Given the insane cost of healthcare in the United States and the reasonable fear of many Americans that any health crisis will wipe them out, the question of health insurance while traveling is a major concern for would-be travelers. Many Americans can’t imagine leaving an employer for fear of losing health insurance, and this same fear can keep families who want to travel stuck in place.
The good news for those wanting to travel abroad (and the bad news for Americans) is that health care will cost less in virtually any other country than in the United States. Depending on where you are, bills for care can be surprisingly low or even free, prompting some travelers to forego health insurance altogether. These folks may choose to budget for unexpected medical expenses instead.
I knew we wouldn’t be comfortable traveling without any insurance, so I started looking at our options months before we left. In terms of covering medical expenses there are two types of insurance options: travel insurance and international health insurance. I researched both at great length.
Travel insurance is generally set up to cover people on typical vacations. This means that many insurance plans will want you to have your departure and return dates predetermined. This was difficult for us since we didn’t know when or if we would be returning to the US. Some insurers will limit the length of the trip to 60 or 90 days - again, we knew we would be gone longer, so this wouldn’t work for us either.
Travel insurance covers medical emergencies, including illnesses (such as appendicitis) or accidents (such as a broken leg), while you are abroad. In most cases, you can get your care, recuperate, and continue with your trip. In serious cases, such as scenarios where you need ongoing, specialized care, travel insurance will cover your return to your home country for treatment. Travel insurance companies may require you to have residency in a country that you would return to in a medical emergency. In that case, you must have health insurance in that country to cover any necessary care moving forward.
In addition to covering medical emergencies, travel insurance frequently includes other coverage such as trip protection (unexpected cancelations), emergency repatriation (in the case of your death or death of a family member), as well as some protection in the case of loss or theft of your items. Some companies to consider for travel medical insurance include World Nomads, GeoBlue Trekker, and Allianz. Some credit cards, such as the Chase Sapphire Reserve, also cover trip cancellation and medical emergencies for travel within certain parameters. Make sure to read some reviews and the fine print to determine which option is best for you!
There are also various types of international medical insurance policies that will cover your care abroad. They may or may not cover preventive care, maternity care or preexisting conditions - it’s always important to read the fine print! These plans are great options if you don’t have a residence and health insurance in any country, as they will cover your complete care wherever you may be. As an example, an international health insurance plan would cover extended cancer care in Germany or Thailand, as opposed to sending you back to your “home” country. Some commonly recommended options for international health insurance include IMG Global, Cigna Global Health, and Aetna International.
We ultimately decided on a travel insurance plan through World Nomads, even though it required us to keep our ACA health insurance plan in the United States. For 2 adults, 2 children and 14 months of travel - mostly in Europe - World Nomads cost us $3366 ($240/month). Luckily, we only used it once when my younger son needed stitches after a bike accident. As an example of low cost of care, his visit to urgent care and stitches only cost 180 Euro ($200) and would certainly have cost much more in the US. World Nomads quickly reimbursed the entire amount.
Note that many of the above discussed plans do not cover dental care, or only cover care if it was due to an accident. Over our year of travel, we actually spent more time visiting dentists than medical doctors, and fortunately the care is very affordable, even without insurance. For example, a dental cleaning in Portugal cost $45 and $18 in Albania. Dental fillings were $45 in Portugal and Spain. Most surprising, I thought I would need a root canal in Portugal (fortunately didn’t!), and was quoted about $280 for the complete treatment (including exams, x-rays, root canal and a filling). The same could easily cost 10x as much in the United States. Needless to say, we did fine even without dental insurance.