Nomad Insurance or Global Expat Health Insurance?: My Experience

*This blog was originally published in 2022, and updated in May 2023

(Note: I am American. This blog is geared towards Americans. If you’re of a nationality that doesn’t have this crazy problem, feel free to skip this one, or, read on and prepare to gasp in horror at the abysmal cost and complexity of U.S. healthcare.)

Health insurance for self-employed or unemployed digital nomads! 

With the astronomical cost of healthcare in the U.S, I’ve heard from a lot of Americans that losing company-sponsored health insurance is one of the main concerns they have when it comes to quitting their job before they’re of retirement age — and that was once one of my main concerns, too.

The company I used to work for paid 100% of my medical, dental and vision premiums — meaning, I did not pay anything additional out of my biweekly paycheck. Not a bad deal!

And I’m a healthy person with no pre-existing conditions, so I’ve never really had to deal much with health insurers… until 2021. In May 2021, I broke my foot jumping into the ocean in Belize (I sought treatment in Texas) — and then a few months later, in September, I tore my bicep during a fall while hiking in Maine. Minus a few co-pays, everything else was paid for.

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And so, because it was a huge relief to have my employer mostly cover my health care troubles in 2021… I wondered what I would do once I quit my job, became uninsured, and started traveling outside the U.S. Here’s my experience (and some thoughts for you to consider!).

Travel health insurance vs. global expat health insurance: Time for a nomenclature check!

But first… what is the difference between travel health insurance and expat/global health insurance?

Travel health insurance oftentimes focuses on emergency situations, and aims to get you back to your home country for care — as in, it will help pay for your initial treatment or to stabilize you for transport, then, it typically wants to send you back to your home country where it (usually) expects your regular insurance to kick in. That’s why it’s so affordable! It often includes trip interruption and baggage delay insurance and a few other travel-related coverage — just don’t confuse it with travel insurance, which usually doesn’t have a medical component. 

Expat/international/global health insurance is much more comprehensive, is typically meant to be your only health plan, and to address ongoing needs. However, “international” or “global” health care COULD be a misnomer, as oftentimes, many policies will exclude coverage in countries where healthcare is extremely expensive. Oftentimes, you can select the areas of coverage to suit your needs.

The way I see it, there are several ways non-insured nomads, frequent travelers, or expats can approach healthcare — and it really depends on what your coverage needs are, where and for how long you’re traveling, and how easy or complicated you want it. Here’s a little table that might help (and this assumes you WILL be in the U.S. a least a little bit of the year. If you aren’t, that simplifies things!). If I’m missing any scenarios, please let me know!

Options	Considerations
A truly global (no country restrictions) expat plan	– One stop shopping – Possibly more expensive or basic/emergency coverage only, unless you want to upgrade for $$ – Probably for people who are spending a lot of time in countries with expensive health care (but be sure to check the length of time restrictions!)
A U.S. plan, and travel medical insurance for the periods and places when you’re outside of the U.S.	– Assumes you can obtain affordable U.S. coverage or ACA, which varies A LOT by state of residence (and sometimes, only applies in your state of residence!) – If you’re traveling a lot, multiple policies (and local addressees) may be hard to keep track of (although some you can bundle) – Do the math to ensure two (or more!) policies are more affordable than a blanket one (in the numbers I’ve run, this is typically the case: for me, an ACA plan and SafetyWing nomad insurance together is ~$50 a month!)
A non-U.S. global or country-specific expat plan, and travel medical insurance for the U.S., for the short periods you’re in the U.S.	– For people who will probably not spend a lot of time in the U.S. and more time in affordable-health-care countries – If an accident happens outside the U.S., are you prepared to stay to receive medical attention (because you don’t have regular U.S. coverage)? – More affordable, but the travel medical part is really not for preventative or ongoing care
A U.S. plan and pay out-of-pocket when outside the U.S.	– While emergency medical is cheaper in a lot of other countries, it is still probably a good idea not to risk going without – …but for wellness, routine tests, and SOME emergency medical, it may STILL be cheaper than paying premiums to pay out-of-pocket should the need arise

2023: Nomad travel medical insurance paired with ACA — a big cost-savings from last year!

In 2023, I am on an Affordable Care Act plan which covers me while in the United States (it will cover emergencies, preventative care, and chiropractic medicine) and, due to the fact I’m low income/under-employed, it is subsidized by the government (I pay $4/month, even if I am only in the country 1-2 months per year).

While I’m in Mexico and beyond, I’m on nomad travel medical insurance called SafetyWing, which is SUPER affordable at $45 for four weeks. That’s NOT a typo! SafetyWing is the first insurance product built specifically for nomads and by nomads, and I find it highly affordable, flexible, and customizable compared to its competitors — and the company has got a great reputation.

SafetyWing’s nomad insurance provides coverage for unexpected illness or injury, including eligible expenses for hospital, doctor or prescription drugs. This means that if you get ill or injured outside your home country, they will cover eligible medical expenses. In addition, it provides emergency travel-related benefits such as evacuation from local unrest, unplanned overnight stay, and lost checked luggage. Learn more and get a quote with my affiliate link.

I have yet to file a claim with SafetyWing, but I’ll definitely share my experience when I do! Buuuut, let me just make clear — I get health care in my home country AND abroad for less than $50 a month!! A vast improvement over last year…

What I did in 2022: A single, pricey (IMO) expat health insurance policy

I wasn’t totally sure what my 2022 would bring, so in late 2021, I decided to go with IMGlobal, or IMG, and I paid $1,884 for the year when I purchased the “Silver” plan in December 2021. IMG’s expat plan is worldwide and includes the U.S., as long as I was there for no more than 6 months a year. Sadly, I didn’t do that much research at the time, and I just assumed — global health care costs what it costs.

I’m not great at understanding health insurance policies (who is?!), so I picked the Silver plan because it included in-network coverage to the tune of $70 per visit/examination with specialists and physicians. I selected this plan because I wanted to be able to see my gynecologist for yearly preventive care, and I was also a little over-cautious because of my accident-ridden experience in 2021 (and I tend to have chiropractic needs). Well, little did I realize in the fine print, well-woman exams with specialists do not qualify as an exam with a specialist. Hmm. Alrighty then! It would’ve been great if the customer service guy had told me that on the phone when I called to authorize care, but he assured me my doctor was in-network and that wellness was covered. Unfortunately, he was wrong, meaning a denied claim and hundreds of dollars in out-of-pocket clinic and lab fees. Lesson learned. 

So you’re gonna be a nomad: What should you do for health coverage?

As you can see, it’s a good idea to have a good idea of where you’re going to be while you’re nomading (especially if you’re on a budget), to avoid over- or under-insuring and to avoid overpaying for coverage you don’t actually need. Plus, keep in mind, if you have employer-sponsored health care (or government-sponsored health care) in your home country, that will not apply to your ventures abroad. Hopefully, my personal experiences and the graph above will help you come to a conclusion about what makes sense for you. ❤️ 

If you’ve had positive or negative experiences with any global or expat-oriented carriers, please leave a comment!

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