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.
Quick Verdict
Choose Cigna Global If:
- ✓ You need US coverage (even occasionally)
- ✓ You move between regions frequently
- ✓ You want the largest global network
- ✓ You prefer unlimited coverage maximums
Choose Now Health If:
- ✓ You're based in Asia or Middle East long-term
- ✓ You want 15-20% lower premiums
- ✓ You value Traditional Chinese Medicine coverage
- ✓ You don't need US coverage
Overview
Cigna Global and Now Health International represent two different philosophies in international health insurance. Cigna, backed by the American healthcare giant, emphasizes global reach and network size. Now Health, headquartered in Hong Kong, focuses on deep expertise in the Asia-Pacific and Middle East markets where most of their members live.
For expats based in Asia or the Middle East, this comparison matters. Cigna offers unmatched global flexibility—useful if you travel frequently or might relocate to Europe or the Americas. Now Health offers competitive pricing and local expertise that translates to smoother claims and better hospital relationships in the region.
Both are legitimate, financially stable insurers with decades of experience. The right choice depends on your location, travel patterns, budget, and whether you need US coverage.
Cigna Global at a Glance
- Parent Company: Cigna Corporation (US)
- Founded: 1792 (Cigna); Global division 1990s
- Network: 1.5M+ healthcare providers
- Headquarters: Bloomfield, CT, USA
- Best For: Global mobility, US coverage needs
- Pricing: Premium tier
Now Health at a Glance
- Parent Company: Now Health International
- Founded: 2012 (by Cigna/Aetna veterans)
- Network: 900K+ healthcare providers
- Headquarters: Hong Kong
- Best For: Asia/Middle East expats, value seekers
- Pricing: 15-20% below Cigna typically
Coverage Comparison
Both insurers offer comprehensive coverage for inpatient and outpatient care. The differences emerge in specific benefits, coverage limits, and add-on options.
| Coverage Feature | Cigna Global | Now Health |
|---|---|---|
| Inpatient Hospital | Unlimited (Platinum) | Up to $2.6M |
| Outpatient Care | Full coverage | Full coverage |
| Mental Health | Included (limits apply) | Included (enhanced) |
| Maternity | Optional add-on | Optional add-on |
| Dental | Optional add-on | Optional add-on |
| Vision | Optional add-on | Included in some plans |
| Wellness/Preventive | Included | Included |
| Medical Evacuation | Unlimited | Up to $1M |
| Alternative Medicine | Limited | Traditional Chinese Medicine included |
| Chronic Conditions | Covered after waiting period | Covered after waiting period |
Plan Tiers Compared
| Plan Tier | Cigna Global | Now Health |
|---|---|---|
| Entry Level | Silver | WorldCare Lite |
| Mid-Range | Gold | WorldCare Classic |
| Comprehensive | Platinum | WorldCare Prestige |
| Deductible Range | $0 - $10,000 | $0 - $5,000 |
| Annual Maximum | Unlimited (Platinum) | $2.6M (Prestige) |
| Lifetime Maximum | Unlimited | Unlimited |
Key difference: Cigna Platinum offers unlimited annual maximums. Now Health caps at $2.6M annually (WorldCare Prestige). For most people, $2.6M is more than sufficient, but if unlimited coverage matters to you, Cigna is the only choice.
Coverage Highlights
Cigna Global Strengths
- ✓ Unlimited annual/lifetime maximums (Platinum)
- ✓ Unlimited medical evacuation
- ✓ Stronger US coverage options
- ✓ Larger global network (1.5M+)
- ✓ Industry-leading mobile app
Now Health Strengths
- ✓ Traditional Chinese Medicine coverage
- ✓ Enhanced mental health benefits
- ✓ Vision included in some plans
- ✓ Stronger Asia hospital relationships
- ✓ More competitive pricing
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Pricing Breakdown
Now Health typically prices 15-20% below Cigna for comparable coverage in Asia and Middle East. The gap narrows for more comprehensive plans and older applicants. Here are representative monthly premiums for Asia (excluding US coverage):
| Profile | Cigna Global | Now Health |
|---|---|---|
| Single, Age 30 (Asia excl. US) | $150-200/mo | $120-170/mo |
| Single, Age 40 (Asia excl. US) | $220-300/mo | $180-250/mo |
| Single, Age 50 (Asia excl. US) | $350-450/mo | $280-380/mo |
| Couple, Age 35 (Asia excl. US) | $300-400/mo | $250-350/mo |
| Family of 4 (Asia excl. US) | $500-700/mo | $420-600/mo |
Pricing note: These are indicative ranges for comprehensive plans excluding US coverage. Actual premiums vary by exact plan, deductible, age, and health history. Adding US coverage increases Cigna premiums by 40-60%; Now Health's US add-on is more limited.
What Drives the Price Difference?
- Network size: Cigna's larger global network costs more to maintain
- US coverage: Cigna has stronger US infrastructure, priced accordingly
- Brand premium: Cigna's name recognition commands higher prices
- Regional focus: Now Health's Asia focus allows operational efficiency
- Coverage maximums: Unlimited maximums cost more to underwrite
Deductible Impact
Both insurers offer significant discounts for higher deductibles. A $2,500 annual deductible typically reduces premiums by 20-30% compared to $0 deductible plans.
