International health insurance feature matrix: Cigna, Bupa, Allianz, AXA, IMG and APRIL compared (2026)
IPMIcompare, a free comparison site for international private medical insurance, built this page as a neutral feature matrix: six international health insurers compared on the same 14 policy terms, every cell taken from the insurer's own published documents. It carries no prices; for premiums by country and age see our cost data.
In short: On the documents read on 15 October 2026, Cigna Global, Bupa Global, Allianz Care, AXA Global Healthcare, IMG Global Medical Insurance and APRIL MyHealth International all cover cancer, evacuation and repatriation (Cigna's as an optional module) and all renew automatically, but they differ on the terms that decide a claim: the top annual limit (from AXA's Foundation at $400,000 to Bupa's Ultimate with no limit), the maternity waiting period (12 months at Cigna, Allianz and APRIL; 18 at Bupa and AXA; 10 or 24 at IMG), the underwriting route (only Allianz Care and AXA publish a moratorium option), the cooling-off period (14 to 30 days) and the deductible menu. Four rows we wanted could not be sourced for every insurer and were left out rather than filled.
How this matrix was built
Each cell was read in the insurer's own published document on 15 October 2026: plan pages, Insurance Product Information Documents, customer guides, benefit guides, policy rules, certificates of insurance and brochures. Where a figure differs by region or edition, the cell says which document it comes from. Nothing on this page comes from a third-party site, a broker comparison or a quote engine. Figures are the insurer's; "paid in full" and "100%" are the insurer's own wording. Terms we could not source from every one of the six insurers' documents were dropped from the table rather than shown with gaps; they are listed under what is not in the table.
The service row is the one exception to the insurer-document rule: it is the Health & Protection IPMI Service Ratings 2026, an independent survey of almost 200 advisers published in May 2026, and it is labelled as such. The full document list is under documents read.
Plan families compared: Cigna Global Health Options (Silver, Gold, Platinum); Bupa Global Health Plans (Major Medical, Select, Premier, Elite, Ultimate); Allianz Care International Healthcare Plans (Care Base, Care Enhanced, Care Signature); AXA Global Healthcare Global Health Plan (Foundation, Standard, Comprehensive, Prestige, Prestige Plus); IMG Global Medical Insurance (Bronze, Silver, Gold, Platinum); APRIL International MyHealth International (Explore, Essential, Extensive, Elite).
The matrix: 14 terms, 6 insurers
| Term | Cigna Global | Bupa Global | Allianz Care | AXA Global Healthcare | IMG Global Medical Insurance | APRIL MyHealth International |
|---|---|---|---|---|---|---|
| Plans and overall annual limit | Silver $1,000,000; Gold $2,000,000; Platinum paid in full (per beneficiary per period of cover) | Major Medical £2,000,000; Select £1,000,000; Premier £1,500,000; Elite £3,000,000; Ultimate unlimited (per person per policy year, UK edition) | Care Base US$1,350,000; Care Enhanced US$2,700,000; Care Signature US$5,000,000 (maximum plan limit) | Foundation $400,000; Standard $1,600,000; Comprehensive $2,400,000; Prestige $3,200,000; Prestige Plus $8,000,000 (overall plan limit per member per year) | Lifetime (not annual) maximum: Bronze $1,000,000; Silver $5,000,000; Gold $5,000,000; Platinum $8,000,000 per individual | Explore €/US$500,000; Essential €/US$1,500,000; Extensive €/US$2,000,000 for treatment in China, Hong Kong, Japan, Singapore and the United States, unlimited elsewhere; Elite €/US$4,000,000 in those countries, unlimited elsewhere |
| Area of cover options | Worldwide including USA, or Worldwide excluding USA | Major Medical: Worldwide, or Worldwide without the U.S.; Select, Premier, Elite and Ultimate: "Worldwide or worldwide without U.S. or Europe" | Worldwide; Worldwide excluding USA; Africa; or Europe | Worldwide, or Worldwide excluding the USA; emergency treatment in the USA still covered on every level except Foundation | Area 2: Worldwide excluding the United States, Canada, China, Hong Kong, Japan, Singapore and Taiwan (the 2026 Platinum certificate also lists Macau); Area 3: Worldwide | Coverage zone set by the declared country of residence and extendable worldwide; accidents and medical emergencies outside the zone covered for stays of up to 60 consecutive days |
