the registered-nowhere life, before any product talk.
Deregistration ends more than a tax residence
Leaving a country's register usually ends your place in its health system — the Swiss basic insurance, an EHIC, a national enrolment — often as a side effect nobody mentions at the Abmeldung counter. The tax plan gets professional advice. The health consequence of the same signature usually gets none.
No system claims you — so nothing catches you
Registered nowhere, you are compelled into nothing and entitled to nothing. Every safety net on this site — PUMA, the SNS, Medicare, GKV — attaches to residence. Yours is a life where the private policy is not a supplement to a system. It is the entire system.
And the way back in is not automatic
Countries readmit returners on their own terms: waiting periods, contribution histories that stopped accruing, underwriting at your return age. The exit is one afternoon; re-entry is a rulebook. The time to read it is before deregistering, not after the years abroad.
All three are manageable — every one of them more cheaply now than later. The load-bearing document of this whole way of living is a policy with guaranteed renewability, bought while buying is easy.
Why this is a consultation, not an article
Your version of nowhere is specific.
The deregistered arrive from different doors and the door matters. The Swiss Abmeldung ends basic-insurance obligation and entitlement together; a UK departure leaves NHS access to fade by practice rather than paperwork; an EU deregistration can end an EHIC that was quietly doing regional work. What actually ended for you depends on what you left and how — and half the people we review are wrong about it in one direction or the other.
\nThen the forward questions, which are just as personal: what your passport still entitles you to (eleven passports carry reciprocal rights into Australia; treaty countries wave you into systems you have never lived in), what anchors your policy honestly now, and which landing countries would take you back gently versus expensively when the nowhere years end — because for most people they do end.
\nThis is a filing-cabinet problem wearing a philosophy costume. Forty-five minutes with your actual documents produces the structure in writing: what ended, what holds, what to buy, what to keep. For a life without a system behind it, that document does the system’s job.
What your declared base is worth
Registered nowhere still means priced somewhere.
Every international policy names a country of residence, and that name sets the price. For most people it is not a choice — it is where they live. For someone with bases in three countries and a registration in none, it can be a genuine choice, and an independent fifty-country benchmark shows what that choice is worth.
Singapore and Malaysia are an hour apart across a causeway and share much of the same private-hospital market. On comparable cover the index puts Singapore at roughly twice Malaysia. The Emirates price about sixteen per cent above Qatar, and Spain almost exactly the same margin above Portugal. None of those gaps reflect a difference in the medicine.
The obvious inference is the wrong one, so we will say it plainly: this is not an argument for naming a country you do not live in. A residence you cannot evidence is the fastest way to have a claim declined, and an insurer asks the question at exactly the moment you are least able to argue. The point is narrower and more useful — where your base genuinely is a choice, it is a priced one, and most people make it without ever seeing the price.
| Rank | Country | At 24 | At 35 | At 50 | Average |
|---|---|---|---|---|---|
| 3 | Singapore | $10,065 | $13,967 | $18,662 | $14,231 |
| 33 | Malaysia | $5,146 | $7,242 | $9,612 | $7,333 |
| 10 | United Arab Emirates | $7,132 | $7,977 | $13,931 | $9,680 |
| 18 | Qatar | $6,463 | $6,553 | $12,052 | $8,356 |
| 14 | Spain | $6,338 | $8,949 | $11,702 | $8,996 |
| 27 | Portugal | $5,485 | $7,686 | $10,184 | $7,785 |
Source: SIP Health Cost Index 2025, SIP Medical Family Office. Data as at August 2025, published 1 December 2025. Averages across seven international insurers and three standard profiles — not quotes, and not a comparison of those insurers against each other. Any comparison or tax-adjusted figure above is our own arithmetic on SIP's published numbers.
All fifty countries, and the three things the ranking hidesFor the deregistered specifically
Three ways the nowhere setup fails.
Optimising taxes and orphaning your health cover
The classic sequence: a well-advised deregistration for tax purposes, and the health insurance discovers it a year later — a policy conditioned on a residence that no longer exists, or a national scheme that quietly ended. The tax adviser did their job. Nobody was holding the other file.
Assuming an insurer will always take you back
The deregistered life runs on private insurability, and insurability is a depreciating asset: every birthday and every diagnosis narrows the market. A policy with guaranteed lifetime renewability, bought while healthy, is the single load-bearing document of this whole way of living.
