Just imagine for a second that you are in the middle of a long-term trip abroad. You are not just on holiday; you are a digital nomad with your travel itinerary booked up for months—but you suddenly get seriously ill.
Are you fully prepared for this type of thing to happen? For a lot of people, the answer is no.
The truth is, perpetual travelers, digital nomads, and serial expats don’t really fit the mold when it comes to most traditional forms of insurance and primary health insurance plans.
If you are using a domestic health program or insurance tied to one specific country, you will usually be required to live the majority of your time there as a tax resident in order to qualify for coverage. You can’t just hop back “home” after being absent for years of not paying taxes and expect free or affordable health care by flashing your passport.
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The world is not yet built with the lifestyles of digital nomads and global citizens in mind, unfortunately. This seeming complexity results in many nomads taking their chances and relying on a cheap travel insurance option at most, even though it really doesn’t cover the needs of a long-term traveler.
On the other end of the spectrum, there are those that are over prepared—throwing away money on ensuring every little thing, with the costs outperforming the benefits. While a better problem to have than too little insurance, forking out hundreds every year to ensure that you are covered if your suitcase goes missing is probably not worth it.
For many digital nomads and serial expats, what you most likely need is a primary global health insurance policy. Ideally, one that’s tailored to your lifestyle. That’s what I’ll cover in this article.
The only exception is if you still have valid primary health coverage in your home country, in which case a comprehensive travel health insurance policy is probably what you need.
If you’re unsure what type of health insurance you need, take our 30-second interactive insurance quiz (no personal details required):
Why you can’t rely on just travel insurance
Having primary health insurance is not an unnecessary expense. If you lived permanently in your home country, it would most likely be scandalous if you didn’t have access to adequate health care. So why should it be any different if you are a digital nomad?
It’s important to remember that as a nomad, you are not just on vacation but you chose to live a permanent or semi-permanent life of travel. This means that you are not just prone to the health risks of adventure and travel, but you also need to check up on your regular health needs that come with daily life.
Travel insurance has its place. It’s a great (and crucial) option if you are on short trips, but it just doesn’t cut it as a long-term health care option for perpetual travelers. Many basic travel insurances don’t contain health coverage at all; the more comprehensive ones usually just cover emergency treatment and emergency evacuation if needed.
Just imagine that you break your leg while climbing Kilimanjaro and need emergency care—travel insurance will save you, but if you are diagnosed with a chronic condition that requires regular check-ups—basically, it’s game over for both your wallet and possibly even your future travel ambitions.
Additionally, even with only emergency health care, it often means that they will send you back to your home country as soon as it is cheaper or more convenient for them to do so, or if it’s the only way they can give you sufficient care.
As you can imagine, it’s less than ideal if you are forced into making an unplanned visit to your country of residence. Even worse, if you don’t have coverage there either, which, if you live full-time abroad, is most likely going to be the case.
Sadly, despite this huge gap in coverage, relying on travel insurance abroad is a risk that many digital nomads and other expats are willing to take, but it comes at a possibly catastrophic cost should you get some serious illness whilst having no primary health insurance at all.
What global primary health insurance gives you instead
Luckily, nowadays, there are many plans out there tailored especially for digital nomads and other citizens of the world.
Thanks to many who choose this lifestyle, international health insurance has become more affordable than ever. You can now easily get location-flexible health care whenever and wherever you need it.
You will see a lot of terms floating around, such as nomad health insurance, expat health insurance, private global health insurance, and overseas primary health insurance—they all essentially meant the same thing as global primary health insurance.
Global primary health insurance can typically cover the following things which travel health insurance doesn’t:
- Long stay trips (many travel health insurance companies won’t cover you for more than three or six months without paying a lot more money)
- Everyday preventative care
- Care related to pre-existing medical conditions
- Long-term care of chronic conditions, cancer treatments
- Routine examinations and treatment
- Access to birth control or prenatal care
- Dental care
In addition to this, you can get all the emergency care you need without the fear of being sent back to your country of residence at the decision of your provider.
Note that while they can cover all of your health needs, they generally do not cover travel-related incidents like missing baggage and delayed flights. Also, some things are an additional add-on, such as extreme sports coverage, dental, and maternity care. The good thing is that it can be tailored personally to your own needs.
What to look for when shopping for digital nomad health insurance
For those who are new to shopping for health insurance, you will quickly realize that it isn’t as simple as looking at the price tag. There are all sorts of things to weigh and consider when comparing one plan to another. Before taking a look at some of the top providers, let’s go over some of the key indicators to be looking at when shopping for an insurance plan that works for you.
Jurisdiction coverage
Seems obvious, but it’s important to know what countries you will be covered in (either as a resident or while traveling). Most companies cover practically every country except a handful of ones where health care is more expensive, such as the US, Canada, Hong Kong, and Singapore. To include these, you can expect an additional cost or another plan entirely.
