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International Health Insurance
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MikeMcLaren Offline
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Post: #1
International Health Insurance
It's a good idea to have health insurance if going abroad. I'm currently in US but am doing my research about options. I have just started my research and Aetna International is at least a recognized name that would provide a decent (probably) level of care in case of a real problem. From my research (I'm in late 20's early 30's no medical problems), I was looking at $1600 SEA, $1600 SA, and $1900 EE yearly (US Dollars) for a high deductible not minor things covered plan and $3000-$5000 yearly for an everything covered type plan for both SEA, SA, and EE.

I could not find a worldwide plan with ease from their website and search plan as it was directing to a specific country (those higher cost plans might have wider coverage). I will continue to post my research. If others have health insurance outside of US and Western Europe, share the name of company, the area of coverage, and how the insurance company has worked out for you so far to get a good thread going.
10-30-2015 04:10 PM
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NomadofEU Offline
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Post: #2
RE: International Health Insurance
I just bought the most minimal plan (675 hrv) needed to apply for a 1-year temporary residence permit here in Ukraine. Medical costs are so small in most countries outside the US that unless you incur catastrophic injury these plans $500+ plans are a complete waste of cash.

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10-30-2015 04:19 PM
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DaveR Offline
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Post: #3
RE: International Health Insurance
There are some other threads on this already, but I'll chime in...

I agree that health insurance isn't a necessity outside the US. In other countries, health insurance is really just a financial planning product - nothing to do with your health. If you're financially independent it will be more cost-effective over the long term to fund your own health care.

You might still want to consider insurance if you plan to spend time in a country where you don't have someone to manage your affairs in case you get sick. If that's the case, your insurance will handle all of the payments (at their preferred hospitals) and medical evacuation if you're living in a third-world country without developed medical care.

In Russia I've found it more effective to sign up for a plan directly with a private hospital. That provides me with preferential rates and access to their ambulances in case the need arises. However, I'm established here and have plenty of friends who would manage things for me if something happened.

If you need it, try the following brokers. Both focus on expatriates and have won a lot of awards in the UK. You'll get the best results if you give them specific details about which cities/countries you do (and don't) need coverage for, what kind of coverage you need, etc.

http://www.medibroker.com

http://www.pmihealthgroup.co.uk/individu...l/service/
10-30-2015 05:10 PM
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CleanSlate
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Post: #4
RE: International Health Insurance
I use MEDEX for my trips. It cost about 90 bucks for the comprehensive plan.
10-30-2015 06:03 PM
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tomtud Offline
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Post: #5
RE: International Health Insurance
I paid 200,000 pesos per month for SURA health insurance while I was in Medellin. I got access to specialists immediately and each visit cost 20,000 pesos for the specialist. Try seeing a specialist immediately in Canada.... Good luck.
However, I found that specialists cost about 120,000 pesos if you dont have the premium insurance plan. Of course if you have the basic plan, you can see the specialists but you will have to wait.
As well, there is another plan for SURA, that is more expensive..... Gives you access to hospitals and special treatment centres all over the world and they pay for it all. If you are living in Colombia for a long time and would like access to the best specialists,,, try this plan.

While I lived in Qatar, they had extra supplemental insurance as well. The employer gives you health care coverage but being alone, far away from home, sometimes it's good to spend on some sort of comfort by paying for
Supplemental coverage.

For some if you who are members of labour unions,,,they have travel insurance for its members. Also, some credit cards have travel insurance as a benefit if you purchase the trip and accommodations on the card. Read the policy before proceeding of course.
10-30-2015 06:48 PM
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popeyearms76 Offline
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Post: #6
RE: International Health Insurance
OP, just wanted to give my two cents:

If you're going abroad to mostly third world countries and can afford the air tickets and other associated travel costs, you should have enough money to cover any routine medical expenses you would encounter. What I mean by routine medical expenses are dental cleanings, x-rays, office visit fees, setting broken bones, medications, etc. Those costs should be quite reasonable. As an example, I had my teeth cleaned and whitened in Thailand last year for ~$55. I picked up some generic Cialis in Moldova for $4 a pill and didn't need to see a doctor about it first. Not too shabby!

IMHO, where the real need for insurance comes into play is when something serious happens. Consider what would happen if you were in a car accident in the third world, say Laos. Most likely you would need to be evacuated to Bangkok as I am sure there is no trauma facility in Laos. And once you are in Bangkok, a series of medical costs that might cost >$250K in the USA might still be $50K in Thailand, still quite a financial blow. Therein lies the need to be covered for serious medical emergencies, to include medical evacuation.

