Ah, health insurance for nomads and long-term travelers!

Suffice to say, it’s complicated. If you’re new to this topic, read my first post on nomad healthcare here.

There have typically been two kinds of health insurance for travelers: international health insurance, which is comprehensive and can indefinitely cover most or all your healthcare needs, and travel insurance, which has traditionally been more of a temporary, supplementary policy to existing health coverage, typically covering emergency care — and not, say, cancer or preventative care. Most travel insurance also includes protections against non-health-related travel mishaps, like trip cancellation or loss or theft of your personal items.

Whichever kind of insurance you purchase, insurance companies are often perplexed by digital nomads or long-term travelers. Most existing policies are aimed at students or expats, who stay primarily in one country. And they almost always require the policy be bought before you leave home — which doesn’t really work for those of us who are always on the move.

Until recently, there have essentially been only two insurance companies that created their products specifically for nomads: SafetyWing (which is the less expensive and less robust option) and World Nomads (which covers more mishaps, and more “extreme sports,” and has higher pay-outs, but also higher deductibles).

Now there’s a third company: Genki, which, like SafetyWing and World Nomads, claims to be created by nomads for nomads.

Keep in mind that all three of these companies are still just offering travel insurance, not comprehensive international health insurance — although both SafetyWing and Genki plan to roll out full international health insurance options in the very near future.

But Genki, unlike SafetyWing and World Nomads, offers strictly travel health insurance, not coverage for non-health-related mishaps (though they will soon offer some options as add-ons). You’re not paying for things you don’t want.

What Genki doesn’t offer in traditional travel protections, it seems to make up for in more generous healthcare offerings. Unlike its competitors, Genki has almost no overall pay-out caps and fewer exclusions. They also cover some non-emergency illnesses.

Genki also has a more generous standard “home country” policy for Americans: we are covered for “emergencies” in America for up to 42 days out of every 180 days, as opposed to SafetyWing, which covers only up to 15 out of every 90 days (and only after 90 days of continuous coverage).

And Genki still manages to be fairly affordable.

The catch? While they have fewer limitations and no caps on pay-outs, they do have a maximum time-limit: only two years of coverage. As with SafetyWing and World Nomads, once Genki’s “temporary” coverage expires, anything that happened during that time can then be considered a “pre-existing condition” and cause denial of some future coverage.

Also, this is a new company with less experience and fewer online reviews (though they are working in association with established insurance companies with solid reputations).

Finally, Genki currently only insures nomads under the age of 50. In 2023, they will offer coverage to people under the age of 70.

In order to find out more about this new player into the nomad health insurance games, I recently Zoomed with Neville Mehra, the co-founder and CMO of the company.

BRENT: Thanks for talking with me. Why don't we start with the inspiration for your company?

Neville: Well, I became a nomad myself in 2012. I’ve read your posts on how you guys started, how you read a newspaper article [in 2016] that described what you were planning on doing [becoming nomads], and you said, “Oh! This is [already] a thing.”

I had that same experience, except I was already traveling. I said, “Oh, there's a name for this way that I've been living.”

But there was still a bunch of stuff that was really hard to do if you didn't live in one country. A lot of that was solved by the internet. Suddenly, there’s WiFi everywhere, so you could work online. Airbnb was a huge game changer for me, because I can't live in hotels or youth hostels forever.

But healthcare is this giant exception. For me anyway, in the first few years when I was traveling, my plan was: Don't get sick. Hope nothing bad happens and just save all those doctor visits for when you get back home.

If you're 22 and healthy, that's probably okay. But the older you get, the more important healthcare becomes.

At Genki, we envision a world where more and more people can do exactly what you guys are doing, traveling, living around the world, exploring and living in different countries. But we don’t think you should have to sacrifice your health to live this lifestyle.

Brent: Explain to me how you see this product. It's not traditional travel insurance — it's solely healthcare. But it also seems like it’s a bit more than just emergency care. Do you see this as international healthcare insurance? Or is it just travel insurance?

Neville: You've zoomed in on the key question.

There's a long-term vision for Genki, more than the product we offer right now. Our long-term vision is to be a health partner for nomads. We don't see ourselves as an insurance company — we see ourselves as a health company. We want to help nomads stay healthy, not just recover from an injury or illness, wherever they go in the world.

With that big vision, the question is: how do we get started? Insurance was the entry point for us, because it's something that people already buy. Over time we plan to go beyond insurance and do things like help you figure out what vaccines you need to travel to different destinations, find great doctors who speak your language, and maybe even save you a trip to the doctor with telemedicine.