In addition, some plans may make you specify which countries or regions you are going to be in before you sign up. That means if you have any last-minute changes, you might end up having to try and change your jurisdiction so you can get treatment in another country (presuming that is even possible according to the plan’s terms). Many also ask you to list a primary country which is typically where you’ll officially be a resident. In case you won’t be based anywhere in particular for long enough to become a resident, you can usually list the first country you go to or the one you plan on staying in the longest.
Home country coverage
If you think you are going to need it, you might want to check the terms of home country coverage. While many plans will list this as ‘home country coverage’, this typically refers to the country where you’re a national, not your country of expatriation/residency. Many plans will cover your home country, typically for up to 3 months or 6 months per year.
Some allow you to opt-in for home country coverage when you start your plan, and some won’t cover it at all if you are from certain countries (such as the US, a consistent outlier when it comes to health insurance 🙂 ). It’s also worth checking that you will get the same treatment coverage in your home country; some might only cover emergency care.
Treatment coverage
As you can probably imagine, when it comes to health care, there are loads of potential things you might need treatment for. Most insurance policies will have a huge list of treatments that are both covered and not covered. Several different plans cover different things at different coinsurance amounts (more on that later), and there are also bonus things you can add on if you think you will need them, etc.
The must-haves are emergency health coverage, as well as outpatient care (all the main types of care that don’t require overnight stays, such as x-rays, MRIs, routine consultations, etc.), and inpatient care (overnight hospital stays, e.g. following complex surgeries), and prescription coverage. There are many things that either aren’t covered or can be added such as dental, vision, maternity, physical therapy, and mental health services. As health is so unique to us all, it’s best just to find their list and compare to see which things are most important to your health.
Reputation of insurer
There is no point paying up each month if the insurance company isn’t there for you when you need them. Reputation and reviews are all subjective and sometimes hard to evaluate, but you will need to have an idea of who is reputable. Things to look for include how fast they pay their claims and if a lot of people have had experiences where they are looking for excuses to avoid paying the costs. That being said, don’t expect an insurance provider to pay for things not covered in the policy wording! Many reviewers seem to expect this. The most important advice here is: Read the damn insurance policy yourself!
Pre-existing and chronic conditions
It gets tricky with these because while most will say they cover pre-existing conditions, there is a lot of fine print. When you declare a pre-existing condition, it is typically subject to medical underwriting. There is also the option to get coverage for everything except your pre-existing conditions, but if you would like it to be covered, the price can vary a lot depending on the risks involved, and as you can imagine, going to each provider for medical underwriting and then evaluating later is quite a time-consuming thing to do. Also, some of the US health insurances, in particular, will want to see if you have had coverage for this before in order to include it. It’s also possible that it won’t be covered from the start, and only when you renew for year two.
Coverage for life
Most plans will list some kind of maximum entry age. This means that you have to be under a certain age to start the insurance agreement, not that you will lose the insurance after you hit a certain age. With most plans, however, your premium will go up when you hit a certain age bracket. If you are reaching retirement age, it’s good to check first of all that the pricing is appropriate for your age, but also that you will be able to stick with them long-term without it getting severely overpriced.
Travel benefits
More of a ‘nice to have’ rather than a necessity. Typically, international primary health insurance does not include the usual travel insurance benefits like lost luggage and missed flights. That said, there are some that will add it on for extra. You may want to consider how much it would cost if you added separate travel insurance on top of the primary health insurance and do some calculations. Maybe a very basic travel insurance plan could go in tandem, or maybe just go for one with a premium option for added care. In many cases, you may be better off getting a dedicated travel insurance for longer trips abroad or stick with what’s included with your credit or debit card.
Cost
One of the most important things to consider, but also one the most complex to determine, is the price you will be paying and if it is all going to pay off. It can kind of feel like a balancing act when deciding if each add-on will be worth it, but if you understand insurance lingo, then you should be fine when evaluating the plans.
Insurance Lingo Glossary
Premium—This is the monthly fee you will pay to keep your insurance plan.
Deductible—The amount you must pay initially for health care before the insurance starts to pay for anything. Since it is agreed based on a shared risk between you and the provider, you can typically select a different deductible amount either higher or lower. If it is higher, the premium is going to be lower, and vice versa. Deductibles can be paid per incident or per year, with the latter being the preferable option as a customer.
Copay and Coinsurance—This is the cost you pay for services where the deductible doesn’t apply. In the US, usually, the copay is the cost before you have paid the deductible and coinsurance is the cost after the deductible. You may find both of these terms used interchangeably internationally, as they are mostly the same thing. Whether you would like these to be lower or higher depends on your financial situation, as it affects whether your premiums are lower or higher.
Out-of-pocket maximum—If listed, you should take a close look at this one. It usually sums up the .absolute max you will pay annually out of pocket. They generally do not include the premium in this figure, just the copay, coinsurance, and deductible amounts.
