How to Get Health Insurance as a Digital Nomad

25 min read
How to Get Health Insurance as a Digital Nomad

How to Get Health Insurance as a Digital Nomad

Authority Insight: This article draws from official government resources, international health insurance regulations, and verified provider data to ensure every recommendation reflects current policy and practical expertise for digital nomad health coverage.

You're sitting in a café in Lisbon, laptop open, espresso cooling beside you—and then it hits. Not inspiration. A sharp pain in your side that won't quit.

Here's the reality of living the digital nomad dream: it's incredible until something goes wrong. When it does, you'll quickly discover that your health insurance situation is about as solid as the Wi-Fi in that beachside co-working space you visited last month.

Too many nomads learn this lesson the hard way. Consider the traveler who faced a $47,000 hospital bill in Thailand after a motorbike accident. Or the remote worker who needed emergency surgery in Mexico and discovered her US insurance considered it "out of network"—insurance terminology for "you're responsible for the full cost."

The fundamental truth? Traditional health insurance wasn't designed for people who treat the world as their office. Most domestic plans include a requirement buried in the fine print: you need to spend a certain amount of time "at home" each year. Miss that threshold, and your coverage evaporates.

The situation grows more complicated when you realize there isn't just one type of "digital nomad insurance." Two completely different tiers of coverage exist, each serving different needs and budgets. Confuse them, and you'll either overpay for coverage you don't need or find yourself dangerously underinsured when it matters most.

Additionally, if you're pursuing one of the increasingly popular digital nomad visas in Spain, Portugal, or Croatia, you'll need to prove you have adequate health insurance coverage. According to official visa requirements, your travel insurance from a two-week vacation won't suffice [1]. These countries require specific minimum coverage amounts, proof of comprehensive care, and sometimes documentation that your insurer is authorized to operate in their territory.

This guide breaks down everything you need to know about health insurance as a digital nomad. We'll explore budget-friendly emergency coverage starting around $56 per month and comprehensive international health plans that rival domestic coverage. You'll see top providers compared head-to-head with actual numbers, learn exactly what different digital nomad visas require for insurance, and discover advanced strategies that some US citizens use to maintain robust domestic coverage while living abroad.

Whether you're just starting your nomad journey or you've been managing without proper coverage, this is your roadmap to protecting yourself without breaking the bank. The only thing worse than paying for insurance you hope you'll never use is needing it and not having it.

Why Your Old Health Insurance Won't Work for a Nomad Lifestyle

Let's start with the uncomfortable truth: that health insurance plan you had back home is basically useless now.

You might still be paying for it. You've got the card in your wallet. But unless you're planning to fly back to your home country every time you need medical care—which defeats the entire purpose of being location-independent—it won't help you.

Here's why traditional domestic health insurance fails nomads:

The "Time at Home" Trap

Most domestic health plans require you to maintain a primary residence and spend a minimum number of days per year in your home country. For US-based plans, this is often 6 months. UK plans follow similar requirements. The moment you cross that threshold, your coverage can be voided. Insurance companies won't inform you of this until you file a claim.

Geographic Limitations

Even if your plan claims to offer "international coverage," examine the fine print carefully. Many plans only cover emergency care abroad. Even then, you'll often need to pay upfront and seek reimbursement later. Try explaining to a hospital in Bali that your insurance company will "totally reimburse you" when they're requesting $15,000 in cash before they'll treat your appendicitis.

Network Restrictions

Domestic insurance operates through provider networks—approved doctors and hospitals. That network doesn't extend to the clinic in Chiang Mai or the hospital in Buenos Aires. You're out of network, which means either no coverage at all or coverage so minimal it barely covers the ambulance ride.

No Preventative or Routine Care

Suppose you find a domestic plan that covers emergencies abroad. Now try getting your annual physical, a dental cleaning, or refills on your prescriptions. Most traditional plans won't cover any routine care when you're outside your home country for extended periods.

The digital nomad lifestyle fundamentally breaks the assumptions that traditional insurance is built on. These plans expect you to have a fixed address, see the same doctors regularly, and be available for follow-up appointments. When your "home" is wherever you set down your laptop, none of that applies.

The situation worsens for nomads who try to game the system by maintaining an address with family back home and flying back periodically to "prove" residency. Insurance companies track your claims. If they identify a pattern of international medical care, they can—and will—investigate. Cases exist of people having claims denied retroactively, meaning they had to repay everything the insurance company had covered for months.