The big name for insurance for medical evacuations is World Nomads, and after that, Allianz. Can't say either way if either are any good or are a hassle to deal with.

What I wonder about is what would happen if one were indeed seriously hurt to the point of being unconscious in a country like Laos. I can just picture some villagers looking on the scene; they speak no English and just keep on quibbling about what to do, then nothing happens and the victim dies. In some cases, insurance will not save you and you're screwed no matter what. It's some real food for thought for next time you're in a remote place doing risky activities!
11-01-2015 07:04 AM
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nomadbrah Offline
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Post: #7
RE: International Health Insurance
(10-30-2015 05:10 PM)DaveR Wrote:  I agree that health insurance isn't a necessity outside the US.

Have to take this out (of context) and comment, because thinking like this is a very bad idea.

People die all the time because they don't have health insurance abroad. It's not the small trips to the doctor with a sore throath you have to worry against, but planning for the worst.

Intensive care is going to cost A LOT regardless of what country you're in and you really, really don't want to have a medical emergency in a third world public hospital. I've seen two people die just from extended network over the last couple of years due to racking up bills and not having health insurance. Medical evacuation costs 100-200K USD, I doubt most have that money lying around.

Stupid not to buy health insurance, World Nomads is high deductible travel insurance for about $150 a month. Bupa International is around $250 a month for premium insurance worldwide (ex US). In other countries you might buy local (such as Thailand) or use some mixed insurance like you mention (Poland, Czech).
11-01-2015 04:44 PM
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DaveR Offline
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Post: #8
RE: International Health Insurance
The OP mentioned premium plans, not just emergency cover. A good broker should be able to arrange hospitalisation and evacuation cover for around $1000/year for someone in their 30s.

$3000+ plans are for people who need to eliminate all of the financial risk for whatever reason (lack of planning or self control, etc.). In my experience, those plans only waste time, create a lot of unnecessary bureaucracy and end up costing more over the long term.
11-02-2015 10:20 AM
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CleanSlate Offline
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Post: #9
RE: International Health Insurance
Bumping this thread, this has been on my mind for some time.

I have a good health plan I get through my job, but when I leave my job to go full time freelancing, this plan will be too expensive to keep up. So when planning to travel the world and post up in other countries, what sort of international plan should I look into under Obamacare?

I would like something a little more than a barebones catastrophic plan - I have some auditory needs that I hope to get partial coverage for (i.e. Hearing aids... they are very expensive out of pocket!)

From what I've researched, it would have to qualify under Obamacare if I'm ever going to spend more than 30 days in the US in any given year. Since I have family and connections in the US, this would probably be a big factor in my decision.

I could be wrong in Obamacare for expats, but I want to get this squared away ahead of time instrad of winging it last minute.
11-30-2015 06:46 AM
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262 Offline
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Post: #10
RE: International Health Insurance
I wrote about Obamacare for expats on my relo thread. Basically, if you're out of the US long enough for a year, you're exempt. Check out the thread for details and a link to the US government source.
11-30-2015 07:46 AM
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CleanSlate Offline
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RE: International Health Insurance
(11-30-2015 07:46 AM)262 Wrote:  I wrote about Obamacare for expats on my relo thread. Basically, if you're out of the US long enough for a year, you're exempt. Check out the thread for details and a link to the US government source.

My bad, I asked you about it before and I forgot.

But the part of my question that went unanswered was whether an international health care plan like World Nomad is recognized as a valid plan under Obamacare.

Like, what if I spent one day too long in the US in a particular year, losing the exemption?
11-30-2015 08:24 AM
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262 Offline
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RE: International Health Insurance
Good question, I'm not sure. My solution is obviously to spend less than the maximum amount of time in the US Wink

Googling healthcare.gov, it seems the worst that could happen is that you pay a penalty for the months in the US that you weren't covered. I've heard this penalty is basically the same amount as if you had paid insurance premiums, but I could be wrong.
11-30-2015 12:36 PM
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nomadicdude Offline
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Post: #13
RE: International Health Insurance
An international health plan like World Nomad is not a valid plan under Obamacare. Only the plans sold on the exchange in your state are valid. As far as I can tell these plans generally do not cover most international treatment, though I've seen them covering some stuff in Canada and Mexico. It would vary by plan but these plans are meant for domestic use and not for ppl living abroad long term.

As others have said, the cost of healthcare abroad is barely a fraction of the cost in the US. I thinK Americans get deluded into thinking it's the same everywhere but it isn't. Paying a US insurer $200 or $300 a month for a insurance plan that covers things abroad is outrageous. I really think the solution is to just self insure and maybe see if you can get a high deductible plan for serious emergencies.

