International health insurance for expats: 'first euro' cover vs CFE complement

When you settle abroad for the long term, travel insurance is no longer enough: it is designed for short trips and rarely covers ongoing care, chronic conditions or routine medicine. Expatriates need dedicated international health insurance.

1. Why local or travel cover often falls short

Public healthcare in your host country may be limited, costly for foreigners, or unavailable to non-residents. Travel insurance usually caps cover, excludes pre-existing conditions and ends after a few weeks or months. For a stay of more than a year, a proper international medical plan is essential, and often required for your visa.

2. 'First euro' plans vs CFE complement

For French expatriates, cover can be structured two ways:

• 'First euro' (premier euro): the insurer pays from the very first euro, with no underlying scheme. Simple and comprehensive, but generally more expensive.
• CFE complement: you first join the Caisse des Français à l'Étranger (CFE), which reimburses on the French scale, then add a complementary plan. This keeps you within the French social-security system (useful when you return to France) and can be cheaper, but involves two contributions and a possible waiting period.

Note: a child above the age limit can no longer be attached as a dependent and must take out their own contracts, including their own CFE membership.

3. What to check before subscribing

• Hospitalisation and repatriation: the non-negotiable core. Check the annual ceiling and geographic zone.
• Routine medicine, optical and dental: not all plans include optical.
• Waiting periods and exclusions: pre-existing conditions, maternity and high-risk sports are often restricted.
• Co-payment options: accepting a 20% co-payment can significantly lower your premium.
• Medical questionnaire: some insurers may decline or load the premium.

4. Visa and legal requirements

Many countries require proof of medical insurance covering the entire stay to issue a long-stay visa or residence permit, often with a minimum for hospitalisation and repatriation. Always check the exact requirement of your destination's consulate.

5. How to choose

Compare on equivalent guarantees, not just price. Match the cover to your real needs and the length of your stay, and factor in whether keeping CFE rights matters to you. A broker such as Aitona compares partner insurers and builds a free, personalised study for your situation.