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Who Has the Best International Health Insurance: SafetyWing or Genki — or Someone Else Entirely?

We have answers.

Brent Hartinger

Nov 18, 2023

This article contains affiliate links, which help support this website. This does not affect our coverage, which is editorially independent.

Regular readers know that I occasionally write about health care for expats, long-term travelers, and nomads like Michael and me.

There are actually two kinds of health insurance for travelers:

Travel Insurance, which is a temporary, term-limited policy that covers you outside your home country, and which pays only for emergencies and “medically necessary” treatments — and also, hopefully, for medical evacuation to the best medical facility and, if necessary, back to your home country. Such a policy is usually purchased in addition to more comprehensive coverage in that home country, which is where you would probably go if you have a really serious or chronic illness.
Full International Health Insurance — sometimes called “expatriate” or “long-term international” insurance — which is is full coverage outside your home country, and which is not term-limited and continues as long as you pay the premiums. These policies typically replace any other coverage you may have, although some people may also have some kind of “national” coverage back in their home country.

For complicated reasons, there are essentially only three companies that sell travel insurance that’s of practical use to most long-term travelers: SafetyWing, World Nomads, and Genki.

I recently compared all the companies, and I found a clear favorite: Genki. And a clear loser: World Nomads.

Earlier this year, both Genki and SafetyWing (but not World Nomads) also started offering full international health insurance. Genki calls this their “Genki Resident” plan (as opposed to “Genki Explorer,” which is their travel insurance), and SafetyWing calls it “Nomad Health” (as opposed to “Nomad Insurance,” which is their travel insurance).

Incidentally, why not just rely on plain old travel insurance, which is cheaper, for your international health care needs? Why pay for full insurance?

It has to do with the limited duration I mentioned above. Travel insurance may pay for some or even all of your health care needs while traveling, and it will pay for the duration of your term. But what happens if you come down with a serious or chronic illness and your term expires? You would then have a major “pre-existing condition,” making it essentially impossible for your illness to be covered by any other company.

At that point, you would have to pay 100% of your care out-of-pocket. And, of course, the whole point of insurance is to cover extreme, extraordinary mishaps that you couldn’t otherwise pay on your own.

One way or another, I think every traveler needs to be covered for both emergencies and longer-term or chronic illnesses.

Michael and I carry a Genki Explorer policy — travel insurance — but we’ve made sure it has good medical evacuation coverage back to the U.S., our home country. And back in the U.S., we also continue to carry a bronze Obamacare policy. Because the Obamacare policy is subsidized due to our lower income — we are writers, after all — we now have very good coverage all over the world for a shockingly low price.

Likewise, if you have an employer or nationalized health care plan, or you’re an American and you qualify for Medicare, you could safely rely on that coverage and travel the world with only travel insurance.

The other option for long-term travelers is full international health insurance, like Genki’s new Resident plan or SafetyWing’s Nomad Health.

How exactly do these two new policies compare — to each other, and also to the other companies’ existing products? Unlike travel insurance, nomads and long-term travelers have lots of different options for this kind of insurance.

That’s what this article is about.

Brent and Michael, near Sydney. — *Staying healthy on the Australian coast.*

Before I get down to the nitty-gritty, here are a few general notes about full international health insurance:

