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
Military families are accustomed to comprehensive healthcare coverage. Tricare covered everything, everywhere. Moving abroad as a civilian—whether retiring, taking a contractor job, or starting a new chapter—means finding coverage that matches what you had.
After analyzing options for veterans and military families abroad, here are our recommendations:
Best for Families: Cigna Global
The good: Comprehensive family coverage with flexibility military families need. Strong global network including US when you visit home. Modular plans let you match what you had under Tricare.
The limits: Premium pricing—$500-1,000+/month for families with US coverage. Worth it for the coverage quality, but budget accordingly.
Best for: Military families with children relocating abroad who want Tricare-equivalent comprehensive coverage.
Best US Integration: Aetna International
The good: US roots mean better understanding of American healthcare expectations. US coverage more naturally integrated. Strong network domestically and internationally.
The limits: Less established outside US/Europe than Cigna/BUPA in some regions.
Best for: Veterans who may return to the US or need frequent stateside care coordination.
Best Budget Option: IMG Global
The good: Comprehensive coverage at lower prices than premium brands. US coverage affordable. Good for families watching budgets after military salary ends.
The limits: Smaller network, less brand prestige. May need to pay-and-claim more often.
Best for: Cost-conscious veteran families who want solid coverage without premium pricing.
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Transitioning from Military Coverage
Moving from Tricare to civilian international insurance involves several adjustments:
What You're Losing
- Free or near-free care: Tricare costs were minimal. Civilian insurance has real premiums.
- Automatic coverage: Tricare just worked. Now you need to shop, compare, and manage.
- Military medical facilities: MTFs provided care worldwide. Now it's civilian hospitals.
- No pre-existing concerns: Tricare covered everything. Civilian insurers may underwrite.
What You're Gaining
- Provider choice: Choose your doctors, hospitals, specialists without referral chains.
- Location flexibility: Coverage follows you anywhere, not tied to base access.
- Continuity: Keep the same insurer as you move; no disruption from PCS cycles.
Key Transition Considerations
- TAMP coverage: Transitional Assistance Management Program extends Tricare for 180 days post-separation. Use this window to research and select permanent coverage.
- Pre-existing conditions: Document everything while under Tricare. Some conditions may need underwriting for civilian coverage.
- Service-connected disabilities: VA healthcare covers service-connected issues even abroad. International insurance covers everything else.
- Timing: Don't let coverage gap. Start civilian insurance when TAMP ends.
VA Healthcare Abroad
Veterans with service-connected disabilities maintain VA eligibility. The Foreign Medical Program (FMP) reimburses for service-connected care abroad. But:
- Only covers service-connected conditions
- Reimbursement-based (you pay, then claim)
- Doesn't cover routine care, family, or non-service conditions
- You still need international insurance for comprehensive coverage
How We Evaluated
We focused on factors that matter for transitioning military families:
- Comprehensive coverage: Military families expect everything covered. We prioritized plans matching Tricare comprehensiveness.
- Family-friendly: Multi-child families need reasonable family pricing, pediatric networks, and maternity options.
- US coverage quality: Veterans often maintain US ties. Strong stateside network matters.
- Pre-existing handling: Military service creates health issues. How do insurers handle these?
- Mental health: PTSD, depression, and transition stress are real. Mental health coverage is essential.
Quick Comparison
| Provider | US Coverage | Family Plans | Pre-Existing | Best For |
|---|---|---|---|---|
| Cigna Global | Optional (+50-100%) | Excellent | With underwriting | Families relocating abroad |
| Aetna International | Good rates | Excellent | With underwriting | US-centric coverage needs |
| GeoBlue | BCBS network | Good | Stable 6 months | Blue Cross familiarity |
| IMG Global | Affordable | Good | With underwriting | Budget-conscious families |
| BUPA Global | Optional | Excellent | With underwriting | Non-US retirement abroad |
Detailed Reviews
Cigna Global
Cigna delivers the comprehensive coverage military families expect. Inpatient, outpatient, mental health, maternity, dental, vision—build the coverage you need. The modular system means you're not paying for what you don't need.
Family coverage is a strength. Multi-child families get reasonable rates. Pediatric networks are strong in major expat destinations. Maternity coverage is available (10-12 month waiting period typical).
Mental health coverage is particularly important for veteran families. Cigna includes mental health modules with generous session limits. Telehealth counseling available for those in remote locations or uncomfortable with in-person care initially.
US coverage adds 50-100% to premiums—expensive but often necessary for families maintaining stateside ties.
Pricing: $500-1,000+/month for families with comprehensive coverage including US.
Verdict: Best overall for military families wanting Tricare-equivalent coverage abroad.
