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AXA vs Allianz vs Cigna vs Bupa: the differences (2026)

IPMIcompare lined up AXA, Allianz, Cigna and Bupa level by level from their own documents, with APRIL, IMG, Expatriate Group and XN Global alongside.

Written by IPMIcompare · Reviewed by Mo Buglow, 25 years in international private medical insurance · Updated 23 October 2026

+35%more overall cover at Allianz Care Base (US$1.35m) than Cigna Silver ($1m)

12 vs 18months’ maternity wait: Cigna and Allianz against Bupa and AXA

2 of 4have an insurer licensed in Thailand by the OIC: AXA and Allianz

Our picks for buyers in Asia

IPMIcompare’s own view for buyers based in Asia, reviewed by Mo Buglow (25 years in international private medical insurance), weighing the facts on this page. The order can differ elsewhere, and the right plan still depends on your needs.

First choice

Allianz

Cigna

Allianz Care: more cover than Cigna at every level; FMU, moratorium or CPME
Cigna Global: the most outpatient cover at entry level; no limit on Platinum
Both: 12-month maternity wait

Second choice

IMG

Expatriate Group

IMG: high lifetime limits; a pre-existing waiver with proof of earlier cover
Expatriate Group: a simple moratorium plan

Third choice

AXA

APRIL

AXA: $8m top plan, but an 18-month maternity wait and $5,600 outpatient on the middle plan
APRIL: no limit on Elite and the highest adviser rating (86.4), but entry starts at €/US$500,000

Also compared

Bupa

XN Global

Bupa Global: no limit on Ultimate, but an 18-month maternity wait and no Thai insurer since 2017
XN Global: one to watch: high limits from entry level; part of the Henner Group

How much each level really buys

Insurer and planOverall limitOutpatient

Allianz CareCare Base

US$1.35m a year

US$13,500optional plan

Cigna GlobalSilver

$1m a year

$15,000optional module

IMGBronze

$1m for life

after inpatient only

Expatriate GroupPrimary+ lite

€/£/$1m a year

€/£/$1,000

AXA Global HealthcareStandard

$1.6m a year

$1,600 or $4,000*optional

Bupa GlobalSelect

£1m a year

USD 12,800

APRIL InternationalExplore

€/US$500,000 a year

€/US$3,000optional

XN GlobalBase

USD/EUR 3m a year

not included

*AXA: or cover up to the plan limit as a further upgrade

Insurer and planOverall limitOutpatient

Allianz CareCare Enhanced

US$2.7m a year

US$33,750

Cigna GlobalGold

$2m a year

$35,000

IMGGold

$5m for life

included

Expatriate GroupPrimary+

€/£/$1.5m a year

up to the annual limit

AXA Global HealthcareComprehensive

$2.4m a year

$5,600

Bupa GlobalPremier

£1.5m a year

USD 25,500

APRIL InternationalEssential

€/US$1.5m a year

no overall limit†optional

XN GlobalAscent

USD/EUR 4m a year

full refund

†APRIL: no overall outpatient limit, with limits per benefit

Insurer and planOverall limitOutpatient

Allianz CareCare Signature

US$5m a year

no limit

Cigna GlobalPlatinum

no limit

paid in full

IMGPlatinum

$8m for life

included

Expatriate GroupSelect

€/£/$5m a year

up to the annual limit

AXA Global HealthcarePrestige Plus

$8m a year

up to the plan limit

Bupa GlobalUltimate

no limit

APRIL InternationalElite

no limit**

no overall limit†

XN GlobalApex

USD/EUR 5m a year

full refund

**APRIL Elite: no limit, except €/US$4m for treatment in China, Hong Kong, Japan, Singapore and the US. †APRIL: no overall outpatient limit, with limits per benefit

Each insurer offers its plans in US dollars, pounds or euros; figures are shown as each publishes them. Striped bars are lifetime limits (IMG), not yearly.

