Living and traveling without (health) insurance is not for the faint of heart, and – seriously – most digital nomads should take care of this topic before they leave the comfort of their home and the area of their neighborhood hospital.
But what are your options for international health insurance, and what are some issues that you should keep in mind before starting your journey around the world?
Basically there are two main approaches on how you can keep your health insurance working for you. Which one works better for you depends on your country of residency and your travel habits.
In the first solution, you will continue to maintain a permanent residence in either your country of citizenship or any other you chose to emigrate to.
You will sign up for a local health insurance in this country (being it a mandatory government program or some private plan) and, in addition, sign up for a travel insurance, that covers health issues and emergency treatments abroad.
If you will not visit your country of permanent residence very often, you might end up paying a significant amount for a local health insurance plan that you will (almost) never use, which might not be the best financial choice, but might give you a feeling of security that you will be covered whenever you are returning “home”.
Keeping your permanent residence in a country will have taxation issues for your personal (and sometimes also your corporate) taxation.
The second solution assumes that you chose not to have a permanent residence anymore (or one where local healthcare is neither needed nor makes sense for you).
In this case you usually sign up for some expat insurance programs that cover you in almost any country. Sometimes the stay in your country of citizenship or country of your last permanent residence is limited.
While these expat insurance plans are often a lot cheaper than your classical government-managed public health plans, they come with a few caveats:
you might need to pay upfront in a hospital with your personal funds and have to wait a few weeks until your insurance pays the money back to you.
they might chose not to renew your contract if you use it too frequently or develop a serious illness (chronic pain, cancer, diabetes, etc.)
they might limit you to a certain chain of hospitals or contract doctors.
you will have a high co-pay.
Some of these plans require you to have some sort of permanent residence at the time you sign up with the company, or it may only be available for residents of certain countries, so make sure you read their terms and conditions very thoroughly before signing up or starting your travels.
Basically these rules also apply for any other insurance contracts, e.g. liability insurance, car insurance, retirement plans, etc.