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
Cigna Global
Best Overall
Most flexible underwriting with both moratorium and full-cover options. Best path to eventually covering pre-existing conditions.
Learn MoreBupa Global
Strong Moratorium
Excellent moratorium option where conditions become covered after 2 years symptom-free. Good for manageable conditions.
Learn MoreAllianz Care
Strictest Approach
Most affordable for healthy applicants but typically excludes pre-existing conditions. Best if conditions are mild or you're healthy.
Learn MoreSide-by-Side Comparison
| Feature | Cigna Global | Bupa Global | Allianz Care |
|---|---|---|---|
| Moratorium Option | Yes (2 years) | Yes (2 years) | Limited |
| Medical Underwriting | Full assessment | Full assessment | Full assessment |
| Full Cover Option | Yes (with loading) | Yes (with loading) | Rarely |
| Waiting Period | 12-24 months | 12-24 months | 24 months+ |
| Chronic Conditions | Can be covered | Can be covered | Often excluded |
| Mental Health History | Moratorium available | Moratorium available | Usually excluded |
| Underwriting Flexibility | Good | Good | Limited |
| Premium Loading | 15-100%+ | 20-100%+ | 10-50% |
Cigna Global
Cigna Global offers the most flexible approach to pre-existing conditions. You can choose moratorium underwriting (conditions excluded for 2 years, then automatically covered if symptom-free) or full medical underwriting (condition-specific exclusions or premium loading, but immediate coverage for everything else).
For applicants willing to pay premium loading (15-100%+ depending on severity), Cigna can often provide full coverage including pre-existing conditions from day one. This is valuable for conditions requiring ongoing treatment. The underwriting team considers each case individually rather than blanket exclusions.
Pre-existing Strengths
- • Moratorium and full-cover options
- • Case-by-case underwriting
- • Full coverage possible with loading
- • Chronic conditions can be covered
- • Mental health moratorium available
Considerations
- • Loading can be substantial
- • 2-year moratorium period
- • Severe conditions may be declined
- • Detailed medical disclosure required
Bupa Global
Bupa Global's moratorium approach is straightforward: pre-existing conditions are excluded for 2 years, then automatically become covered if you haven't received treatment for them during that period. This works well for conditions that are managed and stable—after 2 symptom-free years, full coverage kicks in.
Full medical underwriting is also available with condition-specific exclusions or premium loading. Bupa's underwriting tends toward slightly higher loadings than Cigna but similar flexibility. Their chronic condition management programs are strong once conditions are covered, making them good for long-term care needs.
Pre-existing Strengths
- • Clear moratorium process
- • Automatic coverage after 2 years
- • Strong chronic care once covered
- • Mental health moratorium
- • Case-by-case review
Considerations
- • Slightly higher loadings
- • Strict 2-year symptom-free requirement
- • Premium pricing even without conditions
- • Detailed medical history needed
Allianz Care
Allianz Care takes the strictest approach to pre-existing conditions. Most significant conditions are permanently excluded, with limited moratorium options. If you have diabetes, heart conditions, cancer history, or mental health treatment history, expect exclusions rather than coverage paths.
This strict approach results in lower premiums for healthy applicants—Allianz is often 20-30% cheaper than Cigna or Bupa. For those with minor conditions or no health history, Allianz offers excellent value. But for meaningful pre-existing conditions, look to Cigna or Bupa instead.
Pre-existing Strengths
- • Most affordable for healthy
- • Quick underwriting decisions
- • Clear exclusion terms
- • Minor conditions may be accepted
- • Lower premium loading
Considerations
- • Most conditions excluded
- • Limited moratorium options
- • Mental health usually excluded
- • Full cover rarely available
- • Not ideal for chronic conditions
Get Quotes with Your Health History
Speak with specialists who understand pre-existing conditions and can find coverage options.
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Pricing Comparison
How pre-existing conditions affect pricing:
| Scenario | Cigna Global | Bupa Global | Allianz Care |
|---|---|---|---|
| Healthy applicant (35) | $350/mo | $400/mo | $280/mo |
| Diabetes (controlled) | $420-520/mo | $480-600/mo | Excluded |
| Heart condition history | $490-700/mo | $560-800/mo | Excluded |
| Mental health history | $400-500/mo | $450-550/mo | Excluded |
*Pricing is indicative only—actual premiums depend on specific conditions, severity, treatment history, and underwriting assessment. Loading can vary dramatically.
Pre-existing Condition Details
Moratorium Underwriting
- • Pre-existing conditions excluded initially
- • Typically 2-year symptom-free period
- • Conditions auto-covered after period
- • Any treatment restarts the clock
- • No medical questions required
- • Good for stable, managed conditions
Full Medical Underwriting
- • Complete medical history required
- • Condition-specific exclusions possible
- • Premium loading for higher risk
- • Full cover option available
- • May require medical exams
- • Case-by-case assessment
Common Conditions & Coverage Likelihood
Often Coverable
- • Controlled hypertension
- • Thyroid conditions
- • Allergies/asthma (mild)
- • Previous surgeries (healed)
- • Minor skin conditions
With Loading/Moratorium
- • Type 2 diabetes (controlled)
- • Anxiety/depression (stable)
- • Heart conditions (managed)
- • Autoimmune conditions
- • Back/spine conditions
Difficult to Cover
- • Recent cancer
- • Organ transplants
- • Severe mental illness
- • HIV/AIDS
- • Multiple chronic conditions
Which Is Best For You?
Choose Cigna Global if:
- • You want maximum flexibility
- • Full coverage with loading is acceptable
- • You have chronic conditions needing ongoing care
- • Mental health coverage is important
Choose Bupa Global if:
- • Moratorium approach suits your situation
- • Your conditions are stable/managed
- • You can wait 2 years for full coverage
- • Long-term chronic care matters
Choose Allianz Care if:
- • You're generally healthy
- • Conditions are minor or fully resolved
- • Budget is the priority
- • You're comfortable with exclusions
Frequently Asked Questions
What happens if I don't disclose a pre-existing condition?
Non-disclosure can void your entire policy. If you claim for an undisclosed condition—or even an unrelated condition where your undisclosed history is discovered—your claim may be denied and policy canceled. Always disclose everything; insurers may still offer coverage with exclusions or loading.
Can I get coverage for diabetes abroad?
Yes, particularly with Cigna or Bupa. Well-controlled Type 2 diabetes is commonly covered with premium loading (20-50%). The moratorium option works if you can manage without treatment for 2 years. Insulin-dependent diabetes is more challenging but not impossible—expect higher loading.
How does the moratorium actually work?
Under moratorium, any condition you've had treatment, advice, or symptoms for in the past 5 years is excluded. If that condition remains symptom-free and untreated for 2 continuous years while insured, it becomes covered. Any treatment during the 2 years restarts the clock.
Will my premiums increase because of my conditions?
With full medical underwriting, yes—expect "loading" of 15-100%+ depending on condition severity. Moratorium underwriting may have no loading since conditions are initially excluded. Standard age-related increases apply regardless of underwriting method.
Disclaimer: Underwriting approaches, loading percentages, and coverage options vary by individual circumstance and change over time. This is general guidance—actual coverage depends on your specific health history and underwriting assessment. Always disclose all conditions and consult with insurance specialists for advice specific to your situation.
