Leaving an International Group Health Insurance Plan: What Expats Need to Know Before Transitioning to Individual Cover
For globally mobile employees and expats, leaving an employer-sponsored international health insurance plan – whether due to a job change, sabbatical, retirement, or shift to self-employment – can be a critical turning point. Many assume that transitioning to an individual or family policy will be straightforward. The reality is very different.
This article outlines what expats need to understand about underwriting, pre-existing condition exclusions, portability, and strategic options when exiting a group plan.
The Common Assumption – And Why It’s Often Wrong
When enrolled in a corporate or employer-sponsored international health plan, employees typically enjoy:
- Automatic acceptance (no medical underwriting)
- Coverage for pre-existing conditions from day one
- Preferential group pricing, often with generous benefit limits
It’s therefore understandable that expats believe these protections will continue when moving to an individual plan with the same insurer. However, this is rarely the case.
What is medical underwriting? Detailed health history questionnaire used to assess individual risk before issuing cover. Also known as FMU or ‘Full Medical Underwriting’. FMU allows insurers to exclude or load premiums for certain conditions – unlike group plans with MHD (= medical history disregarded) underwriting, where no health information or disclosure of pre-existing conditions is needed.
The Reality: Individual Plans Treat You Like a New Applicant
Unless your employer or broker has specifically negotiated a continuation-of-cover agreement, international insurers will treat you as a brand-new applicant when you apply for an individual or family policy. That means:
- Medical underwriting is required
- Pre-existing conditions may be excluded, especially common ones like high blood pressure or high cholesterol
- Premiums may be significantly higher – in particular for older individuals or those with health risks
Even when continuation-of-cover is available, it often guarantees coverage – not price. Some insurers may apply steep premium loadings if they assess you as high risk.
Continuation of Cover: What’s Possible (and What’s Not)
There are a few mechanisms that can ease the transition from a group to an individual plan, but they’re not available to everyone:
Long-term Continuation of Cover (Large Corporate Groups Only)
- Some large employers (typically 1,000+ employees) negotiate “continuation of cover” clauses with insurers.
- These allow departing employees to move to an individual plan without new underwriting.
- The catch? The price is not guaranteed, and premiums may be loaded heavily.
Short-Term Coninuation of Cover (AKA “Bridging Coverage“)
- Some employers extend group coverage for 1–3 months after employment ends.
- This is a helpful short-term solution but not a substitute for a long-term individual policy.
SME Group Leaver Options (with Prior Underwriting)
- A few insurers (including AXA, Allianz) offer options for SME group leavers if:
- They were medically underwritten when first joining the group plan.
- The plan was administered in a country where this feature is available.
- AXA refers to this as Continuing Medical Exclusions (CME) – essentially carrying forward any exclusions that were already agreed rather than restarting the underwriting process.
Dormancy Options
- A “Dormancy” benefit that allows members to suspend their individual policy while covered by a group plan and reactivate it later without underwriting.
- Especially valuable for digital nomads, entrepreneurs, or those between jobs.
Why You Should Act Early – Especially If You’re Young and Healthy
We strongly recommend globally mobile employees, entrepreneurs, and those not expecting continuous group plan access to secure individual cover early – ideally before developing pre-existing conditions.
Early adoption of an individual plan provides:
- A clean underwriting profile
- Protection against future exclusions
- Portability across countries and life stages
This is particularly important for:
- Freelancers and contractors
- Start-up employees or founders
- Digital nomads and gig economy workers
- People taking sabbaticals or time between jobs
Unlike international educators or employees of international MNCs who often move between large group plans with guaranteed coverage, these groups are not protected by automatic acceptance or continuity guarantees.
What If You’re Currently Leaving a Group Plan?
If you’re about to leave your group health plan, do not delay. Once your group coverage ends, your medical history becomes a liability when applying for individual coverage.
At One World Cover, we help expats:
- Explore continuation-of-cover options (if available)
- Navigate underwriting and exclusions
- Compare individual plan quotes across multiple insurers
- Plan long-term health insurance strategies based on geography and life plans
What About U.S.-Based Employees?
This article does not apply to U.S.-based employees, who may have access to COBRA or ACA marketplace coverage. We do not advise on U.S. domestic insurance options.
Final Thoughts: A Strategy, Not Just a Stopgap
Switching to an individual international health insurance plan isn’t just about filling a gap – it’s about securing long-term financial protection and health security.
If you expect any gaps in employment or want to build an independent future (as many expats do), individual international cover is a critical part of your personal risk management strategy. Get in touch with us here.
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