As you can see, health insurance costs are very individual. It’s impossible just to pull up a number without knowing who the customer is. To make a relative price comparison, we decided to come up with four typical ‘personas’, submitted quotes to all of our recommended international primary health insurance providers, and have listed the pricing we received in the table below.
| Name | Cheapo (per month) | Typical Nomad (per month) | Early Retiree (per month) | Specced out (per month) | Age multiplier | Market | Get quote |
|---|---|---|---|---|---|---|---|
| SafetyWing Remote Health | $85 | $133 | $318 | $164 | 239% | Global | Get personal quote |
| Integra Global | $108 | $174 | $766 | $644 | 439% | Global | Get personal quote |
| IMG Global | $51 | $129 | $765 | $933 | 595% | Global | Get personal quote |
| Allianz | $98 | $232 | $620 | $985 | 267% | Global | Get personal quote |
| AXA Global Healthcare | $62 | $135 | $442 | $1,435 | 328% | Global | Get personal quote |
| MSH International | $74 | $161 | $679 | $730 | 423% | Global | Get personal quote |
| GeoBlue Xplorer | $174 | $236 | $816 | $882 | 346% | US | Get personal quote |
| Cigna Global | $97 | $101 | $241 | $878 | 239% | Global | Get personal quote |
| William Russell | $146 | $241 | $861 | $1,020 | 357% | Global | Get personal quote |
To give you an idea of our four price profiles, here is what information we used in the quotes for each of our personas:
Cheapo—a 30 year old guy who spends most of his time in low cost of living countries. In this example, we used Thailand as the country of residence/expatriation. He is looking for insurance that is the lowest possible plan, with worldwide coverage minus any additional add-ons (such as the US), he only wants inpatient and emergency care (no outpatient), with a benefit limit of $100,000, and a deductible up to $5,000
Typical Nomad—Another 30 year old guy, but this one lives in a more typical cost of living country, we used Portugal for this one. Like the Cheapo, he wants worldwide coverage minus the US or other extra-cost jurisdictions, same deductible and benefit limit, but the addition of outpatient care.
Early retiree—Basically the same as Typical Nomad, but this guy is 60 years old. If you are one of our older readers, you will definitely find this valuable to know as age can significantly jack up the price in some cases (but not all!) We’ve also added an “age multiplier” column in the table which shows the difference in price between someone aged 60 rather than 30 for the same benefits.
Specced out—Finally with this example, someone who wants to go all out. We used a 30-year-old female in this example, looking for all add-ons such as maternity, dentistry, vision, anything that is offered. The plan should be worldwide with no exclusions, no deductible and an unlimited benefit limit. We also chose a country of expatriation that is known to have expensive healthcare costs, Hong kong.
For all of the personas, we chose Canada as the country of nationality, with the exception of GeoBlue Xplorer, which is only available for US citizens and permanent residents.
Insurance Provider Showdown
Now you know what to look for, here’s a showdown of all the main international primary health insurance providers you should consider. We’ve decided to split it into two sections: one focusing on global options, which are available for residents and citizens of most countries, including the US, and another section exclusively for US residents and citizens.
The main reason for this distinction is that certain countries have higher costs of health care. The US is a notorious example of this, so much that it is often excluded from coverage (or included for a higher price).
Since there are many great options that are only available to US citizens and residents, we thought it was worth exploring if you are American. That’s not to say that some of the Global providers might also be more suitable instead.
Global Providers
SafetyWing Remote Health
SafetyWing is a global company built by nomads for nomads, making it probably the most popular provider out there for digital nomads. What’s truly great about them is their level of flexibility for those who are non-stop traveling, not just more traditional expats.
They offer a product called “Nomad Insurance” which is travel insurance with some emergency health coverage. We’ve covered this in our travel insurance article, so check that out if that’s what you think you need. On top of that, however, they also offer a product called ‘“Remote Health”, which provides global health insurance for remote workers and nomads.
Safety Wing’s Remote Health plan not only gives you access to treatment in over 175 countries, but it also gives you coverage in your home country as well. They will also cover most preexisting conditions, although they must be approved and may bring up the price depending on what it is. The most basic plan covers the scenarios where you are admitted to the hospital abroad, but not things such as visiting a family doctor for a check-up. However, there are premium add-ons available, including outpatient care visits with a 10% copay.
