hi there! Thanks so much for putting this out there! So far the quotes I am getting from some of the companies are pretty steep. My husband and I will just be traveling internationally for 1 year. We do not have preexisting conditions. We plan on getting a nationwide private plan so we can still travel around the united states when we come back which with screening allows you to start it at any time. One of the companies I have spoken with, IMG, seem to have a worldwide medical evacuation plan and they say they can also cover in America with the same benefits. If I am really only wanting catastrophic or treatment needs that come up during that 1 year (won't do any preventative while traveling), do you think a plan that says they cover medical evacuation and treatment in America would suffice? You had mentioned that some say they cover you in America but they really only do it temporarily. It would be nice if we could just stay on the plan we are with while overseas for a few months when we come back to America and be covered. Overall we are trying to avoid paying much but still get an actual policy that would cover us if something unforeseen comes up and would also cover us in America. I feel like I am not understanding the plans correctly. Thoughts?
This would be your entire insurance, yes? You're not being covered by an employer or keeping an ObamaCare plan, right? If you get "international health insurance" WITH the America add-on, you should be covered, and it sounds like that's what you want. In the article, I mean that the America coverage is limited if you DON'T get the add-on. It seems to me that you need to consider your situation if you get sick while traveling. Would you want to return to America? (Probably, right? That's where friends and family are.) So you do need the evacuation issue, and you need some kind of coverage in the US. And then you also need to be sure you can MAINTAIN that coverage once you're living back home, even though you'll now have a "pre-existing condition" of whatever illness you have -- which is where ObamaCare comes, although you'll probably have to wait until the end-of-the-year enrollment period. This the part that makes me uneasy: just how "covered" am I if I get cancer overseas and have to return to the US for treatment? This also probably why the quotes you're getting are high. When I've looked, I've found the price for Michael and me (mid-50s) for international health insurance is about $8-9000 a year, which is about half what we pay for crappy insurance through ObamaCare ($16,000 with really really high deductables). That INCLUDES evacuation and emergency care in most of the world, but there are, of course, caps, and we would have to go through medical questionaires, etc. and coverage is not guaranteed. But that seems like a pretty good deal to me, especially since if we get sick, we can just segue back into ObamaCare during the next enrollment period. Another thing to consider is that both SafetyWing and Genki will offer nomad-specific FULL international health insurance, starting in January (I believe). This much better than the "travel inusrance" they currently offer, and it's specifically FOR nomads like us. Something to consider.
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
Thank you for your help! Yes we are looking to have just one insurance policy that covers us worldwide for the year we are traveling incase anything crazy happens. We do not have preexisting conditions so far and would not do preventative. Do you think it is too good to be true that places like IMG are saying that it is worldwide insurance and they will evacuate to America if needed? I am also being told that they will cover me for 6 months in America? It seems off because it is inexpensive. From what you are saying, it sounds like you guys only have an international health insurance plan as well? We basically want to be covered anywhere in America for a few months when we come back especially if we are evacuated back. We plan to travel the united states as well so we an obamacare plan would not work for us anyway if we do develop preexisting conditions. I read about safety wing, william russel, and genki through your links and it sounds like they cover most health insurance related issues as well but limit the time in America. Basically I am trying to understand if you think these plans actually can cover you in America as well and if you still think its needed to have an American based plans with these worldwide health insurance plans?
Yes, but the problem is that will you CONTINUE to be covered once you're back in America, once your current policy expires. Right now we have an ObamaCare plan (partly subsidized) with Safetywing as "emergency" insurance for being outside of America. Next year (because we will love our subsidy), we are shifting to international insurance only, but yes, I am planning to pay for an "America" feature that will at least last long enough to get us to transition back to ObamaCare. I would be a bit skeptical of any cheap policy that limits the time in America -- I would pay for the American add-on. But of course I am very very cautious, and perhaps that is TOO caution. (I'm also not an expert.)
Thank you so much! Regarding the healthcare.gov nationwide plans, I will look more into that later but last I was told is that because I am registered in Texas, they do not have any available to me that are nationwide. I will keep looking. You are so right about the complications and that the trick is finding something when I get back. I am thinking perhaps if I had bad enough issues while overseas, they will help me get on a government plan as a life event when I come back as an exception like you said. The problem is that we may not make enough income 2023 before leaving and then that would delete any subsidy for healthcare.gov so we arent wanting to risk it but it would be nice to have it so it stinks the minimum income requirement is to where you literally pay back everything if you dont meet it. I would hope I could qualify for a nationwide private insurance plan if not, but it seems like a bit of a risk. Please let me know what luck you end up having finding a worldwide insurance plan (including America) for at least a few months! The ones I am seeing including Genki limit to anywhere between 4-6 weeks of coverage back in America so that is not amazing. IMG says they cover but it is unclear as to how long and I can't get a clear answer. Cigna I am working on getting more info on with them also. That really is what makes the difference I think is How Long they will cover in America. Otherwise, you really might need an American based on plan and then get an International plan that does not have American coverage so you can save a bit through that. Thanks for your updates and we are really enjoying your blog. We plan on traveling So many countries for that year so we are already learning a lot from you!
To be clear, Genki's CURRENT plan is only travel insurance, not full health insurance. I don't know what the situation will be with their FUTURE international health insurance plan, which they're supposedly debuting in early 2023. I suspect the US features will be different on that plan.
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
Hi Brent & Michael, I feel like I know you two because I've been reading your blogs all year. Paul and I have Medicare A, B, D and a gap policy so we're fully covered in the USA and a few territories (American Samoa, for example). We've been kind of winging it with our Chase Sapphire card. But we think we need more. Safety Wing looks reasonable for travel insurance even for old geezers such as ourselves (65 & 66). But it doesn't appear to me that Safety Wing's evacuation assistance would cover someone who has stabilized after an accident or unexpected illness, to send them back to the US for more treatment (which would allow us to use our insurance). We're thinking about Emergency Assistance Plus https://www.emergencyassistanceplus.com/home/#home which pays to send you home with a nurse if needed after you have stabilized. They are really cheap. We were thinking of pairing that with Safety Wing. But, if Safety Wing offers that kind of evacuation assistance, it would be double coverage. Do you know if Safety Wing's evacuation policy covers that situation? Thanks! Kim
Well, caveat: not an expert here, but I'm told that SafetyWing does cover this kind of thing. This is what they tell me:
Notice the number 2 in "You are not covered unless you fill in the following conditions:"
If the physician states that it is medically necessary for the member to return to his/her home country for continued treatment, recuperation and recovery, then the member will be covered (see 1 and 2 under YOU ARE COVERED)
(I can't attach the policy document they sent me, but it quotes from it, above.)
I sounds like if a doctor attests you need to go home for further treatment, you are covered. Likewise, Chase Sapphire might cover that transport too.
