Most U.S. group LTD policies exclude or limit coverage for employees working outside the U.S. for more than 90-180 consecutive days. Individual disability policies vary — some domestic carriers (Guardian, Unum) offer international riders for specific countries, while others exclude non-U.S. residence entirely. If you’re relocating internationally for more than 6 months, verify your existing coverage and expect to need a supplemental international disability policy. The cost of discovering the gap after a disability occurs is catastrophic.

International disability insurance provides income replacement for expatriates, foreign nationals, and globally mobile employees who work outside their home country. Policies are typically written by specialty international carriers (Lloyd’s syndicates, AXA International, Cigna Global) and cover disability regardless of where the insured lives or works. Benefits include monthly income replacement, medical evacuation to the nearest adequate facility, repatriation to home country, and rehabilitation support. Coverage is denominated in USD or the employee’s home currency. Foreign nationals with U.S. assets face unique estate tax exposure — our guide to the estate tax planning loophole for foreign nationals covers the insurance-based strategies available.

Premiums for international disability insurance range from $400-$1,200/month for a $10,000 monthly benefit, depending on the country of residence, occupation, age, and health status. Western Europe and developed Asian markets are at the low end; Africa and the Middle East are at the high end due to limited local healthcare infrastructure and higher evacuation probability. Group international disability programs for companies with 5+ expatriates are typically 20-30% cheaper per person than individual policies.

Yes. The U.S. has social security totalization agreements with 30 countries (including the UK, Germany, France, Japan, Canada, and Australia) that allow work credits earned abroad to count toward U.S. SSDI eligibility. Without a totalization agreement, an employee working outside the U.S. for 5+ years may lose enough recent U.S. work credits to become ineligible for SSDI. For assignments in non-agreement countries (China, India, Brazil, Nigeria, most of the Middle East), private disability insurance is the only reliable income protection.

At minimum: international medical insurance (covering local treatment and medical evacuation), international disability insurance (income replacement), international life insurance, repatriation coverage, and emergency assistance services (security evacuation, legal referral). Many companies also provide cost-of-living adjustments, housing allowances, and hardship differentials for high-risk locations. The total cost of a comprehensive expatriate benefits package typically runs 15-25% of the assignee’s base compensation — significantly less than the cost of a failed assignment (estimated at $250,000-$1M per employee).