Health insurance is something that many young healthy people don’t think about. And many digital nomads are young healthy people, though not all of them are. And if you are from most rich countries you may not think about health insurance as your country makes it pretty easy to just be treated if you have health care needs, without a need to have bought health insurance.

But when you are traveling outside your country health insurance is important. I am not very familiar with the details of how health coverage works for all the different countries so you will have to figure it out for your own country. It wouldn’t amaze me if European countries set up some kind of reciprocal care agreements but I have no idea if they do (they should if they don’t).

In the USA we know what a nightmare health insurance is. The ludicrously expensive USA health care plans generally don’t provide any coverage when you are outside the USA (even inside the USA, but not in your own state there are severe limitations). There are many wonderful things about the USA but the health care system is a nightmare and has been for decades.

If you are going to fly off and become a digital nomad one of the critical items to consider (though many don’t give it the attention it needs) is health insurance. It is true that in many countries you can pay out of your own pocket for health care that would bankrupt you if you used the USA health care system and tried to pay out of your own pocket (tens of thousands of people go bankrupt in the USA due to health costs).

If you use good personal financial planning practices you should have at least 6 months of expenses in an emergency fund (and I would strongly suggest at least a year for any digital nomads). That emergency fund should be able to pay for routine medical visits in many countries (Malaysia, Thailand, India, Indonesia, Vietnam, Singapore… – I would imagine this is true in most countries, but certainly not the USA.) without a need for health insurance.

What you need health insurance for is for the large health care expense from a serious medical condition. Many travelers get travel insurance, which seems to talk about covering health care but it normally only pays to treat inexpensive items or to fly your back to your country at which point all health costs are yours. If you have health coverage in the country they fly you back to that may be sufficient, but if you don’t then you are in big trouble. This is definitely a big problem for anyone from the USA. But even in Europe several of the health care systems don’t cover you if you are not living there so you have to be very careful. For a vacation such coverage may be acceptable. I would not suggest it for digital nomads. I would suggest getting full international health care coverage.

Buying nearly worldwide health care coverage if you are healthy is not very expensive (for those used to the ridiculous USA costs anyway). And that coverage won’t include coverage in the USA (without being hugely expensive). When I looked I could get worldwide except-USA coverage for 1/3 to 1/4 of the price of including the USA.

Insurance companies are not really innovative and forward-thinking in general. They are really based on the notion that you live somewhere. The whole digital nomad notion doesn’t fit their paradigm. Please comment if you know of insurance companies that explicitly state they understand you don’t have a home address but will be nomadic. So there is some risk they will try to weasel out of paying the insurance if you have huge costs and they decide that you don’t really fit what we meant to cover. After they figure out that you are expensive they may seek to find excuses to claim you shouldn’t be covered. This is just an annoying risk that can only be addressed by trying to pick a honorable and reliable insurance company.

For international health insurance I would strongly suggest buying from a very well known company with a long history of providing global health insurance. Some of the names that are worth exploring are:

• Bupa International Health Insurance
• Allianz Worldwide Healthcare
• IMG Global medical insurance
• Cigna International Health Care Coverage
• Geo Blue (Blue Cross/Blue Shield affiliated – “independent licensee of the Blue Cross Blue Shield Association”)

If you are healthy you can probably get coverage with a high deductible for a few hundred USA$ a month. If you have expensive pre-existing conditions my guess is it will be very expensive or impossible to get insurance (though I may be wrong).

Another important factor to consider is your long term coverage. Will you be able to renew your insurance each year? Can the cost rise drastically based on your health or age? If you can’t renew your coverage and have acquired a long term health condition you may have great difficulty getting other coverage.

Health insurance is a very complex topic. I have barely touched on the most basic ideas so far. To do an adequate job you will need to spend some serious time researching what is available for you and what fits your needs.

There are also insurance agents specializing in international insurance. This may well be a wise option to consider. Even if you take this option, make sure your have a very detailed understanding of the costs, limits and risks as well as a very good understanding of the company you are relying on to help with your health care needs.

If you are not a nomad, but an expat that is stationed in one country it may well be cheaper to get insurance in that country. However, remember to consider what your coverage is while traveling to other countries. It may well be more sensible just to get global coverage. If you get coverage through your job, make sure you understand what it actually covers and if there are gaps you should consider getting supplemental coverage for.

Related: Medical Tourism – Finding an International Business Bank as a Digital Nomad – Disability Insurance is Very Important – The Growing Market for International Travel for Medical Care