So it sounds to me like, yes, you have evacuation in most circumstances. I can see a situation in which you recover fully, and they don't cover transportation home, but then it wouldn't really be "evacuation" -- it would be normal transportation.
Thanks, I didn't see that part in the policy, but I'll read it more carefully tomorrow. In that case, I think Safety Wing would be what we need to cover the gap. The "up to $100,000" doesn't bother me that much because insurance is just to stave off catastrophic expense so we could absorb some additional. I like that this policy is designed for Nomads (the Allianz policy, for example, while a good price and decent coverage keeps referring to "trips" which doesn't really fit our situation). Thanks for writing about this - your update was very timely given our decision-making process. The Genki doesn't cover our age group and as I read World Nomads a trip cannot be more than 180 days (also begging the question, What is a trip?) I also really like the simplicity of the 28 day periods that we can adapt to when we are back in the US and don't need it. Thanks! Kim
Yes, it's also important to remember that many of these policies don't cover you AT ALL unless you have a specific "home." You leave on a "trip," and you're covered. If there's no home, there's no trip, and no coverage.
With World Nomads, I believe you can simply re-enroll. Although the never "policy" may not cover you for any condition that happened previously -- that is a "pre-existing condition."
Hi Brent, I've been doing a deep dive into the travel medical insurance market and I think I've actually landed on World Nomads for these reasons: 1. the price is half of the price for Safety Wing for us (65 & 66 years old); I'll note that is for lower coverage - Safety Wing covers up to $250,000, while World Nomads maxes at $100,000. But we are willing to take that risk to be treated and stabilized until we can get to the US and our full insurance 2. the evacuation part is clearer (not a deal-breaker, but when I contacted Safety Wing the response was: "So, in your question you asked if Emergency Medical Evacuation would get you back to the US for continued care were something to happen. It is possible, however, it is important to note that the policy states that you will be transported to the nearest hospital where you can receive care rather than sending you back to your home country by default. That being said, it is not impossible, but it would depend on the circumstances and the recommendations of the medical staff." She then included a section of the policy that I had read, but not the section you quoted (which I couldn't find). I'm concerned that needing our insurance would not count as medical necessity for ongoing treatment of a serious illness or accident. Senior Nomad policies can be purchased online while outside the US, and up to 180-day policies. You can then buy another policy up to 180 days after that. That allows us to tailor the dates as we want. The only caveat is that if you get sick in, say Japan, then have a recurrence of that illness in Thailand under a new policy, it's a pre-existing condition. But acute episodes of pre-existing conditions are covered (just like Safety Wing). Finally, my read of Chase Sapphire is it does not cover medical for emergency illness at all - only transportation related accidents and limited ($2500) other accident while traveling. And, only up to 90 days. But it does cover evacuation. Thanks again for your information - can they make this any more complicated? I don't think so! Your article really helped me define the issues. Kim
Hi Kim: I'm writing an article about this (it was in the works!), but I'm using this information. I realized that it's a paid post, which you wouldn't have been able to read, so I upgraded you to a full paid subscription for one year. Thanks again for the info!
Thanks for this, very helpful. Yes, I just checked too, and World Nomads is cheaper for us too (but only a little bit, not half). FYI, with SafetyWing (and Genki), you can also buy travel insurance while ON the trip, away from home. WN asks us to declare exactly where we'll be, and SW seems looser in that regard. But I think you're 100% right on the medical evacuation thing. SW is now telling me that transportation HOME falls under "trip interruption," which tops out at $5000. This has me rethinking our own policy (which is SW for another month) and our site recommendations, frankly. Thanks again!
Feb 19, 2023·edited Feb 19, 2023Liked by Brent Hartinger
Hey guys, I noticed the title on this one has a spelling mistake. Heath instead of Health. Definitely an SEO killer. Unless you are insuring uncultivated land in Britain, of course!
BTW, tons of great info in here. Thanks for providing such comprehensive detail.
Haha, it happens! I've done it on my blog/substack too. Luckily, the human brain is great at substituting what it knows should be there. Google crawlers, on the other hand... Happy to help! My wife and I are enjoying going back through your archives, fantastic stuff.
Jan 25, 2023·edited Jan 25, 2023Liked by Brent Hartinger
Thanks, this is extremely helpful and thorough
One small note about medical evacuation coverage - the simple act of having the American Amex Platinum credit card gives you medical evacuation coverage everywhere, and you don't have to buy your Himalayan trip etc with that card. This might be true for other credit cards also, but amex platinum for sure gives you medivac coverage just by having the card.
There are some caveats, your trip has to be within 90 days etc so may not work for true nomads like you, but if someone goes back and forth from US to fulfill the 90 day requirements this works, details in this doc under Medical Assistance
Okay, that's impressive! So the only challenge would be making sure that every member of the party knows to arrange all this through their help line, which is the way to get reimbursed. Nice!
(That's an affiliate link, which means we get a small cut if you use it)
They're the only company I know of that is currently offering a full-time remote plan for companies (but I know several others are in the works). SafetyWing and Genki will also have full individual by early next year. :-)
Also, forgot to ask. Do you know if this works for people moving to different countries each 3 months? Would they be able to do doctor appointments when needed or just for emergencies?
Yes, I believe this is for workers than move. I'm not sure the details of the remote workers plan, but my understanding is that, yes, this is comprehensive health care, not just emergencies.
The only affiliate link I have is to the website, but if you click around and buy a different product than the one on that page, we will still get credit. Thanks for checking though!
Brent, thank you for writing this article. I have a question about the plan you and Michael use: I know you would have a regular doctor back home, and these days you could get a virtual appt, but then I imagine they wouldn't be able to prescribe you anything overseas. So do you then pay for preventative care locally, out of pocket?
Hi Sean: To add to what Michael said, yes, for emergencies overseas, we pay out of pocket (though we haven't had anything TOO expensive, and if we did, we would be reimbursed by Safety Wing, which I think has a $250 deductible). We've never paid more than $100 for anything anywhere -- and that includes dental appointments/cleanings (though Michael once paid $125 to have a dental filling Mexico City). We usually pay around $20-$50 for a doctor visit (!!!!!) overseas, though we haven't engaged with the medical system in Western Europe yet. Back home, yes, we both have primary care physicians (the same doctor, in fact), and we do do virtual calls if we have questions (free). We make a plan to be back in the US at least once a year, and that's when we go in for our annual Wellness visit, and we also have our prescriptions refilled. But we've worked it out with our doctor, he knows that we travel all year, so we have our prescriptions filled for an entire year in advance -- it's called "vacation refills," so you can get double or triple or quadruple refills. In some cases, we can only get 6 months, in which case we have had a few things sent our way via friends. But our doctor is a good guy who's worked with us and our specific needs. Honesty, our medical care for the year, including all premiums and prescriptions and out of pocket foreign visits and even dental and optical has been less than $3300/year for both of us and we have fairly good coverage. But that's because our income the last few years has been pretty low, so we've had a generous ACA subsidy, and because health care/dental/optical is so unbelievably cheap outside of America.