The first product that we launched, the one that we have right now, is our World Explorer, which is travel health insurance. And as you rightly said, it sits somewhere in between the idea of travel insurance and traditional health insurance. It's not coverage for your suitcase — it's coverage for you. Although we were planning to add optional add-ons later this year, for personal property coverage while you're traveling and stuff like that.

This is technically a short-term product that has a maximum of two years. We've done everything we can to twist travel insurance to be better for nomads. So we cover anyone from any country in the world traveling in any country in the world. They don't need to tell us which countries they're going to ahead of time. And they don't need to tell us when they'll be back. It's like a monthly subscription like for Netflix or Spotify.

Brent: What happens after two years?

Neville: No one's gone that far yet. But the other half of the answer to your question is to have a long-term product. And that's international health insurance, so we're launching that later this year. That's Genki product number two, the long-term product. There's no two-year limit, and it will also include wellness, preventive care, and more comprehensive coverage for pregnancies that are not covered by a travel health policy.

[Currently, there is some pregnancy coverage, providing the pregnancy did not precede the coverage.]

Brent: I'm comparing your product to the products that I know fairly well, SafetyWing and World Nomads. And you seem more generous with fewer limitations. How are you able to do this?

Neville: I can tell you that SafetyWing is actually a little bit cheaper than we are. But we cover more activities, have lower deductibles, and have practically no limits on medical expenses. It's really only mental health, dental, and pregnancy where the limitations come in.

You can also go to any doctor in the world, any hospital in the world, as long as they're locally licensed. If you are hospitalized, and you need serious medical care, we have a 24/7 hotline. You can call them at any point. If you're hospitalized, they get in touch with the hospital, and they set up direct billing with the hospital. So you don't even get a bill.

That's why we're not always cheaper than our competitors.

I don't have final pricing yet for our international health insurance, but it will be significantly more expensive than our current plan.

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Brent: Your materials say that unlike most travel insurance, you also cover “non-emergency illnesses.” What does this mean exactly?

Neville: We cover anything that’s “medically necessary.”

For example, an ear infection, or visiting the eye doctor if your eyesight suddenly got worse. These are real claims that came up and were covered.

What is medically necessary is decided by the doctor and measured against local medical standards.

If you want to get very technical, medically necessary treatment is defined as follows: treatment is considered medically necessary if "at the time of the treatment, based on objective medical findings and knowledge, it was reasonable to consider the treatment necessary.”

It might also be helpful to mention what’s not covered: the most notable exclusions are pre-existing conditions and pre-existing pregnancies, as well preventive care, non-emergency dental care, psychotherapy, eyesight correction, and alternative medicine.

Any medical issue caused by the use of drugs or too much alcohol can also be excluded. We cover almost all sports and activities with just eight exceptions — the most notable one is diving. We’re aware that a lot of nomads love diving and we’re working hard to find a way to get that covered.

Brent: A lot of nomads use these “travel insurance” products as their primary health insurance. Is anything else excluded? Cancer? Chronic conditions? If you have a serious illness, will you cover the entire treatment for up to the two-year maximum?

Neville: There is no special rule regarding cancer or chronic conditions. If it’s a pre-existing condition, then it’s excluded. If it came up while you’re covered, then it’s covered — until the limit of two years is reached or you cancel the insurance.

Here again it’s worth noting that only medically necessary diagnosis, treatment, and medication are covered. Not, for example, a caregiver at home.

The distinction between travel health insurance and international health insurance is a very important point: travel health insurance is always limited to a certain time while “international health insurance” is typically not.

That can have significant consequences. If you have travel health insurance for the full two years, and then you sign up a second time, any medical conditions that arose during the previously covered period could become excluded, as they are now pre-existing conditions.

That’s a noteworthy risk, especially if you think about cancer and chronic diseases. To cover for such risk, nomads would need to have international health insurance, access to local healthcare, or insurance in their home country, or a prospective entitlement for such insurance which some insurers offer.

Brent: That’s an excellent point! I see the risk in using “travel insurance” as your only coverage. Even a more robust policy will have some limitations, and the policy itself may be time-limited, so if disaster strikes, you have a major “pre-existing condition” and could have a hard time getting coverage after the current policy expires.

Moving on, I also like your “home country” coverage [which includes 42 days for every six months of coverage, even for Americans — more generous than SafetyWing].

Neville: The policies we sell cover the US and Canada, but there is a limitation. But it's accidents and emergencies only. Like, bona fide life threatening emergencies, basically.