Cigna Deductible Options
- $0 — Full premium
- $250 — ~10% discount
- $1,000 — ~20% discount
- $5,000 — ~35% discount
- $10,000 — ~45% discount
Now Health Deductible Options
- $0 — Full premium
- $500 — ~15% discount
- $1,500 — ~25% discount
- $3,000 — ~35% discount
- $5,000 — ~40% discount
Network & Direct Billing
Network quality determines your day-to-day experience. Both insurers offer extensive networks, but their strengths differ by region.
| Region | Cigna Global | Now Health |
|---|---|---|
| Global Network Size | 1.5M+ providers | 900K+ providers |
| Hong Kong | Strong | Excellent (HQ) |
| Singapore | Excellent | Excellent |
| UAE/Dubai | Strong | Excellent |
| Thailand | Good | Strong |
| China (Mainland) | Good | Excellent |
| Europe | Excellent | Good |
| USA | Excellent (add-on) | Limited (add-on) |
| Direct Billing | Extensive | Strong in Asia |
Direct Billing Experience
Cigna Direct Billing
Cigna's network is extensive—most major hospitals in Asia, Middle East, and Europe offer direct billing. Their guarantee of payment (GOP) system is well-established, meaning hospitals trust Cigna to pay without requiring you to pay upfront.
The mobile app shows nearby in-network facilities with real-time GOP availability. Customer service can arrange direct billing at most hospitals within 24 hours if pre-authorization is needed.
Now Health Direct Billing
Now Health has strong direct billing relationships in Asia and Middle East, particularly Hong Kong, Singapore, UAE, and Thailand. Their regional focus means deeper relationships with key hospitals in their core markets.
Some members report smoother direct billing experiences in Asia with Now Health due to their Hong Kong headquarters and established local operations. However, direct billing outside Asia can be less consistent.
Regional Strengths
Where you live matters. Here's how each insurer performs in key expat destinations:
Hong Kong & Singapore
Winner: Now Health (slight edge) — Now Health is headquartered in Hong Kong with strong Singapore operations. Their hospital relationships are deep, and claims processing is fast. Cigna is also excellent here, but Now Health's local expertise shows.
UAE & Middle East
Winner: Tie — Both have strong UAE presence. Now Health has grown aggressively in Dubai and Abu Dhabi. Cigna has long-established relationships. Either works well for Middle East expats.
Thailand & Southeast Asia
Winner: Now Health (edge) — Now Health's Traditional Chinese Medicine coverage appeals to expats using integrated medicine. Their network in Bangkok's international hospitals is strong. Cigna is solid but less specialized.
China (Mainland)
Winner: Now Health — Now Health's Hong Kong base gives them advantages navigating mainland China healthcare. Better hospital relationships in Shanghai, Beijing, and Guangzhou. Cigna works but Now Health is more established.
Europe
Winner: Cigna Global — Cigna's larger global network shows in Europe. Better direct billing availability across the continent. Now Health works but isn't their focus market.
United States
Winner: Cigna Global (clearly) — Cigna is a US healthcare giant. Their US coverage add-on is comprehensive with extensive direct billing. Now Health offers US coverage but it's more limited and expensive. If you need US coverage, Cigna is the clear choice.
Claims Experience
Claims processing is where insurers prove their value. Both Cigna and Now Health have good reputations, but their approaches differ.
Cigna Global Claims
- Submission: App, portal, email, or mail
- Processing time: 5-10 business days (typical)
- Reimbursement: Direct deposit or check
- Languages: 15+ languages supported
- 24/7 support: Yes, global service centers
Cigna's mobile app makes claims submission easy—snap a photo of receipts and submit directly. Their global service centers provide round-the-clock support in multiple languages.
Now Health Claims
- Submission: App, portal, or email
- Processing time: 5-7 business days (typical)
- Reimbursement: Direct deposit preferred
- Languages: English, Chinese, Arabic
- Support hours: Extended hours, not 24/7
Now Health members often report faster claims processing within Asia. Their Hong Kong operations team is responsive and familiar with regional healthcare systems. Support isn't 24/7 but covers most business hours across Asia.
Both perform well: Neither insurer has significant claims complaints. For routine claims, expect 5-10 day processing with either. Complex claims (surgeries, hospitalizations) are handled professionally by both.
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Pre-existing Conditions
Both insurers can cover pre-existing conditions, but with limitations. Understanding these is crucial if you have ongoing health issues.
Cigna Global Approach
- • Full medical underwriting at application
- • Case-by-case evaluation of pre-existing conditions
- • May exclude, load premium, or apply waiting periods
- • Moratorium option available in some markets
- • Typically 24-month wait for pre-existing coverage
Now Health Approach
- • Medical underwriting required
- • Individual assessment of conditions
- • Exclusions or premium loading possible
- • Generally 24-month wait for pre-existing
- • Some group schemes have more flexibility
Important: Always disclose pre-existing conditions fully. Non-disclosure can void your policy entirely. Both insurers will investigate claims related to pre-existing conditions, and denied claims due to non-disclosure are common industry-wide.