I forgot our Safety Wing premiums, which would probably bring our annual spending to $4300/year. But that's EVERYTHING: optical, glasses, dental, emergencies, prescriptions, doctor visits, etc. That's pretty good for being in our 50s.
So far we have been pretty lucky and haven't needed much prescribed overseas, but when we have -- Brent got sick in Thailand and I got sick in Mexico -- we just went to a local clinic, got checked out, and they prescribed the meds. And even when I had to see a doctor in Mexico and get three different meds, it was still way cheaper than if I had been in the States.
I had researched each and every one of the options you have outlined here. I also came to the conclusion that Safety Wing + ACA was the best way forward. That said, I wasn't sure if I had overlooked something. Your analysis, very well laid out and comprehensive, also confirmed the conclusion I had also drawn.
Thanks! I really appreciate that. Honestly, I've gone through this many times in my head, and I've tried to learn as much as possible, but I too sometimes wonder, "What am I missing? Is there something I've overlooking?" But the feedback tells me, probably not.
This is a great article. My husband and I have been traveling a lot and have been trying to figure out how to handle medical expenses when outside the US
Hi Brent, thanks so much for all your writing on this topic. I'm a single late 30s guy with (for now) minimal medical needs. I'm on a high-deductible Bronze ACA plan, which I got for catastrophic situations but haven't ever used. A few months ago I went full DN, with the intention to spend around 11 months per year outside the US. I still have the ACA coverage but nothing else, which obviously I should fix. I'm thinking about dropping my ACA plan (for which I'm paying full price) and replacing it with the Genki travel insurance option. If I understand correctly, that plan will give me essentially full medical coverage (excluding preventative) outside the US/Canada for 2 years. I'm fine to pay for any preventative care out of pocket. The main risk I'd be taking is not being able to go back to the US in case of serious illness until I could sign up for ACA again. I have family in the UK and Australia, so I could imagine going to one of those countries for treatment in the interim (which Genki would cover, I think?). On my brief visits back to the US during the 2 years, I would have emergency coverage, which I think is good enough in my situation (I definitely wouldn't hit the 42 day cap). Am I missing anything here?
Hi Sean: I think keeping ONLY travel insurance is a mistake, because yes, you're covered for mishaps and accidents, but you would have zero coverage if, for example, you got cancer or, say, needed a kidney transplant and dialysis, etc. There are real limitations for "travel" policies -- lots of stuff that is "catastrophic" but not really covered. This is only for EMERGENCES -- real emergencies. Like, I was in an accident, and I need to go to the hospital, and then I need to be flown back to my home country. So no, travel insurance is definitely NOT full medical coverage, preventative or otherwise. Plus, keep in mind that if you DID have a serious illness, you now have a "pre-existing condition," so you will not be insurable anywhere at any cost, except through the ACA. EVERYTHING will be out of pocket after your travel insurance policy runs out, which it will after six months (World Nomads), a year (SafetyWing) or Genki (2 years). There are real risks to using "emergency"-only insurance (which is VERY different from "catastrophic" insurance, which DOESN'T pay for incidentals and preventative but DOES pay for ALL serious illnesses like cancer, etc)., and it will depend on your tolerance for that risk, and also your age (so-so in terms of risk -- serious chronic stuff can happen even that young. And even an "emergency" can quickly segue into long-term care, and you won't be covered at all, for anything).
If I were you, if you have a decent ACA subsidy, I would absolutely keep that, because I think the subsidized ACA policies are an EXTREMELY good value. And I would ALSO get some kind of travel insurance WHICH INCLUDES GOOD EMERGENCY EVACUATION BACK TO AMERICA -- that would be Genki or World Nomads, not SafetyWing. I think Genki is the best travel insurance.
Then you're completely covered for emergencies, but also long-term care, in America even.
Conversely, another option would be to get "full" international health insurance and lose the ACA and use that for all your coverage. Since you're an American, I think Genki's "full" policy is the best here too, although it IS more expensive than their travel insurance option. It would also give you decent US coverage -- more than just emergencies-only in the US, which is important if you EVER come come.
Hi Brent, thank you for the comprehensive response. I will be sure to use the affiliate link if I sign up for one of those providers. I don't have any ACA subsidy, so Genki "full" (Resident) would be more affordable for me than my ACA + Genki "travel" (Explorer). And maybe Genki Resident is indeed the solution.
However, the way you've described the travel insurance category ("emergency"-only insurance) doesn't seem to apply to the Genki Explorer plan. On the Genki homepage, the Explorer and Resident options are compared, and the sole reference to "emergencies only" is in relation to home country treatment (42 days emergency coverage per half year). I read that to mean non-emergency services are covered when outside the home country. This reading is consistent with what the Genki founder told you about cancer treatment when you interviewed him.
So it seems to me that if I go for Resident over Explorer, it should be because I want to avoid the risk of developing a pre-existing condition and want the security of 180 days of full US coverage, rather than 42 days of emergency US coverage. Does that sound right?
Ah, now I understand the confusion. And I apologize, I haven't written on this topic in several months, and I'm reminding myself of the terminology.
The key word is not "emergency," it's "medically necessary." They will cover what it takes to keep you alive. So yes, this could (and does, with Genki) cover cancer treatments. But this is limited insurance -- the whole point is to get you to your place of MAIN insurance. So they're definition of "medically necessary" is going to be fairly strict, I think. I suspect Neville in that interview is kinda overstating things -- though I could be wrong. I don't know what that means for cancer or kidney failure. They do the treatment that will keep you alive but not everything you might need? And kidneys, they'll give you dialysis but not a kidney transplant? This seems like it gets complicated FAST.
And from personal experience, I was previously with SafetyWing, which also has this "medically necessary" terminology. The last time I needed treatment, I had a problem with my foot -- very painful, very difficult to walk. SafetyWing would NOT tell me if the treatment was covered (which was infuriating, and Genki is different, which is why I've personally switched). But in the end, I submitted my initial consultation to SafetyWing (ridiculously onerus), and any surgery or treatment on my foot was deemed NOT medically necessary -- even though I could barely walk. Likewise, I had a cyst on my face which the doctor said should be removed and examined -- again, it was deemed NOT medically necessary. I have yet to submit a claim with Genki, and it sounds like they're more generous that SafetyWing (which is a bunch of scrooges, IMHO). But who knows? It's all about those words "medically necessary." And I do know that even talking to Neville (Genki CFO), he referred to "initial treatment" in, say, a car crash, implying that follow-ups, PT, stuff that wasn't "medically necessary" would NOT be covered.
In short, I think there are more reasons that just the ones you mentioned to choose Resident over Explorer.
But to complicate things MORE, if you DO go the "Full" route, I'm not sure Genki is absolutely your best bet. If you're looking for great US coverage, using our hack -- that other article I posted -- is a great idea. But if you don't care about that, it might be possible to get better "full" coverage elsewhere.