Many international plans require you to declare one country of residence, but they generally provide “world-wide” coverage (except for a few countries, outlined below); always ask for exact details. SafetyWing and Genki both provide coverage virtually everywhere in the world and do not require you to declare your residence in advance.
Because health is so insanely expensive in America, “world-wide” international coverage works differently in the U.S. (and sometimes in a few other expensive countries or cities, like Canada, Hong Kong, and Singapore). In these places, international policies might only offer emergency coverage (and only for a limited time). You usually have an option to pay for expanded “full” U.S. coverage, but you have to choose this in advance of any illness, and it’s very expensive, probably doubling your premiums. Also, even this “full” coverage might have limitations, unlike in the rest of the world. All this said, I mention a hack below that will allow Americans to get this full coverage in the U.S. and Canada for much less money.
No international policy is Obamacare-compliant; the strict regulations of America’s Affordable Health Care Act are not in effect here. That means you can be denied coverage as a result of a pre-existing condition (or they may charge you more to cover your condition). On the other hand, these policies are still regulated, often in the EU (which has strong legal protections for the consumer). Once you have coverage, and you continue paying your premiums, you usually can’t be dropped because you get sick. But always ask where exactly your insurance company is based and regulated.
Speaking of Obamacare, many American nomads think, “I’ll just carry travel insurance while I travel, and if I get sick, I’ll go home, and I can’t be denied insurance even with a pre-existing condition.” But outside of the annual November enrollment period, you can only get coverage if you have a “qualifying life event.” Moving home for the purpose of receiving medical treatment definitely does not qualify. (And if you’re just returning to your previous location — a place where you’ve continued to receive mail, for example — that’s not considered a “move” anyway.)
In my opinion, all international insurance — travel or full — should have very strong medical evacuation coverage. The added cost to your premium is usually minimal, but medical transport can be very expensive: hundreds of thousands of dollars, or even more if a helicopter is involved. Lacking this coverage can easily bankrupt a person.
Finally, full disclosure: I’m not a medical or insurance expert. I’m just a long-term traveler who has a vested interest in this topic. I’m also an American, although a lot of this information is applicable to any traveler.

Keeping all this in mind, here are my assessments of SafetyWing’s new Nomad Health and Genki’s new Resident plan — followed by some other international insurance options for comparison purposes:

SAFETYWING’S NOMAD HEALTH

This is a new plan, started in 2023, offering full health insurance world-wide (including the U.S., Singapore, and Hong Kong, if you choose this expensive add-on). It’s complete healthcare coverage, and can include prescriptions, dental, mental health, pregnancy, and more, and it lets you choose any licensed doctor.

Nomad Health offers two tiers: Standard and Premium. Premium pays for preventative care — check-ups, teeth-cleanings, and the like — and also pregnancy.

It requires a twelve-month contract, which is renewable, but unlike SafetyWing’s travel insurance, you must fill out a medical questionnaire for this plan, and you can be denied coverage.

What I Like:

SafetyWing’s Nomad Health is straightforward and relatively affordable. The monthly premiums below are in USD. The column on the right is the premium with the U.S., Singapore, and Hong Kong add-on.

Safety Wing Nomad Health premiums — *Monthly premiums for Safety Wing’s Nomad Health in USD.*

Nomad Health has no deductibles, and they offer a 10% discount if you pay the year in advance.
Their America, Singapore, and Hong Kong add-on lets you be residents of Hong Kong and Singapore, living there up to twelve months out of the year. But the American coverage only lets you be in that country six months in one year, and you can’t be a U.S. citizen or resident to use this aspect of the add-on.

What’s the catch?

Pay-outs are capped at $1.5 million in any given year for in-patient (more serious treatments), and $5000 for out-patient (less serious treatments). Both of these are on the very low end of insurance coverages.
This coverage stops at age 74. If you have the policy, it expires at this age.
Without the add-on, the Standard and Premium plans both limit their coverage in the U.S., Hong Kong, and Singapore to only 30 days per year, and it is a limited, emergency-only coverage.
SafetyWing’s medical evacuation coverage is terrible — it maxes out at $100,000, and it’s more limited than other companies.
Pregnancy coverage is only included in the Premium plan, not the Standard one, and requires a 20% co-payment. On this coverage, there is also a ten-month waiting period.
HIV/AIDS coverage is limited to $50,000 USD.

Brent’s Take

I wasn’t a fan of SafetyWing’s travel insurance, but I like this product better. The primary advantage is that it’s cheap. The problem is that, while it’s fairly comprehensive coverage, the pay-out limits are low, especially that $5000 out-patient maximum.