The bottom line? You need insurance that's actually designed for your lifestyle. Not a workaround, not a "hope they don't notice" strategy. Real coverage that acknowledges you're living and working across borders.

The #1 Mistake Nomads Make: Confusing Travel Medical Insurance vs. International Health Insurance

This is where most nomads make critical errors—and the insurance industry does a poor job of explaining this distinction.

Two fundamentally different types of insurance exist for people who live and work internationally. They're not interchangeable. They serve different purposes, different budgets, and different lifestyles. Mix them up, and you'll either waste money or leave yourself dangerously exposed.

Travel Medical Insurance: The Emergency Safety Net

Think of this as your "emergency only" insurance. It's designed to cover medical emergencies and accidents while you're traveling. That's the extent of its purpose.

What it covers:

  • Emergency hospital visits
  • Urgent care and emergency room treatment
  • Emergency medical evacuation (transport to a proper hospital)
  • Accidental injuries (broken bones, cuts requiring stitches, etc.)
  • Sudden illness requiring immediate treatment

What it doesn't cover:

  • Routine doctor visits
  • Annual physicals or check-ups
  • Prescription refills for ongoing medications
  • Preventative care (vaccines, screenings)
  • Dental cleanings or routine dental work
  • Mental health therapy or counseling (usually)
  • Pre-existing conditions (in most cases)

Who it's for: Younger nomads on a tight budget. People with a primary health plan back home who just need emergency coverage abroad. Nomads who are generally healthy and don't need regular medical care.

Price range: $50-100 per month, depending on age and coverage limits.

Popular providers: SafetyWing Nomad Insurance, Atlas Travel Insurance, World Nomads.

International Health Insurance: The Comprehensive Solution

This is actual health insurance—the kind that covers you like a regular person with a regular life. It's designed to work across borders.

What it covers:

  • Everything travel medical insurance covers, plus:
  • Routine doctor visits and check-ups
  • Preventative care and screenings
  • Prescription medications (ongoing)
  • Dental and vision care (depending on plan)
  • Mental health services
  • Maternity care (some plans)
  • Treatment for chronic conditions
  • Pre-existing conditions (after waiting periods)

What it doesn't cover:

  • Elective cosmetic procedures
  • Experimental treatments
  • Some plans exclude coverage in your home country (varies by provider)

Who it's for: Long-term nomads who plan to stay abroad for years. People with chronic health conditions. Older nomads. Families with children. Anyone who wants comprehensive healthcare regardless of where they are.

Price range: $100-500+ per month, depending on age, coverage level, deductibles, and whether you include home country coverage.

Popular providers: SafetyWing Remote Health, Cigna Global, Allianz Care, AXA Global Healthcare.

The Visual Breakdown

Feature Travel Medical Insurance International Health Insurance
Primary Purpose Emergency coverage only Comprehensive healthcare
Routine Care ❌ Not covered ✅ Covered
Preventative Care ❌ Not covered ✅ Covered
Pre-existing Conditions ❌ Usually excluded ✅ Covered (after waiting period)
Mental Health ⚠️ Limited or excluded ✅ Usually included
Dental/Vision ⚠️ Emergency only ✅ Often included
Monthly Cost $50-100 $100-500+
Best For Budget nomads, short-term travel Long-term nomads, families

Here's the key insight most articles miss: you're not choosing between good and bad insurance. You're choosing between emergency coverage and full healthcare. Both are valid choices depending on your situation. You need to be honest with yourself about which one you actually need.

If you're 28, healthy, and just need a safety net in case you break your leg surfing in Bali—travel medical insurance is probably sufficient. You can handle a doctor's visit for a cold out of pocket, and you're not on any medications.

But if you're 45, take daily medication for a chronic condition, and want the peace of mind of being able to see a doctor for anything—you need international health insurance. Yes, it costs more. But it's not "more expensive insurance." It's actual healthcare coverage versus emergency-only coverage.

The mistake isn't choosing one over the other. The mistake is choosing travel medical insurance and expecting it to work like international health insurance—or worse, having no insurance at all because you couldn't afford the comprehensive option and didn't realize the emergency-only option existed.

