What does this actually cost?
Most sites give you a range so wide it's useless — "$100 to $1,000 a month" — and leave you to figure out where you land. This page is more specific: real market ranges by age, what drives the number up or down, and the one adjustment most retirees don't make.
Exact pricing requires a quote. But you should be able to walk in knowing roughly what to expect — and knowing which levers you can pull.
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Updated · Published
Ranges on this page reflect typical 2026 market pricing for a healthy retiree on a mid-tier international plan with a $2,500 annual deductible, Worldwide Excluding USA coverage. Your actual quote will vary based on age, health history, plan tier, deductible, and destination. Always get at least two quotes before purchasing.
Here's the picture before the detail.
For a typical retiree — healthy, fully relocating, not spending significant time in the US — here's what to expect:
- A Worldwide Excluding USA plan runs roughly $155–240/month at 65, rising to $240–360 by 70. Not cheap — but a fraction of what it would cost with US coverage included.
- The deductible is the biggest lever you can pull. Going from a $1,000 to a $5,000 deductible can cut your premium by 30–40%.
- Adding US coverage adds 30–50% to your premium. If you only visit the US a few weeks a year, short-term travel insurance for those trips is almost always cheaper.
- Premiums jump at age bands — typically 65, 70, and 75. The increase at 70 is the largest for most plans.
The sections below go deeper on each of these. Skip to what moves your price →
What retirees actually pay, by age band.
These are typical market ranges for a healthy retiree on a mid-tier IPMI plan with a $2,500 annual deductible, Worldwide Excluding USA coverage. Think of this as your baseline before adjusting for your specific situation.
Actual premiums vary by insurer, plan tier, deductible, health history, and destination. These ranges reflect published market data from major IPMI providers as of 2026. Get a direct quote for your exact number.
The most favorable pricing window. You're entering the market before the significant step-up at 65, and pre-existing condition underwriting is typically lighter. Lock in coverage now if you're in this range.
Annualized: ~$1,400–2,200/year
Most retirees enter the expat insurance market here — and it's also when Medicare decisions become real. Premium is meaningfully higher than the pre-65 window, and the gap widens with each passing year.
Annualized: ~$1,860–2,880/year
The 70 age band typically carries the steepest premium increase of any transition. If you're approaching 70, check renewal terms on your current plan — some insurers increase more sharply than others at this band.
Annualized: ~$2,880–4,320/year
Pricing at this band varies most between insurers. Some plans become significantly more expensive; others age-cap or stop accepting renewals entirely. Check renewal guarantees before choosing a plan — not at renewal time.
Annualized: ~$4,320–6,240/year
How to read these ranges.
The low end of each range assumes a high-deductible ($2,500+), Worldwide Excluding USA, mid-tier plan with no significant pre-existing conditions. The high end reflects lower deductibles, more comprehensive outpatient coverage, or health history that affects underwriting. The same age, different choices — wide range.
Adding US coverage: 30–50% more. Is it worth it?
The single biggest pricing decision you'll make. Not whether to get coverage — but whether to include the US.
Baseline pricing
You're abroad full-time
Based abroad, visiting the US a few weeks a year. Your day-to-day coverage is in your country of residence. For US trips, you layer a short-term travel policy — typically $50–150 for a two-week trip.
The math: short-term travel insurance for 3 weeks per year costs roughly $150–450 total. Carrying US coverage on your main plan for 12 months costs $600–1,200 extra per year. Most retirees in this pattern save $400–900/year with the travel-insurance layering approach.
The hybrid most retirees overlook
You want a US safety net
Worldwide ex-USA IPMI for life abroad, plus you keep Medicare Part B as your continuous US coverage. Right for retirees who spend extended time stateside, want protection for a possible permanent return, or want a US option for serious diagnoses.
The math: Part B is $202.90/month in 2026 (more if IRMAA applies). More expensive than either alternative on premium alone — but it sidesteps the Part B late-enrollment penalty (10%/year, for life) and gives you any-length US coverage. The right answer if you're keeping one foot in the US.
+30–50% premium
You split time with the US
Several months a year in the US, several months abroad — and you've already dropped Medicare Part B. Continuous US coverage rolled into your IPMI plan, with no separate Medicare premium.
At 65: a Worldwide ex-USA plan at ~$175/month becomes ~$230–265/month with US coverage included. That's $660–1,080 more per year. Cheaper than the Medicare hybrid on premium — but you give up the Part B penalty protection if you ever want to return.
Visa rule to check first.
Some residency visas — Portugal's D7, Spain's non-lucrative visa — specify that coverage must be worldwide, not "worldwide excluding USA." Confirm your destination country's visa insurance requirement before choosing a plan. See the relevant country guide for specifics.
Five factors. One of them is a real lever.
Four of these are mostly fixed — you can't change your age or your health history. But the fifth one — your deductible — is a genuine choice that can move your premium by 30–40%.