And as with their travel insurance, I’m especially annoyed by their stingy, limited medical evacuation coverage. Keep in mind that if you’re visiting the U.S. — where your coverage may be limited — and suffer a major injury or illness, they may not even transport you back to your home country. Which means you could be stuck without coverage in a country with ridiculously expensive health care.

As a result, if you opt for this policy, consider supplementing it with better evacuation insurance, like Emergency Assistance Plus or DAN diver insurance (which isn’t just for divers). Both of these annual plans are very inexpensive.

Unless you have specific preventative needs, I would also probably not pay for the more expensive Premium option; I would simply pay out-of-pocket for preventive care. As Michael and I have traveled, we have generally found that, outside of America, health care is almost always fairly or extremely inexpensive.

Finally, SafetyWing’s America, Singapore, and Hong Kong add-on doesn’t cover Americans living even part-time in America, so it should never be purchased for this purpose.

GENKI RESIDENT

This is also a new plan, started in 2023, offering full health insurance world-wide (including the U.S. and Canada, if you choose the expensive “Region 2” add-on). It too is complete healthcare coverage, and includes prescriptions, dental, mental health, pregnancy, and more. It also lets you choose any licensed doctor.

Like SafetyWing, it offers two tiers, here called Resident and Resident Premium. With Premium, you’re also getting coverage for preventative care — check-ups, teeth-cleanings, and the like — but it also includes perks like single room occupancy in hospitals.

Genki Resident requires a twelve-month contract, which is renewable until death, but once again, you must fill out a medical questionnaire, and you can be denied coverage.

What I Like:

Unlike SafetyWing, Genki Resident has no treatment caps limits. Except on some specific treatments, most of the pay-outs are unlimited, even for out-patient treatments.
Genki Resident has a plan with no deductible, but it also includes options with deductibles (at lower prices). Genki is more expensive than SafetyWing, but in many ways, it’s a better value. I also have a special “hack” to lower the price, outlined below.

*Genki Resident monthly premiums, in USD, converted from euros. Calculator here.*

Unlike SafetyWing, Genki Resident has no maximum age. You keep this policy as long as you keep paying the premiums (although your premiums will go up dramatically).
The company offers a telemedicine option and 24/7 emergency assistance (which I really like: in remote areas, it can be hard to find reliable health care. Also, you can get your “silly” questions answered).
They include various benefits that other companies don’t, like a $10,000 search-and-rescue pay-out.
Their medical evacuation coverage is very solid. If you’re in an accident, you’ll mostly get to decide where you want to go. That said, if you use this coverage to return to your home country, the expectation is that you will have coverage there, and this policy immediately becomes void.

What’s the catch?

This is great coverage, but fairly expensive.
Without the Region 2 add-on, coverage in the U.S. and Canada is limited to six weeks a year, and it’s only emergency coverage.
Coverage in your home country, where you’re a resident or citizen, is limited to six months out of every year. Furthermore, you’re not eligible for home country coverage until you leave that country at least once.
There is no discount for paying a year in advance (Genki says it’s because regulations in Europe, where they’re based, do not allow them to charge different people different prices for the same product).
Dentures, tooth and jaw adjustments, childbirth, and psychotherapy may be only partially covered, and aren’t covered at all during the first ten months of insurance; eyesight correction surgeries ($2174 max pay-out per eye) aren’t covered during the first two years of insurance. Except for pregnancy, SafetyWing tells me they don’t have these time-limitations — but they have pay-out limits too, and they don’t cover certain procedures, like eyesight correction, at all.

Brent’s Take

This plan is much more comprehensive than SafetyWing’s Nomad Health with better pay-outs — and it also has superior medical evacuation coverage. But it’s also more expensive.

That said, the price can be greatly reduced with one of my secret “travel hacks,” at least if you’re a U.S. resident looking for full U.S. coverage.