| Outpatient cover | Optional International Outpatient module: annual maximum $15,000 Silver, $35,000 Gold, paid in full Platinum | Out-patient day-to-day care: not covered on Major Medical; USD 28,800 Select; USD 38,500 Premier; USD 75,000 Elite; unlimited Ultimate (per policy year, Hong Kong comparison table) | Optional Out-patient Plan added to the core plan (GP visits and day-to-day care); an optional out-patient deductible lowers the premium | Foundation and Standard: optional upgrade with a combined allowance of $1,600 or $4,000, or cover up to the plan limit; Comprehensive: included, combined limit $5,600; Prestige: included, combined limit $16,000; Prestige Plus: included up to the plan limit | Included on all four plans; on Bronze outpatient services must follow inpatient treatment or outpatient surgery (physician visits up to $500); Silver physician visits capped at $70 per visit and 25 visits | Optional Outpatient Care option: Explore overall limit €/US$3,000; Essential, Extensive and Elite: unlimited overall outpatient limit with per-benefit sub-limits |
| Deductible / excess options | Inpatient: $0, $375, $750, $1,500, $3,000, $7,500 or $10,000, plus a cost share of 0, 10, 20 or 30% with an out-of-pocket maximum of $2,000 or $5,000; outpatient module: $0, $150, $500, $1,000 or $1,500 | Optional annual deductible: USD 4,000 or USD 10,000 on Major Medical and Elite; USD 1,500, 4,000 or 10,000 on Select and Premier; none on Ultimate; optional 15% co-insurance on Select and Premier (Hong Kong comparison table) | Optional deductible on the core plan and an optional out-patient deductible; where a deductible applies it covers all benefits per person per Insurance Year and is shown in the Table of Benefits | Five excess levels per person per year: £100/$160, £250/$400, £500/$800, £1,000/$1,600, £2,000/$3,200; two more on Standard without an outpatient upgrade: £5,000/$8,000 and £10,000/$16,000 | Bronze and Silver $250 to $10,000; Gold $250 to $25,000; Platinum $100 to $25,000; 50% of the deductible waived (up to $2,500) for Medical Concierge or international treatment; coinsurance 100% internationally, 100% US in-network, 80% US out-of-network up to $5,000 then 100% | No deductible by default; optional annual deductible of €/US$500, 1,000, 2,500 or 5,000 (5,000 on Extensive and Elite only); or an outpatient co-payment of 10, 20 or 30% |
| Maternity waiting period | Routine maternity on Gold ($7,000) and Platinum ($14,000) once the mother has been covered for 12 months, 24 months depending on insurance entity or where treatment occurs; not covered on Silver | 18 months on the plan before pregnancy and childbirth are covered; routine maternity on Elite (USD 10,200) and Ultimate (USD 17,000) per policy year | 12 months; routine maternity and complications on Care Enhanced and Care Signature | 18-month waiting period (moratorium); pregnancy cover standard on Prestige (up to $16,000) and Prestige Plus (up to $19,200), not available as an add-on to other levels | Platinum only: available after 10 or 24 months of continuous coverage, set at underwriting; $2,500 maternity deductible on top of the plan deductible; $50,000 lifetime maximum; Bronze, Silver and Gold: not applicable | Optional on Essential, Extensive and Elite (needs the Outpatient option): 12-month waiting period for routine pregnancy and childbirth, €/US$4,000, 8,000 or 12,000 per pregnancy; waived with proof of equivalent prior cover ended less than a month before |
| Pre-existing conditions and underwriting | Medical questionnaire (full disclosure): symptoms or advice before the start date may lead to special exclusions; certain pre-existing conditions may be included at an additional premium | Full medical history reviewed at application; pre-existing conditions may be covered (possibly for an extra premium), excluded or restricted, shown on the insurance certificate | Choice of Full Medical Underwriting (pre-existing conditions generally covered unless the policy documents say otherwise), Moratorium (no questionnaire; eligible after a continuous 24-month period free of symptoms, treatment, medication or advice) or CPME/CTT switch terms from a previous insurer | Plans cover conditions that start after you join; three underwriting bases: fully underwritten, continuing medical exclusions, or moratorium; a pre-existing condition is one with symptoms, medication, advice or treatment in the five years before cover | Full Medical Underwriting; known disclosed conditions covered the same as any illness unless excluded by rider (Silver, Gold) or covered if disclosed and not excluded by rider (Platinum); non-disclosed conditions not covered; unknown conditions after 24 months' continuous coverage up to $5,000 a year / $50,000 lifetime (Silver, Gold); a Pre-Existing Condition Waiver with proof of prior comprehensive cover and no break over 63 days | Declarative health questionnaire (no doctor visit needed); pre-existing conditions excluded at application, including their consequences, are not covered |
