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
Best Overall
Cigna Global
Strong chronic disease management. Moratorium option for pre-existing conditions. Excellent worldwide network for retirees who travel.
Learn MoreBest Value
Allianz Care
Most competitive senior pricing. Good coverage at lower premiums. Case-by-case pre-existing condition review.
Learn MoreBest for 75+
Bupa Global
Accepts new members up to age 85. Industry-leading cardiac care. Best for older retirees needing comprehensive coverage.
Learn MoreSide-by-Side Comparison
| Feature | Cigna Global | Allianz Care | Bupa Global |
|---|---|---|---|
| Maximum entry age | 74 years | 74 years | 85 years |
| Lifetime renewal | Yes—guaranteed | Yes—guaranteed | Yes—guaranteed |
| Pre-existing conditions | Moratorium option | Case-by-case | Multiple options |
| Chronic disease management | Comprehensive | Good | Excellent |
| Cancer coverage | Full coverage | Full coverage | Full coverage |
| Cardiac care | Comprehensive | Comprehensive | Industry leading |
| Home country coverage | Up to 90 days | Up to 90 days | Up to 90 days |
| Evacuation to home | Included | Included | Included |
Cigna Global
Cigna Global offers retirees comprehensive worldwide coverage with strong chronic disease management. Their moratorium underwriting option lets those with pre-existing conditions get coverage—conditions become covered after 2 years without treatment.
Retiree Strengths
- Accepts new members up to age 74
- Guaranteed lifetime renewal
- Moratorium option for pre-existing conditions
- Comprehensive chronic disease management
- Excellent worldwide network
- Up to 90 days home country coverage
Limitations
- Cannot join after age 74
- Higher premiums than Allianz
- Moratorium excludes conditions for 2 years
- Pre-existing conditions may face exclusions
Allianz Care
Allianz Care offers the most competitive pricing for retirees among major international insurers. Their case-by-case approach to pre-existing conditions means healthy retirees can secure good rates, though those with complex histories may face exclusions.
Retiree Strengths
- Most affordable senior premiums
- Accepts new members up to age 74
- Guaranteed lifetime renewal
- Case-by-case pre-existing review
- Good chronic condition coverage
- Strong European network
Limitations
- Cannot join after age 74
- Pre-existing exclusions can be strict
- Network weaker in some regions vs Cigna
- Less flexible underwriting options
Bupa Global
Bupa Global stands out for accepting new members up to age 85—a significant advantage for older retirees. Their industry-leading cardiac care and chronic disease management make them ideal for those with health concerns or advancing age.
Retiree Strengths
- Accepts new members up to age 85
- Guaranteed lifetime renewal
- Industry-leading cardiac care
- Multiple pre-existing condition options
- Excellent chronic disease management
- Strong global network
Limitations
- Highest premiums of the three
- Premium increases significant with age
- Pre-existing conditions still face scrutiny
- Premium pricing for premium coverage
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Pricing by Age
Annual premiums increase significantly with age. Prices exclude US coverage—add 30-50% for US inclusion.
| Age | Cigna Global | Allianz Care | Bupa Global |
|---|---|---|---|
| 55-59 | $5,500-8,000/yr | $5,000-7,500/yr | $5,800-8,500/yr |
| 60-64 | $7,000-10,500/yr | $6,500-9,500/yr | $7,500-11,000/yr |
| 65-69 | $9,500-14,000/yr | $8,500-12,500/yr | $10,000-15,000/yr |
| 70-74 | $12,000-18,000/yr | $11,000-16,500/yr | $13,000-19,500/yr |
| 75-79 | Renewal only | Renewal only | $16,000-24,000/yr |
| 80+ | Renewal only | Renewal only | $20,000-30,000/yr |
Prices are estimates for comprehensive coverage excluding US. Actual premiums depend on health status, residence country, and plan level. Apply early—premiums and acceptance become harder with age.
