By Karim Idilby, Chief Growth Officer, AXA Global Healthcare 

Throughout 2025, approximately 142,000 millionaires chose to relocate to another country, with projections suggesting this could rise to 165,000 in 2026, marking the largest voluntary transfer of private wealth in modern history. In particular, the UK saw its largest-ever exodus last year losing 16,500 millionaires, representing the steepest net loss of any country worldwide. 

The UK provides a clear example of how domestic policy shifts and foreign incentives can reshape the mobility patterns of high-net-worth individuals (HNWIs). Between 2024 and 2025, the UK government abolished the non-domicile tax regime (April 2025), increased capital gains and inheritance tax rates (October 2024), and closed the Tier 1 Investor Visa route. For globally mobile individuals seeking to preserve wealth and optimise investment returns, these policy shifts have fundamentally altered the UK's attractiveness. 

In this iPMI Global article we outline a dramatic transformation in the international medical insurance industry as it adapts to heightened geopolitical instability in the Middle East. By 2026, providers have shifted from passive coverage to dynamic intervention, incorporating autonomous clinical authorizations and localized "Red-Pricing" models to manage war-related risks. Duty of Care obligations for corporations have expanded significantly, now requiring comprehensive safety nets that include psychological trauma support, secure evacuations, and "shelter-in-place" protocols.

The deteriorating stability of the "Dubai Dream" in 2026 as regional military conflicts and missile threats shatter the city's reputation as a safe haven. This shift from an insulated metropolis to a strategic target has forced a radical reassessment of the risks associated with long-term residency for the global elite. Beyond physical security concerns, the passage highlights a regulatory transition involving new taxes and rising costs that further complicate the traditional expatriate lifestyle. Consequently, the international insurance and healthcare sectors are pivoting toward crisis management and specialized coverage for war-related risks. While the city remains a magnet for some, the narrative suggests a market bifurcation where Western talent is increasingly replaced by those fleeing even more volatile regions. Ultimately, Dubai is characterized as transitioning into a high-risk, high-reward environment that requires a more sober calculation of physical and financial safety.

Across Europe, access to outpatient healthcare remains one of the most persistent challenges in private and travel insurance, particularly for expatriates navigating unfamiliar and fragmented healthcare systems. What should be a straightforward medical visit often becomes complex, slow, and difficult to coordinate, creating frustration for patients and inefficiency across the insurance value chain.

This iPMI report presents a comprehensive 2025 overview detailing the mandatory health insurance requirements for expatriates seeking long-stay visas and residency permits worldwide. This strict enforcement primarily exists to ensure that incoming foreigners can cover their own medical expenses, thereby avoiding the overburdening of local public health systems. The article emphasizes that short-term travel insurance is inadequate, noting that governments require policies that are comprehensive and long-term, covering essentials such as hospitalization, emergency care, and repatriation for the entire visa duration. Extensive regional examples show stringent compliance, particularly in the Schengen Area and the Gulf Region. Finally, the article provides practical advice, urging expats to confirm specific visa rules, avoid high deductibles, and ascertain whether the host country requires a local insurer.

The Growing Need for Global Health Coverage for Expats

In a world where career and lifestyle opportunities increasingly transcend borders, more professionals and families are choosing to live and work abroad. According to Finaccord, there were around 66.2 million expatriates in 2017, growing at nearly 6% annually. Broader data from the United Nations suggests that as of 2024, there are over 300 million people living outside their birth country, accounting for 3.6% of the global population.

Behind these figures is a booming market: the expatriate health insurance industry—valued between USD 17 billion and USD 25 billion in 2024—is projected to reach USD 65–75 billion by 2035. This growth is driven by international mobility, rising healthcare costs, and the increasing importance of health security abroad.

In this iPMI Global Expatriate Life article, we focus on the growing strategic importance of Western-style international hospitals for the highly mobile populations of expatriates and global travelers. It argues that these facilities, characterized by evidence-based protocols, internationally credentialed staff, and transparent administration, are crucial for mitigating clinical and non-clinical risks abroad. For insurers and global employers, a network of such hospitals provides continuity of care, facilitates claims adjudication, and ensures brand assurance, especially given the rising average and extreme costs of overseas medical claims. The text concludes that as international mobility and the related medical tourism market continue to grow, the seamless integration of these high-standard hospitals, insurance products, and mobility services is essential for managing global health risk.

AXA Global Healthcare’s new Mind Health Report reveals a notable generational divide in how expats experience and manage their mental wellbeing. The fifth edition of the report shows that while older expats lean on their resilience and life experience, younger expats are more open about the challenges they face. It also highlights how younger generations are driving the adoption of AI and digital mind health tools, even though many report being adversely affected by excessive use of social media.

In this iPMI Global Expatriate Life article, Virginie Faucon, relocation expert at AXA Global Healthcare talks about smart workplace benefits and how they can benefit expatriates. 

April’s Stress Awareness Month is a timely reminder that the well being of globally mobile employees is more than just a tick-box exercise – it’s a business essential. For expats adjusting to life overseas, the stresses and emotional burden of relocating can be subtle, slow-burning and all too easily overlooked. 

They’re the globally mobile professionals that work around the world in the offices of some of the largest companies – and around half are lonely. 

New research by health benefits provider Cigna Healthcare’s International Health business found that nearly half (48%), of globally mobile workers are lonely - lacking companionship in their new city or country.