Sick Leave Abroad: What Expats Should Know About Health Insurance

When you’re living or working abroad, falling ill can be more than just a personal setback — it can also raise complicated questions about your legal status, healthcare access, and financial protection. Whether you’re posted abroad temporarily or living long-term as an expat, your health insurance situation plays a major role in what coverage you’ll receive during sick leave.

If you're heading to Asia, understanding the difference between being a posted worker and an expatriate will help you avoid unwanted surprises.

Posted Worker vs. Expatriate: What’s the Difference?

Your classification affects how your medical expenses and sick leave are handled:

• Posted worker: Sent abroad by your home-country employer for a short, defined period
• Expatriate: Living and working abroad independently, often no longer tied to your home country’s social security

This legal status determines whether your sick leave and medical costs are covered by your home country or the country you’re working in.

If You're a Posted Worker in Asia

Let’s say you're a French engineer sent to Indonesia for 9 months. Your employment remains linked to France — and so does your health insurance.

Here’s what you need to do:

• Make sure your employer registers your overseas posting with the correct institutions
• Confirm there’s a bilateral social security agreement between your home and host country
• Request and hold onto your certificate of social security coverage

Submitting a Sick Note:

• See a local doctor and get a medical certificate with:
  • Your name and employer
  • Diagnosis and sick leave dates
  • Permission (or not) to leave your residence
• Send the certificate promptly to both your employer and your home country’s health insurance

What will be covered:

• Sick leave compensation will come from your home country
• Medical reimbursements are calculated based on your home country's rates
• Family members with you are also typically covered under your national health plan

Important tip: If you're working in Asia but originally from an EU country, the European Health Insurance Card (EHIC) helps simplify access — but outside of the EU, always check your bilateral agreement.

If You're an Expat Living in Asia

If you’ve left your home country and taken up residence in Vietnam, Thailand, or Japan on your own terms, you are no longer a posted worker — you’re an expat. That means you’re now part of your host country’s healthcare system, whether you’re there for a year or for good.

You’ll need to:

• Register with the local healthcare system
• Comply with the local sick leave laws and waiting periods
• Understand that compensation and benefits vary from country to country

Let’s take an example. Emma, a UK citizen working as a freelance designer in Thailand, fell ill with dengue fever. Because she was self-employed and not covered by the Thai public system, she was responsible for her entire treatment — which ran into the thousands of baht.

This is why many expats — especially freelancers and remote workers — opt for private international coverage that gives them more reliable access to doctors, medication, and sick pay.

What To Do If You Fall Sick Abroad

Being prepared makes a huge difference. Here’s what you should do if you get sick while working or living in Asia:

1. Know Your Insurance Situation

• Are you covered by your home country or your host country?
• Do you need additional private insurance?

2. Send In Your Sick Note

Make sure your doctor provides all necessary information:

• Diagnosis
• Sick leave dates
• Permission to leave home (if applicable)

Then send it to:

• Your employer
• Your relevant health insurance provider

3. Understand Your Compensation Rules

• Posted workers: compensation comes from home country
• Expats: local laws apply, and private insurance may be needed

4. Check Local Requirements

In Asia, systems vary widely:

• In Japan, you must notify your insurer within 3 days
• In Vietnam, public clinics require extra paperwork to approve sick leave
• In Thailand, employers often act as intermediaries in submitting claims

5. Plan Ahead

Before relocating:

• Research healthcare options in your destination country
• Look at both public and private systems
• Explore private plans if you’re not eligible for local coverage

Why Health Insurance Matters More Than Ever

Many people assume that short-term stays or temporary contracts won't require serious medical planning. But all it takes is one illness or accident to rack up significant bills — especially in countries where private care is the only option for English-speaking service.

Health Insurance for expats in Asia bridges the gap between local coverage and international needs. It ensures you get access to the care you need, when and where you need it — without the bureaucracy or unexpected costs.