Age
The biggest driver of your premium — and the one you can't negotiate. Premiums step up at each age band (65, 70, 75). The jump at 70 is typically the largest. Plan for it: get quotes at your current age AND at your next age band so you're not surprised at renewal.
Health history and pre-existing conditions
Conditions disclosed on your application are typically subject to a 6–24 month waiting period or excluded entirely. They don't necessarily increase your premium — but they affect what gets covered and when. Being upfront is what protects your future claims.
US coverage included or excluded
Covered above — the 30–50% premium difference. The right answer depends on how much time you spend stateside. Worth modeling both options and comparing the total annual cost including any travel insurance you'd layer on top.
Plan tier: inpatient-only vs. comprehensive
A hospital-and-surgery-only (inpatient) plan costs significantly less than one that includes routine outpatient visits, specialist care, and dental. For retirees with access to good, affordable local healthcare (Portugal, Thailand, Mexico), covering routine care locally and using IPMI for serious events is a legitimate cost-reduction strategy.
Your deductible. This is the one you can actually control.
Most retirees default to a low or no-deductible plan because it feels safer. But for healthy retirees who aren't filing small claims frequently, a higher deductible is often the right trade — meaningfully lower premiums in exchange for self-insuring routine care.
Premium impact — age 65, Worldwide ex-USA, mid-tier plan
Typical market ranges. Actual pricing varies by insurer and plan — get a direct quote to compare deductible tiers on the same plan.
Going from a $0 deductible to a $5,000 deductible can save $150–200/month — that's $1,800–2,400 per year. If you don't expect to file small claims, that's money back in your pocket every year. The deductible only costs you anything in a year when you have a significant claim.
The costs that make the premium make sense.
For healthy retirees who rarely file claims, insurance can feel like an expensive nothing. The math changes fast when something serious happens.
Hospital stay, 3–5 days
Out-of-pocket cost in most of Western Europe or Latin America: $5,000–20,000+ depending on country and facility.
Even in lower-cost countries like Portugal or Mexico, private hospital care for a serious illness or injury is not cheap.
Medical evacuation
A medevac flight back to the US: $50,000–100,000+. This is not a hypothetical — it's the exposure that justifies the entire policy.
Most quality IPMI plans include evacuation coverage. Confirm it's in the policy, not a separate add-on you forgot to buy.
Serious illness, extended treatment
Cancer, cardiac events, or a major surgery with ongoing care: costs can reach $50,000–200,000+ in a single year.
This is the tail-risk an IPMI plan protects against — not the routine doctor visit, but the event that would otherwise consume your retirement savings.
The ranges above are a starting point. A quote from IMG gives you the real number.
IMG's Global Medical plan is what most expat retirees we'd recommend end up on — long-term design, multiple deductible tiers, evac included, US coverage available as an add-on. Their quote tool lets you run the same plan at different deductible levels side by side, which is exactly what you need to see the tradeoff.
Run your deductible options on IMGIMG's tool shows the same plan at every deductible level on one screen — $1,000, $2,500, $5,000. Enter your age and destination to see exactly how the ranges above translate to your actual quote. No account required.
Affiliate link — we earn a commission if you purchase, at no cost to you.
Want context first? The insurance guide explains which plan features matter most before you start quoting.
Add ~30–50% for Worldwide including USA coverage. Evac included on most plans. Pre-existing waiting period: 12 months standard. Confirm final pricing with the insurer.
Cost questions, answered.
Why does the same plan cost so much more at 70 than at 65?
Should I buy now or wait until I move?
Can I lower my premium after I've bought a policy?
Does getting a quote affect my application?
What about prescription drugs — are they part of this cost picture?
What happens to my premium if I develop a health condition while on the plan?
Three things to do, in order.
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Decide: Worldwide ex-USA or with US coverage?
This single choice is the biggest variable in your quote. Estimate how many weeks per year you'll actually spend in the US, then run the math: short-term travel insurance for those trips vs. adding US coverage to your main plan year-round.
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Pick your deductible before you start quoting
The deductible comparison above gives you a sense of the tradeoff. Going in with a number in mind — rather than defaulting to the lowest deductible option — will make your quotes more useful and your decision faster.
See how deductibles affect your premium → -
Get a quote from IMG, then one more from an alternative
Pricing varies more than you'd expect for nearly identical coverage. Run IMG plus Cigna Global or BCBS Global Solutions — two quotes is the minimum that tells you whether you're overpaying.
Run your numbers on IMG →
Cost is one part of the picture. What to look for is the other.
Knowing your budget range is the starting point. Knowing which plan features actually matter — pre-existing waiting periods, evacuation coverage, renewal-age limits, direct billing vs. reimbursement — is what makes the comparison meaningful. Our insurance guide covers all six.
Back to the insurance guidePrimary sources
- IMG (International Medical Group) — plan details and quote tool
- Cigna Global — international health insurance for retirees
- InternationalInsurance.com — senior expat health plan comparison
- Emergency Assistance Plus — medical evacuation cost guide
- CMS — 2026 Medicare Parts A & B premiums and deductibles