| Cancer | Cancer care paid in full on Silver, Gold and Platinum; cancer preventative surgery $10,000 / $18,000 / $20,000 after a 12-month waiting period | Covered on all plans: once diagnosed, fees specifically related to planning and carrying out cancer treatment | Oncology benefit on Care Base, Care Enhanced and Care Signature ("Cancer treatment" in the cover list) | Radiotherapy and chemotherapy (inpatient, day patient or outpatient) on all five levels, including drugs to prevent recurrence; home chemotherapy nurse up to $1,600 a year | Chemotherapy or radiation therapy covered on Bronze, Silver, Gold and Platinum, inpatient and outpatient | Oncology, chemotherapy and radiotherapy 100% on all four plans; cancer preventive surgery €/US$25,000 on Elite only (12-month wait) |
| Mental health | Inpatient and daypatient mental and behavioural health: Silver $5,000 (30 days), Gold $10,000 (60 days), Platinum paid in full (90 days); optional Health and Wellbeing module adds up to 20 counselling sessions per condition | Day-patient and in-patient mental health where medically necessary on all plans (limitations on Select and Premier); out-patient mental health within the Select 15 / Premier 30 / Elite 60 visits a year, Ultimate paid in full; none on Major Medical | "Psychiatry and psychotherapy" benefit: treatment of mental, behavioural and personality disorders by a psychiatrist, clinical psychologist or psychotherapist; out-patient sessions limited to 10 per condition initially, with a psychiatrist review after every 10; plan limits in the Table of Benefits | Psychiatric inpatient treatment: 100 days over the membership lifetime on all five levels; outpatient psychiatric consultations within the outpatient limits (up to 30 sessions on Prestige and Prestige Plus) | Mental or nervous disorders covered after 12 months of continuous coverage on Silver, Gold and Platinum; Platinum lifetime maximum $50,000 | Inpatient psychiatric care: not covered on Explore and Essential; €/US$8,000 and a maximum of 15 days on Extensive; up to 30 days on Elite |
| Evacuation and repatriation | Optional "International Evacuation and Crisis Assistance Plus" module: medical evacuation, medical repatriation and repatriation of mortal remains paid in full | Evacuation (transport to the nearest appropriate place of treatment) and repatriation to the country of residence or nationality included, paid in full on all five plans | Medical evacuation and repatriation included in the medical plans; Allianz Care must be contacted at the first indication so it can organise them | Evacuation and repatriation service included as standard on all five levels | Emergency medical evacuation up to the lifetime maximum; no coverage if pre-certification requirements are not met | Emergency medical evacuation or repatriation 100% on all four plans, plus repatriation of mortal remains; assistance insured by Chubb European Group SE |
| Network and direct billing (as published) | Medical network of over 2.2 million partnerships; direct billing available with many providers in the network; the Customer Area search lists providers with direct billing; otherwise claims are targeted for processing within five working days | Network of 2 million+ providers found through the Facilities Finder; providers may settle bills directly with Bupa; direct settlement is arranged for in-patient and day-case treatment | Over 2 million medical providers; direct settlement for most in-patient treatments; fully completed medical claims processed within 48 hours | AXA Select network of over two million providers in 192 countries; inpatient and day-patient fees settled directly with a pre-approval letter; outpatient fees paid directly "where we can"; 83.2% of eligible online claims (Jan-Dec 2025) paid within two days | International and U.S. provider networks of more than one million physicians and facilities; free choice of provider worldwide; treatment in the United States through the Preferred Provider Network | Over 2 million partner healthcare professionals in 192 countries; direct billing for hospitalisation and planned treatment in partner facilities, and for outpatient care in certain countries; an Easy Pay Card preloaded for approved treatment where direct billing is unavailable |
| Adviser service rating (Health & Protection IPMI Service Ratings 2026, score out of 100) | Overall 78.5; claims handling 77.0 (Five Star) | Overall 80.9; claims handling 85.8 (Five Star) | Rated as "Allianz Partners": overall 71.3; claims handling 76.6 (Four Star); Allianz Care is the international health brand of Allianz Partners | Overall 79.5; claims handling 80.4 (Five Star) | Overall 76.9; claims handling 78.5 (Five Star) | Overall 86.4, the highest of all providers rated; claims handling 87.5 (Five Star) |