One final great thing about Safety Wing Remote Health is that they also have a full-company plan option. So, if you have a remote company, you are able to provide access to worldwide health care for all your employees. The company plan actually includes maternity care as well, which is not available on an individual plan. Otherwise, it is a similar plan, but on a company-wide scale, however, one major benefit is that when your company has more than 10 employees, all pre-existing conditions are covered without any prior approval. This makes it great for employees who wouldn’t otherwise be able to get affordable private health insurance, and is a valuable strategy for companies to retain talent.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $85 | Standard | None | $0 |
| Typical Nomad | $133 | Premium | Dental, vision, routine screenings | $0 |
| Early Retiree | $318 | Premium | Dental, vision, routine screenings | $0 |
| Specced out | $164 | Premium Plus | Dental, vision, routine screenings | $0 |
Monthly premiums start at $123 for someone who is aged 18-39 (annual plan), however, pre-existing conditions, add-ons, and other age groups can significantly add to the price. In addition to that, coverage in Hong Kong, the US, and Singapore isn’t included in this price if you need coverage for more than 30 days per trip. If you need more permanent coverage in these countries, the starting price is $227 per month instead.
One nice thing is that there is no deductible for any of the plans. There is only 10% co-insurance for outpatient services in the Standard plan (none for the Premium plans) and 20% co-insurance for maternity care under the Premium Plus plan.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Worldwide minus US, Hong Kong, and Singapore on standard plan. Sanctioned countries are also excluded. |
| Home country coverage |
 Emergency treatment at home for up to 30 days per 90 days, 15 days per 90 days if your home country is the US. |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected |
| Reputation of insurer |
Great 4.2 on TrustPilot, based on 801 service ratings |
| Pre-existing and chronic conditions |
Some Requires medical underwriting, except on team plans with more than 10+ employees |
| Coverage for life |
As long as you sign up before you’re 69 |
| Travel benefits |
Some None |
Safety Wing at a glance
Highlights 
-
Highly reputable among digital nomads
* Pricing starts at $123/month for ages 18-39
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Coverage in more than 175 countries including your home country
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Short-term coverage in more expensive jurisdictions (such as the US) without increased premiums
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Medical history disregarded for team plans with a certain number of members, pre-existing conditions must be approved for individual plans
Things to note 
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Dental, health screenings, vision and maternity aren't included in the basic plan
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Maternity comes with a 20% co-insurance on the Premium Plan
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Maximum entry age is 79.
Integra Global
Integra Global is a UK-based international health insurance provider, claiming to be an ‘uncommon company for uncommon people’. Their insurance is aimed at virtually any type of expat—even people who work as part of a boat crew have specific coverage options.
The plans can range from their most basic ‘InCare’ plan which covers everything except outpatient care, wellness visits, vision, and dental care. This one doesn’t cover pre-existing conditions either. The best choice for most is probably their middle plan called ‘yourLife’, which will cover essentially everything except dental and accidental death and dismemberment insurance. These however can be added on for an additional cost.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $108 | InCare-Life | None | $0 |
| Typical Nomad | $174 | yourLife | Outpatient, Vision | $0 |
| Early Retiree | $766 | yourLife | Outpatient, Vision | $1,000 |
| Specced out | $644 | premierLife | Outpatient, Vision, Wellness, Dental | $0 |
They also have a premium plan ‘PremierLife’, it has a higher lifetime benefit, but apart from offering you a private room in a hospital instead of a semi-private room, it really doesn’t add much extra value to the ‘yourLife’ plan other than some extra medical concierge services (advanced health checks). The only thing all plans don’t cover is maternity, services related to special needs, and treatment in the case of an accident as a result of doing extreme sports.
While not specifically mentioning the countries they cover, they do say they offer global coverage, except in the US and Canada, which will cost extra due to their higher healthcare costs. You will also need to list a primary country when you sign up, which is your country of residence where you spend at least 9 months out of the year.
The coverage is wide, and deductible options range from $0 to $5,000 on all plans. For most coverage, there is no copay either.
Their insurance can be customized to cover the needs of a lot of travelers, with plans for individuals, families, other groups, and employers. They also offer very industry-specific options for the energy sector and maritime crews. Those who sign up for their plans also get access to digital health tools and a confidential support hotline for mental health, called the Life Aware Program.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Worldwide minus US and Canada on standard plan |
| Home country coverage | ❌ Only covered outside of your home country |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected |
| Reputation of insurer |
Great 4.5 on TrustPilot, based on 20 service ratings |
| Pre-existing and chronic conditions |
Some Only with PremierLife and yourLife |
| Coverage for life |
As long as you sign up before you’re 69 |
| Travel benefits | No |
Integra Global at a glance
Highlights
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Worldwide plans both inc. and excl. coverage in the US and Canada.
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Pre-existing conditions covered in PremierLife and yourLife.
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Maternity and dental add-ons available
Things to note
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One of the more expensive options on our list
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Maximum entry age is 69, and even at that age the price is quite high
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If you reside in the US, or have US permanent resident, then you are not eligible
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No home country coverage
IMG
IMG is another well-established international health insurance provider that covers nomads globally. They offer both short-term and long-term options from simple travel insurance to full health coverage for expats and multinational workers. Coverage is open for people of all nationalities under the age of 75. For US citizens and permanent residents, you must be already residing abroad when the plan starts and when it is renewed and must stay abroad for at least 6 months out of the year.
