Est. 2020

International Health Insurance Guide

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So, you’ve decided to make a lifestyle change and become a digital nomad, congrats!

However, before you jet off to France, Thailand or Turkey, it’s a good idea to consider what might happen if you unfortunately get sick, need, medical care, or have an accident. (Even if you’re not from the U.S., health insurance is different in each country!!)

Now, the best way to be fully prepared is to ensure that you have digital nomad health insurance AKA International Health Insurance. I’m not going to sugar coat it, health insurance is confusing. However, the unconventional path of remote work creates a unique dilemma.

Starting below, you will see a list of each company, the coverage, but not the price. (Please note: There are no affiliate links in this blog post.)

Premiums (The amount of money you pay each month for health insurance.) are dependent on home country, residency, health history, travel destination, etc. 

All information on this blog post is sourced directly from each company’s website; however, check each site for updated information. Like all things, insurance policy can change overnight. 

(From Kyle) 

Important Note: For you adventurous U.S. folk, a quick way to negate any claim is by failing to adhere to the State Department Travel Advisory’s website. In a Level 4, “Do Not Travel” advisory country, your health insurance will almost certainly deny any claim in that country or if they can trace your predicament back to that country. For residents of other countries, I imagine the same situation applies. 

Table of Contents

International Health Insurance vs Travel Insurance 

International Health Insurance is not the same as travel insurance. 

Travel insurance cvers any mishaps on short trips like vacations. This may include  lost baggage, delayed or canceled flights, and medical emergencies.You may see the word “medical” and assume the plan is sufficient for digital nomads. However, that’s not the case. 

If you have a non-emergency problem, like a mild illness, rash, or want a check-up abroad, you’ll likely be on the hook for the cost if you just have something like World Nomads.

Additionally, in the aforementioned example, you’d likely be covered for a quick hospital stay in Thailand, but the main goal is to repatriate you back home for care.

Travel insurance assumes you maintain coverage in your home country. This is why it’s essential to purchase international health insurance. 

All of the plans below provide full medical coverage. If you want additional coverage for your tech supplies, bags, etc., feel free to purchase travel insurance, but please understand it’s not a replacement for health insurance.

Digital Nomad Health Insurance

Insurance Terms to Know

In-Patient: A procedure is referred to as an “in-patient” procedure if it requires a stay in the hospital overnight.

Out-Patient: A procedure that allows the patient to go home after its completion.  

In-Network: When a doctor, hospital, or health care provider has a contract with your insurance provider. 

Out-of-Network: When a doctor, hospital, or health care provider does not have a contract with your insurance provider. They can charge you full-price 

Primary Care Physician (PCP): The main point of contact for your health. This is generally a family specialist, but it doesn’t necessarily have to be a doctor

Lapse in Coverage: The amount of time between the termination of your previous insurance policy and the new insurance policy. 

Claim: A request for your insurance to reimburse you or your health care provider for losses covered under your health insurance policy. 

Deductible: The amount of money you pay before insurance kicks in

Premium: The amount you pay each month for health insurance. This is a recurring payment that is a fixed amount depending on your contract length. 

Co-Pay: A fixed out-of-pocket cost you pay for covered services. 

International Health Insurance Companies 

Safety Wing

Founded in Norway in 2018, Safety Wing grew quickly in 2020 as one of the only digital nomad insurance providers that (at that time) covered Covid-19.

The flagship plan for Safety Wing is Nomad Insurance, and it is cheap. The cost is $42 for plans excluding US travel and $77 for US-inclusive pricing.

However, there are some potential benefits to this plan. For every 90 days spent abroad, you receive coverage in your home country. US citizens receive 15 days of home-coverage, and non-US citizens receive 30 days. Unfortunately, this does not apply if you return to your home country for the sole purpose of receiving treatment for an issue that developed abroad.

Soon, Safety Wing plans to offer a more expensive plan called Remote Health. It will cover everything in the Nomad plan, additional treatments, and offer full home-country coverage. These plans are currently waitlist-only. More information can be found here

Plan Duration

Safety Wing plans are monthly subscriptions, renewable for up to 364 days. After a year, you’ll need to sign up for a new policy.