Thanks you so much for this article! I'm currently planning a 9-month trip abroad and this completely clarifies all my confusion around health insurance. I had no idea what I needed and was very puzzled by all the different options. Basically, I was completely at sea until I found this post, which addresses all my questions and lays out everything in an extremely clear way.
Great article but many of we 'Senior' Nomads have hit the cut-off age of 70 and are therefore eliminated from the great coverage World Nomads and Safety Wing offer. So just forget trying to find reasonable travel insurance if you are 70+. It's outrageous. I guess the companies all presume we are ready to drop dead of some serious illness once we reach our 70th birthday. But so many of the travelers I know are of this age and we are really hurting trying to find anything that you might call reasonable. All I can say is enjoy World Nomads (my choice until it wasn't) and Safety Wing while you can.
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
hi! Thank you so much for looking into this! I am still only looking to get international full medical with worldwide USA coverage. They have several plans and I am interested in the most minimal and least expensive plan. I am getting the base plan so it covers medical evacuation, emergencies, etc. I would not be buying the outpatient plan for either Cigna or NOW health international. With NOW a broker actually got me quotes from them and recommended them. Both Cigna and NOW will cover up to 6 months within the United states in the event I have to go back for treatment so I like that. I just want to make sure I am looking at it right and they are hopefully legit. Their website is https://www.now-health.com/en/. Just wanted to know if you think they are reputable or not because I know you did so much research on so many companies! Thanks again and happy holidays!
Thank you for this article! We've been nomads for the past 8 years, doing some of the things you don't recommend (I agree, it's not ideal), paying out of pocket, returning to the US for emergencies. We have Medicare, and you are right, that is another complicated issue. I am very interested in finding that Genki may work for us, but I think there's a typo in your text. Did you mean to say Genki will cover people over 50 by the end of 2022? I went to their site and immediately found incorrect information about travel, disappointing. (For Peru: US citizens can only stay 90 days, down from 183 a few years ago). Still, I plan to check and see if they add us codgers to their options by the end of the year.
Hi folks. Thanks for clear breakdown of options and solutions. You mentioned Safety Wing several times but their coverage looks a little lite for us. We were looking at Seven corners. Any pro or cons you can share?
I haven't heard of Seven Corners before now, but I like their clear FAQ. I like SafetyWing because they (and World Nomads and Genki) are the only two companies that let you buy WHILE ON THE ROAD. All other companies make you buy before you leave, for a specific time (and sometimes for specific countries). These are bad requirements for nomads like us, who are never "home" and who are constantly on the move. Here are the questions I would ask yourself (and them): (a) What is medical evacuation coverage like? and (b) do you want/need "trip protection" and theft/loss (which you might already have on your credit card, because that is combined in this product (unlike Genki, which has it as an add-on). Also, are you keeping some kind of catastrophic "home" policy in case disaster strikes? In short, will you still be covered in your home country, because travel insurance alone may not be enough for you needs. Cheers! Brent
Thank you so much, Brent! Yes the international health insurance would be our entire insurance because with the companies I have been looking at, it seems they are claiming they would also cover me in America....even up to 6 months...with the same coverage I would get internationally. It is not considered an add on, but it is considered a worldwide health plan. I think that is part of where the confusion lies for me. If it really does cover me in America and around the world, I should be okay without another policy. But it seems this can't be true. Also, yes you are right about the open enrollment issue if I now have a preexisting condition so if the insurance only lasts for 6 months after I get back, that would be a problem. The other issue is that most of the healthcare.gov plans do not cover in more than just your home state from what I am seeing (none that I am currently eligible for). So even if I got on one of those, I guess it would not help me since we plan to travel the US when we get back. It would help me if I no longer was able to travel the US because of my new condition. The thing is I feel what they are saying about American coverage is too good to be true or maybe they are misunderstanding my questions? Also with Genki and Safety Wing, are you saying they have full policies where you could be covered completely worldwide including America? Or would you still need an American based plan?
Some of the plans DO cover you in different states, if you're traveling, but it can be complicated and cumbersome. Kaiser Permanente, for example, (which we have) has offices in other states, and ALSO covers you for some emergency care when out of state, but it requires coordinating between different state branches. (Did I mention American health care is insane?) Genki and SafetyWings plans (as I understand) will cover everywhere but NOT America, unless you pay for an America add-on, and there could be conditions on the amount of time you spend back in the US. Hopefully that's enough time to segue back to ObamaCare during an open enrollment or a "life event." I also think (as long as a Democrat is president) the "life event" factor will be interpreted fairly liberally, at least in blue states. That was the case during covid: if you moved home, you could re-enroll, even apart from open enrollment, thanks to a "life event change." But it has also been explained to me that if you keep a "residency" in America while traveling (which you kind of have to), you can NOT just return to that state and be re-enrolled under the "life event" exception (because technically never "left" the state), but you COULD move to a different state and enroll there at any time. Complicated!
hi there! Thanks so much for putting this out there! So far the quotes I am getting from some of the companies are pretty steep. My husband and I will just be traveling internationally for 1 year. We do not have preexisting conditions. We plan on getting a nationwide private plan so we can still travel around the united states when we come back which with screening allows you to start it at any time. One of the companies I have spoken with, IMG, seem to have a worldwide medical evacuation plan and they say they can also cover in America with the same benefits. If I am really only wanting catastrophic or treatment needs that come up during that 1 year (won't do any preventative while traveling), do you think a plan that says they cover medical evacuation and treatment in America would suffice? You had mentioned that some say they cover you in America but they really only do it temporarily. It would be nice if we could just stay on the plan we are with while overseas for a few months when we come back to America and be covered. Overall we are trying to avoid paying much but still get an actual policy that would cover us if something unforeseen comes up and would also cover us in America. I feel like I am not understanding the plans correctly. Thoughts?
This would be your entire insurance, yes? You're not being covered by an employer or keeping an ObamaCare plan, right? If you get "international health insurance" WITH the America add-on, you should be covered, and it sounds like that's what you want. In the article, I mean that the America coverage is limited if you DON'T get the add-on. It seems to me that you need to consider your situation if you get sick while traveling. Would you want to return to America? (Probably, right? That's where friends and family are.) So you do need the evacuation issue, and you need some kind of coverage in the US. And then you also need to be sure you can MAINTAIN that coverage once you're living back home, even though you'll now have a "pre-existing condition" of whatever illness you have -- which is where ObamaCare comes, although you'll probably have to wait until the end-of-the-year enrollment period. This the part that makes me uneasy: just how "covered" am I if I get cancer overseas and have to return to the US for treatment? This also probably why the quotes you're getting are high. When I've looked, I've found the price for Michael and me (mid-50s) for international health insurance is about $8-9000 a year, which is about half what we pay for crappy insurance through ObamaCare ($16,000 with really really high deductables). That INCLUDES evacuation and emergency care in most of the world, but there are, of course, caps, and we would have to go through medical questionaires, etc. and coverage is not guaranteed. But that seems like a pretty good deal to me, especially since if we get sick, we can just segue back into ObamaCare during the next enrollment period. Another thing to consider is that both SafetyWing and Genki will offer nomad-specific FULL international health insurance, starting in January (I believe). This much better than the "travel inusrance" they currently offer, and it's specifically FOR nomads like us. Something to consider.