Aetna International
Aetna's US background means they understand American healthcare expectations. For veterans accustomed to military medicine's thoroughness, this cultural fit helps.
US coverage integrates naturally—you're not adding an expensive foreign element to a European plan. This often means better US value than competitors.
Network is strong in US, Europe, and major international cities. Coverage in more remote locations may require pay-and-claim.
Pricing: $400-900/month for families with US coverage—often better US value than European brands.
Verdict: Strong choice for veteran families prioritizing US coverage quality and value.
GeoBlue
GeoBlue brings Blue Cross Blue Shield familiarity to international coverage. Many veterans know BCBS from civilian family members' coverage. That recognition has value.
Coverage for trips up to 364 days suits some expat patterns. Pre-existing conditions covered if stable for 6 months—reasonable for many controlled conditions.
The app is solid, claims processing straightforward, and the BCBS network provides domestic familiarity when stateside.
Pricing: $300-700/month for families depending on coverage level and destinations.
Verdict: Good for families wanting Blue Cross familiarity and solid coverage.
IMG Global
IMG offers comprehensive coverage at lower prices than premium brands. For families transitioning from military salary to civilian budgets—often with pay cuts—this matters.
Coverage up to $8M handles any realistic scenario. US coverage is more affordable than European competitors. Mental health, maternity, chronic conditions can all be covered.
Trade-off: smaller network means more pay-and-claim situations. But coverage itself is solid.
Pricing: $300-600/month for families with US coverage—20-30% below Cigna/BUPA.
Verdict: Best value for budget-conscious military families who want comprehensive coverage.
BUPA Global
BUPA offers premium comprehensive coverage with global reach. For veterans retiring abroad without US ties—or willing to exclude US coverage—BUPA delivers excellent international care.
Lifetime renewal guarantee matters for long-term planning. Once enrolled, coverage continues regardless of health changes.
Pricing: $400-700/month for families excluding US; add $200-400 for US coverage.
Verdict: Excellent for veteran families retiring abroad, especially if US coverage isn't priority.
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Choosing the Right Plan
By Situation
- Retiring abroad, maintaining US ties: Cigna Global or Aetna (US coverage essential)
- Retiring abroad, cutting US ties: BUPA Global (can exclude US, save money)
- Contractor job abroad: Check if employer provides coverage; supplement if inadequate
- Transition period/exploring: IMG or GeoBlue for value while you figure things out
By Budget
- $300-500/month: IMG Global—solid coverage, US affordable
- $500-800/month: Cigna, Aetna, or BUPA—premium coverage
- $800+/month: Cigna or BUPA with all modules—Tricare-equivalent comprehensive
By Health Status
- Healthy family: Any option works; price and network drive decision
- Service-connected disabilities: VA FMP covers those; civilian insurance for everything else
- Chronic conditions: Cigna or BUPA (better underwriting flexibility)
- Mental health needs: Cigna (strong mental health modules) or ensure any plan includes adequate coverage
Common Questions
Can I keep Tricare overseas?
Active duty families have Tricare Overseas. Retirees may qualify for Tricare Retired Reserve or Tricare for Life (with Medicare). But once you separate without retirement benefits, Tricare ends after TAMP. You need civilian coverage.
Will VA healthcare work abroad?
Limited. The Foreign Medical Program (FMP) covers service-connected conditions only. You pay upfront, then claim reimbursement. It doesn't cover routine care, family members, or non-service conditions. You need international insurance for comprehensive coverage—VA supplements for service-connected issues.
How do I handle pre-existing conditions from service?
Disclose everything during application. Service-related conditions may be underwritten with exclusions, waiting periods, or premium loading. Service-connected disabilities covered by VA remain separate. Controlled conditions (managed diabetes, hypertension) usually coverable after stability periods.
What about PTSD and mental health?
Critical consideration. VA covers service-connected PTSD. Civilian insurance varies—Cigna has strong mental health coverage; others may have session limits or exclusions. If mental health is a concern, verify coverage carefully. Telehealth options provide access from anywhere.
How much should I budget for family coverage?
Plan for $500-1,000+/month for comprehensive family coverage with US inclusion—significantly more than Tricare's minimal costs. Budget option (IMG) might be $300-500/month. Factor this into retirement or transition planning. Good coverage costs money, but medical emergency without insurance costs more.
When should I start my civilian coverage?
Start researching during your TAMP period (180 days post-separation). Apply 30-60 days before TAMP ends to ensure no gap. Underwriting can take time, especially with health history. Don't wait until the last minute—coverage gaps create pre-existing condition complications.
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Disclaimer: VA and Tricare benefits vary by service status, retirement eligibility, and disability ratings. Verify your specific entitlements with VA and Tricare before making insurance decisions. This guide provides general information—consult benefits counselors for personalized guidance.