Excluded Countries

Safety Wing does not offer coverage in Cuba, North Korea, Syria, or Iran.

If you want to include coverage for travel in the US, you’ll need to indicate “include travel in the US” when you sign up. If you are an American citizen or resident, you automatically receive 15 days of coverage for every 90 days spent abroad.

Reimbursement Process

You’ll need to submit all claims within 6 months.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Emergency evacuation (including non-medical reasons)
  • Trip interruption 
  • Baggage protection
  • Some sports
  • Physical therapy and chiropractic, if recommended by a physician
  • Covid-19 and other pandemics (as of 2021, this includes quarantine costs)
 

What’s Not Covered

  • High-risk sports  (see website for details)
  • Pre-existing disease or injury
  • Cancer treatment
 

*Applicable to the Nomad Plan, Remote Health coverage differs, as detailed below.

2 Types of Plans

Nomad — The standard option, intended for extended trips, includes everything listed above and can be purchased abroad.

Remote Health — Good long-term travel (including extended stays in countries) option, covers additional medical issues not included in the Nomad plan, and can be purchased abroad.

*Note: Currently, waitlist-only for individuals.

Pros/Cons

Pros — Includes coverage in your home country, one of the few companies that cover quarantine for Covid-19, 24/7 customer service, no need to indicate countries of travel in advance, user-friendly website.

Cons — Autorenewal stops after a year, low maximum payout compared to other plans.  

Insured Nomads

Insured Nomads offers short-term travel insurance as well as Global Health Insurance. As this article focuses on full coverage health insurance for digital nomads, we’ll focus on the Global Health Insurance plans.

These plans cover emergency, preventative, and chronic care. To sign up, you’ll need to select “area of coverage, so a general idea of what countries you plan to visit would be helpful. Insured Nomads also offers short-term travel insurance if you want coverage for things beyond your health. 

Plan Duration

1 year

Excluded Countries

Insured Nomads does not offer coverage in North Korea, Iran, Cuba, and Myanmar. 

Pre-approval may be required for treatment in the US. 

Reimbursement Process

In case of hospitalization, you must notify Insured Nomads at least 3 weeks in advance or 48 hours post-admission emergencies.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Emergency coverage outside of your “area of coverage” for a maximum of $97,000 (100,000 Euros) for 45 days
  • Emergency evacuation (including non-medical reasons)
  • In-patient and hospitalization
  • Outpatient and prescription drugs
  • Diagnostic tests
  • Maternity
  • Vision
  • Covid-19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)
 

What’s Not Covered

  • Pre-existing medical conditions (unless approved at the time of application)
  • Treatment outside geographic coverage area (unless emergency, as detailed above)
  • Experimental treatment
  • Over-the-counter drugs
  • Podiatry or Chiropractic treatment
  • Screening tests
  • Organ acquisition
  • Elective or cosmetic surgery
  • Quarantine, delays, etc. due to Covid-19
 

Types of Plans

Insured Nomads offers two types of coverage: Preferred Global Health and Preferred Plus Global Health. Preferred Global Health offers regional coverage, excluding the USA and Preferred Plus is worldwide coverage, including the USA.

Pros/Cons

Pros — Emergency coverage outside your area, maternity, and vision included, as well as emergency evacuation.

Cons — Unlike many other companies listed, 24/7 customer service isn’t indicated. 

Allianz

Allianz is a longstanding German-based health insurance company. They offer international health insurance as well as travel insurance.

To sign up, you’ll need to choose a host country, but you can receive treatment almost anywhere in the world. However, you can only receive coverage if you choose a US-inclusive plan. As a digital nomad, the simplest option is to select the country you plan to spend the most time in, or if you’re not sure, the country you’ll travel to first.

Note: If you select one of the following countries/regions, you’ll need a specialized medical plan; China, Dubai, Egypt, France, Benelux (Belgium, Netherlands, and Luxembourg), Monaco, Latin America, Lebanon, Singapore, Switzerland, or the United Kingdom.

Plan Duration

Typically, Allianz international plans are 1-year contracts. 

