Do not confuse this with travel or trip insurance. As of 2022 this is no longer optional. of the twelve countries on three continents that I traveled to in the first four months of the year, over two thirds require proof of medical insurance that specifically covers COVID related health issues. skip the next six paragraphs if you are not looking for full time non-US coverage.
So far I have been extremely lucky with my health. In all my travels I have barely suffered more than an occasional bellyache. And that is the problem with evaluating insurance plans. They are often bought and very seldom used, so the feedback from previous buyers is anecdotal. Testimonials tend to fall in the ‘phew, it worked’ and ‘this sucked because they would not…’ camps.
As long as I spend a fair amount of time in the US (averaging two months a year at this point) I opted to keep my US based health insurance plan (thank you Obama). That premium payment each month is really painful, but in years past I have needed a some very expensive treatment and want to insulate myself from catastrophic financial loss (medical bills are the number one factor in personal bankruptcy).
I was surprised by how many options are available – with names like Global Health, Patriot multi trip and Global Medical. Some cover specific trip dates, or a number of days outside the US. There are plans tailored to resident ex-pats, for time spent in a single country. Another option is to have non-US coverage and then either buy an also-US option, or find a plan that covers a few weeks of travel to the US. There is a plan for each individual style of travel, length of stay in each location, and time spent in the US. However, nothing on offer is cheap.
Most US plans do not cover medical expenses abroad so if something bad happens the options are to pay for treatment locally or get back to the US. Many credit cards include a benefit for emergency medical evacuation that sounds great, but I suspect that this only triggers in very limited circumstances – they are not going to pay for medevac if I break my arm. The Chase Sapphire Reserve card I carry has a $2,500 emergency medical/dental benefit that may be of some help.
The good news is that there is a lot of really good, and reasonably priced, medical care in a lot of the world. A simple example is the near universal pharmacy. In most of the world a pharmacist can help with a consultation and dispense a wide range of medication, some very powerful, that you have to jump through hoops to get in the US. Prices are most often ridiculously low. In Dakar, Senegal a pair of professionals quickly diagnosed the cause and treatment of a malady (though my atrocious French was deemed incurable). In Mexico recently pharmacists dispensed antibiotics on request and, for medication that they could not approve, directed me next door to a no wait, no fee consultant who helped me with a diagnosis and prescription.
Also understand that health care delivery options vary widely in style. When I had need of low level care in Canada and Australia, as a non resident, my only option appeared to be hospital emergency. And when a companion had a perceived need for emergency care in Vietnam the hospital was, by leaps and bounds, better equipped, more efficient, and stunningly less expensive than the place I used to work in in the US.
For years I self insured when I traveled. I already had a ‘medical event’ account, which I originally funded to pay for non-covered expenses in the US. I figured that I would pay for any acute care abroad, and return to the US for follow up and treatment for chronic conditions. I maintain my $5/day auto investment in this account to continue to build up assets. To date I have made only three very modest withdrawals from that account for foreign care.
I did finally throw in the towel, and bought travel health insurance from well regarded World Nomads. Of course, they are just marketing the product, which is underwritten by a company called TripMate. Reviews of the latter company are pretty dreadful. Again, I have no real way to evaluate whether this is a good investment and frankly I could not find any aggregate data on customer experience. A very wide range of the most visible travel bloggers, and Lonely Planet recommend this product. It has worked for me on three occasions. That being said lots of people recommend mortgages and enemas, and neither seems like a good idea to me.
A relative newcomer to the field is SafetyWings. As with World Nomads there is praise and good reviews for the signup and ease of initial use, but really mixed reviews of the Tokyo Marine, the actual underwriter. Their model is a monthly ’subscription’, instead of individual date ranges. Additionally, for a higher price, you are able to add ’incidental’ medical cost coverage while you are in the US for short periods. I.e. this does not cover if you have travelled specifically for treatment. This may be very attractive for nomads who do not have existing US medical coverage. Ditto for Genki .
World Nomads insurance is very easy to buy. The online tool generates an instant quote for coverage to a specified country or region for a particular date range. I really like the regional coverage option, as I can be pretty certain that I will be in Africa for a date range, but may be spending more time in Ethiopia if that Eritrean visa does not come through in time (it did not). There are two levels of coverage; I always choose the less expensive one. And finally, you are able to begin coverage even if you have started a trip.
For a quick fortnight away the cost for me has be around $5/day. For runs of more than two months the price drops to about $3/day, which seems pretty reasonable to me. In these COVID end times know that that insurance may be essential rather than optional, as a number of countries (eg Mauritius) now require proof of medical coverage before they will let you in the door. Of course have pictures of the documents on your ’phone, and definitely print out and carry the policy page and the purchase confirmation.
A final note. There is an interesting trend in ‘medical tourism’ – traveling abroad to find high quality medical care at much reduced prices. If you are considering major dental work, or major surgery for a chronic condition you might want to look at Patients Beyond Borders.