Top 7 Digital Nomad Health Insurance Providers: A Head-to-Head Comparison

Let's examine the actual providers. These are the seven companies that consistently appear in nomad communities, have solid reputations, and actually understand the unique needs of location-independent workers.

The Ultimate Comparison Table

Provider Type Price Range (Monthly) Max Coverage Deductible Options Pre-existing Conditions Home Country Coverage Mental Health Dental/Vision Repatriation Visa Letter
SafetyWing Nomad Insurance Travel Medical $56-100 $250,000 $250 ❌ No ⚠️ Limited (US: 15 days/90 days) ❌ No ⚠️ Emergency only ✅ Yes ✅ Yes
SafetyWing Remote Health International Health $200-400 $1,500,000 $500-5,000 ✅ Yes (after 12 months) ✅ Optional add-on ✅ Yes ✅ Yes (optional) ✅ Yes ✅ Yes
Genki Resident Travel Medical €105-150 €500,000 €0 ⚠️ Limited ❌ No ❌ No ⚠️ Emergency only ✅ Yes ✅ Yes
Allianz Care International Health $150-600+ Unlimited (some plans) $0-10,000 ✅ Yes (varies by plan) ✅ Optional ✅ Yes ✅ Yes (optional) ✅ Yes ✅ Yes
Cigna Global International Health $200-800+ $1,000,000-5,000,000 $0-5,000 ✅ Yes (after waiting period) ✅ Optional ✅ Yes ✅ Yes (optional) ✅ Yes ✅ Yes
AXA Global Healthcare International Health $180-700+ Varies by plan $0-5,000 ✅ Yes (after waiting period) ✅ Optional ✅ Yes ✅ Yes (optional) ✅ Yes ✅ Yes
Atlas Travel Travel Medical $45-150 (per trip) $50,000-2,000,000 $0-2,500 ❌ No ⚠️ Emergency only ❌ No ⚠️ Emergency only ✅ Yes ⚠️ Sometimes

Prices are approximate and vary based on age, coverage level, and selected options. All prices in USD unless noted.

Now, let's break down each provider with the details that actually matter.

1. SafetyWing Nomad Insurance (Best for Flexibility & Budget)

Type: Travel Medical Insurance
Starting Price: $56.28 per 4 weeks (ages 10-39)
Max Coverage: $250,000

SafetyWing has become the default choice for budget-conscious nomads. The company launched in 2018 specifically for remote workers.

What makes it special: The flexibility is unmatched. You can sign up while already traveling (most insurers require you to purchase before leaving home), and it auto-renews every 4 weeks. Need to pause coverage for a month? You can do that. The subscription model means you're never locked into a long-term commitment.

The catch: It's emergency-only coverage. You won't use this plan for a routine check-up. The $250 deductible applies per incident, and there's a $250,000 lifetime maximum. For most nomads, that's sufficient—but if you experience a catastrophic medical event, you could hit that cap.

Coverage details:

  • 185+ countries covered
  • Emergency medical expenses up to $250,000
  • Emergency dental up to $1,000
  • Trip interruption coverage
  • Political evacuation
  • Natural disaster evacuation

Best for: Digital nomads under 40 who are generally healthy, need flexible month-to-month coverage, and want something that works in 185+ countries without complexity.

Important limitations: The plan excludes coverage for pre-existing conditions entirely. If you have any ongoing health issues, this isn't the right choice. Additionally, home country coverage is limited—US citizens get only 15 days of coverage per 90-day period in the United States.

2. SafetyWing Remote Health (Best for Comprehensive Coverage at a Reasonable Price)

Type: International Health Insurance
Starting Price: ~$200-400/month
Max Coverage: $1,500,000

This is SafetyWing's answer to the "I need real health insurance" crowd. Launched more recently, Remote Health is their comprehensive plan that covers routine care, preventative medicine, and even pre-existing conditions after a 12-month waiting period.

What makes it special: It bridges the gap between budget travel medical insurance and expensive international health plans. You get comprehensive coverage at a price point that's significantly lower than traditional international health insurers like Cigna or Allianz.

Coverage details:

  • Outpatient care (doctor visits, specialists)
  • Inpatient care (hospital stays, surgery)
  • Preventative care (annual check-ups, screenings)
  • Prescription medications
  • Mental health services
  • Physical therapy
  • Medical evacuation
  • Optional dental and vision add-ons

The catch: There's a 12-month waiting period for pre-existing conditions. If you have ongoing health issues that need immediate coverage, you'll need to wait a year before those are covered. Also, the base plan doesn't include home country coverage—you need to add that separately, which increases the cost.