If you don’t want a long-term commitment or know the amount of time you will spend overseas, Flexicare is available. These plans are available in 3, 6, or 9-month options.

Yan can pay monthly, quarterly, half-yearly, or annually.

Excluded Countries

Plans have 3 coverage area choices; Worldwide, Worldwide excluding the US, and Africa.

Reimbursement Process

Once all necessary documentation is received, Allianz aims to reimburse you within 48 hours for most claims.

What’s Covered 

  • Emergency medical and dental (including transportation)
  • Emergency evacuation (including non-medical reasons)
  • Pre-existing and chronic medical conditions
  • In-patient treatment (including mental health)
  • Prescription drugs
  • Diagnostic tests
  • Organ transplant
  • Cancer treatment
  • Covid-19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)

 

What’s Not Covered

  • Out-patient treatment*
  • Screening tests
  • Vision*
  • Maternity*
  • Dental*

 

*Additional coverage is available for purchase areas.

Types of Plans

Allianz has 3 tiers of coverage; Care, Care Plus, and Care Pro. All inclusions listed above are for the Core plans. If you purchase a Care Plus or Care Pro plan, asterisked exclusions can be included.

Pros/Cons

Pros — Pays provider directly, 24/7 customer service, and includes mental health services as a core benefit.

Cons — Outpatient benefits require purchasing a separate plan.

Cigna

Cigna Global is known for quick and high-quality customer service. Cigna offers worldwide (including or excluding the US) coverage and flexible deductibles.

To sign up, you’ll need to choose a host country, but you can receive treatment anywhere in the world, including the US if, and only IF, you purchase a US-inclusive plan.

Plan Duration

1 year, payable on a monthly, quarterly, or annual basis.

Excluded Countries

The US if you don’t purchase the “including the US” option.

Reimbursement Process

Once all necessary documentation is received, Cigna aims to reimburse you in 5 days.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Emergency coverage outside of your “area of coverage” up to $97,000 – 245,000
  • Pre-existing and chronic medical conditions
  • In-patient treatment (including mental health)
  • Outpatient rehabilitation treatments such as physiotherapy, occupational therapy, etc. 
  • Cancer treatment (including preventative surgery and appliances such as wigs or mastectomy bras)
  • Organ transplant
  • Acupuncture and Chinese medicine
  • Covid 19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)
 

What’s Not Covered

  • Outpatient treatment and consultations* (except for rehabilitation reasons)
  • Medical evacuation and crisis assistance*
  • Diagnostic tests
  • Prescribed drugs or dressing that you may require on an outpatient basis 
  • Maternity*
  • Vision*
  • Dental*
 

*Additional coverage is available for purchase areas.

Types of Plans

Cigna offers two plan types; Cigna Global Health and Cigna Close Care. 

For digital nomads, Global Health is the most relevant, as it offers worldwide coverage, with an option to include 6 months of US coverage. These plans come in 3 tiers, from cheapest (and least amount of coverage) to highest; silver, gold, and platinum.

Cigna Close Care is best if you will primarily be based in one country abroad as it covers you there and for trips back to your home country. 

Pros/Cons

Pros — Adjustable (upon application) deductibles and out-of-pocket maximums, 24/7 customer service, covers many aspects other plans don’t, like cancer appliances and acupuncture.

Cons — No maternity for low-tier plans, which involves a lengthy signup process that requires more personal info than other companies.

Geo Blue

Geo Blue has a few different types of Travel Medical Plans. I will focus on the XPLORER plan, meant for long-term travelers and expats. This makes it the best digital nomad insurance option. 

Please note a minimum of 3 months a year outside of your home country is an eligibility requirement.

Plan Duration

1 year

Excluded Countries

The US if you don’t purchase the “with comprehensive US coverage” option.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Pre-existing and chronic medical conditions (with proof of previous coverage.)
  • Preventative care, primary and specialist visits
  • In-patient treatment (including mental health) and prescription drugs
  • Outpatient treatment (including mental health) and prescription drugs
  • Diagnostic Tests
  • Covid-19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)
 

What’s Not

  • Maternity
  • Dental
 

Pros/Cons

Pros — There’s much more comprehensive (including mental health) coverage than other plans.