| Underwriting entity and regulator | Cigna Global Insurance Company Limited (Guernsey, company no. 41925), regulated by the Guernsey Financial Services Commission; EU residents are underwritten by Cigna Life Insurance Company of Europe or Cigna Europe Insurance Company (Belgium, supervised by the National Bank of Belgium) | Bupa Insurance Limited (authorised by the Prudential Regulation Authority, regulated by the PRA and FCA); for EEA residents from 29 March 2019, Bupa Global Designated Activity Company (regulated by the Central Bank of Ireland) | AWP Health & Life SA, acting through its Irish Branch, regulated by the French Prudential Supervisory Authority | UK plans arranged and administered by AXA Global Healthcare (UK) Limited (regulated by the FCA) and underwritten by AXA PPP healthcare Limited; AXA Global Healthcare (EU) Limited is regulated by the Central Bank of Ireland | SiriusPoint Specialty Insurance Corporation; IMG is owned by SiriusPoint, rated A- by A.M. Best | Designed and managed by APRIL International Care France (insurance intermediary, ORIAS no. 07 008 000); medical expenses insured by Groupama Gan Vie; assistance and liability by Chubb European Group SE; all subject to the French Prudential Supervisory and Resolution Authority |
| Cooling-off period | 14 days from the policy start date (free look period); full refund if no claim has been paid or guaranteed | Cancellation within the first 30 days of cover refunds all premiums for that policy year if no claims were made in those 30 days | 30 days from the start date (right to change your mind), with a full refund if no claims have been made | 14 days from the day the contract is concluded (or the day the documents are received), nothing to pay if no claim | 15 days from the Initial Effective Date (Review Period), with a full premium refund on cancellation | 14 days from the conclusion of the contract |
| Renewal | Annual contract that renews automatically unless Cigna decides not to renew or you opt out; not re-underwritten at renewal without material changes; renewal premium not based on claims made | Automatic renewal and no cancellation based on claims history on all five plans; Bupa may decline to renew at its discretion with at least 30 days' notice | Renews automatically at the end of every Insurance Year while premiums are paid and payment details valid; revised terms may apply from the renewal date | Renewal premium is not increased because of claims; premiums may still rise with medical inflation and age | Automatically renewed on each anniversary for up to 12 months, subject to the plan terms then in effect and payment of the renewal premium; eligibility to renew may be modified by changes in law | One-year policy, automatically renewed on its anniversary unless terminated; the member may cancel at renewal with 60 days' notice, or at any time after 12 months of cover |
What is not in the table, and why
Four terms we set out to compare could not be sourced from every insurer's documents, so they are not shown as rows with gaps:
- Chronic conditions. Bupa, AXA and APRIL state their cover in the documents read; Cigna's customer guide describes a nurse-led Chronic Condition Management programme but not the cover rule, and Allianz Care's benefit guide defers to the notes in each Table of Benefits, which we did not have.
- Maximum entry age. Published by IMG (up to age 74) and APRIL (16 to 60 in listed countries, 10 to 74 elsewhere); not found in the Cigna, Bupa, Allianz or AXA documents read.
- Claims turnaround published by the insurer. Cigna (five working days), Allianz Care (48 hours) and AXA (two working days online) publish one; Bupa, IMG and APRIL do not in the documents read. The adviser-rated claims-handling score above is the comparable measure.
- Financial strength rating. Allianz Care cites an A.M. Best "A+ Superior" rating and IMG an A- for its owner SiriusPoint; the other four do not state one in the documents read.
The absence of a term from an insurer's public documents is not evidence that the benefit does not exist. Ask the insurer, or use the quote.
How to use this matrix
- Start with the limit and the area of cover. They set the ceiling and the map; everything else sits inside them. Excluding the USA is the single biggest price lever (see the cheapest way to buy).
- Check the underwriting route before the price. A moratorium policy (Allianz Care, AXA) is quicker to set up but holds pre-existing conditions out for 24 months; a full-disclosure policy (all six offer one) tells you on day one what is excluded.