Genki Resident offers six months of coverage in your “home country.” But what happens if your home country is the U.S.? Do you still need the U.S. add-on for full coverage there?

No! With Genki Resident or Resident Premium, you’ll have six months of full U.S. coverage every year even without the U.S. add-on (assuming you leave the country at least once after starting your policy). This is full U.S. coverage for up to six months for less than half the usual price.

And, yes, this is perfectly legal, and I’ve verified it multiple times (but please: do your own due diligence, and, of course, always get everything in writing).

All this said, keep in mind that you can’t use Genki’s medical evacuation coverage to return to the U.S. from another country for medical treatment; if you did, Genki’s coverage would end immediately upon arrival. You also probably couldn’t use this coverage for transport from America to get treatment to some cheaper country. For Americans, this is a serious limitation.

But bottom line? If you’re an American and you need some full American coverage, this is an incredible value. In this respect, it’s far superior to SafetyWing, whose full coverage here is literally worthless, at least for Americans.

Finally, as with SafetyWing’s Nomad Health , I would probably not pay for Resident Premium — unless you’re taking advantage of the above-mentioned insurance hack.

Comparisons to Other International Plans

When I analyzed “travel insurance” for nomads, my conclusion was clear: Genki seemed like far and away the best value over SafetyWing and (especially) World Nomads.

With full international insurance, the picture is a bit more muddled. Safety Wing’s Nomad Health plan has serious limitations, but it’s also fairly cheap. Meanwhile, Genki Resident is more robust but expensive — especially for more-than-emergency U.S. coverage.

For greater context, I decided it might be helpful to explore the plans of other existing companies.

Unfortunately, every company does things a little — or a lot — differently, so it’s impossible to make direct comparisons. Unlike SafetyWing’s Nomad Health and Genki Resident, most international plans allow much more customization, raising or lowering deductibles, and adding or eliminating lots of different features. This affects the price — often dramatically.

Of course, price isn’t everything. Value lies in exactly what you’re paying for, not how cheap something is.

First, I looked at Cigna International, a popular choice. These are the premiums for their mid-range Silver Plan, always with medical evacuation coverage (which I think is essential); with and without “out-patient” coverage; and with and without full U.S. coverage in the U.S. (although the non-USA plans include brief emergency coverage).

These numbers are with a $1500 deductible, which can be raised or lowered, changing the premiums.

Cigna premiums. — *Monthly premiums for Cigna Silver, in USD, with a $1500 deductible.*

I looked at Allianz (which is also one of the companies associated with Genki). This is their most basic plan, with a $1015 deductible and includes medical evacuation. I looked at options with and without full U.S. coverage.

Allianz premiums — *Monthly premiums for Allianz, in USD, with a $1015 deductible.*

And I looked at IMG Global Medical Insurance (GMI). These are two different plans, a basic Silver plan, and a more premium plan, Xplorer Premier. These numbers are with a $1000 deductible, and both include medical evacuation. Again, I looked at options with and without full U.S. coverage.

IMG premiums. — *Monthly premiums for IMG Global, in USD, with a $1000 deductible.*

Finally, I looked at GeoBlue, which, frankly, seemed so expensive that I’m assuming I was doing something wrong.

These numbers tell me several things:

The prices for both SafetyWing Nomad Health and Genki Resident are both within the ballpark for what other companies are offering and charging (though Nomad Health does seem especially stingy on benefits and pay-outs; I think SafetyWing is relying on their name recognition among nomads to sell a somewhat mediocre product).
Full coverage in the U.S. is really expensive, and for Americans, my above Genki hack is a really good deal.
Prices can vary dramatically based on one’s age, region of coverage, deductible, and specific benefits — and a lot of these exact details are still confusing even to me.

Bottom line? There’s still more to figure out about this topic. Which means that, whether I like it or not, I probably have to research and write at least one more of these damn articles.

Check out Safety Wing’s Nomad Health here.

Check out Genki Resident here.

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