If you're weighing up a move abroad, there's a line item that can quietly rival your rent: private health insurance. SIP Medical Family Office, a Switzerland-based medical consultancy, has released its second annual Health Cost Index, comparing average private healthcare premiums across the 60 most popular expat destinations — and the gap between the priciest and cheapest countries is striking.
The United States tops the list for the second year running, with an average annual premium of $23,987. Hong Kong follows at $19,353, then Singapore ($17,613), China ($15,235) and the UK ($14,987) — the same top five as last year. What links them, according to SIP, are strong private healthcare systems, expensive treatments and heavy demand for advanced care. Rounding out the top ten: the UAE, Mexico, Brazil, the Bahamas and Thailand, all above $11,000 a year.
At the other end, Romania is the cheapest of the 60 countries at $7,519, with Malta, Morocco, the Netherlands, Norway, Kenya, Mauritius, Sweden, Egypt and Nigeria clustered just above. Regionally, Asia is the most expensive continent and Africa the most affordable, while the Middle East and South America are getting costlier fast.
The bigger story is medical inflation. Average private healthcare costs jumped 18% year on year, driven by ageing populations, new technology, regulatory shifts and rising demand for preventative care. But regulation matters: countries with tighter cost controls saw smaller hikes — Japan's premiums rose just 3% and Greece 6%, while the US and Saudi Arabia each saw a 33% spike.
There's also a self-reinforcing dynamic at play. The countries that attract wealthy expats — think Singapore, the Bahamas, the UAE — tend to have the most expensive private care, because an influx of affluent residents fuels demand for top-tier hospitals and treatments, which pushes investment, and premiums, ever upward.
For anyone planning a relocation, insurance rules vary more than you might expect. Some visas demand proof of medical cover upfront, such as Italy's Elective Residence visa for retirees and Taiwan's two-year digital nomad visa. Others build healthcare in: the UK's Global Talent visa includes access to the NHS, Norway, Portugal and Canada offer universal care to permanent residents, and Panama's Pensionado visa discounts non-covered hospital treatment by 15%.
The study used three sample profiles — a 35-year-old British man, a 50-year-old American woman and a 24-year-old Indian woman — and premiums from seven international insurers including Cigna Global, AXA Global Healthcare and April International. It doesn't factor in public healthcare quality or cost, which matters because temporary residents often can't access local systems anyway.
The takeaway for long-stay travellers, retirees and digital nomads is simple: budget for healthcare before you commit to a destination, not after. As SIP's CEO Kevin Bürchler puts it, understanding a country's medical system before you relocate — rather than when you suddenly need it — can make an enormous difference. On these numbers, that could mean the difference between $7,500 and $24,000 a year.
Story via Condé Nast Traveler.