Keeping the paperwork vague on purpose
It feels clever until claim time. Insurers pay against declared facts — residence, itineraries, home country — and a life arranged to be hard to pin down is also hard to pay a claim to. The setup needs to be deliberate and declared, not ambient and deniable.
Any of these sound like your situation? See how a review works
How a review works
What a first review actually looks like.
Arranging international cover for the first time, or checking what you already hold — the process is the same, in this order.
The demand intake
Right after you book, we email you a short intake form. Where you are, where you're going, who's coming with you, anything you already hold. It takes a few minutes, and it means the 45 minutes start prepared — with your situation, not with paperwork.
We study your situation
Not products first. Your life first. We look at the country you're moving to and what it legally requires, the country after that if there is one, who depends on you, and where the real exposure sits. We don't quote anything at this stage.
The consultation
45 minutes, by video, in English. Every question you bring gets an answer. We compare the international insurers on how each of them behaves in your situation — underwriting, renewal, exclusions, and what happens on the day a claim is filed. If there is already a policy in force, we go through it clause by clause. Nothing is pitched at the end of it.
Your Private Client Report
One working day later, your Private Client Report arrives — around twelve pages setting out what we found, what we weighed it against, what each option costs, and why we would choose one over the others. What to arrange, what to keep, and where you are paying for something that isn't doing any work. Sometimes the report says: keep what you have. It is yours either way.
45 minutes. By video, wherever you are. Free. Nothing has to change afterwards.
The Cleveland Clinic charges $1,690 for a written second opinion. Ours comes with the review, and there is no fee for it.
The team
The people who'll actually review your situation.
Specialists by topic, not a rota. You'll know who you're speaking to before you book, and you'll speak to the same person again next year.
Robert Kolar
Health insurance expert
Twenty-plus years spent on the distance between what a health policy promises and what it pays when a claim actually lands. German and English. He has been the foreigner working out somebody else's health system from the outside, which is its own kind of qualification.
Book with Robert
Nicole Bohne
Life and protection expert
Spent her career inside Basler Versicherung and Zurich Insurance before crossing to this side of the table. Nicole reads a life-cover decision against the whole household — who depends on whom, what already exists, and whether the answer is a policy at all.
Book with Nicole
Virginie Josten
IPMI expert
Came to insurance from luxury and consulting, where the clients were demanding and the work was international. Then a Swiss insurer’s international desk — cross-border employees, expats and retirees abroad. Legal training and a master’s from Paris Dauphine. English and French.
Book with Virginie
Davide Nezel
IPMI expert
FINMA-certified independent insurance intermediary, who began in financial advice at Swiss Life. He works with globally mobile households, and coordinates with the insurer when a medical need actually arises — which is where a policy is finally tested. German, French and English.
Book with Davide
Chantal Leprêtre
IPMI expert
Client advice for internationally mobile households. English and French. Her fuller biography follows shortly — until it does, this card carries only what we can stand behind.
Book with ChantalGlobal citizen questions
What the registered-nowhere actually ask us.
I deregistered from my home country. What happened to my health cover?
In most systems, it ended — national health cover attaches to residence, and deregistration is the formal end of residence. The severity varies: some systems end entitlement immediately, some have grace mechanics, some (like Switzerland’s) end the compulsory insurance that was also your right to hold it. If you deregistered recently and have not checked this, check it this week — the gap is usually discovered in a hospital.
Can I be insured if I am not resident anywhere?
Yes — this is precisely what international private health insurance exists for, and insurers handle deregistered clients routinely. The mechanics matter though: the policy still needs an honest anchor (nationality, last residence, or a declared base), the declaration has to match the life, and the product has to be one that does not quietly assume a home system behind it. This is a setup worth building deliberately, once, with advice.
What happens when I eventually settle somewhere again?
The country you settle in readmits you on its own terms, not your old ones: waiting periods where they exist, compulsory enrolment where it applies, underwriting at your then-age for anything private. Two things soften re-entry: a portable policy that keeps covering you across the transition, and choosing the landing country with its re-entry rules in view — they differ more than people expect, and we keep the differences on file.
Is this setup even legal?
Being registered nowhere is a legal state many people pass through — the issues are practical, not criminal. What is not workable is misdeclaring: telling an insurer you live somewhere you do not, or a country that you are elsewhere when you are present past its thresholds. The deregistered life works when it is documented honestly; it fails expensively when it is arranged to be vague.