Best for: Long-term digital nomads who want comprehensive healthcare without breaking the bank. People who are generally healthy but want the security of being able to see a doctor for routine issues.

Deductible options: You can choose from $500, $1,000, $2,500, or $5,000 annual deductibles. Higher deductibles lower your monthly premium significantly.

3. Genki Resident (Best for European Digital Nomads)

Type: Travel Medical Insurance
Starting Price: €105/month
Max Coverage: €500,000

Genki is a German-based insurer that's gained popularity among European nomads, particularly those applying for digital nomad visas in Europe.

What makes it special: Zero deductible. You read that right—no out-of-pocket costs before your insurance kicks in. This is rare in travel medical insurance. Additionally, Genki is well-recognized by European immigration authorities for visa applications.

Coverage details:

  • Emergency medical treatment up to €500,000
  • No deductible
  • Worldwide coverage (excluding some high-cost countries)
  • Emergency dental treatment
  • Medical repatriation
  • Covers COVID-19 treatment

The catch: It's still travel medical insurance, so no routine care. Also, Genki doesn't cover the United States, Canada, or a few other high-cost healthcare countries unless you purchase their more expensive plan.

Best for: European digital nomads or those applying for European digital nomad visas who need recognized coverage for visa applications. People who want emergency coverage without dealing with deductibles.

Visa acceptance: Genki is widely accepted for digital nomad visa applications in Portugal, Spain, Croatia, and other European countries. They provide visa letters quickly, usually within 24 hours.

4. Allianz Care (Best for Premium Comprehensive Coverage)

Type: International Health Insurance
Starting Price: $150-600+/month
Max Coverage: Unlimited (on some plans)

Allianz is one of the largest and most established international health insurers in the world. Their plans are comprehensive, flexible, and—unsurprisingly—expensive.

What makes it special: True unlimited coverage options on premium plans. No lifetime or annual maximums. If you need $2 million in cancer treatment, you're covered. They also have an extensive global network of hospitals and clinics with direct billing, so you won't need to pay out of pocket and wait for reimbursement.

Coverage details:

  • Inpatient and outpatient care
  • Preventative care and wellness programs
  • Maternity coverage (optional)
  • Dental and vision (optional)
  • Mental health services
  • Cancer care and chronic condition management
  • Medical evacuation
  • Home country coverage (optional)

The catch: Price. Allianz is expensive, especially for older nomads or those who want comprehensive coverage including the US. Expect to pay $400-800/month for robust coverage if you're over 40.

Best for: High-earning digital nomads who want the absolute best coverage with no compromises. Families who need comprehensive healthcare for children. People with chronic conditions who need ongoing specialist care.

Plan flexibility: Allianz offers modular plans where you can add or remove coverage areas, adjust deductibles, and customize your coverage level. This flexibility means you can create a plan that fits your specific needs, but it also means you need to understand what you're buying.

5. Cigna Global (Best for US Citizens Abroad)

Type: International Health Insurance
Starting Price: $200-800+/month
Max Coverage: $1,000,000-5,000,000

Cigna Global is the international arm of Cigna, one of the largest health insurers in the United States. They're particularly popular with American expats and digital nomads because they offer seamless coverage that includes the US.

What makes it special: Cigna has one of the most extensive international hospital networks. They offer direct billing at thousands of facilities worldwide, meaning you won't need to pay upfront. For US citizens, they can provide coverage that includes the United States without the astronomical price increases that some insurers charge.

Coverage details:

  • Comprehensive inpatient and outpatient care
  • Preventative care and health screenings
  • Prescription medications
  • Mental health and wellness programs
  • Maternity and newborn care (optional)
  • Dental and vision (optional)
  • Chronic condition management
  • Medical evacuation

The catch: Premium plans that include US coverage are expensive. If you're a US citizen who wants comprehensive coverage including the States, expect to pay $500-1,000+/month depending on your age and coverage level.

Best for: US citizens who want comprehensive international coverage that includes the ability to receive care in the United States. Digital nomads who travel frequently and want the security of direct billing at major hospitals worldwide.

Network advantage: Cigna's global network includes over 1.5 million healthcare providers and facilities. In major cities, you'll almost always find a hospital or clinic that accepts Cigna with direct billing.