You can use IMG in over 190 different countries, but the US, Canada, Hong Kong, China, Japan, Macau, Singapore, and Taiwan are not automatically included, although they can be for an extra cost. Home country coverage is also included in this one, however, when you sign up you must list one country as your primary country. So, if you are traveling to many places, you can just pick the one you will spend the most time in, or the first country you will stay in.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $51 | Bronze | None | $0 |
| Typical Nomad | $129 | Gold | Outpatient | $0 |
| Early Retiree | $765 | Gold | Outpatient | $1,000 |
| Specced out | $933 | Platinum | Outpatient, Dental, Maternity, Vision | $0 |
The plans are split into Bronze, Silver, Gold, and Platinum coverage. Their pricing can be quite a puzzle to be honest as there are so many different factors. The main differences are the lifetime maximum limit getting higher from bronze to platinum (the amount the insurance company is willing to pay out for your non-essential treatment in your lifetime), also the deductibles grow more flexible with Platinum ($100-$25000) compared to Bronze ($250-$10,000). While the bronze and silver packages cover most of the basic health needs, Gold and Platinum cover more things like dental, maternity, preventative child care, vision, mental health, travel insurance, etc. It would be better to observe the chart in their detailed brochure to discover the terms for each treatment - they vary greatly depending on the service and package. For example, sometimes they will set a maximum cost per visit or other limits, so it’s worth checking this yourself.
If you have Gold or Platinum, you are likely covering every possible health service you will need and more, but it’s subject to a lot of conditions and exemptions. It’s also worth noting that they usually cover 100% of treatment costs, but in the US, if the hospital is not in IMG’s network, it is only 80%. This doesn’t apply worldwide, just the US, however, their network is very extensive anyway.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Worldwide minus US on standard plan |
| Home country coverage |
Coverage all year round (except the US which is 6 months per year) |
| Treatment coverage |
Good No major exclusions depending as long as relevant add-ons are selected |
| Reputation of insurer |
Ok 4.5 on TrustPilot. Based on 2,319 service ratings, but many complaints about slow claims and unfair exclusions of pre-existing conditions. |
| Pre-existing and chronic conditions |
Some Not covered in Bronze |
| Coverage for life |
As long as you sign up before you’re 75 |
| Travel benefits | No |
IMG at a glance
Highlights
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Coverage in over 190 countries, and home country coverage all year round (except the US where it is 6 months per year)
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Covers a range of budgets and benefits with their plans from Bronze to Platinum
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Pre-existing conditions may be covered (except in Bronze)
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Maximum entry age is 75
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Low starting premiums
Things to note
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Quite a lot of countries are excluded unless you pay extra
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Could be overwhelming to navigate and evaluate (lots of terms and conditions for each treatment and plan)
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Reputation for being slow at paying out claims
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A tendency to deny many claims as being pre-existing conditions, even when previously undiagnosed despite regular check-ups
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The highest “age multiplier” among all the providers at a 595% price increase from age 30 to 60
Allianz
Germany-based international insurance provider Allianz could be another option for you. From what I’ve seen, they seem very modern and straightforward. When you sign up with them, you can manage and view all your coverage information from their easy digital portal. In addition to all their insurance plans, you will get access to other bonuses such as digital health apps for your wellbeing, an expat assistant program, a travel security benefit that offers an emergency travel hotline, as well as the occasional special deals. As an example of their deals, they currently offer 200 euros back towards wellness benefits, which you can use towards things such as yoga classes, gym equipment, and massages.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $98 | Care Core | None | $0 |
| Typical Nomad | $232 | Care Plus | Outpatient | $0 |
| Early Retiree | $620 | Care Plus | Outpatient | $1,015 |
| Specced out | $985 | Care Pro | Outpatient, Dental, Maternity | $0 |
They have several plan levels with opt-in features that cover students, individuals, businesses, families, and people planning to have a family in the future. Their cheapest plan is Care, which offers most of the basic needs such as inpatient care and medical evacuation. Emergency outpatient treatment isn’t automatically included, but if you upgrade to Care Plus or Care Pro this will be included as well, along with emergency dental treatment on the Care Pro plan. There are several optional things that can be added on for maternity, dental, repatriation, and a full out-patient plan.
Pre-existing conditions again are subject to full medical underwriting and can affect the price, or possibly lead to exclusions depending on the situation. The plan is open to any nationality, although the prices and conditions will depend on where you are a resident. Any changes to your residency status must be shared with Allianz so that you can continue to get coverage. You can be covered in your home country as well if it is under your area of cover. Where you are covered depends on your residency, and where you choose to live. You decide this when you first create your plan.