Some links:
https://safetywing.com/nomad-insurance/?referenceID=24741851&utm_source=24741851&utm_medium=Ambassador
https://genki.world/?with=brentandmichael
https://app.william-russell.com/products/?RR_WCID=5F493CC2-B6A3-40F6-8FD6-5E2E474C39C7&RR_WCID_TTL=396&REFERRALCODE=BRENTH
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
Thank you for your help! Yes we are looking to have just one insurance policy that covers us worldwide for the year we are traveling incase anything crazy happens. We do not have preexisting conditions so far and would not do preventative. Do you think it is too good to be true that places like IMG are saying that it is worldwide insurance and they will evacuate to America if needed? I am also being told that they will cover me for 6 months in America? It seems off because it is inexpensive. From what you are saying, it sounds like you guys only have an international health insurance plan as well? We basically want to be covered anywhere in America for a few months when we come back especially if we are evacuated back. We plan to travel the united states as well so we an obamacare plan would not work for us anyway if we do develop preexisting conditions. I read about safety wing, william russel, and genki through your links and it sounds like they cover most health insurance related issues as well but limit the time in America. Basically I am trying to understand if you think these plans actually can cover you in America as well and if you still think its needed to have an American based plans with these worldwide health insurance plans?
Yes, but the problem is that will you CONTINUE to be covered once you're back in America, once your current policy expires. Right now we have an ObamaCare plan (partly subsidized) with Safetywing as "emergency" insurance for being outside of America. Next year (because we will love our subsidy), we are shifting to international insurance only, but yes, I am planning to pay for an "America" feature that will at least last long enough to get us to transition back to ObamaCare. I would be a bit skeptical of any cheap policy that limits the time in America -- I would pay for the American add-on. But of course I am very very cautious, and perhaps that is TOO caution. (I'm also not an expert.)
Thank you so much! Regarding the healthcare.gov nationwide plans, I will look more into that later but last I was told is that because I am registered in Texas, they do not have any available to me that are nationwide. I will keep looking. You are so right about the complications and that the trick is finding something when I get back. I am thinking perhaps if I had bad enough issues while overseas, they will help me get on a government plan as a life event when I come back as an exception like you said. The problem is that we may not make enough income 2023 before leaving and then that would delete any subsidy for healthcare.gov so we arent wanting to risk it but it would be nice to have it so it stinks the minimum income requirement is to where you literally pay back everything if you dont meet it. I would hope I could qualify for a nationwide private insurance plan if not, but it seems like a bit of a risk. Please let me know what luck you end up having finding a worldwide insurance plan (including America) for at least a few months! The ones I am seeing including Genki limit to anywhere between 4-6 weeks of coverage back in America so that is not amazing. IMG says they cover but it is unclear as to how long and I can't get a clear answer. Cigna I am working on getting more info on with them also. That really is what makes the difference I think is How Long they will cover in America. Otherwise, you really might need an American based on plan and then get an International plan that does not have American coverage so you can save a bit through that. Thanks for your updates and we are really enjoying your blog. We plan on traveling So many countries for that year so we are already learning a lot from you!
To be clear, Genki's CURRENT plan is only travel insurance, not full health insurance. I don't know what the situation will be with their FUTURE international health insurance plan, which they're supposedly debuting in early 2023. I suspect the US features will be different on that plan.
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
Hi Brent & Michael, I feel like I know you two because I've been reading your blogs all year. Paul and I have Medicare A, B, D and a gap policy so we're fully covered in the USA and a few territories (American Samoa, for example). We've been kind of winging it with our Chase Sapphire card. But we think we need more. Safety Wing looks reasonable for travel insurance even for old geezers such as ourselves (65 & 66). But it doesn't appear to me that Safety Wing's evacuation assistance would cover someone who has stabilized after an accident or unexpected illness, to send them back to the US for more treatment (which would allow us to use our insurance). We're thinking about Emergency Assistance Plus https://www.emergencyassistanceplus.com/home/#home which pays to send you home with a nurse if needed after you have stabilized. They are really cheap. We were thinking of pairing that with Safety Wing. But, if Safety Wing offers that kind of evacuation assistance, it would be double coverage. Do you know if Safety Wing's evacuation policy covers that situation? Thanks! Kim
Well, caveat: not an expert here, but I'm told that SafetyWing does cover this kind of thing. This is what they tell me:
Notice the number 2 in "You are not covered unless you fill in the following conditions:"
If the physician states that it is medically necessary for the member to return to his/her home country for continued treatment, recuperation and recovery, then the member will be covered (see 1 and 2 under YOU ARE COVERED)
(I can't attach the policy document they sent me, but it quotes from it, above.)
I sounds like if a doctor attests you need to go home for further treatment, you are covered. Likewise, Chase Sapphire might cover that transport too.
So it sounds to me like, yes, you have evacuation in most circumstances. I can see a situation in which you recover fully, and they don't cover transportation home, but then it wouldn't really be "evacuation" -- it would be normal transportation.
Thanks, I didn't see that part in the policy, but I'll read it more carefully tomorrow. In that case, I think Safety Wing would be what we need to cover the gap. The "up to $100,000" doesn't bother me that much because insurance is just to stave off catastrophic expense so we could absorb some additional. I like that this policy is designed for Nomads (the Allianz policy, for example, while a good price and decent coverage keeps referring to "trips" which doesn't really fit our situation). Thanks for writing about this - your update was very timely given our decision-making process. The Genki doesn't cover our age group and as I read World Nomads a trip cannot be more than 180 days (also begging the question, What is a trip?) I also really like the simplicity of the 28 day periods that we can adapt to when we are back in the US and don't need it. Thanks! Kim
Yes, it's also important to remember that many of these policies don't cover you AT ALL unless you have a specific "home." You leave on a "trip," and you're covered. If there's no home, there's no trip, and no coverage.
With World Nomads, I believe you can simply re-enroll. Although the never "policy" may not cover you for any condition that happened previously -- that is a "pre-existing condition."
