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
Irish expats are everywhere—the US, UK, Australia, and increasingly farther afield. Your insurance choice depends heavily on where you're going. Here's what we recommend:
- Cigna Global: Best overall for Irish expats. Strong networks in the US, UK, and globally. Comprehensive coverage with reasonable pricing.
- Bupa Global: Excellent for those in the US or Middle East. Premium coverage with particularly strong US networks.
- VHI International: Best for maintaining Irish healthcare connections. Irish company, familiar brand, includes Irish coverage.
- Irish Life Health Global: Another Irish option with international reach. Good for those who want an Irish provider.
- Allianz Care: Strong European coverage, good for EU-based expats. Competitive pricing.
Going to the US?
US healthcare costs are dramatically higher than Ireland. If you're moving to America, prioritize insurers with strong US networks and direct billing to avoid six-figure bills.
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Leaving Irish Healthcare
Ireland's healthcare system is a mix of public (HSE) and private insurance. Leaving doesn't require formal notification, but there are implications.
HSE and Medical Cards
If you have a Medical Card or GP Visit Card, these become invalid when you leave Ireland. You'll need to surrender them or they'll be cancelled when your address changes. There's no "pause" option.
When you return to Ireland, you can reapply for a Medical Card based on your income at that time. There's no penalty for having been abroad—assessment is based on current circumstances.
Private Health Insurance (VHI, Irish Life, Laya)
Your Irish private health insurance generally doesn't cover you outside the EU. Even within the EU, coverage is limited to emergencies under EU regulations. Options:
- Cancel your policy (you can rejoin when you return without lifetime community rating penalty if you've maintained continuous cover)
- Switch to an international plan from the same provider (VHI and Irish Life offer these)
- Get separate international coverage
Lifetime Community Rating
Ireland's Lifetime Community Rating means your health insurance premiums increase if you don't take out cover before age 35 or have gaps in coverage. Time abroad with international insurance may count as continuous cover—check with your Irish insurer before leaving.
PRSI and Pensions Abroad
PRSI (Pay Related Social Insurance) contributions affect your future State Pension (Contributory) and other benefits. Here's what Irish expats need to know:
Voluntary Contributions
You can make voluntary PRSI contributions while abroad to maintain your contribution record. This is particularly important if you're close to retirement or want to ensure maximum State Pension entitlement. Current rate is €500/year.
EU Social Security Coordination
If you're working in another EU country, your social security contributions there count toward Irish pension entitlements. EU regulations coordinate benefits so you don't lose out by working across multiple countries.
Non-EU Countries
Ireland has bilateral social security agreements with several countries including the US, Canada, Australia, and Japan. These agreements help ensure your pension contributions abroad count toward your Irish entitlements.
Quick Comparison
| Provider | US Network | Irish Doctors | Ireland Visits | Starting Price |
|---|---|---|---|---|
| Cigna Global | Strong | Limited | Add-on | €180/mo |
| Bupa Global | Excellent | Via UK | Included | €200/mo |
| Allianz Care | Good | Limited | Add-on | €190/mo |
| VHI International | Basic | Strong | Included | €220/mo |
| Irish Life Health Global | Basic | Strong | Included | €210/mo |
Detailed Reviews
Cigna Global
Cigna Global is our top recommendation for Irish expats. They offer comprehensive international coverage with particularly strong networks in the US—important since that's where many Irish expats end up. Plans come in three tiers (Silver, Gold, Platinum) with coverage from €1 million to unlimited.
The claims process is straightforward, with direct billing available at most major hospitals worldwide. Customer service is available 24/7, and you can add home country coverage for visits back to Ireland.
Best for: Irish expats who want comprehensive global coverage, especially those in the US.
Bupa Global
Bupa Global offers premium international health insurance with excellent US coverage. They're particularly strong in the Gulf region and Asia. The Bupa brand is well-known internationally, making it easier to navigate healthcare in unfamiliar locations.
Plans include direct billing, mental health coverage, and comprehensive maternity benefits (after waiting period). Ireland coverage is included via their UK operations.
Best for: Irish expats in the US or Middle East who want premium coverage.
VHI International
VHI is Ireland's largest health insurer, and VHI International extends their coverage globally. The advantage is continuity—you're dealing with a company you know, and coverage in Ireland is seamless when you visit home.
Plans may be more expensive than international-only competitors, but the peace of mind of dealing with an Irish company and maintaining your Lifetime Community Rating status can be worth it.
Best for: Irish expats who want to maintain their VHI relationship and ensure smooth coverage during Ireland visits.
Irish Life Health Global
Irish Life Health offers international plans for Irish expats. Like VHI, the benefit is dealing with an Irish company that understands Irish healthcare needs. Plans include worldwide coverage with comprehensive benefits.
Customer service is Irish-based, and claims can be handled in euros. Home country coverage is included, making visits to Ireland straightforward.
Best for: Irish expats who prefer dealing with an Irish insurance company.
Compare International Options
Pricing varies significantly between providers. Get quotes from multiple insurers to find the best value for your destination and coverage needs.
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Returning to Ireland
Ireland makes returning relatively straightforward—there's no mandatory health insurance, and the HSE covers everyone who's ordinarily resident.
Ordinary Residence
To be "ordinarily resident" in Ireland, you need to be living here with the intention of living here for at least one year. Once you're ordinarily resident, you can access HSE services.
Returning with Private Insurance
If you've maintained continuous health insurance coverage (including international), you should be able to return to Irish private health insurance without Lifetime Community Rating penalties. Keep documentation of your international coverage.
EHIC/GHIC
Irish citizens abroad in the EU should have had an EHIC. Upon return, you can get an EHIC for travel based on your Irish residence. This covers emergency medical treatment elsewhere in the EU.
Common Questions
Does my VHI cover me abroad?
Standard VHI plans offer limited EU emergency coverage only. For full coverage abroad, you need VHI International or a separate international health insurance policy.
Will I lose my Medical Card?
Yes, Medical Cards are based on Irish residence and income. When you leave Ireland, your card becomes invalid. You can reapply when you return based on current circumstances.
Should I make voluntary PRSI contributions?
It depends on your age and existing contributions. If you have gaps in your record or are near retirement, voluntary contributions can help maximize your State Pension.
Is Irish Life or VHI International better?
They're comparable. Both are reputable Irish companies with good international coverage. Compare quotes for your specific situation—pricing varies based on age and destination.
What about Laya Healthcare?
Laya doesn't have a dedicated international arm like VHI or Irish Life. If you're a Laya customer, you'll likely need to cancel and get separate international coverage.
Are there Irish doctors abroad?
In cities with large Irish populations (London, New York, Sydney), you can often find Irish-trained doctors. International insurers typically cover any qualified doctor.
Final Verdict
Irish expats have good options for international health insurance. Cigna Global is our top recommendation for comprehensive coverage worldwide, especially for those heading to the US. Bupa Global offers premium coverage for those who want the best.
If you prefer staying with an Irish company, VHI International or Irish Life Health Global both offer solid international coverage while maintaining your relationship with a familiar insurer. This can simplify the transition when you eventually return home.
Before you leave, check your PRSI record and consider voluntary contributions if you're building toward the State Pension. And keep documentation of your international health insurance coverage—you'll need it to maintain your Lifetime Community Rating status.