6. AXA Global Healthcare (Best for Families)

Type: International Health Insurance
Starting Price: $180-700+/month
Max Coverage: Varies by plan

AXA is a French multinational insurance company with a strong international health insurance division. They're particularly well-regarded for family coverage.

What makes it special: AXA offers some of the most competitive family rates in the industry. While individual coverage is comparable to other providers, their family plans often come out significantly cheaper per person when covering multiple people.

Coverage details:

  • Comprehensive inpatient and outpatient care
  • Preventative care and vaccinations
  • Maternity and newborn care
  • Pediatric care
  • Mental health services
  • Dental and vision (optional)
  • Chronic condition management
  • Medical evacuation

The catch: AXA's customer service can be hit or miss depending on your region. Some nomads report excellent experiences, while others have struggled with claim processing times.

Best for: Families with children who need comprehensive international health coverage. Digital nomads who plan to have children while living abroad and want maternity coverage included.

Family benefits: AXA offers discounts when covering multiple family members. Children under 18 are typically covered at significantly reduced rates, and some plans include coverage for newborns from birth.

7. Atlas Travel Insurance (Best for Short-Term Trips)

Type: Travel Medical Insurance
Starting Price: $45-150 per trip
Max Coverage: $50,000-2,000,000

Atlas Travel Insurance is a bit different from the others on this list. It's designed for specific trips rather than ongoing coverage, but it deserves mention because it's useful for certain nomad situations.

What makes it special: You can purchase coverage for specific trip durations (5 days to 2 years). This makes it ideal for nomads who spend part of the year in their home country with domestic coverage and part of the year traveling.

Coverage details:

  • Emergency medical treatment
  • Emergency medical evacuation
  • Trip interruption
  • Lost luggage
  • Emergency dental
  • COVID-19 coverage

The catch: You need to purchase it before each trip, and it's not designed for perpetual travel. If you're a full-time nomad, the subscription model of SafetyWing or ongoing coverage of international health plans makes more sense.

Best for: Part-time nomads who maintain domestic health insurance but travel internationally for 3-6 months per year. People taking specific extended trips who need temporary coverage.

Flexibility: You can choose your coverage maximum from $50,000 to $2,000,000, which directly affects your premium. For young, healthy travelers, the $50,000 or $100,000 options are usually sufficient and very affordable.

Digital Nomad Visa Insurance Requirements by Country

One of the fastest-growing trends is countries offering specific digital nomad visas. These visas allow remote workers to legally live and work in a country for extended periods (typically 6-12 months, sometimes renewable). However, nearly all of them require proof of adequate health insurance [2].

Here's what you need to know about insurance requirements for the most popular digital nomad visa programs:

Portugal Digital Nomad Visa (D8 Visa)

Insurance Requirement: Comprehensive health insurance valid in Portugal with minimum coverage of €30,000.

Accepted Insurance Types:

  • International health insurance plans that specifically cover Portugal
  • Portuguese national health insurance
  • EU-recognized health insurance (if you're an EU citizen)

Important Notes: Portugal requires that your insurance cover the entire duration of your visa. Travel medical insurance is generally accepted if it meets the minimum coverage amount, but some immigration officers prefer to see comprehensive international health insurance.

Recommended Providers: Allianz Care, Cigna Global, AXA Global Healthcare, SafetyWing Remote Health (with Portugal specifically included in coverage area).

Processing Time: Insurance documentation is reviewed as part of the visa application. Ensure your insurance provider can issue a visa letter confirming coverage in Portugal.

Spain Digital Nomad Visa

Insurance Requirement: Health insurance with a Spanish insurance company or international insurance valid in Spain with minimum coverage equivalent to Spanish public health system.

Accepted Insurance Types:

  • Spanish private health insurance (preferred)
  • International health insurance with Spain coverage
  • EU health insurance cards (for EU citizens)

Important Notes: Spain is more particular about insurance than some other countries. They strongly prefer insurance from Spanish companies or major international insurers with a presence in Spain. Budget travel medical insurance may not be accepted.

Recommended Providers: Cigna Global, Allianz Care, AXA Global Healthcare, or Spanish providers like Sanitas or Asisa.

Processing Time: Insurance is a critical component of the application. Expect scrutiny of your coverage levels and provider legitimacy.