Retiree Considerations
Apply Early
International health insurance becomes harder to obtain as you age. Apply before you develop conditions that could lead to exclusions. Those in their 50s get better terms than those in their 70s. If you're planning retirement abroad, secure coverage while relatively young and healthy—guaranteed renewal protects you later.
Pre-Existing Conditions
All three insurers evaluate pre-existing conditions, but approaches differ. Cigna's moratorium option covers conditions after 2 years symptom-free. Allianz reviews case-by-case—may exclude or load premiums. Bupa offers multiple options including moratorium and full medical underwriting. Be honest on applications—fraud voids coverage.
Premium Affordability Long-Term
Premiums increase 5-15% annually with age. A $6,000/year policy at 60 may cost $15,000+ at 75. Budget for rising costs over 20-30 years of retirement. Some retirees choose higher deductibles to control premiums. Plan for healthcare costs as a significant retirement expense—don't underestimate future premiums.
Home Country Visits
All three offer up to 90 days home country coverage annually—important for retirees visiting family. Verify this meets your needs. If you spend more time in your home country, you may need different arrangements. Medical evacuation to home country is included for serious conditions.
Chronic Condition Management
Diabetes, heart conditions, and other chronic diseases require ongoing management. All three insurers cover chronic conditions once accepted—but getting accepted is key. Cigna and Bupa have stronger chronic disease programs. Allianz coverage is good but less comprehensive. If you have chronic conditions, prioritize insurers with disease management support.
Best For
Choose Cigna If:
- You have pre-existing conditions
- Moratorium underwriting appeals
- You want worldwide coverage
- Chronic disease management matters
- You're under 75
Choose Allianz If:
- Budget is primary concern
- You're relatively healthy
- You're based in Europe
- Lower premiums matter most
- You're under 75
Choose Bupa If:
- You're 75 or older
- Cardiac care is priority
- You want premium coverage
- Budget is less concern
- Comprehensive coverage matters most
Frequently Asked Questions
What happens if I develop cancer or heart disease after enrollment?
Conditions developed after enrollment are covered—that's the point of insurance. All three insurers provide comprehensive cancer and cardiac coverage for conditions that arise after your policy starts. Lifetime renewal guarantees you can't be dropped due to claims. This is why enrolling while healthy is so important.
Can I get coverage if I'm already 78?
Only Bupa accepts new members up to age 85. Cigna and Allianz stop accepting new members at 74. If you're over 74 and need new coverage, Bupa is your main option among major international insurers. Some regional insurers may also accept older applicants, but with more limited coverage.
Will my premiums keep increasing forever?
Yes—premiums increase with age, typically 5-15% annually plus any general rate increases. This continues throughout your life. A policy costing $8,000 at 65 might cost $20,000+ at 80. Some retirees increase deductibles over time to manage costs. Budget for healthcare as a major retirement expense.
What's moratorium underwriting?
Moratorium underwriting (offered by Cigna and Bupa) accepts you without medical questionnaires, but excludes pre-existing conditions for a period (typically 2 years). After 2 years without treatment for a condition, it becomes covered. This helps those with conditions get coverage—but you're unprotected for those conditions initially.
Does Medicare work abroad?
US Medicare does not cover healthcare outside the US (with rare exceptions near borders). American retirees abroad need international health insurance. You can maintain Medicare Part A (free if you qualify) for US visits, but need separate international coverage. These three insurers serve US retirees well with home country visit coverage.
What if I can no longer afford premiums?
Options include increasing your deductible, reducing coverage level, or relocating to a country with affordable public healthcare. Some retirees combine local public healthcare with catastrophic-only international coverage. Once you cancel, getting new coverage may be impossible due to age and health. Exhaust other options before canceling.
Disclaimer: Retiree insurance needs are complex and highly individual. Pre-existing conditions, age, and health status significantly impact availability and pricing. This comparison provides general guidance—consult insurers directly and consider working with an international insurance broker for personalized advice.
