Why is the USA a special case for expat health insurance?
The United States has no universal healthcare system. Unlike most European countries, every resident — including expats — must fund their own medical coverage. The result: healthcare costs in the US are among the highest in the world.
⚠️ Without health insurance in the USA, a simple ER visit can cost between $1,500 and $3,000. A car accident or hospitalization can reach hundreds of thousands of dollars.
Medicare and Medicaid: are they accessible to expats?
No. These two public American programs are exclusively reserved for US citizens and permanent residents (green card holders with several years of residency). As a foreign expat, you have no access to them, regardless of how long your stay is.
Similarly, your home country's social security system will generally not cover you outside your home country, except for short trips and in a very limited way.
What should your international health insurance cover in the USA?
Essential coverage
- Hospitalization: 100% coverage, no cap or very high cap ($1M minimum recommended)
- Emergency care: including ER visits, which are billed separately in the US
- Medical repatriation: if extended hospitalization occurs, repatriation may be preferable
- Outpatient care: GP visits, specialists, lab tests, imaging
- Prescription drugs: medications are very expensive in the US
Recommended options
- US care network: access to a network of providers with direct billing avoids out-of-pocket advances
- 24/7 repatriation assistance: essential
- Dental & Optical: dental and vision care are particularly expensive in the US
- Maternity: childbirth in the US averages $10,000 to $30,000
💡 Good to know: MSH and April plans offer a "worldwide with USA/Canada" or "worldwide without USA/Canada" option. If you live in the USA, you must choose the version with USA — the price difference is far less than the financial risk.
Comparison: MSH vs April coverage in the USA
| Coverage | MSH Neo Tempo | MSH First Expat | April My Health Intl |
|---|---|---|---|
| USA Coverage | Option ✓ | Option ✓ | Option ✓ |
| Hospitalization | 100% | 100% | 100% |
| Emergency care | 100% | 100% | 100% |
| GP / Specialist | ✓ | ✓ | ✓ |
| Repatriation | ✓ | ✓ | ✓ |
| Maternity | Option | ✓ (Premium) | ✓ (Premium) |
| Duration | Up to 36 months | Long-term | Long-term |
Our recommendations by expat profile
Short-term assignment or internship (under 36 months)
MSH Neo Tempo is ideal. Flexible, suited to temporary stays, with a USA/Canada option. Instant online quote.
Long-term relocation to the USA
Go with MSH First Expat or April My Health International. These long-term plans offer comprehensive coverage, an extensive US care network, and premium 24/7 assistance.
Relocating with family and children
Choose a Premium plan including maternity, pediatrics and orthodontics. April My Health International offers comprehensive family coverage adapted to the US market.
💡 Also read our guides on health insurance in Dubai & UAE, Singapore and Hong Kong.
Our recommended plans for the USA
FAQs — International Health Insurance USA
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