And you have to leave your own country once before that coverage kicks in. It’s fine if you're already traveling, like in your case. But if someone was in the US, signed up for Genki but hadn't left yet, they wouldn't have coverage until they have at least left once.

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Brent: But you currently only insure people up to the age of 50?

Neville: With Genki World Explorer — our travel health insurance — currently, we can cover people under the age of 50, as of the day the insurance cover begins.

We are going to offer cover for people under age 70 starting in 2023.

With our international health insurance, there will be no age limits — and still no restrictions regarding citizenship or residence.

Brent: With “nomad” travel policies, where you can sign up anywhere at any time, I'm curious how you avoid the problem of somebody having an injury, and then signing up and going to the hospital and expecting to be covered.

Neville: We have a 14-day waiting period from the time of your policy starting until claims are covered, with a couple of exceptions. One, life-threatening emergencies, and two, if you have existing coverage that extends up until the start date.

Basically, if you are switching insurance companies, if you had coverage up until the time your Genki insurance started, obviously, the risk of fraud is a lot lower, because you will just be filing a claim with your other insurance.

In order to have coverage, to not be subject to the 14-day waiting period, you have to show that you have prior insurance.

The second thing is that pre-existing conditions within a six-month window, looking back six months, are not covered. This is where we really get into the weeds in terms of definitions. But a pre-existing condition includes anything you've sought treatment for during that time, or basically that you obviously should have. Not if there was just some hidden thing that you had no idea that you had, and there's no way you could have gotten treatment for it.

But if you've been walking around with an obviously broken leg, or something like that, and just wait until you have insurance to get treatment, that would be clear in the medical record. And that would be a pre-existing condition. You could still have the insurance, but treatment for that condition would not be covered.

Brent: There is no underwriting for this first product, correct? You just sign up online, and you’re good?

Neville: Technically speaking, there’s always underwriting. That actually refers to accepting the risk as an insurance company — basically signing the contract. But I know what you mean. Our travel health insurance has no medical questionnaire. You just sign-up online, as you said.

The sign up process for our international health insurance will include a medical questionnaire. Based on your medical situation, you’ll either be accepted directly, accepted at a higher premium, accepted with specific exclusions for pre-existing conditions, or (in rare cases) we won’t be able to offer insurance.

Brent: You launched this product — when? Last year, in 2021? How many subscribers do you have? How big are you?

Neville: Marc Knaup, our CEO, started laying the groundwork for Genki a few years ago. But we officially started the first insurance cover exactly one year ago — we just celebrated Genki’s first birthday on September 16.

We have a few thousand subscribers so far.

Brent: I think a lot of people are going to say, “There's no track record, there aren't a lot of online reviews.” I know you have a reputable corporate partner, but aren’t you asking people to make a leap of faith, as opposed to going with a more established company?

Neville: I think that's fair. I would look at it, honestly, the exact same way.

Ultimately, the best way for us to handle that is just to continue providing great care to the people who do want to take that leap of faith and let them write good reviews about us and spread the word.

And we do have good reviews so far.

Genki is a broker registered in Germany. Our insurance partner who handles claims, DR-WALTER, is also a German company. And the risk carrier, Allianz Partners, is based in France. The company itself, and all our partners, the insurance behind the insurance, that kind of thing, are all based in Germany or France, but most importantly, they’re in the EU, which is a very strict regulatory environment.

What we've taken is an existing insurance product from Allianz, a company that's many decades old, and another company, DR-WALTER, that has a long track record in providing insurance to all sorts of international travelers in and out of Germany.

And we basically partnered with them, and they actually invested in Genki. So the actual company who's handling the claims, and doing all that behind the scenes, is a company that has been around a long time, and they have a good track record, both within the insurance world, but also you can find them on Trustpilot and read reviews about them.

The biggest concern with insurance is: you’re going to pay all this money, and then when you actually need them, they're going to have gone belly up. But we have a giant company behind the scenes that isn't going anywhere, and [we have all that] EU and German insurance regulation.

Brent: Thanks for talking with me!

For more information about Genki, go here.

For information on SafetyWing, go here.

For information on World Nomads, go here.

For full international health insurance coverage, consider GeoBlue (which is Blue Cross/Blue Shield), William Russell, Cigna International, Insured Nomads, and Aetna.

Also, I’d love to hear about any experiences you’ve had with Genki.

And feel free to chime in below with any thoughts, comments, or corrections! As I said, this is a complicated topic, and I think all nomads and long-term travelers can benefit from learning more — including me!

Finally, here’s my first nomad health care article again.

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Brent Hartinger is a screenwriter and author. For more about Brent, visit him at BrentHartinger.com.

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