What does a consultation actually do for my situation?
It reads your specific version of nowhere: what actually ended when you deregistered, what your passport and history still entitle you to, whether your current policy’s anchor survives scrutiny, and what the re-entry options look like for the places you might eventually land. You leave with the structure in writing. For a life without a system behind it, that document does the system’s job.
From the journal
Reading on this situation.
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MM2H health insurance: what the guidelines actually require
MM2H requires health insurance only under 60 and names no minimum sum. The RM 80,000 figure repeated by agents appears nowhere in the official text.
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Dubai to Cyprus: cheaper cover, and GESY may not take you
Cover runs 15% cheaper in Cyprus than in the UAE. But GESY is gated on employment or a qualifying status, so a household moving on capital stays outside.
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Dubai to Hong Kong: the largest step-up in cover cost
Hong Kong ranks 2nd of fifty countries for private medical cover, about 67 per cent above the UAE. What that gap means for a household leaving Dubai.
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Dubai to Singapore: the policy crosses, the subsidy does not
Singapore keys its health subsidies to citizenship and permanent residence — so a household arriving from Dubai lands with no public floor underneath it.
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Dubai to Switzerland: cheaper cover, nothing that transfers
The UAE mandate is employer-linked and ends with the permit. Switzerland compels the individual to hold KVG cover three months from taking up residence.
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Health insurance for digital nomads in Australia
Australia's reciprocal Medicare covers eleven passports — three limbs for most, public hospitals only for Ireland and New Zealand, ambulance for nobody.
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Nomad health cover in Brazil: the 180-day waiting clock
A Brazilian plano de saúde covers emergencies within 24 hours and almost nothing else for 180 days — and the nomad visa never asks for a domestic plan.
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Nomad health cover in Canada: the card belongs to a province
There is no Canadian health plan — provincial plans are residence-tested. Ontario covers eligible newcomers immediately; BC and Quebec still apply waits.
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Costa Rica's nomad route sits outside the CAJA entirely
Ley 10008 puts remote workers in the non-resident estancia category — up to two years outside the CAJA, on private cover of at least US$50,000 per person.
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The Cyprus nomad visa hands you a policy, not GESY
GESY opens on category, not residence, and the usual route is employment in Cyprus — which a nomad visa forbids. The private policy is the floor.
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Nomad health insurance in France: the affiliation nobody has
French cover runs on affiliation — French work, or three months' unbroken residence. A nomad's calendar opens neither, so the private layer is the floor.
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Freelancing in Germany: the health-insurance choice you own
Germany's 2026 threshold of €77,400 is an employee rule. The self-employed may elect GKV or PKV at any income — and past 55 the way back is largely shut.
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Nomad health insurance in Indonesia: no floor, a ceiling
Working from Bali for a foreign employer leaves you outside BPJS Kesehatan by the regulation's own wording — and Bali's definitive care has a ceiling.
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Japan's nomad visa: excluded from National Health Insurance
Japan's Designated Activities nomad status excludes holders from National Health Insurance and requires private cover instead. Your policy is the only net.
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Malaysia as a nomad base: what health cover actually buys
Malaysia ranks 33rd of 50 for international cover, at $7,333 a year. There is no public fallback for foreigners, and private care carries 6% tax.
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Nomad health insurance in Mexico: eighth-dearest of fifty
Mexico ranks 8th of 50 for what comparable international cover costs — above Switzerland. Nothing in the residency process asks to see a health policy.
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Dutch health insurance and the remote worker in the middle
Dutch Zvw duty attaches to work or residence, not nationality — and a remote worker billing foreign clients from an Amsterdam flat sits between the two.
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Nomad health insurance in the Philippines: the transfer gap
PhilHealth's foreign membership excludes overseas confinement, and local plans reimburse care abroad at token levels. Nothing funds the transfer.
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Portugal's D8 visa: the policy that passes AIMA
AIMA's checklist asks only for health insurance or proof of SNS cover — no minimum sum, no duration. Which is why a D8 nomad's plan stops at the border.
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Qatar's mandate reaches your family, not the self-employed
Qatar's health-insurance duty covers an employee's spouse and up to three children — every clause names the employer. Independent workers stand outside it.
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Remote work in Saudi Arabia: every route has a sponsor in it
Saudi health insurance duty attaches to a sponsor — employer, household, family head. We could not verify any remote-worker route into that architecture.