Real-World Scenarios
Here's how each insurer typically performs in common expat situations:
Hong Kong Finance Professional
35-year-old, single, wants comprehensive coverage including mental health. Occasional US travel for conferences.
→ Now Health WorldCare Classic — Better value for Asia-based coverage. Mental health benefits are strong. Can add limited US coverage for occasional trips. Saves ~$400/year vs comparable Cigna.
American Family in Singapore
Family of 4, parents age 40. Need coverage for annual US visits to family. Kids' routine care important.
→ Cigna Global Gold with US add-on — The US coverage is essential. Cigna's US network is unmatched. Higher premium but necessary for their needs. Mobile app excellent for managing family claims.
British Retiree in Thailand
62-year-old, controlled hypertension, uses traditional and Western medicine. Budget-conscious but wants quality coverage.
→ Now Health WorldCare Classic — TCM coverage is valuable. Thailand network is strong. Hypertension covered after waiting period (disclose fully). 15-20% savings vs Cigna at this age matters.
Digital Nomad Across Asia
28-year-old moving between Thailand, Vietnam, and Indonesia. Healthy, wants flexibility and good value.
→ Now Health WorldCare Lite — Lower premium for healthy young person. Good coverage across Southeast Asia. No US needed. Can upgrade later if circumstances change.
Executive Relocating Globally
45-year-old moving from Dubai to possibly London or NYC next year. Needs flexibility and premium coverage.
→ Cigna Global Platinum — Global flexibility is key. Unlimited coverage for executive peace of mind. US option ready when needed. Direct billing works everywhere they might go.
Couple in UAE with Pre-existing
Both 50, one has Type 2 diabetes (controlled). Want comprehensive coverage in Dubai long-term.
→ Either works—get quotes from both — Underwriting will determine pricing. Now Health may be more competitive. Cigna's diabetes management programs are strong. Compare actual quotes with full disclosure.
Who Should Choose Which
Choose Cigna Global If You:
- ✓ Need US coverage (even occasionally)
- ✓ Move between regions frequently
- ✓ Want the largest possible network
- ✓ Prefer unlimited coverage maximums
- ✓ Value 24/7 multilingual support
- ✓ Want the best mobile app experience
- ✓ Are American or have US healthcare expectations
Choose Now Health If You:
- ✓ Are based in Asia/Middle East long-term
- ✓ Want 15-20% lower premiums
- ✓ Don't need US coverage
- ✓ Value Traditional Chinese Medicine
- ✓ Prefer regional expertise over global scale
- ✓ Are in Hong Kong, Singapore, or mainland China
- ✓ Want enhanced mental health coverage
Final Verdict
Both Cigna Global and Now Health International are legitimate, well-established insurers that will take care of you when you need healthcare abroad. The choice comes down to your specific situation:
Cigna Global is the better choice if you need US coverage, travel globally, or want the peace of mind of unlimited coverage maximums and the largest network. You pay more, but you get more flexibility.
Now Health is the smarter choice if you're settled in Asia or the Middle East, don't need US coverage, and want to save 15-20% without sacrificing quality. Their regional expertise translates to smoother experiences in their core markets.
If you're genuinely unsure, get quotes from both. The actual pricing for your specific situation—age, location, health history, family size—may make the decision clearer than any comparison article can.
Bottom Line
Cigna Global for global flexibility and US coverage. Now Health for Asia/Middle East value. Both are excellent insurers—you won't go wrong with either if they match your needs.
Frequently Asked Questions
Is Now Health a legitimate insurer?
Yes. Now Health International was founded in 2012 by executives from Cigna and Aetna. They're regulated in Hong Kong and have grown to serve expats across Asia and the Middle East. They're smaller than Cigna but well-established and financially stable.
Can I switch from Cigna to Now Health (or vice versa)?
Yes, but you'll go through underwriting again. Pre-existing conditions may be treated as new. Some insurers offer "continuous coverage" benefits if you switch within certain timeframes. Ask specifically about your situation when getting quotes.
Which is better for families?
Both offer family plans. Cigna is generally better if you have US ties or travel globally. Now Health can save a family $1,000-2,000/year if you're Asia-based without US coverage needs. Children's coverage is comprehensive with both.
How do claims compare?
Both have good claims reputations. Cigna has more 24/7 support options and a better mobile app. Now Health members often report faster processing within Asia. For routine claims, expect similar experiences with 5-10 day processing.
What about dental and vision coverage?
Both offer dental as an optional add-on. Cigna's dental add-on is comprehensive but expensive. Now Health includes basic vision in some plans; Cigna requires an add-on. If dental is important, compare the specific add-on costs.
Should I get quotes from both?
Yes—if you're genuinely considering both. The actual premium for your specific situation may differ significantly from published ranges. Both offer free quotes, and comparing actual numbers makes the decision easier than any comparison article.