Complicated, no? LOL
Hi Brent, I've been doing a deep dive into the travel medical insurance market and I think I've actually landed on World Nomads for these reasons: 1. the price is half of the price for Safety Wing for us (65 & 66 years old); I'll note that is for lower coverage - Safety Wing covers up to $250,000, while World Nomads maxes at $100,000. But we are willing to take that risk to be treated and stabilized until we can get to the US and our full insurance 2. the evacuation part is clearer (not a deal-breaker, but when I contacted Safety Wing the response was: "So, in your question you asked if Emergency Medical Evacuation would get you back to the US for continued care were something to happen. It is possible, however, it is important to note that the policy states that you will be transported to the nearest hospital where you can receive care rather than sending you back to your home country by default. That being said, it is not impossible, but it would depend on the circumstances and the recommendations of the medical staff." She then included a section of the policy that I had read, but not the section you quoted (which I couldn't find). I'm concerned that needing our insurance would not count as medical necessity for ongoing treatment of a serious illness or accident. Senior Nomad policies can be purchased online while outside the US, and up to 180-day policies. You can then buy another policy up to 180 days after that. That allows us to tailor the dates as we want. The only caveat is that if you get sick in, say Japan, then have a recurrence of that illness in Thailand under a new policy, it's a pre-existing condition. But acute episodes of pre-existing conditions are covered (just like Safety Wing). Finally, my read of Chase Sapphire is it does not cover medical for emergency illness at all - only transportation related accidents and limited ($2500) other accident while traveling. And, only up to 90 days. But it does cover evacuation. Thanks again for your information - can they make this any more complicated? I don't think so! Your article really helped me define the issues. Kim
Hi Kim: I'm writing an article about this (it was in the works!), but I'm using this information. I realized that it's a paid post, which you wouldn't have been able to read, so I upgraded you to a full paid subscription for one year. Thanks again for the info!
Thanks!!!
Thanks for this, very helpful. Yes, I just checked too, and World Nomads is cheaper for us too (but only a little bit, not half). FYI, with SafetyWing (and Genki), you can also buy travel insurance while ON the trip, away from home. WN asks us to declare exactly where we'll be, and SW seems looser in that regard. But I think you're 100% right on the medical evacuation thing. SW is now telling me that transportation HOME falls under "trip interruption," which tops out at $5000. This has me rethinking our own policy (which is SW for another month) and our site recommendations, frankly. Thanks again!
And no, this can not be any more complicated! LOL
(Up to $100,000 total, which is very good but not great)
Hey guys, I noticed the title on this one has a spelling mistake. Heath instead of Health. Definitely an SEO killer. Unless you are insuring uncultivated land in Britain, of course!
BTW, tons of great info in here. Thanks for providing such comprehensive detail.
OMG all this time, and we never noticed!!! THANKS SO MUCH
Haha, it happens! I've done it on my blog/substack too. Luckily, the human brain is great at substituting what it knows should be there. Google crawlers, on the other hand... Happy to help! My wife and I are enjoying going back through your archives, fantastic stuff.
Thank you! Appreciate that.
Thanks, this is extremely helpful and thorough
One small note about medical evacuation coverage - the simple act of having the American Amex Platinum credit card gives you medical evacuation coverage everywhere, and you don't have to buy your Himalayan trip etc with that card. This might be true for other credit cards also, but amex platinum for sure gives you medivac coverage just by having the card.
Good to know! Thanks!
There are some caveats, your trip has to be within 90 days etc so may not work for true nomads like you, but if someone goes back and forth from US to fulfill the 90 day requirements this works, details in this doc under Medical Assistance
https://www.americanexpress.com/content/dam/amex/us/credit-cards/features-benefits/policies/pdf/PGA_Benefit_Guide_Rev_09-17.pdf
This reads like a somewhat limited benefit -- I wonder if they would pay $240,000 medi-vac. But yes, it's a good benefit!
No cost caps!
https://viewfromthewing.com/know-benefits-amex-platinum-medical-evacuation-claim-award-ticket-saves-275000/
(Comment thread there clarifies that purchase didn't need to be made on the card either)
Okay, that's impressive! So the only challenge would be making sure that every member of the party knows to arrange all this through their help line, which is the way to get reimbursed. Nice!
Hello guys, thanks for this article.
As a company, we want to offer a full remote health insurance (the one you said is the only way to get the 4 points)
Do you have any suggestions around it? Thanks!
I know one possibility would SafetyWing which currently offers a group plan for nomad workers. https://safetywing.com/nomad-insurance/?referenceID=24741851&utm_source=24741851&utm_medium=Ambassador
(That's an affiliate link, which means we get a small cut if you use it)
They're the only company I know of that is currently offering a full-time remote plan for companies (but I know several others are in the works). SafetyWing and Genki will also have full individual by early next year. :-)
Also, forgot to ask. Do you know if this works for people moving to different countries each 3 months? Would they be able to do doctor appointments when needed or just for emergencies?
Thanks!
Yes, I believe this is for workers than move. I'm not sure the details of the remote workers plan, but my understanding is that, yes, this is comprehensive health care, not just emergencies.
Hello! Happy to use your referral if i take it but i think you shared the one for nomad workers instead for remote companies?
The only affiliate link I have is to the website, but if you click around and buy a different product than the one on that page, we will still get credit. Thanks for checking though!
Brent, thank you for writing this article. I have a question about the plan you and Michael use: I know you would have a regular doctor back home, and these days you could get a virtual appt, but then I imagine they wouldn't be able to prescribe you anything overseas. So do you then pay for preventative care locally, out of pocket?
Hi Sean: To add to what Michael said, yes, for emergencies overseas, we pay out of pocket (though we haven't had anything TOO expensive, and if we did, we would be reimbursed by Safety Wing, which I think has a $250 deductible). We've never paid more than $100 for anything anywhere -- and that includes dental appointments/cleanings (though Michael once paid $125 to have a dental filling Mexico City). We usually pay around $20-$50 for a doctor visit (!!!!!) overseas, though we haven't engaged with the medical system in Western Europe yet. Back home, yes, we both have primary care physicians (the same doctor, in fact), and we do do virtual calls if we have questions (free). We make a plan to be back in the US at least once a year, and that's when we go in for our annual Wellness visit, and we also have our prescriptions refilled. But we've worked it out with our doctor, he knows that we travel all year, so we have our prescriptions filled for an entire year in advance -- it's called "vacation refills," so you can get double or triple or quadruple refills. In some cases, we can only get 6 months, in which case we have had a few things sent our way via friends. But our doctor is a good guy who's worked with us and our specific needs. Honesty, our medical care for the year, including all premiums and prescriptions and out of pocket foreign visits and even dental and optical has been less than $3300/year for both of us and we have fairly good coverage. But that's because our income the last few years has been pretty low, so we've had a generous ACA subsidy, and because health care/dental/optical is so unbelievably cheap outside of America.
I forgot our Safety Wing premiums, which would probably bring our annual spending to $4300/year. But that's EVERYTHING: optical, glasses, dental, emergencies, prescriptions, doctor visits, etc. That's pretty good for being in our 50s.