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Health cover in Singapore without an employer
MediShield Life covers only citizens and permanent residents, and the statutory floor belongs to employers. Self-employed foreigners have neither.
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South Africa's medical schemes are built for people who stay
A South African scheme cannot refuse you for your health. It prices time instead: a penalty set by your age, and three months that can exclude even PMBs.
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The Spanish nomad visa policy that only works in Spain
Spain's nomad visa needs an insurer authorised in Spain — statutory, and travel cover fails. That policy is a closed-network one, thin outside Spain.
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Health insurance in Thailand: the line your budget missed
Thailand ranks 9th of fifty countries for international health cover at $9,854 a year — dearer than Switzerland, because the premium prices the hospitals.
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UAE health insurance with no employer: the sponsor is you
Since 1 January 2025 no UAE residence permit issues or renews without evidence of cover. With no employer, the duty falls to the sponsor — which is you.
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Worldwide excluding USA: what the exclusion means for nomads
Most nomad policies are sold worldwide excluding USA. The United States ranks 1st of 50 for cover cost, and a visitor joins no national scheme on arrival.
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PhilHealth for foreigners: what ₱17,000 a year actually buys
Foreigners can join PhilHealth for ₱15,000–17,000 a year. It pays a fixed case rate per condition, not a share of your bill, and carves out the Z Benefits.
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Brazil's two health systems: SUS and the private layer
SUS covers everyone in Brazil by constitution, but routine care needs a Cartão SUS. Private plans run on ANS rules: 24-hour, 180-day and 300-day waits.
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Cyprus GESY: who gets in, and what the permit asks
The permit rule is an or, not an and: Plan A, or GESY registration plus repatriation cover. Co-payments cap at €150 a year, not the €300 guides repeat.
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Japan health insurance: 14 days to enrol, 2 years backdated
Japan gives residents staying over three months 14 days to enrol in NHI. Miss the window and the ward bills premiums backwards, for up to two full years.
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Health insurance in Mexico: the IMSS table nobody publishes
IMSS voluntary cover in Mexico runs $8,900 to $21,300 pesos a year by age band, and excludes cancer, advanced diabetes and chronic kidney disease outright.
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The Dutch four months: a repair window, not a grace period
The Dutch insurance duty starts the day you become liable, not four months later. The four months only backdate the cover — and only if you use them.
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A second opinion on the insurance cover you already hold
A second opinion reads the policies you already hold, clause by clause, against your current life — and often the written answer is keep everything.
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Singapore's coverage cliff: what your work pass carries
MediShield Life covers citizens and PRs only. Employment Pass holders have no statutory cover, and S Pass holders get an inpatient floor of S$60,000.
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Who reads your policies? One adviser across every border
A globally mobile household holds policies no one has read side by side. What an independent adviser reads across borders, and why the review is free.
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Retiring to the Algarve: what the D7 actually asks at 62
Portugal's D7 stage asks only for health insurance or proof of SNS cover — AIMA sets no minimum sum. At 62 the cost is when you buy, not the rule.
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The American returning home: re-entering US insurance
Moving back to the US opens a 60-day Special Enrollment Period on the ACA marketplace. Miss that window and the market stays shut until open enrollment.
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Reading your schedule: the five-minute area-of-cover check
One line on your policy schedule decides whether you are insured in America. Most people have never read it. Here is how, and what each wording means.
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Reciprocal Medicare in Australia: cover follows the passport
Australia's reciprocal Medicare follows the passport, not the visa. Eleven countries qualify, and Italian and Maltese cover ends six months after arrival.
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The Bali evacuation bill nobody prices
An air-ambulance evacuation from Bali to Singapore runs USD 25,000–80,000. BPJS does not fund it. What an Indonesian policy's evacuation clause must say.
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Canada's three-month health wait: what each province does
Canada has no national three-month healthcare wait. The Canada Health Act sets three months as a ceiling — Ontario waits nobody, BC and Quebec still do.
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Carte vitale: the cardless months nobody budgets for
France's PUMA residence test for non-workers is three months to apply and six a year to keep — and being eligible is a long way from being enrolled.
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Joining the CAJA: the Costa Rica number you cannot borrow
Costa Rica's CAJA is priced as a share of the income you declare — 2.89% to 10.69% on the January 2025 scale — and pre-existing conditions wait six months.