Cons — No indication of 24/7 customer service, no maternity or dental options.

Integra

Integra is a new-ish company with a user-friendly website and a globally based team. To sign up, you’ll need to choose a host country, but you can receive treatment anywhere in the world. However, for this is does not include the US and Canada. For these countries, this will work only IF you choose a US/Canada-inclusive plan.

Plan Duration

1 year, payable on a quarterly, semi-annual or annual basis.

Excluded Countries

The US and Canada are only included if you select the “including the US and Canada” option. Coverage within the US is limited to 180 days a year.

Reimbursement Process

Once all necessary documentation is received, Integra aims to reimburse you within 5 – 7 days.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Emergency evacuation  (including non-medical reasons)
  • In-patient treatment (including mental health)
  • Diagnostic tests
  • Physiotherapy and occupational therapy post-hospitalization
  • Organ transplant
  • Cancer treatment
  • Covid-19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)
 

What’s Not

  • Outpatient treatment and consultations*
  • Pre-existing and chronic medical conditions outpatient mental health services
  • Over-the-counter medication
  • Experimental treatment
  • Cosmetic surgery
  • Injuries related to professional or adventure sports
  • Maternity*
  • Vision*
  • Dental*

*Additional coverage is available for purchase areas.

Types of Plans

Integra offers two types of plans; worldwide including the US and Canada and worldwide excluding the US and Canada. These plans have three tiers of coverage; core, comprehensive, and premium. All inclusions listed above are for the Core plans. The asterisked exclusions can be included if you purchase a comprehensive or premium plan, which will also have lower deductibles and cost shares but higher premiums to pay (cost more).

Pros/Cons

Pros — 24/7 Customer Service, mental health services, and emergency evacuation are included in most plans.

Cons — No maternity or vision coverage in basic Core plans.

AXA

AXA offers annual and shorter 3-month plans, which are both good options for digital nomads. They also have flexible premiums if you choose to “add an excess, or an agreed-upon amount you pay post-claim, in exchange for lower premium costs.”

As a bonus, some of their more expensive plans even include travel insurance to cover your gear and tickets.

Plan Duration

3 months or 1 year.

Excluded Countries

The US is excluded if you don’t purchase the “including the US” plan. 

Reimbursement Process

Eligible claims are usually processed within 48 hours once all documentation is received.

What’s Covered

  • Emergency medical and dental (including transportation)
  • Emergency evacuation 
  • In-patient treatment (including mental health)
  • Diagnostic tests
  • Cancer treatment
  • Covid-19 and other pandemics (treatment only, if you require coverage for cancellation due to Covid, quarantine measures, etc., it’s recommended to purchase short-term travel insurance)
 

What’s Not

  • Outpatient treatment and consultations*
  • Pre-existing and chronic medical conditions*
  • Prescribed drugs or dressing that you may require on an outpatient basis* 
  • Over-the-counter medication
  • Experimental treatment
  • Cosmetic surgery
  • Maternity*
  • Vision*
  • Dental*

*Additional coverage is available for purchase areas.

Types of Plans

AXA offers two types of plans: worldwide including the US and worldwide excluding the US. These options come in five tiers; foundation, standard, comprehensive, prestige, and prestige plus. 

All “What’s included” listed above are based on the foundation and standard plans. 

The asterisked exclusions can be included if you purchase a comprehensive, prestige, or prestige plus plan (the latter two include travel insurance).

 

AXA Health Insurance Plans

Pros/Cons

Pros — 24/7 Customer Service, five tiers of coverage options.

Cons — The cheapest plans, foundation, and standard don’t cover much compared to other options.

Bonus — Keep US Coverage

Keeping your US plan might be worth looking into if you can afford it and know you’ll spend a significant amount of time in the US. Additionally, if you require particular treatments or medication that is difficult to obtain abroad, talk to your provider. You can always purchase travel insurance for your time abroad.

In Conclusion

As you can see, there is a lot to consider for your international health insurance needs. Please reach out if you have any questions!