So far we have been pretty lucky and haven't needed much prescribed overseas, but when we have -- Brent got sick in Thailand and I got sick in Mexico -- we just went to a local clinic, got checked out, and they prescribed the meds. And even when I had to see a doctor in Mexico and get three different meds, it was still way cheaper than if I had been in the States.
I had researched each and every one of the options you have outlined here. I also came to the conclusion that Safety Wing + ACA was the best way forward. That said, I wasn't sure if I had overlooked something. Your analysis, very well laid out and comprehensive, also confirmed the conclusion I had also drawn.
Thanks! I really appreciate that. Honestly, I've gone through this many times in my head, and I've tried to learn as much as possible, but I too sometimes wonder, "What am I missing? Is there something I've overlooking?" But the feedback tells me, probably not.
This is a great article. My husband and I have been traveling a lot and have been trying to figure out how to handle medical expenses when outside the US
Thanks! Appreciate that. It was admittedly a lot of work. :-)
Hi Brent, thanks so much for all your writing on this topic. I'm a single late 30s guy with (for now) minimal medical needs. I'm on a high-deductible Bronze ACA plan, which I got for catastrophic situations but haven't ever used. A few months ago I went full DN, with the intention to spend around 11 months per year outside the US. I still have the ACA coverage but nothing else, which obviously I should fix. I'm thinking about dropping my ACA plan (for which I'm paying full price) and replacing it with the Genki travel insurance option. If I understand correctly, that plan will give me essentially full medical coverage (excluding preventative) outside the US/Canada for 2 years. I'm fine to pay for any preventative care out of pocket. The main risk I'd be taking is not being able to go back to the US in case of serious illness until I could sign up for ACA again. I have family in the UK and Australia, so I could imagine going to one of those countries for treatment in the interim (which Genki would cover, I think?). On my brief visits back to the US during the 2 years, I would have emergency coverage, which I think is good enough in my situation (I definitely wouldn't hit the 42 day cap). Am I missing anything here?
Hi Sean: I think keeping ONLY travel insurance is a mistake, because yes, you're covered for mishaps and accidents, but you would have zero coverage if, for example, you got cancer or, say, needed a kidney transplant and dialysis, etc. There are real limitations for "travel" policies -- lots of stuff that is "catastrophic" but not really covered. This is only for EMERGENCES -- real emergencies. Like, I was in an accident, and I need to go to the hospital, and then I need to be flown back to my home country. So no, travel insurance is definitely NOT full medical coverage, preventative or otherwise. Plus, keep in mind that if you DID have a serious illness, you now have a "pre-existing condition," so you will not be insurable anywhere at any cost, except through the ACA. EVERYTHING will be out of pocket after your travel insurance policy runs out, which it will after six months (World Nomads), a year (SafetyWing) or Genki (2 years). There are real risks to using "emergency"-only insurance (which is VERY different from "catastrophic" insurance, which DOESN'T pay for incidentals and preventative but DOES pay for ALL serious illnesses like cancer, etc)., and it will depend on your tolerance for that risk, and also your age (so-so in terms of risk -- serious chronic stuff can happen even that young. And even an "emergency" can quickly segue into long-term care, and you won't be covered at all, for anything).
If I were you, if you have a decent ACA subsidy, I would absolutely keep that, because I think the subsidized ACA policies are an EXTREMELY good value. And I would ALSO get some kind of travel insurance WHICH INCLUDES GOOD EMERGENCY EVACUATION BACK TO AMERICA -- that would be Genki or World Nomads, not SafetyWing. I think Genki is the best travel insurance.
https://www.brentandmichaelaregoingplaces.com/p/which-is-better-safetywing-world
Then you're completely covered for emergencies, but also long-term care, in America even.
Conversely, another option would be to get "full" international health insurance and lose the ACA and use that for all your coverage. Since you're an American, I think Genki's "full" policy is the best here too, although it IS more expensive than their travel insurance option. It would also give you decent US coverage -- more than just emergencies-only in the US, which is important if you EVER come come.
https://www.brentandmichaelaregoingplaces.com/p/brent-and-michaels-secret-travel-08f
Take a look at those two links. Hope that helps!
And if you do get Genki or Safetywing, please use our affiliate links:
https://genki.world/products?with=brentandmichael
https://safetywing.com/nomad-insurance/?referenceID=24741851&utm_source=24741851&utm_medium=Ambassador
Hi Brent, thank you for the comprehensive response. I will be sure to use the affiliate link if I sign up for one of those providers. I don't have any ACA subsidy, so Genki "full" (Resident) would be more affordable for me than my ACA + Genki "travel" (Explorer). And maybe Genki Resident is indeed the solution.
However, the way you've described the travel insurance category ("emergency"-only insurance) doesn't seem to apply to the Genki Explorer plan. On the Genki homepage, the Explorer and Resident options are compared, and the sole reference to "emergencies only" is in relation to home country treatment (42 days emergency coverage per half year). I read that to mean non-emergency services are covered when outside the home country. This reading is consistent with what the Genki founder told you about cancer treatment when you interviewed him.
So it seems to me that if I go for Resident over Explorer, it should be because I want to avoid the risk of developing a pre-existing condition and want the security of 180 days of full US coverage, rather than 42 days of emergency US coverage. Does that sound right?
Ah, now I understand the confusion. And I apologize, I haven't written on this topic in several months, and I'm reminding myself of the terminology.
The key word is not "emergency," it's "medically necessary." They will cover what it takes to keep you alive. So yes, this could (and does, with Genki) cover cancer treatments. But this is limited insurance -- the whole point is to get you to your place of MAIN insurance. So they're definition of "medically necessary" is going to be fairly strict, I think. I suspect Neville in that interview is kinda overstating things -- though I could be wrong. I don't know what that means for cancer or kidney failure. They do the treatment that will keep you alive but not everything you might need? And kidneys, they'll give you dialysis but not a kidney transplant? This seems like it gets complicated FAST.
And from personal experience, I was previously with SafetyWing, which also has this "medically necessary" terminology. The last time I needed treatment, I had a problem with my foot -- very painful, very difficult to walk. SafetyWing would NOT tell me if the treatment was covered (which was infuriating, and Genki is different, which is why I've personally switched). But in the end, I submitted my initial consultation to SafetyWing (ridiculously onerus), and any surgery or treatment on my foot was deemed NOT medically necessary -- even though I could barely walk. Likewise, I had a cyst on my face which the doctor said should be removed and examined -- again, it was deemed NOT medically necessary. I have yet to submit a claim with Genki, and it sounds like they're more generous that SafetyWing (which is a bunch of scrooges, IMHO). But who knows? It's all about those words "medically necessary." And I do know that even talking to Neville (Genki CFO), he referred to "initial treatment" in, say, a car crash, implying that follow-ups, PT, stuff that wasn't "medically necessary" would NOT be covered.
In short, I think there are more reasons that just the ones you mentioned to choose Resident over Explorer.