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Deductible, franchise, excess: one concept, five names
Deductible, excess, franchise and retention name one mechanism: the first slice you pay. The national versions, and the cap that decides your worst year.
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Coming to Germany at 45: the age nobody warns you about
At 45, three clocks run at once in Germany: PKV premiums priced on your entry age, the return to GKV that §6(3a) closes at 55, and the €77,400 threshold.
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facts checked 2026-08-10
GKV or PKV: Germany gives you one chance to decide
Germany's private-insurance decision is practically one-way. §6(3a) SGB V keeps you outside statutory cover past 55 without five recent statutory years.
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facts checked 2026-08-10
The €77,400 question: who may even choose PKV
Germany's PKV door only opens above the Jahresarbeitsentgeltgrenze — €77,400 in 2026, verified against the federal figures. Below it, there is no choice.
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facts checked 2026-08-10
GKV with a family vs PKV alone: the arithmetic that flips
In Germany, GKV covers non-earning dependants at no extra contribution. PKV charges a separate age-rated premium per head — that flips the comparison.
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facts checked 2026-08-16
Dubai, Abu Dhabi, Doha, Riyadh: four rules, one assumption
A correction: Saudi Arabia and Abu Dhabi reach the family, Dubai does not, and Qatar's real distinction is sequencing rather than family scope.
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The mutuelle, explained in one page
A mutuelle covers the share of French medical bills PUMA leaves with you — consultations, prescriptions, dental. What to buy, and when to start it.
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The declared-residence question every nomad gets wrong
Your insurer anchors the policy to one declared country of residence. That single line drives your premium, your network and whether a claim is admissible.
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Portugal asks for insurance twice: the consulate and AIMA
Neither Portuguese stage names a sum. The consulate asks for travel insurance, AIMA for health insurance or SNS cover — the €30,000 is Schengen short-stay.
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facts checked 2026-08-16
Portugal vs Spain visa insurance: a sum versus a shape
Portugal's AIMA asks for health insurance or SNS cover, no minimum sum. Spain's law asks for less — the strict specification comes from your consulate.
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Portugal's arrival year: from consulate to número de utente
Portugal's arrival chain — consulate, AIMA appointment, permit, SNS number — can run close to a year, and your insurance must be right at each stage.
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How to read a policy schedule in fifteen minutes
A policy schedule is your personalised contract, not the brochure. The nine lines that decide a claim — geography, renewal, ceiling, cost-sharing.
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The late-joiner clock: the formula South Africa runs on you
Penalty years equal your age at application, minus 35, minus your South African years. Foreign cover earns none, and the bands are ceilings not rules.
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Spain's NLV at 65: insurability before paperwork
Spain's non-lucrative visa repeats its insurance test at every renewal — and Spanish insurers set entry-age ceilings, between 65 and 75. Get quotes first.
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Sin copagos: the two words that reject excellent policies
Sin copagos is not in Spanish law — the regulation it came from was repealed in May 2025. It is a consular requirement, and consulates genuinely differ.
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The franchise decision, explained for your arrival year
Swiss basic insurance leaves one pricing lever: the franchise, on fixed rungs from 300 to 2,500 francs. The arithmetic, and why arrival year is hardest.
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Your first ninety days in Switzerland, dated
Switzerland gives you three months to take out KVG basic insurance, backdated to the day you register your residence — but only if you are on time. Dated.
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Thailand's O-A visa: the insurance floor is USD 100,000
Thailand's O-A visa requires at least USD 100,000 of cover including Covid-19, for the whole stay. The 40,000/400,000-baht figures are the old rule.
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facts checked 2026-08-16
What deregistering from Switzerland actually ends
Swiss basic insurance attaches to residence, so an Abmeldung ends it. Coming back is treated as an arrival: the three-month enrolment deadline runs again.
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facts checked 2026-08-01
When not to buy international health insurance
Five situations where the honest answer is don't: a compulsory local scheme already has you, a treaty covers you, or the local rule rejects the policy.
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What "worldwide cover" actually means
Worldwide cover is a defined term with edges: the area-of-cover line, home-country limits, per-trip day caps and sub-limits. Where worldwide stops.
Read itReady for a calm conversation about cover?
A first review is free — 45 minutes, in English, wherever in the world you happen to be. We'll listen first. Then you'll hear exactly what we would arrange if the situation were ours. What you do with that is yours to decide.
Book a reviewOr write to hello@expatsavvy.com — we reply within the working day.