Five questions to ask before buying international health insurance

International medical insurance brochures tend to look alike. Five questions cut through the marketing and tell you whether a policy will hold up the day you have to use it.

1. What is the annual limit, and is it per-person or per-family?

Annual limits range from US$500,000 on entry-level plans to US$5,000,000 or more on top tiers. Some policies cap the limit per family rather than per insured person - read the small print before assuming you have the full limit available for each applicant.

2. Who pays the hospital - me, or the insurer?

A policy that reimburses you after you pay upfront is not the same as a policy that pays the hospital directly. Direct billing matters more than you would think when you are recovering from surgery and not in a state to fight with admin.

3. Is the USA included?

Most international policies exclude the USA by default. If you pass through it regularly, ask for a USA-inclusive variant and compare premiums - it is often a sizeable jump, but a more accurate quote than discovering on arrival that you are not covered.

4. What happens at renewal if I have claimed?

A policy that renews "without exclusions" means a condition diagnosed in year one is still covered in year two. A policy that does not is effectively cover only while you are healthy. This is the single biggest line you should check before signing anything.

5. How do I cancel?

Ask for the cancellation policy in writing before you pay. A reasonable insurer offers a 14-day cooling-off period and pro-rata refunds after that. If the cancellation terms are vague, treat that as a signal about how easy renewals will be too.