Deductibles range from none to 10,000 euros, their brochure has more detailed pricing and terms, as well as showing you what is covered and not covered in each individual plan.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Worldwide minus US on standard plan |
| Home country coverage |
Coverage for short trips |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected |
| Reputation of insurer |
Ok 4.4 on Feefo. Based on 767 services ratings. Note: Feefo is not as unbiased as TrustPilot. |
| Pre-existing and chronic conditions |
Yes Subject to full medical underwriting |
| Coverage for life |
As long as you sign up before you’re 75 |
| Travel benefits | No |
Allianz at a glance
Highlights
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Plans worldwide both excluding and including the US, as well as home country coverage.
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Travel security program
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Digital portal for managing access to your health services
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Reputation for relatively speedy claims processing
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Flexible Deductibles
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Maximum entry age is 75
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The second lowest “age multiplier” at 267%
Things to note
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Coverage area has to be decided in advance
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Outpatient care, dental and maternity are extra.
AXA Global Healthcare
AXA has plans for both short-term and long-term travel health insurance coverage. It’s aimed at anyone living in another or multiple other countries year-round. They have five different plans, which is quite a lot of flexibility. Their ‘comprehensive’ and ‘prestige’ give you added coverage with prescriptions and treatment for chronic conditions. The lower packages only really cover emergencies.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $62 | Foundation | None* | $0 |
| Typical Nomad | $135 | Standard | None* | $0 |
| Early Retiree | $442 | Standard | None* | $800 |
| Specced out | $1,435 | Prestige Plus | Outpatient*, Dental, Maternity | $0 |
You can access the full policy document here.
I’d personally recommend the ‘comprehensive’ package from looking at the comparisons, as it seems to be the best balance between necessary and not always necessary. Prestige and Prestige Plus just give you added travel insurance, and higher annual limits. There are optional upgrades for dental and outpatient treatment as well. They also give you the choice to include or exclude the US, however with all plans except foundation, you will be covered for emergency treatment there regardless.
They are another one who kind of likes to keep their deductibles and premiums a secret — you need to get a quote from them to see anything like this. They do however mention that you can choose how you pay your premiums, paying either monthly, quarterly, or annually. If you pay annually, you will save 5% on the annual cost.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great |
| Home country coverage |
Coverage for short trips |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected. Outpatient care included in all plans. |
| Reputation of insurer |
Great 4.5 on Feefo. Based on 154 services ratings. Note: Feefo is not as unbiased as TrustPilot. |
| Pre-existing and chronic conditions |
Some Only covered in more premium plans |
| Coverage for life |
No restrictions on age |
| Travel benefits |
Some Covered automatically in more premium plans. |
AXA at a glance
Highlights
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Easy digital portal for managing access to your coverage
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Plans worldwide both excluding and including the US, as well as home country coverage.
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Travel insurance included in upper plans
Things to note
-
Chronic conditions only covered in more expensive plans
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A lot of add-ons, including outpatient care and dental
William Russell
William Russell specializes in several different types of expat insurance, offering international health insurance, in addition to life insurance, income protection, and employee plans. Their international health insurance plans not only cover traditional expats but also work as a great option for those who move more frequently from one place to another.
You can choose between their Bronze, Silver Lite, Silver and Gold plans. The Bronze plan is a budget-friendly option that offers full cover for hospital treatment, cancer treatment, and medical evacuation, with outpatient treatment limited to post-hospital treatment for up to 90 days. Silver and Silver Lite offer the same but with full outpatient treatment, the main difference being whether you get a private or shared hospital room. The gold plan includes extras like mental health and maternity care, with a higher annual limit.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $146 | Bronze | None | $0 |
| Typical Nomad | $241 | Silver | Outpatient | $0 |
| Early Retiree | $861 | Silver | Outpatient | $250 |
| Specced out | $1,020 | Gold | Outpatient, Maternity, Mental health, Dental, Wellbeing, | $0 |
What’s good about these plans is that they are fully personalizable depending on your needs, for example, if you want additional coverage in the US. One thing to note is that coverage is split into five zones, where Zone 1 is worldwide with limited cover in the US. You will have to specify the country you are primarily residing in when signing up with them, however, you are free to travel about and receive coverage anywhere as long as it is in your area of cover.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great |
| Home country coverage | ✅ Yes (if your home country is in the area of cover you’ve selected) |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected. |
| Reputation of insurer |
Great 4.5 on Feefo. Based on 249 services ratings. Note: Feefo is not as unbiased as TrustPilot. |
| Pre-existing and chronic conditions |
Great |
| Coverage for life | ✅ Maximum entry age of 75 |
| Travel benefits | No |
William Russell at a glance
Highlights
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Plans are worldwide with coverage in the US for an additional price
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Cancer treatment covered on all plans
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Great variety of add-ons, including affordable mental health coverage
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Range of deductibles from $0 to $10,000 (depending on plan)
Things to note
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While maximum entry age is 75, it is definitely not the cheapest option for retirees.
