While there are many types of insurance you might buy as a digital nomad or long-term traveler, the most essential for most is a comprehensive travel insurance. Specifically a “travel health insurance”.
This is great @tkrunning! I’ve been with World Nomads for a long time, but I also find them a bit expensive. I’ll give SafetyWing a go!
Great article! I like the flexibility of SafetyWing with respect to home country treatment. However, I have been reading up on the terms and conditions, and found the following issues:
Repatriation (e.g. getting flown back to your home country for treatment in case of serious illness) is not covered, unless you are dead or your visit is to the US. This is one of the main reasons for choosing a travel insurance as an EU citizen travelling withing the EU. But of course, as a nomad, you may no longer be eligible for social security in your home country anyway, so it is individual whether this is a concern. Bedside visit (having a relative getting flown in to visit you in case of serious illness) is, however, covered.
Pepole involved in vivid sports (and also some normal ones) should check the list of sports excluded from cover thoroughly. For example, American football, soccer, and kite surfing are not covered. So don’t play soccer in your coverage period (which may be full time if you pay every month as a nomad)…! And stay away from the kite surfing school on your vacation / life as a nomad.
Unclear wither Search & Rescue costs are covered. For instance, if you have an accident breaking a leg while doing recreational downhill skiing, you will get a large search & rescue bill if you are not covered by your insurance. But maybe you have an accident insurance which covers this.
Personally, for shorter travels, I prefer Bupa Global, which covers these things (exept for search and rescue I think) by default and also allows for trips to start/end outside of your home country (but no treatment in the home country). It is correspondingly more expensive. But of course, this is always individual, and people should in general read the terms and conditions carefully, as you note.
One more thing that might be worth covering is third-party liability and maybe certain types of legal assistance. Be aware that business related liability insurances and legal assistance will be quite expensive, but insuring private matters will be affordable.
Thanks for clarifying this point! I still prefer a policy where I have complete freedom to choose the medical facility, but I’ll link to your response from the article so my readers will be aware of it.
I’d also love to see you introduce a recurring subscription like SafetyWing offer. I think that would make you a lot more relevant to long-term travelers and nomads. Do you have any plans for introducing that?
Oh, and it would be great if you could clarify this edge case then: What if a person is a legal resident of an EEA country, but not part of that country’s public healthcare system (not that uncommon among nomads)? In that case they wouldn’t qualify for the EHIC, and probably not the reciprocal health agreements (correct me if I’m wrong), so would they then not qualify for your insurance or would you still cover them?
Thanks for this review. It's interesting for us to read up on other insurers. One point though in this about True Traveller is just a tiny bit misleading, and that's the comment that "Does not cover private medical treatment unless no public treatment is available. Personally, I was really happy that my insurance covered private hospital stays when I got hospitalized in India a few years ago. Just saying."
We actually say in our FAQ's "This policy covers accident and emergency expenses only and is not a private health insurance policy. This means that you are covered if there is a sudden and unexpected accident or if you become ill during a trip. We will pay for private treatment, but only if there is no appropriate reciprocal health agreement in existence and no public medical service available. Likewise we would not expect you to be treated in a medical facility if it does not have the equivalent care that we would expect ourselves under European standards. However, if you have been taken to a private hospital and there is a public service in the area that we can move you too safely, then we reserve the right to organise a transfer where is it medically appropriate."
The reason for this is that in most of Europe, Australia and New Zealand, public hospitals are very good, and quite often there's a reciprocal health agreement, so to keep costs and premiums down, we do reserve the right to move an insured person to such a facility. In all honesty, it doesn't happen that often anyway, but there's zero chance that you will be moved to a public hospital if our Medical Assistance Service physicians (who are totally independent and separate from us) do not recommend it, and it just wouldn't happen in Africa, South America or Asia anyway. In addition, in countries like Cambodia and Laos, where the medical facilities aren't that great, we would just medevac an insured person to Bangkok if they were very ill or badly injured. We have a little joke internally that the Bumrungrad International Hospital in Bangkok should have a ward called "True Traveller" as we always seem to have someone there.
Thanks for clarifying this point! I still prefer a policy where I have complete freedom to choose the medical facility, but I'll link to your response from the article so my readers will be aware of it.
