Health Insurance for Expat Entrepreneurs

As an expat entrepreneur, you're responsible for your own health coverage—there's no employer to provide it. Whether you're a solo founder, running a small team, or scaling internationally, getting the right insurance protects both you and your business.

Unique Challenges for Expat Entrepreneurs

Running a business abroad creates specific insurance challenges that employees don't face:

• No employer coverage: You must arrange and pay for your own insurance
• Business continuity risk: If you're incapacitated, who runs the business?
• Multi-country operations: You may need coverage across several markets
• Visa requirements: Entrepreneur visas often mandate health insurance
• Variable income: Cash flow fluctuations affect what you can afford
• Employee obligations: Some countries require you to insure your staff

Coverage Options

Expat entrepreneurs typically choose from these insurance types:

Local Insurance Options

Depending on where you're based, local insurance may be an option:

• Mandatory systems: Some countries (Germany, Netherlands) require enrollment in local insurance
• Public healthcare: Countries like Spain or Portugal may allow access after residency
• Local private insurance: Often cheaper but limited to one country

International insurance makes more sense if you travel frequently, want worldwide coverage, or prefer English-language service.

What to Look For

When evaluating plans as an entrepreneur, prioritize:

• Geographic coverage: Does it cover all countries where you operate or travel?
• Visa compliance: Will it satisfy entrepreneur visa requirements?
• Direct billing: Can hospitals bill the insurer directly, or do you pay upfront?
• Mental health coverage: Entrepreneurship is stressful—therapy coverage matters
• Evacuation coverage: Critical if you're in countries with limited healthcare
• Flexibility: Can you upgrade/downgrade as your business situation changes?
• Pre-existing conditions: How are existing health issues handled?

Deductible Strategy

Many entrepreneurs opt for high-deductible plans ($2,500-$5,000) to lower premiums. This works well if:

• You have cash reserves to cover the deductible
• You're generally healthy
• You want catastrophic protection without paying for routine care coverage

Recommended Plans

These providers are commonly used by expat entrepreneurs, with options for both individual and group coverage.

For Solo Founders

IMG Global or Allianz Care offer good value for individuals. IMG's high-deductible options keep costs low while providing solid coverage.

For Growing Teams

Cigna Global and BUPA Global have established group plans that scale well. BUPA allows groups as small as 2 people, making it accessible for early-stage companies.

For US Entrepreneurs Abroad

Aetna International or GeoBlue provide good US network access when you return home, which matters if you maintain US ties or visit frequently.

Covering Employees

If you have employees, you'll need to consider:

Legal Requirements

Many countries require employers to provide health insurance:

• UAE: Mandatory employer-provided insurance
• Singapore: Required for foreign workers
• Germany: Contribution to statutory insurance required
• US: ACA requirements for 50+ employees

Group Plan Minimums

Most international insurers require minimum group sizes:

• BUPA Global: 2+ employees
• Allianz Care: 3+ employees
• Cigna Global: 5+ employees
• Aetna International: 5+ employees

For smaller teams, individual policies may be more practical.

Remote Team Considerations

If your team is distributed across countries:

• International group plans can cover employees in multiple countries
• Some providers have restrictions on certain countries
• Local insurance may be required in addition to international coverage in some jurisdictions

Tax Considerations

Health insurance costs can often be tax-advantaged for business owners:

• Business expense: Insurance premiums are typically deductible as a business cost
• Employee benefits: Group insurance contributions are usually tax-deductible
• VAT/GST: In some jurisdictions, business insurance is VAT-exempt

Insurance by Business Stage

Common Questions

Can I deduct health insurance as a business expense?

In most jurisdictions, yes—health insurance premiums are a legitimate business expense. However, the specific treatment (pre-tax, deductible, etc.) varies by country and business structure. Consult a local accountant.

What if I'm between companies or pivoting?

Individual international health insurance stays with you regardless of your business situation. This is an advantage over employer-provided coverage—your insurance doesn't depend on any single company's success.

Do I need insurance for contractor teams?

Generally, contractors are responsible for their own insurance. However, offering to cover or subsidize insurance can be a competitive advantage when hiring top contractors. Some group plans allow contractor inclusion.

What about key person insurance?

Key person insurance (covering the business if a crucial person becomes incapacitated) is separate from health insurance. If you're a solo founder or have key employees, this is worth considering alongside health coverage.

How do I handle insurance during fundraising or acquisition?

Individual plans provide continuity regardless of corporate changes. If you have a group plan, acquisitions or major restructuring may require plan transitions—work with your broker to ensure no coverage gaps.