At a glance

Insurer	Top plan	Maternity wait	Evacuation	Underwriting	Licensed in Thailand
Allianz CareFirst choice	US$5m	12 months	Included	FMUmoratoriumCPME	Allianz Ayudhya
Cigna GlobalFirst choice	no limit	12 months	Optional module	FMU	No
IMGSecond choice	$8m for life	10 or 24 months	Included	FMUpre-existing waiver	Not checked
Expatriate GroupSecond choice	€/£/$5m	12 months	Included	moratorium	Not checked
AXA Global HealthcareThird choice	$8m	18 months	Included	FMU	AXA Insurance
Bupa GlobalThird choice	no limit	18 months	Included	FMU	No, since 2017
APRIL InternationalThird choice	no limit**	12 months (optional)	Included	FMU	Not checked
XN GlobalAlso compared	USD/EUR 5m	12 months	Included	FMU	Not checked

Licensed in Thailand: whether the group also has an insurer licensed by Thailand's OIC to sell there (the Thailand example below). Not checked: outside this comparison. **APRIL Elite: no limit, except €/US$4m for treatment in China, Hong Kong, Japan, Singapore and the US. APRIL has the highest adviser service rating of any insurer rated (86.4, Health & Protection, 2025).

Which one is right for you?

No ceiling on cover

Cigna Platinum, Bupa Ultimate

No overall limit at all

You see a doctor often

Cigna Silver, Allianz Care Base, Bupa Select

$12,800 to $15,000 of outpatient at entry level

A baby in the next year or two

Cigna Gold, Allianz Care Enhanced, Expatriate Group Select

12-month wait, against 18 at Bupa and AXA

You have a medical history

Full medical underwriting: any insurer here except Expatriate Group

You know what is covered from day one

Healthy, and want no questionnaire

Moratorium: Expatriate Group, Allianz Care

Cover follows 2 clear years

A plan from an OIC-licensed Thai insurer

AXA Insurance, Allianz Ayudhya

Compare them on HelloPrakan

Living in Thailand: which of the four are licensed there

Thailand's insurance regulator, the Office of Insurance Commission (OIC), supervises the insurers it licenses and can help with complaints and disputes about them. AXA and Allianz have OIC-licensed insurers in Thailand; Cigna and Bupa do not.

✓

AXA

AXA Insurance (Thailand). EasyCare Visa for O-A, O-X and LTR visas: 2m or 4m baht per illness, entry to age 80, renewable to 99.

✓

Allianz

Allianz Ayudhya. Long Stay Visa plans for O-A, up to 200m baht.

Cigna

No Thai insurer: its Thai business was sold to Chubb, completed 1 July 2022.

Bupa

No Thai insurer: Bupa sold Bupa Thailand to Aetna in 2017.

In Thailand and want a Thai plan? HelloPrakan, our Thai partner, compares them

AXA and Allianz Ayudhya are on the TGIA list for the O-A visa (read 15 October 2026); Cigna and Bupa are not.

AXA plans Allianz Ayudhya plans Visa guide

How three of these insurers treat a condition you already have, from their documents: Cigna Global, Allianz Care and Bupa Global on pre-existing conditions.

How cover works

Full medical underwriting (FMU)

Declare it, know it on day one

You declareAcceptedAccepted with a loadingDeclined or excluded

The right path if you have a pre-existing condition. Declare every condition so the insurer can understand the risk: you know where you stand before you buy, so there are no surprises at claim time.

Standard at every insurer here except Expatriate Group

Moratorium

No questionnaire, a waiting rule

Look-back: typically 5 yearsStart2 clear yearsCovered

The simplest to apply for. Anything with symptoms, advice or treatment in the look-back is excluded until you go 2 years clear after the start. Look-backs vary: Expatriate Group's wording uses 2 years.

Expatriate Group as standard; Allianz Care as an option

Continued personal medical exclusions (CPME)

Switch insurer, keep your terms

Old policy exclusionsSame, nothing new

A good way to change insurer without full underwriting again. Insurers typically ask around 5 or 6 questions about ongoing treatment or serious illness; some are more flexible than others.