I'd also love to see you introduce a recurring subscription like SafetyWing offer. I think that would make you a lot more relevant to long-term travelers and nomads. Do you have any plans for introducing that?
Oh, and it would be great if you could clarify this edge case then: What if a person is a legal resident of an EEA country, but not part of that country's public healthcare system (not that uncommon among nomads)? In that case they wouldn't qualify for the EHIC, and probably not the reciprocal health agreements (correct me if I'm wrong), so would they then not qualify for your insurance or would you still cover them?
In the event of a medical emergency, we tell people to go to the nearest medical facility and contact our 24/7 Medical Emergency Service. If then you need to be moved to a better facility for your well-being, that will be arranged. In countries where there is a good public health system, like the UK, Australia, Germany etc., the best hospitals are usually public ones anyway; the private hospitals in the main usually specialise in one area, like cosmetic procedures.
Arguably, the best hospital in London is St Thomas’. The Royal Adelaide Hospital is acknowledged as the best hospital in Australia. Both are public hospitals.
But at the end of the day it’s down to the Doctors. It would take a somewhat courageous insurer to tell their Doctors what to do in a claim scenario!
Regular Payments (known as a continuous payment authority), for travel insurance, is viewed by us as something we’d never want to do and never have done. There are so many complaints which used to go to the Financial Ombudsman Service about these payments which were never ending, and as I result I think most travel insurers have stopped doing it now anyway. The problem is, will you notice a small amount of money being taken from your credit card each week, or your bank account? Sure, we accept the majority of travellers will notice, but a fair minority won’t – which is great for the company or individual who put the continuous payment authority there in the first place. It’s only from when you tell them to stop do they have to stop taking your money.
At True Traveller, we just email people 6 days before their policy ends, and we tell them if they need more cover, they can just take out an extension policy. On these, our policy holders get a 10% discount, if their extension policy is the same duration or shorter than their original policy, up to a duration of 1 year. It’s all done online and people can arrange it in minutes, wherever they are. As a rule of thumb, the cost of a travel insurance policy, pro-rata, reduces on a daily basis the longer a policy is for. We accept that premiums for a week look to be high, but most insurers build in cancellation cover in case you become sick and can’t travel. Will your insurance pay for your non-refundable package holiday if you get sick and can’t go?
Travel insurance is all about claiming, and that’s why TT was set up. Yes, we have a lot of TrustPilot reviews, but we only really ask people to review us on their claims experience. But on review sites, just ignore all the 5-star reviews. Look at the 1-star ones!
For your last follow up, people should get an EHIC (I have one… you just sign up online!) as then you can get treatment free without having to fill out forms. But it’s not a requirement for our insurance to have one. We do ask that the nationalities who are able to register for Medicare in Australia, as it keeps the premiums lower. But some nationalities, like Spanish citizens, can’t apply for Medicare, so their insurance pays.
Take a look at a UK based company called GLOBAL VOYAGER.
Covers all the points needed above and very affordable.
Thanks for sharing this. Travel insurance companies can be really dodgy. Its good advice you stated keeping a copy of all travel documents (especially boarding cards). I would advise people to look at International medical insurance, or “Expat Medical Insurance” policies that aren’t specifically for travel. Of course you don’t get insurance for luggage etc, but you can get proper medical care that you can use anywhere or in a specific region. I went to see Assist Thai visa in Chiang Mai who work with over ten insurers. I ended up with insurance from ACS AMI which covers me permanently in South East Asia. Premiums cant be increased due to illness and I am covered for life. OK Im not strictly a nomad but Im travelling a lot to other SE countries now while being based in Chiang Mai at the moment. Also covered for 2 months trips worldwide (although outside Asia its for emergency treatment but similar to most travel insurance plans etc). For $1000 a year Im covered for anything that involves staying in hospital overnight, or any operation, or any follow up care connected to it. In Asia most hospitals will gladly keep you overnight if you ask them. Also good is Pacific Cross and a number of others.
