The cost of international health insurance by country — the SIP Health Cost Index 2025

Most healthcare cost comparisons measure national health expenditure — a number that tells a household moving to Lisbon or Dubai almost nothing. The SIP Health Cost Index does something more useful: it collects real quotes for a comparable international plan and uses the price insurers charge as a proxy for what private healthcare in that country actually costs.

The plan quoted is a comprehensive one — inpatient, outpatient, maternity, preventive medicine, dental, vision, evacuation and repatriation, with no deductible — priced for worldwide cover excluding the United States. Where a country levies insurance premium tax, SIP adds it in, because that is what the policyholder pays. Where a country requires a locally compliant product, the local equivalent is priced instead.

The result is the closest thing there is to a like-for-like answer to the question every relocating household asks and almost nobody can answer: is healthcare going to cost me more where I am going than where I am now?

Thailand is ninth of fifty. It prices above Switzerland, Spain, France, Germany and Italy. Mexico is eighth, Brazil seventh — both above every European country in the index except the United Kingdom. Against everything a cost-of-living table would predict.

The explanation is in what the premium buys. In Bangkok, Mexico City or São Paulo, the hospitals an international policy sends you to are private, international-standard, and priced for a market that includes medical tourism. A foreign resident uses almost nothing else. The insurer is not pricing the country — it is pricing the small, expensive slice of the country you will actually be treated in.

Switzerland, fifteenth, shows the inverse. Swiss private cover sits on top of a compulsory system that already buys good care, so the international policy is the top layer rather than the whole building. That is why one of the most expensive countries in the world to live in is mid-table here, and why "healthcare is expensive in Switzerland" and "insurance is expensive in Switzerland" turn out to be different claims.

Nine of the fifty countries levy insurance premium tax on health cover, and SIP adds it into the published figure — rightly, because it is money that leaves your account. But it means the ranking is measuring two different things at once: what care costs, and what the state charges you for insuring against it.

So we took the tax back out. Divide each published figure by one plus that country's rate, re-rank the whole table, and the picture shifts. This is our arithmetic on SIP's numbers, not a SIP finding — but the inputs are theirs and the rates are published in their methodology.

France is the striking one: twenty-second on the published table, around thirty-seventh once its 14 per cent premium tax comes out. Greece, at 15 per cent the highest rate in the index, falls six places. Cyprus levies nothing — which is why it looks so much cheaper than Greece, and why, tax aside, the two sit within about three per cent of each other.

None of this makes the published figure wrong. You do pay the tax. But if you are comparing two countries and one of them takes fifteen per cent off the top, you are not comparing healthcare — and knowing which part of the number is which changes what you do about it.

It does not rank the insurers. SIP says so in its methodology and again in its disclaimer, and it is worth repeating because a table of seven prices invites exactly the wrong reading. The seven plans differ in benefits, area of cover, service levels and medical network. A lower quote is a different product, not a better deal. We have not ranked them here either, and the list below is in SIP's order, not ours.

It is not a quote. Each figure is an average across seven insurers for one of three people who do not exist. Your premium turns on your age, your health history, whether you are insuring a family, your deductible, and whether you need cover in the United States — none of which a country average knows about.

It does not promise availability. The index makes no guarantee that any of these plans can be bought in any given country, and local regulation decides that, not the price list.

Every figure in the fifty-country table is transcribed from the SIP Health Cost Index 2025, published by SIP Medical Family Office on 1 December 2025 from quotes taken in August 2025. We checked the transcription arithmetically: the report's own average column equals the exact mean of its three profile columns on all fifty rows, which it would not if a digit had slipped.

Everything beyond the table — the tax adjustment, the age multiples, the country-to-country comparisons — is our own arithmetic on those published figures and is labelled as ours wherever it appears. SIP is responsible for the data and not for our reading of it.

We work with SIP on internationally mobile cover, and Expat Savvy operates under SIP's licences. We did not commission this index, we are not paid to cite it, and no insurer named on this page paid for, reviewed or influenced anything on it. How we are paid is set out on our about page.