High medical inflation is causing companies across the globe to seek more bang for their buck from international private medical insurance (IPMI).
The desire to expand globally now extends as much to SMEs as it does multinationals.
While multinationals are also questioning the effectiveness of single global policies, both groups are laser focused on cost containment and want more from flexible offerings that meet the wellbeing needs of their employees.
Though providers are responding in kind with innovations such as prepaid payment cards and more medical history disregarded (MHD) underwriting.
In any event, as demand for more digital solutions grows from both SMEs and multinationals, it is clear AI will play a greater role in providing the IPMI solutions of tomorrow.
Spiralling healthcare costs
Employers across the globe have been wrestling with increased healthcare costs for some time.
In August the Business Group on Health’s 2026 Employer Health Care Strategy Survey found employers have faced steep, beyond expectation rises in healthcare costs over the last two years with a further 9% rise predicted for next year and a whopping 62% rise from 2017.
The same month Aon’s 2025 Global Benefits Trends Study showed high medical inflation is the biggest driver of benefits costs across the world and many employers are planning to renegotiate insurance contracts.
“Many clients are looking at cost and how to mitigate the increasing costs associated with international PMI,” Linda Beavis, global leader – mobility, global benefits at Aon, tells Health & Protection.
“Therefore we often see discussions regarding potential cost containment strategies or localisation of long term expats onto local benefits,” Beavis continues.
“Everyone is looking for plans that can maintain a comprehensive level of cover but with manageable costs, this may not be possible in the current environment and therefore flexibility around packages and focus on what benefits are important for clients is key.”
Transparency in costs
Flexibility in benefit offerings remains a key consideration for employers, Joe Cronin, president at advice firm International Citizens Insurance, highlights.
“As global mobility and hybrid operations expand, employers want benefit structures that adapt by geography, role, or budget, moving away from traditional static plans toward highly customisable modules,” Cronin explains.
“At the same time, with medical costs climbing worldwide, companies are using IPMI to both protect their employees and manage financial risk,” Cronin continues.
“They’re asking for transparent cost-sharing, network optimisation, and predictable renewals to keep budgets under control while maintaining strong coverage.”
Insurers are seeing this trend filter down as well.
UnitedHealthcare Global notes advisers and customers are increasingly seeking packages from it that offer modular and flexible plan designs.
They are looking for these to be tailored to specific needs and budgets as well as with transparent pricing and value-driven coverage, especially in light of economic pressures and inflation.
According to Joe Thomas, managing director of April International UK, for multinational firms, there is a more strategic discussion underway.
“Some are questioning whether a single global policy is truly the best approach, especially when operating across diverse markets such as the US, Singapore, the UK and Dubai, as each jurisdiction has its own regulatory, cost and access challenges,” Thomas says.
“In some cases, a more localised, subsidiary led strategy can actually deliver a more cost effective and efficient outcome than a centralised solution.”
Alternatives to UK PMI
Though David Booth, group sales director at Santé Group, points out in some cases IPMI offerings can become a more cost effective solution to domestic PMI.
“This is mainly due to the extreme rising costs, it’s now at the point where IPMI is a cost effective solution for some clients to move away,” Booth says.
“We’re also making way with a few businesses who are looking to find solutions for their colleagues in other parts of the world, but this isn’t a growing trend, it’s always been there.
“Insurers bringing in payment cards is a great addition to their plan and is helping them become attractive to UK insured members moving to global.”
This welcoming of payment cards is echoed by Ian Abbott, international director at Engage Health Group, who explains the importance of employees making outpatient claims on prepaid cards.
“This is very welcome and is receiving positive feedback from clients and their employees,” Abbott explains.
“These help to make outpatient claims more seamless and reduce out of pocket expense, which is appreciated when people are feeling recent rising inflation while also reducing administration.
“SME clients are increasingly focussed on good value and strong online functionality for employees, while corporates are often focussed on reducing the administrative burden through technology and being able to maintain a strong benefits offering in the face of increasing inflationary pressures year on year.”
Greater push for MHD underwriting
Though there are other tools available to employers seeking to unlock greater value from their IPMI offerings.
Chantal Leprêtre, client adviser at SIP Medical Family Office, reveals her advisory firm has seen a greater push for medical history disregarded (MHD) underwriting, even on SME groups with under five members.
“Employers are recognising the strategic value of MHD arrangements,” Leprêtre says.
“This is not only for the streamlined onboarding process at inception and for new joiners, but also for the comprehensive nature of the cover, which serves as a compelling tool for talent acquisition and retention.”
This product innovation is growing in importance as customers are more than prepared to vote with their feet and switch providers as Kevin Melton, global head of IPMI for IMG, notes.
“Cost continues to be a key factor when companies are selecting a group international PMI solution, and brokers are tasked with finding the most cost-effective solutions for their clients, often switching providers to accomplish this,” Melton explains.
Trend towards digitalisation
Whether budgetary pressures persist or not, this is a sector experiencing increased digitalisation driven by policyholder demand and the efficiency of procedures on behalf of the insurers, according to Victor Ioannides, managing director at Nicos Rossos.
“In SMEs usually you have more input by plan members and therefore sometimes you have more specific requests,” Ioannides explains.
“With corporates, usually HR teams start building their policies on standard benefits and expect more advice from the brokers.
“In terms of providers addressing workforce health goals, a lot of investment has gone into tools helping policyholders handling mental health issues.”
For Jack Escourt, global product manager at Axa Global Healthcare, as economic pressures continue to hit, employers will want more out of their products while also managing costs and digitalisation is helping here.
“The challenge we face is to provide groups with this flexibility while ensuring value in the product,” Escourt says.
“We also see trends to more digitisation in the PMI space and with the rise of AI, how new technology can be woven into our overall proposition and stay ahead of the curve.”
A future shaped by AI
And this sector can also expect increased personalisation in IPMI, driven by data analytics and AI, to meet unique individual health needs, says David Clare, consultant for healthcare and protection at Sutton Winson.
“To adapt, the IPMI sector must continue to innovate in coverage and technologic integration, responding to global healthcare disparities to meet these evolving demands,” Clare continues.
Chris Beardshall, head of expatriate benefits solutions at WTW, agrees, adding the future is going to be shaped by AI, personalisation, and prevention.
“AI is already being used for claims efficiency and fraud detection, but its potential goes much further — predictive health analytics, personalised care recommendations, and even agent-based AI support for employees navigating complex systems,” Beardshall says.
“We expect virtual-first models, blockchain-secured health data, and real-time care navigation to become mainstream.
“Employees will increasingly expect seamless, digital-first experiences: one app where they can access telehealth, claims, travel risk alerts, and wellbeing tools in real time.”