That quote above is a bit surprising to me. How do the countries check if a traveler has insurance? I’ve entered Ecuador in February 2019, and nobody asked me to show any proof of any insurance. I’ve also visited Europe in 2016 and 2017 on several business trips and again, I was never asked to show proof of any insurance. I’m a EU citizen, and was based in the US at the time. Now that I think of it, I’ve never had to show any proof of insurance anywhere I’ve traveled, and I’ve never had travel insurance outside of what the credit card I had used might have offered.
It may depend on which particular visa you’re entering the country on (visa on arrival/ETAs are often more lax or might not have the requirement at all). If you don’t need to apply for a traditional visa in advance (you know, where you have to show up at an embassy with a bunch of paperwork), you may not be required to ever show proof of insurance.
Although countries could also choose to verify insurance details as part of the immigration procedure on arrival, I also haven’t experienced that as someone with a top-tier European passport.
Some examples of countries requiring proof of health insurance coverage here. I personally needed to show proof of insurance when traveling to the US on a J-1 visa (when submitting the visa application).
EDIT: Here are the official requirements for the Schengen visa, including medical insurance coverage of 30,000 EUR minimum.
Re. IMG:
IMG also has a Global Medical Insurance plan with Worldwide (including US) coverage, whose Gold and Platinum levels benefits include Preventative Care. The Platinum plan has no limitations on Pre-Existing Conditions (brochure screenshot below).
The monthly premium for a $2500 deductible us under $300, for the Platinum plan, while it’s well over $300 for the Bronze plan with the US insurers for the same deductible. Here’s IMG Global’s quote for a male, late 30s, US resident:
What’s extra interesting is that IMG doesn’t have an open enrollment period. I don’t know how they deal with the adverse selection but IMG seems like an interesting option even for Americans who don’t have regular health insurance coverage and plan on medical tourism. The eligibility requirements are:
Global Medical Insurance is available to individuals and families of all nationalities. U.S.
citizens must plan to be residing outside the U.S. on or before their effective renewal dates,
and for at least six (6) out of the next 12 months. Additional eligibility restrictions apply to
non-U.S. citizens residing in the United States.
The only catch I’ve found*, and fortunately not applicable to those of use who stay in the US less than 35 days/year, is that the plan is not ACA-compliant, so you’ll have to pay a tax penalty if you’re a US tax resident and do stay in the US for more than 35 days a year.
UPDATE: I’ve found a lot of terrible reviews for IMG (Yelp, reviewcentre, this site, some on reddit).
None of the reviewers complaining about IMG mentioned being on the Premium plan, so maybe those customers get treated better; or maybe that’s wishful thinking.
* Have I missed something?
Regarding IMG plans; They offer both a Travel Medical Plan, Patriot Plan, that includes emergency medical and travel insurance benefits (evacuation, trip interruption, etc.) as well as a Global Medical Plan, IMG Global Medical, that offers more comprehensive medical benefits and very little to no travel insurance benefits. The company is solid financially but, as previously mentioned, has some customer service issues it is working to overscome.
Take a look at the Aimviva Travel Club - a lot of the issues that you describe are taken care of. Trips longer than 90 days can be taken care of and the cost is a fraction of Safety Wing or World Nomads with much higher limits
These plans are all travel policies which are poor choices for a long term traveler.
If you are living abroad for more than a year you should look into a fully underwritten policy that will cover your conditions beyond renewal. Going through underwriting at the beginning of a policy instead of during the claims process ensures that any condition that happens after to you will be covered for life, where as a travel policy will make you prove your condition did not exist before, and can refuse coverage after policy is renewed. Many even outright deny long term treatments if it is not a life threatening emergency. (check your conditions of coverage)
Imagine a situation where you are battling cancer over an extended time, claims can easily reach hundreds of thousands of dollars. A travel policy MIGHT cover the first treatment, but it will be damn hard to prove that it wasn’t already starting to develop at the time of your last payment. If you do get it covered I can guarantee the insurer will not continue treatment past their renewal extension, leaving you with a serious condition and uninsured. Long term plans on the other hand make you disclose your medical history during the application and will make an offer, any condition after that is guaranteed cover for the rest of your life on the insurers dime.
Here is World Nomads exact wording that many people gloss over:
So this isn’t a health insurance plan?