Allianz Care

Medical history disregarded (MHD)

Company groups: history ignored

5+ employeesPast conditions covered

Group plans only. Available from as few as 5 employees, and each insurer sets its own minimum, so check it at quote.

Group plans

Co-pay vs co-insurance

Example: a 1,000 outpatient bill

Co-pay of 25 per visityou pay 25Co-insurance of 20%you pay 200Difference on one bill175

A co-pay is fixed per visit; co-insurance is a share of the bill, usually capped each year. XN: per-visit excess nil, 15, 25 or 50, or co-insurance of 10, 20 or 30% capped at 2,000, 4,000 or 6,000 a year. Cigna: 0, 10, 20 or 30%, capped at $2,000 or $5,000.

Annual vs per-condition deductible

Example: a 1,000 deductible, two illnesses in one year

Annual deductibleyou pay 1,000 oncePer-condition deductibleyou pay 1,000 twiceDifference that year1,000

A higher deductible lowers the premium. Allianz Care: US$1,350, 4,050 or 8,100 a year for 10, 20 or 30% off. XN: 1,000 to 20,000. Expatriate Group's excess applies per person, per year, for each new medical condition.

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Frequently asked questions

What is the difference between AXA, Allianz, Cigna and Bupa?

Level for level, Allianz Care gives more overall cover than Cigna Global (US$1.35m against $1m at entry), while Cigna gives slightly more outpatient cover. Only Cigna Platinum and Bupa Ultimate have no overall limit. Cigna and Allianz apply a 12-month maternity wait, Bupa and AXA 18 months. All offer full medical underwriting as standard; Allianz Care also offers moratorium and CPME. In Thailand, AXA and Allianz have OIC-licensed Thai insurers; Cigna and Bupa do not.

Does Bupa have an insurer in Thailand?

No. Bupa has had no Thai insurer since it sold Bupa Thailand to Aetna in 2017.

Which insurers can give me the insurance certificate for the O-A visa?

Insurers on the Thai General Insurance Association's O-A list. On the list read on 15 October 2026 these included AXA Insurance and Allianz Ayudhya General Insurance; Cigna and Bupa were not on it.

What is the difference between moratorium and full medical underwriting?

With full medical underwriting you declare your medical history and know from day one what is covered. With a moratorium there is no questionnaire: conditions from the years before you join are excluded until you go a set period, usually 2 years, without symptoms, treatment or advice after the policy starts.

Documents read

Cigna Global: Plans in Detail and Optional Benefits pages; IPID Silver CGIC EN 02/2025 (read 15 October 2026).
Allianz Care: Table of Benefits, Care, valid from 1 November 2025 (PDF); International Healthcare Plans page; Individual Benefit Guide, Care, November 2025.
AXA Global Healthcare: Global Health Plan combined summary of benefits; Pregnancy and maternity page; Comprehensive Global Health Plan handbook, April 2021 (read 15 October 2026).
Bupa Global: Global Health Plans brochure, April 2026, UK edition (read 19 October 2026).
IMG: Global Medical Insurance brochure; Platinum Certificate of Insurance, sample, 1 January 2026.
Expatriate Group: iPMI Benefit Schedule, 1 May 2023 (PDF); iPMI Policy Wording, July 2026; IPID, June 2026; Brochure, October 2020.
XN Global: Plan Comparison, Individual & Family, 3 February 2025; brochure, May 2025.
Thailand: AXA EasyCare Visa page (axa.co.th); Allianz Ayudhya Long Stay Visa and foreigners' pages (allianz.co.th); Chubb, completion of the acquisition of Cigna's Asia-Pacific businesses, 1 July 2022; Bupa, sale of Bupa Thailand, 2017; TGIA O-A participating companies, read 15 October 2026; Life Insurance Act B.E. 2535 (OIC translation), section 83.

General information, not personal advice. Figures summarise each insurer's own published document on the date shown; terms are confirmed at quote and can differ by country of residence. Worked examples are illustrations, not quotes. Insurer names and marks belong to their owners.