MSH International
MSH International is one we have chosen to include on this list due to its mostly positive reviews. It seems that making a claim with them is pretty straightforward, thus making them a reliable option for international health care.
This one may be more suitable for slow travelers rather than those who hop around quite frequently, as you have the opportunity to select certain countries for full coverage, while getting emergency coverage for everywhere else up to 2 months at a time. The benefit to this is that if you are staying in countries with lower cost health care, then your insurance costs will also reflect that, compared to programs that cover you everywhere the same but the cost is also the same. They have a zone system where Zone 5 covers the countries with the most expensive health care (such as the US), and Zone 1 which covers the lowest cost health care.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $74 | Quartz (zone 2 and below) | None | $0 |
| Typical Nomad | $161 | Pearl (zone 3 and below) | Outpatient | $0 |
| Early Retiree | $679 | Pearl (zone 3 and below) | Outpatient | $1,000 |
| Specced out | $730 | Pearl (all zones) | Outpatient, Dental, Maternity | $0 |
Starting at 25 euros per month, their ‘First Expat’ plan is suitable for those who need coverage for more than a year. Like most plans, it covers hospitalization and routine care, but what’s special about it is you also get third-party liability coverage, which is nice to have. They also have good add-ons such as dental, vision, maternity and repatriation assistance.
Within this plan, they have four tiers of coverage (Quartz, Pearl, Sapphire, and Diamond). The main difference is not the treatment you have access to, but rather the maximum coverage amounts. From Quartz which covers you up to 400,000 euros, and Diamond, covering you up to 2,400,000 euros.
Finally, while their list of covered services is quite extensive, many of them come with a waiting period. For example, prescription drugs and psychiatric treatment comes with a 12 month waiting period before you can make a claim. There are also waiting periods for the maternity, dental and vision add-ons.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Coverage split in 5 zones (based on healthcare costs), with zone 5 covering you globally. |
| Home country coverage |
Coverage for short trips |
| Treatment coverage |
Great No major exclusions depending as long as relevant add-ons are selected. Outpatient care included in all plans. |
| Reputation of insurer |
Great 8/10 on Verified Reviews, based on 33 service ratings. |
| Pre-existing and chronic conditions |
Yes Subject to medical underwriting |
| Coverage for life |
As long as you sign up before you’re 75 |
| Travel benefits |
Some 60 days emergency health coverage in any country. |
MSH International at a glance
Highlights
-
Plans priced according to where you will be
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Third-party liability cover included
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Flexible Deductibles
-
Pre-existing conditions accepted
Things to note
-
Add-ons for maternity, repatriation, dental and vision
-
Maximum entry age is 71
-
Many treatments come with a waiting period anywhere from 3 to 12 months
For US Citizens & Residents
GeoBlue Xplorer
GeoBlue is part of the Blue Cross Blue Shield network, one of the most popular domestic primary care options in the US. They have several different plans from “Voyager” (single trips) and “Trekker” (multiple trips) to “Xplorer” (long term for expatriates). The first two are health travel insurance plans and act as sort of an add-on coverage for those who already have Blue Cross Blue Shield for their primary care (although you can add it to other primary care plans as well). The Xplorer plan, however, is a fully-fledged primary health insurance option for location independents covering over 180 countries. It’s probably one of the most pricy options on this list, but it does have great coverage as a result.
For this plan, you must be a US citizen or foreign national with permanent residency to be eligible. Having said that, if you are a US permanent resident (not a citizen), it’s really only suitable if you are working for a US company from abroad, due to the immigration laws on permanent residency.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $174 | Xplorer Essential | None* | $0 |
| Typical Nomad | $236 | Xplorer Essential | None* | $0 |
| Early Retiree | $816 | Xplorer Essential | None* | $1,000 |
| Specced out | $882 | Xplorer Premier | Outpatient*, Dental, Vision, Prescription Drug Upgrade | $0 |
You can access the full policy document here.
What’s important to note about this, is how it would be covered if you were to receive treatment when going back to the US. GeoBlue currently has two options for the Xplorer plan - one with comprehensive added US coverage, and one with basic or no US coverage. This means you can have no coverage, or you can do an optional upgrade for medical emergency coverage while in the US. Think of it as home travel insurance for Americans visiting home. Otherwise, you can just have both and it will be more expensive. It of course depends on how likely you are to go back to the US, and how long you plan on staying, but it’s great that GeoBlue is able to offer this kind of flexibility.