"No, it’s a travel insurance policy. It’s there for overseas medical emergencies. It’s not designed to cover ongoing illness or treatment overseas, or any treatment when you get home. "
I find it exceptionally foolish in that a travel policy like world nomads is about the same price as a comprehensive international insurance policy. This is not a good strategy for a “long term traveler”.
I’ll add my bit on WorldNomads: don’t trust them and read reviews online - that aren’t from travel bloggers.
They stiffed me over a relatively minor medical bill, and not by straight up saying “we won’t pay you”, but just asking for more onerous paperwork until I gave up (and by onerous I mean requiring things that were impossible to provide or answer). And that’s after I finally managed to file the initial claim - which is ridiculously hard and the website kept glitching out - which I believe is deliberate.
So obviously if they’re going to do that for a minor one, and the whole reason I was buying it was if I got wrecked in either an accident or illness, so much for “peace of mind”. You’d probably have to sue them to get the money out of them (and court cases tend to drag out a fair bit longer than a tropical disease take to kill without treatment…).
The biggest thing to note about them is where most of their advertising is coming from. They’re deliberately getting all the major travel bloggers on their payroll, selling out without concern for their fellow travelers’ safety. Everything surrounding WorldNomads is dodgy to say the least. But don’t take my word for it: search reviews yourselves (that aren’t from travel bloggers).
I looked into SafetyWing as an alternative, but doesn’t seem that great. The limit is too low (250K isn’t enough to cover catastrophic events if you look up how much those usually cost – needs at least 0.5M, esp. if you go to US - which is a separate option but same limit for some silly reason), the claim process is manual via mailing them and has a long lead time, and the underwriter is Tokio Marine based in Bermuda as far as I recall from reading the Ts&Cs (so if they don’t pay, good luck suing it out of them).
I’d be interested in them if they’d raise the limit or give an option to, and they had an online claiming system, and good authentic reviews from people who claimed.
Currently I’m on a plain travel insurance (meaning will have to return after a year). Will probably have a look at those international medical insurance plans for next round, but they’re designed to act as a full primary care cover – and given the country I’m still legally resident in has public health care (which, by residency, means also I’m paying them taxes for that), all I’m really looking for is medevac travel insurance that’s perpetual.
Which plans are you referring to? IMG offers primary health insurance plans, and so does Aetna international.
Anyway, just wanted to send an update here that IMG’s computer systems and web site have been down for more than TWO WEEKS. This is a snapshot from Jan 29 and they were still down today (Feb 13, 2020).
I’ve never seen an outage this long. I also filed a claim on Jan 15 and haven’t heard from them at all since. They also haven’t billed me in February.
I haven’t tried calling them to see if they’re out of business.
UPDATE: looks like IMG / International Medical Group got hacked:
Notice there’s no “Forgot password” link anywhere.
I haven’t received any email or other communication about the outage, and they still have taken ANY action on the claims I filed 2+ months ago.
When I log in, I see this:
Our systems have been restored. However, we are currently experiencing a high volume of calls and emails.
No details, no apologies. IMGlobal have been really unprofessional about this, yet the first thing they did after they came back online was to ask for my monthly insurance premium (which their system wasn’t able to automatically take in February).
UPDATE
Turns out IMG was hacked, but have never disclosed the date breach to their customers. This is illegal in the US and the European Union, and probably in other jurisdictions. Here’s an excerpt of my communication with IMG, in which a representative slipped up:
IMG experienced a cyber-attack and the system was shut down in response, they were unable to access their phones or the IMG system from 1/27 until 2/28. Due to the volume of buildup during that time, combined with COVID-19, they have been extremely overwhelmed.
I hope to see a class-action lawsuit against them, but in the meantime, I ended my policies and stuck with Aetna International. They too have lousy customer support, and their messaging system is incredibly backwards, but they’ve been covering most of my claims according to the policy.
Nice review on Safetywing, good stuff! Probably the most comprehensive one I’ve seen. I have researched them too and consider them a great insurer overall. We’re collecting and have collected a ton of user reviews for them and most are positive. Just a couple people we’ve heard from who had a negative experience regarding safetywing not paying out on claims.