Croatia Digital Nomad Visa

Insurance Requirement: Health insurance valid in Croatia covering the entire stay.

Accepted Insurance Types:

  • International travel health insurance
  • International health insurance
  • EU health insurance cards (for EU citizens)

Important Notes: Croatia is relatively flexible with insurance requirements. They accept most legitimate travel medical and international health insurance plans as long as they explicitly cover Croatia.

Recommended Providers: SafetyWing (Nomad Insurance or Remote Health), Genki Resident, Allianz Care, Cigna Global.

Processing Time: Croatia's digital nomad visa is one of the easier ones to obtain, and insurance verification is straightforward if you have proper documentation.

Estonia Digital Nomad Visa

Insurance Requirement: Valid travel medical insurance or health insurance covering Estonia for the duration of the stay.

Accepted Insurance Types:

  • International travel medical insurance
  • International health insurance
  • EU health insurance

Important Notes: Estonia accepts most standard travel medical insurance plans. The key is ensuring your policy explicitly states coverage in Estonia.

Recommended Providers: SafetyWing Nomad Insurance, Genki Resident, Allianz Care, AXA Global Healthcare.

Processing Time: Estonia's e-Residency program makes them tech-savvy and efficient with digital nomad visa processing. Insurance verification is typically quick if documentation is clear.

Greece Digital Nomad Visa

Insurance Requirement: Health insurance coverage valid in Greece with minimum coverage of €30,000.

Accepted Insurance Types:

  • International health insurance
  • Travel medical insurance with adequate coverage
  • EU health insurance (for EU citizens)

Important Notes: Greece requires proof that your insurance covers medical expenses, hospitalization, and repatriation. Travel medical insurance is generally accepted if it meets the minimum threshold.

Recommended Providers: Allianz Care, Cigna Global, SafetyWing Remote Health, Genki Resident.

Processing Time: Greece's digital nomad visa is relatively new (launched in 2021), and requirements are still being standardized. Allow extra time for insurance verification.

General Tips for Visa Insurance Requirements

Get a Visa Letter: Most insurance providers can issue a visa letter that confirms your coverage, policy dates, coverage amounts, and geographic coverage area. Request this as soon as you decide to apply for a visa.

Verify Coverage Area: Ensure your insurance policy explicitly lists the country where you're applying for a visa. Some policies have exclusions or limitations for specific countries.

Meet Minimum Coverage: Most European countries require minimum coverage of €30,000-50,000. Ensure your policy meets or exceeds this amount.

Coverage Duration: Your insurance must cover the entire duration of your visa. If you're applying for a 12-month visa, you need 12 months of insurance coverage.

Legitimate Providers: Immigration authorities are familiar with major insurance providers. Stick with recognized companies rather than obscure or budget insurers that might raise red flags.

Advanced Strategy: Maintaining US Health Insurance While Living Abroad

This section is specifically for US citizens who want to maintain domestic health insurance while living as digital nomads. This is an advanced strategy that doesn't work for everyone, but for those who can make it work, it provides the most comprehensive coverage possible.

Disclaimer: This involves maintaining a US address and spending some time in the US each year. It's not for full-time perpetual travelers who never return home. Consult with a tax professional and insurance advisor before implementing this strategy.

Why Consider This Approach?

US health insurance, despite its many flaws, provides some of the most comprehensive medical coverage in the world when you're in the United States. If you:

  • Plan to spend 3-6 months per year in the US
  • Have chronic conditions that require specialist care
  • Want access to specific US doctors or treatment facilities
  • Are older and concerned about long-term health coverage
  • Have family in the US you visit regularly

Then maintaining US health insurance alongside international coverage might make sense.

How It Works

Step 1: Maintain a US Address

You need a legitimate US address to qualify for domestic health insurance. This can be:

  • A family member's address where you stay when visiting
  • A property you own or rent
  • A mail forwarding service (though some insurers may not accept this)

Step 2: Choose the Right US Health Insurance Plan

Not all US plans work for this strategy. You need:

  • A plan that doesn't require you to be in the US full-time
  • Coverage that allows for extended absences
  • Ideally, a plan with some international emergency coverage

Best options:

  • Private health insurance (not employer-based): More flexible about residency requirements
  • Health sharing ministries: Some have more flexible location requirements, though these aren't technically insurance
  • Catastrophic plans: If you're under 30 or qualify for a hardship exemption

Step 3: Add International Travel Medical or Health Insurance

Your US insurance covers you when you're in the States. For the rest of the year, you need international coverage:

  • Travel medical insurance (like SafetyWing Nomad Insurance) for emergency coverage abroad
  • International health insurance (like SafetyWing Remote Health or Cigna Global) for comprehensive coverage abroad

Step 4: Coordinate Benefits

When you're in the US, you use your domestic insurance. When you're abroad, you use your international insurance. The key is ensuring there are no gaps in coverage during transitions.

