As we leave the US for at least two years, we’ve researched our medical health insurance options, and we’ve finally weeded through the clutter and the noise to determine the best health insurance option for us. Read below for how we picked our provider, what we’re paying, and how we sorted out the choices.

Travel Insurance vs Travel Insurance with Medical vs Medical/Health Insurance

When we started this process of finding insurance, it was very unclear to us exactly what we needed and how to get it. We were looking for insurance that would cover our ongoing medical needs while we travel as nomads. Once we leave the US, we will not have any medical insurance that covers us in the US. So we sorted, researched, and asked a lot of questions. Lots of the understanding became clearer when we started understanding different terms. We break them down here:

Travel Insurance: This type of insurance covers you for the times when the travel gods are not in your favor. Think lost luggage, cancelled flights, missed connections. If something bad happens, your travel insurance will reimburse you in a variety of ways for missed flights, botched hotel reservations, etc. Most good travel credit cards have this type of coverage as a benefit and it’s automatically included if you book your trip with said credit card. The Chase Sapphire Preferred is an excellent card that includes Travel Insurance.

Travel Insurance with Medical: This type of insurance includes all the coverage mentioned above for Travel Insurance, and it also includes dramatic stuff like getting hit by a bus, needing evacuation due to terrorism, or food poisoning. The underlying assumption to most of these types of policies is that you have insurance at home and that you will transport yourself back to the US to finish your medical care under your current medical insurance in the US. Many good travel credit cards (such as the Chase Sapphire Preferred mentioned above) include this type of coverage, too.

Medical Insurance/Health Insurance/Global Medical Insurance: This type of insurance is the type of insurance we’re used to in the US. It generally covers your catastrophic needs, chronic illnesses, acute scenarios, emergency room care, etc. Many people in the US have this type of coverage through their employer or they buy it through the Affordable Care Act Exchanges (Obamacare) or other. This is the type of insurance that we need and purchased.

Nomad Insurance, Global Nomad, Expat Insurance: These are various terms, brands, and websites that target Americans who live abroad. These are the terms we often see to describe the type of insurance we need. But regardless of the terminology or branding used, it’s all Global Medical/Health Insurance. What makes these terms confusing is that the terms are actually brokers who sell Travel Insurance, Travel Insurance with Medical, and Global Medical Insurance. In addition, some brokers with brand names only sell Travel Insurance but make it look like it’s Global Medical Insurance. (Safetywing, Allianz, and World Nomads are examples.)

How to Buy Global Medical/Health Insurance

In order to buy Global Medical/Health Insurance, you can go to a broker or go directly to the insurance company’s website. A broker often represents several different insurance company providers. If you go directly to the provider, they’ll most likely just assign you a broker based on your zip code. If you go to a broker, you’ll have someone to talk to and will help you sort out all the options. In our experience, there was no price difference between going directly to the insurance provider’s website or talking directly to a broker.

The Brokers Differed Drastically: Here’s Who We Used Ultimately

We talked to two completely different brokers. Both of them represented the same sets of companies, but each had very different advice and understanding of the policies. Although they both recommended the same company to us, the price quoted between the two of them was drastically different. The broker we decided to work with eloquently discussed the differences and also developed quotes for us that were cheaper than the first broker. We recommend:

Justin Barsketis +1 435 647 6379. He is also on What’s App, which is a super feature for when we travel internationally and don’t want to pay international communication fees. Please tell him we sent you.

The Main Global Medical Insurance Providers

Although there are probably more providers than we’ll mention here, the major US providers of global medical/health insurance for Americans are GeoBlue (Blue Cross/Blue Shield), Aetna, Cigna, and IMG. When we went through their quoting tools on our own, we got extremely different price quotes, varying by almost $2000 monthly. We did our best to answer all the questions equally so that we could compare apples to apples. We focused on our deductible and lifetime benefit amounts. When we scanned the differences in coverage between the cheapest and the most expensive providers, we found miniscule differences in the coverage.

We sorted through all the quotes and returned to our broker to confirm what we were reading. He could not explain why the relatively same policies would differ so much in price. We ran through our health scenarios and our risk tolerance, and he confirmed our choice and talked through our exclusions. Additionally, we sorted through reviews and looked specifically for comments about claims. Not one company necessarily rose above another.

By the way, we did look at medical health shares like Sedera and Liberty, and we decided they were not a fit for us, particularly because they generally also included US coverage. We’re not looking for US coverage. If we need to return to the US for a short period, we’ll buy Travel Insurance with Medical for a month or trip at a time.

Our Medical/Health Scenarios and Underwriting

We are both healthy with no chronic illnesses. Steve is 61, Chris is 54. Chris had a hysterectomy due to cervical cancer four years ago with no reoccurrence.

Our broker accurately stated that we would have to go through underwriting, and regardless of whom we’d chose, Chris would get an exclusion for her female parts until she had a clear medical record for five years. Conversely, she could pay almost 5x the monthly premium to have her uterus covered. And Chris thought, hum, why should she pay to have a part covered that she doesn’t have anymore? (This is her risk tolerance, and not something she’s recommending for someone else.)

