Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Our Top Picks
British expats are found worldwide—Spain, France, the US, UAE, Australia, and beyond. Post-Brexit, European healthcare access has changed significantly. Here's what we recommend:
- Bupa Global: Best overall for British expats. British company, premium service, excellent worldwide networks.
- Cigna Global: Strong global coverage at competitive prices. Good for any destination.
- AXA Global: Excellent European networks. Good for EU destinations.
- Allianz Care: Strong EU coverage at good value. Popular with European expats.
- William Russell: British insurer specializing in expats. Includes UK coverage.
Post-Brexit Warning
The EHIC no longer provides EU healthcare access for British expats living in Europe. The new GHIC covers only temporary visits. Proper health insurance is now essential for living in EU countries.
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Leaving the NHS
The National Health Service provides free healthcare to UK residents. Here's what happens when you leave:
NHS Entitlement
NHS coverage is based on ordinary residence in the UK—not citizenship. When you move abroad permanently, you cease to be ordinarily resident and lose NHS entitlement. Brief visits to the UK may still be covered for emergency care, but not routine treatment.
GHIC (Global Health Insurance Card)
The GHIC replaced EHIC for UK residents post-Brexit. It covers medically necessary treatment during temporary stays in EU countries. However, it doesn't cover living in the EU—only visits. British expats in Europe need proper health insurance.
Private UK Insurance
UK private health insurance (Bupa UK, AXA PPP, Aviva) is designed for UK residents and typically doesn't work abroad. Some policies offer limited travel coverage but not expatriate coverage.
State Pension Healthcare
UK state pensioners living in certain countries may be entitled to healthcare coverage through the UK government under the S1 system. This applies to some EU/EEA countries and has specific eligibility rules.
Post-Brexit Reality
Brexit fundamentally changed healthcare access for British expats in Europe:
Before Brexit
British citizens could live anywhere in the EU and access local healthcare systems through EU coordination rules. The EHIC provided reciprocal coverage, and long-term residents integrated into local healthcare systems.
After Brexit
British citizens are now third-country nationals in the EU. Healthcare access depends on individual country immigration rules and bilateral agreements. The GHIC only covers temporary visits—not residence.
Country-by-Country Rules
Each EU country now sets its own rules for British resident healthcare:
- Spain: Legal residents can access public healthcare, but many British expats choose private insurance for better access
- France: Residents join the French system after 3 months; private insurance covers the transition
- Portugal: Public healthcare available to legal residents; private insurance supplements it
- Other EU: Rules vary—check specific country requirements
Withdrawal Agreement Protection
British citizens who were legally resident in EU countries before Brexit (December 31, 2020) have protected healthcare rights under the Withdrawal Agreement. New arrivals don't have these protections.
The Insurance Reality
Post-Brexit, comprehensive health insurance is essential for British expats in Europe. Even where public healthcare is accessible, private insurance provides faster access, English-speaking service, and coverage for the transition period.
Quick Comparison
| Provider | EU Network | Global Network | UK Coverage | Starting Price |
|---|---|---|---|---|
| Bupa Global | Excellent | Excellent | Add-on | £220/mo |
| Cigna Global | Strong | Excellent | Add-on | £200/mo |
| AXA Global | Excellent | Strong | Add-on | £190/mo |
| Allianz Care | Excellent | Strong | Add-on | £185/mo |
| William Russell | Good | Good | Included | £170/mo |
Detailed Reviews
Bupa Global
Bupa is a British company with a strong heritage in international health insurance. Their global products offer premium coverage with excellent service quality. Strong networks worldwide, particularly in Europe and popular British expat destinations.
English-language service throughout. UK coverage can be added for visits home. Comprehensive benefits including mental health and wellness.
Best for: British expats who want premium coverage from a familiar British brand.
Cigna Global
Cigna Global offers excellent international coverage at competitive prices. Strong networks in Europe, the US (important for British expats there), and worldwide. Three coverage tiers with flexibility.
Good service quality, comprehensive benefits. UK coverage available as an add-on.
Best for: British expats who want reliable global coverage with good value.
AXA Global
AXA has excellent European networks—useful for British expats who've moved to EU countries post-Brexit. Strong presence in France, Spain, and other popular British expat destinations.
Good service, comprehensive coverage. Strong option for European destinations.
Best for: British expats in Europe, especially France or Spain.
Allianz Care
Allianz Care offers excellent European coverage at competitive prices. Strong networks throughout the EU, good global coverage. Popular with expats throughout Europe.
Good value for comprehensive coverage. UK coverage available.
Best for: British expats seeking good value for European coverage.
William Russell
William Russell is a British insurer specializing in expatriate insurance. UK coverage is typically included, which suits those who visit home frequently. Personalized service, good for British expats who prefer dealing with a UK-based company.
Best for: British expats who want UK coverage included and prefer a UK-based insurer.
Compare Your Options
British expats have excellent insurance options. Compare based on your destination and how important UK coverage is to you.
Get Free QuotesWe may earn a commission when you apply through our links. This does not affect our recommendations.
Returning to the UK
Returning to NHS coverage involves re-establishing ordinary residence:
Ordinary Residence
NHS coverage is based on being "ordinarily resident" in the UK—living here lawfully and voluntarily, with settled purpose. Returning to live in the UK should restore NHS entitlement, but the definition can be complex.
Registration
Register with a GP surgery when you return. You'll need to prove your address and may need to discuss your circumstances if you've been abroad for an extended period.
Immediate Needs
Emergency care is always available through A&E. GP and specialist access may take time as you register and await appointments. Keep your international insurance briefly for continuity.
Waiting Lists
The NHS has significant waiting lists for non-urgent care. Returning expats used to private healthcare abroad may find NHS waiting times frustrating. Private UK insurance can supplement NHS access.
Common Questions
Does the NHS cover me abroad?
No. NHS coverage is for UK residents only. The GHIC covers temporary EU visits but not living abroad. You need international health insurance.
What about my EHIC?
EHIC has been replaced by GHIC for UK residents. It covers temporary visits to EU countries but not residence. Living in the EU requires proper health insurance.
Can I access Spanish healthcare?
Legal residents can access Spanish public healthcare. The process involves NIE, residency registration, and enrollment. Private insurance provides coverage during the transition and better access.
What if I was in Europe before Brexit?
The Withdrawal Agreement protects healthcare rights for those legally resident before December 31, 2020. Your rights should be maintained, but individual situations vary.
Is Bupa or Cigna better?
Bupa is British with premium positioning. Cigna offers similar quality at sometimes lower prices. Both are excellent—choose based on specific coverage needs and pricing.
What about the S1 for pensioners?
UK state pensioners may be entitled to healthcare coverage in certain countries through the S1 system. Check eligibility with the NHS Overseas Healthcare Services team.
Final Verdict
British expats need comprehensive international insurance—the NHS doesn't work abroad, and Brexit has complicated European access. Bupa Global is our top recommendation as a premium British brand with excellent worldwide coverage. Cigna Global offers similar quality at competitive prices.
AXA Global and Allianz Care are strong choices for European destinations. William Russell suits those who want UK coverage included from a UK-based insurer.
Post-Brexit, don't assume you can access EU healthcare easily. Even where public healthcare is available, private insurance ensures coverage during transitions and provides better access. Plan properly before you move.