The Costs

This is not a budget strategy. You're essentially paying for two insurance policies:

  • US health insurance: $300-700/month (depending on age, state, and plan)
  • International coverage: $50-400/month (depending on type and level)

Total: $350-1,100+/month

For many nomads, this is prohibitively expensive. But for those with significant health needs or who genuinely split their time between the US and abroad, it can provide peace of mind that single-country coverage cannot.

Important Considerations

Tax Implications: If you're spending significant time outside the US, you may qualify for the Foreign Earned Income Exclusion (FEIE), which affects your tax situation. Consult a tax professional who specializes in expat taxation.

ACA Subsidies: If you qualify for Affordable Care Act subsidies based on income, maintaining US health insurance becomes much more affordable. However, you must meet residency requirements to qualify.

State Residency: Some states have stricter residency requirements than others. Florida, Texas, and South Dakota are popular choices for digital nomads maintaining US residency due to favorable tax and residency rules.

Insurance Fraud: Do not lie about your residency or time spent in the US to maintain insurance. This is insurance fraud and can result in denied claims, policy cancellation, and legal consequences.

Who This Works For

This strategy makes sense if you:

  • Spend 3-6 months per year in the US
  • Have significant health needs requiring US specialists
  • Can afford the double coverage cost
  • Have a legitimate US address and residency
  • File US taxes and maintain US banking

This strategy doesn't work if you:

  • Never or rarely return to the US
  • Are on a tight budget
  • Don't have a legitimate US address
  • Want to fully commit to international living

How to Choose the Right Insurance for Your Situation

Now that you understand the landscape, how do you actually choose? Here's a decision framework based on your specific situation:

If You're Under 35, Healthy, and Budget-Conscious

Best Choice: Travel Medical Insurance

Recommended Providers:

  1. SafetyWing Nomad Insurance ($56-100/month)
  2. Genki Resident (€105-150/month)
  3. Atlas Travel Insurance ($45-150/trip)

Why: You don't need comprehensive coverage for routine care. You need a safety net for emergencies. Travel medical insurance provides that at a fraction of the cost of international health insurance.

What to look for:

  • Minimum $100,000 coverage
  • Emergency medical evacuation
  • Coverage in all countries you plan to visit
  • Ability to purchase while already traveling
  • No long-term commitment

If You Have Pre-existing Conditions or Chronic Health Issues

Best Choice: International Health Insurance

Recommended Providers:

  1. Cigna Global ($200-800+/month)
  2. Allianz Care ($150-600+/month)
  3. SafetyWing Remote Health ($200-400/month)

Why: You need ongoing access to healthcare, prescriptions, and specialist care. Travel medical insurance won't cover your existing conditions. International health insurance will (after waiting periods).

What to look for:

  • Pre-existing condition coverage (check waiting periods)
  • Coverage for prescription medications
  • Access to specialists in your field of need
  • Direct billing at major hospitals
  • Reasonable deductibles

If You're Over 50

Best Choice: International Health Insurance (Comprehensive)

Recommended Providers:

  1. Allianz Care ($300-800+/month)
  2. Cigna Global ($300-1,000+/month)
  3. AXA Global Healthcare ($250-700+/month)

Why: As you age, the risk of serious health issues increases. You want comprehensive coverage that includes preventative care, screenings, and treatment for any condition that arises.

What to look for:

  • No lifetime maximums (or very high ones)
  • Comprehensive inpatient and outpatient coverage
  • Cancer care and chronic condition management
  • Direct billing at quality hospitals
  • Medical evacuation to home country if needed

If You're a Family with Children

Best Choice: International Health Insurance (Family Plan)

**Recommende

Further Reading & Sources

Final Reminder: Stay compliant with health insurance for US citizens living abroad to protect your move.