Deductibles vary depending on plan but can range anywhere from $500 to $10,000. It also depends on whether you are in the US network, in the US but outside of their network, or outside the US. Overall they are still quite flexible, and you can find their comprehensive list with all the deductible options, types of coverage, where deductibles are waived, and percentages the insurer pays in this chart. Overall, it will pay 100% for most professional services, preventative care, and hospitalizations after the deductible is met, and slightly less for rehabilitation or therapy.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Over 180 countries |
| Home country coverage |
Varied levels of US coverage |
| Treatment coverage |
Great No major exclusions, as long as relevant add-ons are selected. Outpatient care included in all plans. |
| Reputation of insurer |
Okay 3.1 on TrustPilot, but a limited number of service reviews online. |
| Pre-existing and chronic conditions |
Some You must have had prior creditable coverage (preferably on a US plan) |
| Coverage for life | ❌ You cannot renew past age 84, and you have to sign up by age 74. |
| Travel benefits | No |
GeoBlue Xplorer at a glance
Highlights
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Coverage in more than 180 countries
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24/7 support regardless of timezones
-
Varied levels of US coverage
-
It covers pre-existing conditions if you had prior creditable coverage. If you were previously on a US plan it is usually considered enough to be creditable. If the plan was from another country, GeoBlue will have to confirm it meets their standards
Things to note
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Only covers you up to age 74. You can renew until age 84
-
Maternity only covered after the first year
-
Only covers 100% for a maximum of $1000 with prescriptions, but there is the possibility to upgrade to cover a maximum of $25,000. If you want 100% coverage in a basic plan, then try Cigna.
Cigna Global
Cigna is a popular international health insurance provider from the US, however, it is available for most nationalities and for coverage in a wide range of countries around the globe. It is also one of the most well-known international health insurance providers out there. Having said that, US customers seem to be the main focus here, and they are linked to a large network of US hospitals and doctors, which is why I thought to include it in this section. While it isn’t uniquely tailored to nomads like some of the other programs, it is definitely still a viable option.
It will cover you in emergencies, overnight hospital stays, as well as dental emergencies during an accident. It also covers limited outpatient care, but extra can also be added on if desired. The main drawback is that they tend to exclude a lot of pre-existing conditions, so if that’s you, probably it is wise to take advantage of one of the other options.
Costs for each persona
| Persona | Price per month | Plan | Add-ons | Deductible/copays |
|---|---|---|---|---|
| Cheapo | $97 | Silver Health | N/A* | $0 |
| Typical Nomad | $101 | Gold Health | N/A* | $0 |
| Early Retiree | $241 | Gold Health | N/A* | $1,000 |
| Specced out | $878 | Platinum Health | N/A* | $0 |
You can access the full policy document here.
It generally has good reviews, as well as being one of the cheaper options, with the lowest plans starting around the $100 per month mark. As for plans, you have the possibility of both including and excluding the US (affecting the price no doubt). It is up to you if you think you will need it and the price you are willing to pay. They offer family and employer plans as well.
Separate from Cigna Global, they also have Cigna Close Care, which instead focuses on expats rather than perpetual travelers. It’s a good option for those who only want to pay for coverage where they will need it most, plus coverage while home as well.
| Checklist | Rating/comments |
|---|---|
| Jurisdiction coverage |
Great Over 200 countries |
| Home country coverage |
If you sign up for US coverage for an extra cost |
| Treatment coverage |
Great Even the lower plans offer some degree of outpatient, dental and vision without add-ons |
| Reputation of insurer |
Great 4.2 on TrustPilot, based on 709 service reviews. |
| Pre-existing and chronic conditions |
Some Subject to medical underwriting |
| Coverage for life |
There is no maximum entry age |
| Travel benefits | No |
Cigna Global at a glance
Highlights
-
Coverage in 200+ countries
-
Flexible deductibles and low out-of-pocket maximum
-
Large and established global hospital network that is linked to both the US network and internationally.
-
Outpatient care, dental, and vision are covered in all plans, albeit at different levels.
-
The lowest “age multiplier” in our test at 239%
Things to note
-
May exclude pre-existing conditions
Closing thoughts
As you can probably tell, purchasing international primary health insurance is a huge puzzle with many different pieces to fit together. Each provider tends to have a completely different approach to their plans, pricing models, coverage, and business model overall. With so many variables involved, it can make things a little bit of a headache to compare at times (trust us, it took a lot of blood, sweat, and tears, as well as patience, to get this article as useful and accurate as possible for you 😅). However, such flexible options mean that there should be a suitable plan for just about anyone, no matter your budget, travel plans, age, or medical priorities.
We hope you are able to find the best health coverage possible thanks to these recommendations, and at the very least, we hope it highlights the importance of looking after yourself while enjoying a nomadic lifestyle. Nobody should have to sacrifice their health for a location-independent lifestyle, and likewise, nobody should have to end up penniless because they suddenly get ill.
That being said, since health is often a personal and subjective topic, everyone has their own mixed experiences with health insurance providers. So, we’d love to hear you share your personal experiences, as well as any other providers that you feel deserve an honorable mention.
Please share your experiences and questions in the comments below. You, as the reader, can also provide enormous value and contribute to helping people make informed decisions on their health.
Good luck and stay healthy!
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