American Health Insurance in Europe: What You Need to Know

When you're traveling or living in Europe, your American health insurance, a system designed for U.S.-based care providers and networks. Also known as private U.S. health plans, it typically doesn't cover medical care outside the United States. Most plans—whether through an employer, Medicare, or a marketplace insurer—only pay for emergencies, and even then, often with heavy restrictions or no reimbursement at all. This leaves millions of Americans traveling, working, or retiring in Europe without real protection when they need it most.

If you're planning a trip, you might think your credit card’s travel insurance is enough. But most of those policies only cover accidents, lost luggage, or flight delays—not hospital stays, doctor visits, or prescription drugs. Even if you have a high-end plan like UnitedHealthcare or Aetna, their international coverage is usually limited to emergency evacuation or urgent care. Medicare, the U.S. federal health program for people over 65. Also known as government health insurance for seniors, it generally doesn’t pay for any care received outside the U.S., with only a few rare exceptions like on a cruise ship near American waters. That means if you’re 70 and living in Spain, and you need a heart procedure, you’re on your own unless you’ve bought separate coverage.

That’s where international health insurance, a private plan designed for people living or traveling outside their home country. Also known as expat health insurance, it’s built to work across borders and often includes coverage for routine care, dental, and even mental health services. These plans are available from providers like Cigna Global, Allianz, and GeoBlue, and they let you choose hospitals in Paris, Berlin, or Rome without worrying about upfront payments. Many Europeans also have public healthcare, but as a foreigner, you usually can’t access it unless you’re a legal resident paying taxes there. So if you’re just visiting or not yet settled, you need your own plan.

Some Americans try to use travel insurance for long stays, but those are meant for short trips—usually under 90 days. If you stay longer, you’re no longer covered. And if you get sick during that time, you could end up with a $20,000 bill for a simple surgery. The cost of a single day in a European hospital can be less than in the U.S., but without insurance, you still pay it all out of pocket.

What you’ll find in the posts below isn’t a sales pitch—it’s real, practical advice. You’ll learn how to compare plans, what to watch out for in fine print, and how to avoid the traps most Americans fall into. You’ll also see what happens when people assume their insurance works abroad—and how to fix it before it’s too late. Whether you’re planning a three-month trip or moving to Portugal for good, the right coverage makes all the difference.