But to complicate things MORE, if you DO go the "Full" route, I'm not sure Genki is absolutely your best bet. If you're looking for great US coverage, using our hack -- that other article I posted -- is a great idea. But if you don't care about that, it might be possible to get better "full" coverage elsewhere.
I wrote about that here:
https://www.brentandmichaelaregoingplaces.com/p/what-are-we-doing-for-health-care
I would definitely shop around.
(Again, not an authority, I just write about this online and have talked to a few folks.)
Thanks you so much for this article! I'm currently planning a 9-month trip abroad and this completely clarifies all my confusion around health insurance. I had no idea what I needed and was very puzzled by all the different options. Basically, I was completely at sea until I found this post, which addresses all my questions and lays out everything in an extremely clear way.
You are very welcome! I write about this topic fairly regularly. And I agree, it's confusing!
Great article but many of we 'Senior' Nomads have hit the cut-off age of 70 and are therefore eliminated from the great coverage World Nomads and Safety Wing offer. So just forget trying to find reasonable travel insurance if you are 70+. It's outrageous. I guess the companies all presume we are ready to drop dead of some serious illness once we reach our 70th birthday. But so many of the travelers I know are of this age and we are really hurting trying to find anything that you might call reasonable. All I can say is enjoy World Nomads (my choice until it wasn't) and Safety Wing while you can.
Oh, I'm sorry! I was not aware of that, and it seems really unfair. Good to know, though. :-(
ReAnn - you should look into Morgan White or VUMI.
Hello! Thanks again for all of your help! It has really been a life saver! I am wondering if you could do one huge favor for me? Could you look over the NOW international Health Insurance plans (worldwide including USA) and tell me your thoughts on how good they are compared to cigna international health insurance (worldwide including USA)? I feel like they are similar though I am not sure if perhaps NOW is not as reliable or something of that nature. They are less expensive but I dont just want to pick the least expensive option if they are not going to actually be good about paying claims etc. You have done so much research so I feel you would be able to see pretty well how good they may be! Thanks again!
Do you have direct links to the benefit plans your considering? It's hard to compare them in general. (I had not heard of NOW before now)
hi! Thank you so much for looking into this! I am still only looking to get international full medical with worldwide USA coverage. They have several plans and I am interested in the most minimal and least expensive plan. I am getting the base plan so it covers medical evacuation, emergencies, etc. I would not be buying the outpatient plan for either Cigna or NOW health international. With NOW a broker actually got me quotes from them and recommended them. Both Cigna and NOW will cover up to 6 months within the United states in the event I have to go back for treatment so I like that. I just want to make sure I am looking at it right and they are hopefully legit. Their website is https://www.now-health.com/en/. Just wanted to know if you think they are reputable or not because I know you did so much research on so many companies! Thanks again and happy holidays!
You might take a look here, and look at the LOW reviews:
https://uk.trustpilot.com/review/www.now-health.com
And as I'm sure you know, there are definitely exclusions:
https://www.now-health.com/en/insurance-plans/
But that's too be expected if the price is low-ish. They seem legit to me.
Do you know of any travel insurances that cover nomads who are over the age of 70? Medicare cannot be used abroad.
Hmmm, I'm always skeptical of websites these days, but I found these suggestions. They seem legit:
https://www.nerdwallet.com/article/travel/senior-travel-insurance
https://www.forbes.com/advisor/travel-insurance/best-senior-travel-insurance/
Thank you for this article! We've been nomads for the past 8 years, doing some of the things you don't recommend (I agree, it's not ideal), paying out of pocket, returning to the US for emergencies. We have Medicare, and you are right, that is another complicated issue. I am very interested in finding that Genki may work for us, but I think there's a typo in your text. Did you mean to say Genki will cover people over 50 by the end of 2022? I went to their site and immediately found incorrect information about travel, disappointing. (For Peru: US citizens can only stay 90 days, down from 183 a few years ago). Still, I plan to check and see if they add us codgers to their options by the end of the year.
Yes sorry, typo..they currently cover UP TO 50 but will raise that for 2023. Sorry! And thanks!
Hi folks. Thanks for clear breakdown of options and solutions. You mentioned Safety Wing several times but their coverage looks a little lite for us. We were looking at Seven corners. Any pro or cons you can share?
I haven't heard of Seven Corners before now, but I like their clear FAQ. I like SafetyWing because they (and World Nomads and Genki) are the only two companies that let you buy WHILE ON THE ROAD. All other companies make you buy before you leave, for a specific time (and sometimes for specific countries). These are bad requirements for nomads like us, who are never "home" and who are constantly on the move. Here are the questions I would ask yourself (and them): (a) What is medical evacuation coverage like? and (b) do you want/need "trip protection" and theft/loss (which you might already have on your credit card, because that is combined in this product (unlike Genki, which has it as an add-on). Also, are you keeping some kind of catastrophic "home" policy in case disaster strikes? In short, will you still be covered in your home country, because travel insurance alone may not be enough for you needs. Cheers! Brent
Thank you so much, Brent! Yes the international health insurance would be our entire insurance because with the companies I have been looking at, it seems they are claiming they would also cover me in America....even up to 6 months...with the same coverage I would get internationally. It is not considered an add on, but it is considered a worldwide health plan. I think that is part of where the confusion lies for me. If it really does cover me in America and around the world, I should be okay without another policy. But it seems this can't be true. Also, yes you are right about the open enrollment issue if I now have a preexisting condition so if the insurance only lasts for 6 months after I get back, that would be a problem. The other issue is that most of the healthcare.gov plans do not cover in more than just your home state from what I am seeing (none that I am currently eligible for). So even if I got on one of those, I guess it would not help me since we plan to travel the US when we get back. It would help me if I no longer was able to travel the US because of my new condition. The thing is I feel what they are saying about American coverage is too good to be true or maybe they are misunderstanding my questions? Also with Genki and Safety Wing, are you saying they have full policies where you could be covered completely worldwide including America? Or would you still need an American based plan?
Some of the plans DO cover you in different states, if you're traveling, but it can be complicated and cumbersome. Kaiser Permanente, for example, (which we have) has offices in other states, and ALSO covers you for some emergency care when out of state, but it requires coordinating between different state branches. (Did I mention American health care is insane?) Genki and SafetyWings plans (as I understand) will cover everywhere but NOT America, unless you pay for an America add-on, and there could be conditions on the amount of time you spend back in the US. Hopefully that's enough time to segue back to ObamaCare during an open enrollment or a "life event." I also think (as long as a Democrat is president) the "life event" factor will be interpreted fairly liberally, at least in blue states. That was the case during covid: if you moved home, you could re-enroll, even apart from open enrollment, thanks to a "life event change." But it has also been explained to me that if you keep a "residency" in America while traveling (which you kind of have to), you can NOT just return to that state and be re-enrolled under the "life event" exception (because technically never "left" the state), but you COULD move to a different state and enroll there at any time. Complicated!