In underwriting, the provider kicked Chris out of “Silver” level down to Bronze. This limited Chris’ lifetime coverage from $5million to $1million and excluded her female parts. Chris can apply for Silver on the fifth anniversary of her surgery. For Steve, the underwriter asked for a copy of his medical records from his last wellness check, including the notes. They put him in the Silver category with one exclusion for a minor condition, and he has a $5000 deductible with $5million lifetime coverage.

What Insurance We Selected, How Much We Pay, What It Covers

Ultimately, we selected IMG Bronze for Chris and IMG Silver for Steve. We will pay about $175 month with a $5000 annual deductible, a $1million lifetime coverage for Chris and a $5million lifetime coverage for Steve. We have set aside a $5000 medical fund of our own to cover dental, massages, out-of-pocket procedures and co-pays. Our policy does not include Covid-19 coverage (we are vaccinated for it), but it does include one annual wellness check and prescription coverage (with limits.) You can read all the details here about our coverage, if are you so inclined to read fine print.

It’s Really Not that Confusing

After all the angst about medical insurance and sorting through the choices, we realized that our angst about it was around general health insurance fear that most Americans have in the US. We are so worried about health care because it’s so expensive and complicated in the US that we assume it will be like that in other countries. So far, it’s not. (Ask Chris about the extensive medical care she got in Mexico for bum knees and cortisone shots for $300 total, including xrays and exam.) Obviously, we’re assuming we won’t end up in urgent care in the future, but if we do, we’ll be sure to write about it.

What questions do you have about getting medical/health insurance abroad?


  1. Bonnie Truax

    Thank you! I knew when you first published this that I would need it someday. Today is that day. 🙂 I just sent a message to Justin as we are in the market to possibly change our insurance company.

  2. Amy Mason

    Thank you for sharing it is a daunting task to know where to even begin. Happy travels. Cheers!

    • EatWalkLearn

      You are welcome. My book breaks it all down with narrative and examples. There’s to do list and worksheets, too. It might be helpful for you.

  3. Kevin

    Sorry in advance if I overlooked it, but did you opt for the worldwide coverage or excluding US and Canada? Also, I couldn’t find the annual wellness check in the PDF from IMG. Have you had one of these yet? Any problems?

    • EatWalkLearn

      Thanks for asking. We have the IMG Global Silver and Bronze plans, excluding US and Canada. The Silver plan includes Wellness, but the Bronze does not. But do check with them directly, as I’m sure the plans change all the time. I did try to submit a wellness check on Bronze, and they denied it.

      • Julie Rose

        I tried to submit a wellness check on silver, and they denied it. This is a 2022 policy. Not sure where I went wrong! But very, very frustrated about it…

        • EatWalkLearn

          There are some version of the Silver that don’t cover Wellness…but certainly read the policy.

  4. albis

    Thx for the Information! We have a 3-month countdown! Questions: If you were to have a major issue, let’s say Breast Cancer, need a bypass or brain surgery and you are let’s say Turkey. Where will you get that treatment? Do you have a”home base for medical care?” If so, how did you choose that location? Thank you

    • EatWalkLearn

      Good question. I have an international plan, so I’ll research my options and pick the best place for it. Currently, I do not have a home base. But, I now know, based on the knee work I had done in Puerto Vallarta, Mexico, I’d return there for any knee surgery. I’d likely return there for other medical needs too because the hospitals are good and the housing is affordable. I use my provider to research docs and destinations, and I also google “medical tourism in X” for starters.

  5. Debra MacKillop

    Thank you for explaining all this. I’m not looking at the nomad life, but I am someone who has had a lot of trouble getting health insurance at some times of my life and affording to pay for it. I was on the ACA for 3 years and very impressed with it (saved my life when I had cancer), and it’s even cheaper now under the Am. Rescue Plan, but I’m assuming that was not helpful coverage outside the US. ACA has free brokers. I worked as social worker many years with very low-income clients and the Medicaid expansion was a game changer for them. I’m sure many will find the broker recommendation very helpful. I’m on Medicare now, and sadly that is also very complicated and confusing with many plans that have different costs. If the US ever goes to Medicare for All, it should not be modeled after Medicare. Stay well, and hope you don’t need your insurance! Keep the updates coming too.

    • EatWalkLearn

      Groan. Our US medical system is so messed up. Honestly, it’s one of the reasons we’re taking a break from the US. I hope it gets fixed sometime soon as it’s seriously not sustainable. I’m glad ACA works for you.


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handsome hiking couple

Chris and Steve, the empty-nesting nomads, travel the world, one month at a time, housesitting and Airbnbing along the way. We uncover urban walks, great hikes, and vegan/vegetarian eats that other guide books miss. And we throw in a bit about Forex trading along the way.

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