Nothing you wrote makes any sense to me.

> If your pay is less than your cover, do you have to give it back?

How can your pay be less than your cover? Your cover job is paying you. Your host agency is not.

> How does health insurance work for spy stuff?

At this point, I'm curious if this is an attempt at humor?

> How does health insurance work for spy stuff?

Russia, as most of Europe, has free public health care. You don't have to pay for it.

Also, I think you have some confusion.

1) you are an officer in your army/services. You get your salary on your Russian bank account

2) you have a cover job that pays you. You use that money for your cover life.

you get paid at your cover job. it's your 9-5. you work in IT, or as a baker, or insurance salesman or whatever. the money you get pays for your flat, and your dinner, etc.

you also have a bank account in your home country, and that gets a salary, too.

your insurance is through your cover job, or the country's healthcare system (if socialized). which also means you have crappy insurance salesman coverage :/ twenty years later when you return to the home country to retire you can sup on your pension and any retirement healthcare coverage, but until then it's on you.

Ah, this makes more sense. The "cover" life is independent from the home country life.