- Read the waiting periods against your plans. Maternity waits run from 12 to 24 months; dental and some screenings carry their own.
- Deductibles and cost share move the premium more than switching insurer for its own sake. Our July 2026 price data shows the same profile quoted up to 8.8 times apart.
- Then price it. This page has no premiums by design; Nomi quotes the whole panel for your age, country and cover level.
Head-to-head pages: Cigna vs Allianz Care · Cigna vs IMG · Allianz vs IMG. Insurer profiles: Cigna Global, Bupa Global, Allianz Care, AXA Global Healthcare, IMG, APRIL International. Where each insurer publishes direct billing: hospital networks by city. Our evidence-bound ranking: best international health insurance companies 2026. New to the terms? IPMI insurance explained: what international private medical insurance covers and costs.
Price the six against the rest of the market
Nomi quotes 20+ insurers live for your age, country and cover level in about a minute.
Frequently asked questions
Which international health insurers offer moratorium underwriting?
Of the six compared, Allianz Care and AXA Global Healthcare publish a moratorium option in the documents read on 15 October 2026: Allianz Care's needs no medical questionnaire and makes pre-existing conditions eligible after a continuous 24-month symptom- and treatment-free period; AXA lists moratorium alongside fully underwritten and continuing medical exclusions. Cigna Global, Bupa Global, IMG and APRIL use a medical questionnaire or full medical underwriting.
Which plans have the shortest maternity waiting period?
Twelve months: Cigna Global (Gold and Platinum, 24 months for some entities), Allianz Care (Care Enhanced and Care Signature) and APRIL MyHealth International (Essential, Extensive and Elite). Bupa Global and AXA Global Healthcare apply 18 months; IMG's Platinum plan applies 10 or 24 months, set at underwriting.
Is evacuation included or an optional extra?
Included on Bupa Global, Allianz Care, AXA Global Healthcare, IMG and APRIL in the documents read. On Cigna Global, medical evacuation and repatriation sit in the optional International Evacuation and Crisis Assistance Plus module.
Why are there no prices on this page?
Because a feature matrix and a price table answer different questions and go stale at different speeds. IPMIcompare publishes aggregated premium ranges by country and age, measured on 27 July 2026, on a separate page, and prices the whole market live through Nomi.
Why are age limits and chronic conditions missing from the matrix?
Every cell on this page must come from the insurer's own published document. Four terms could not be sourced for all six insurers, so they were left out rather than shown with gaps; they are listed with the reason under "What is not in the table".
Documents read (15 October 2026)
- Cigna Global: Global Health Insurance Plans in Detail and Optional Benefits pages (benefit table for policies from 15 February 2026); IPID Silver CGIC EN 02/2025; Customer Guide EN 02/2026; Policy Rules CLICE EU EN 02/2026; Global Health Options sales brochure 02/2025; FAQ; Legal information.
- Bupa Global: Compare our plans (United Kingdom) and Our most extensive healthcare plans pages; Global Health Plans comparison table, Hong Kong edition, from 16 June 2025; Major Medical Global Health Plan membership guide, 1 December 2024 (France/Monaco edition); FAQ Understanding your coverage; Legal notices.
- Allianz Care: International Health Insurance Plans page; Personal FAQ; Individual Benefit Guide, Care International healthcare plans, valid from 1 November 2025.
- AXA Global Healthcare: International Health Insurance Plans, Pregnancy and maternity, How bills are paid and Legal information pages; Comparing our plans (individual combined summary of benefits); Comprehensive Global Health Plan handbook, April 2021 (personal, UK).
- IMG: Global Medical Insurance brochure (Summary Schedule of Benefits); Global Medical Insurance Platinum Certificate of Insurance, sample, 1 January 2026.
- APRIL International: MyHealth International product page; Benefits schedule 2026; Insurance product information document, updated June 2026 (ref. NMHI26); General Terms and Conditions; Providers list, updated March 2026; Right of withdrawal page.
- Health & Protection: IPMI Provider Service Ratings, May 2026 (independent survey of almost 200 advisers).
General information, not personal or medical advice. Each cell summarises the insurer's own published document on the date shown; terms, limits and underwriting are confirmed at quote and may differ by country of residence and edition. Insurer names and marks belong to their owners.