Another problem with the intl health plans sold by US companies is what do you do if you get evacuated back to the US? To me that sounds like the WORST option. If you are living long term abroad and then you get sent back to the US how the fuck are you going to pay for a 200,000 dollar 3-day hospital stay in the US? It's a fraud. I would rather be evacuated to a top hospital in Bangkok or Mexico City or whatever is closest to where I'm at and not have to deal with the fraud "free market" healthcare system in the US.
11-30-2015 02:59 PM
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CleanSlate Offline
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Post: #14
RE: International Health Insurance
I tried researching the health insurance for expats with respect to Obamacare, including reading IRS publications and healthcare.gov.

It's so damn complicated and I don't understand it at all. Perhaps I should talk to my CPA...

If I could venture a guess, I'd just buy an international plan like World Nomad, and do my best to stay out of the US for at least 335 days. If not, then whoops - I cough up the penalty or something. Can World Nomad be used within the US if I need to see a doctor when visiting the US?
(This post was last modified: 11-30-2015 03:27 PM by CleanSlate.)
11-30-2015 03:24 PM
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262 Offline
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RE: International Health Insurance
(11-30-2015 02:59 PM)nomadicdude Wrote:  An international health plan like World Nomad is not a valid plan under Obamacare. Only the plans sold on the exchange in your state are valid.

I'm not sure if WorldNomads is valid under Obamacare, but I know you don't have to go through your state exchange for the plan to be valid. Link:

https://www.healthcare.gov/fees/plans-th...-coverage/
11-30-2015 03:27 PM
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262 Offline
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RE: International Health Insurance
(11-30-2015 03:24 PM)CleanSlate Wrote:  I tried researching the health insurance for expats with respect to Obamacare, including reading IRS publications and healthcare.gov.

It's so damn complicated and I don't understand it at all. Perhaps I should talk to my CPA...

If I could venture a guess, I'd just buy an international plan like World Nomad, and do my best to stay out of the US for at least 335 days. If not, then whoops - I cough up the penalty or something. Can World Nomad be used within the US if I need to see a doctor when visiting the US?

Yeah, I more or less stopped at the 335-day exemption, since otherwise I'd have to ask WorldNomads if they are valid under Obamacare.

If I recall correctly, WorldNomads is valid in the US, but only outside a 100 mile radius of the US address you give them.

I think it's also only meant for catastrophic injuries, so I wouldn't use it to see a doctor for minor problems, especially in the US.

Finally, as I understand, healthcare outside the US is usually reasonable, so for minor problems, I'd get those taken care of abroad, without health care insurance.

Again, all the above is based on my understanding ... Of this ridiculously complicated topic.

Edit: As an aside, as I understand, staying outside the US that long also exempts you from taxes on your first like $95k in income. So more money for you, less money for parasites.
(This post was last modified: 11-30-2015 03:47 PM by 262.)
11-30-2015 03:41 PM
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CleanSlate Offline
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RE: International Health Insurance
I talked to my CPA. He said as long as you stay out of the US for 335+ days/year, you're exempt from needing to buy a US health plan. If you're in the US more than 30 days, though, you'll have to buy a US health plan.

Not quite what I was hoping to hear. I've been seeing posts here that they're trying to make it harder for people to leave the US... well, it's already happening. Thanks, Obamacare.

Under a scenario where I happen to stay in the US more than 30 days in a year, I'd like to know what sort of minimal or catastrophic plans I could maintain just for a few weeks or few months until I got out of the US again. Hopefully they have low premiums...
12-01-2015 02:00 PM
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262 Offline
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Post: #18
RE: International Health Insurance
Probably the easiest - and likely closest to the cheapest - way under that scenario would be to simply enroll for a bronze plan at your state or federal exchange (depending on your state).

As I understand Obamacare, the plans come in three flavors - bronze, silver, and gold - with premiums increasing as coverage increases.

Only catch might be that you have to enroll beforehand if your stay ends up being longer than 30 days.

Hopefully that should be enough to allay your fears on this topic. We want to see you out there posting fun trip reports and rubbing it in the face of our feminist lurkers Wink
12-01-2015 02:14 PM
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wolfer Offline
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Post: #19
RE: International Health Insurance
i am from germany, and i pay 1,15€ for a day for an international insurance, covered everything, for trips less than 40 days, its 15 € year
12-01-2015 02:36 PM
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CleanSlate Offline
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RE: International Health Insurance
(12-01-2015 02:14 PM)262 Wrote:  Probably the easiest - and likely closest to the cheapest - way under that scenario would be to simply enroll for a bronze plan at your state or federal exchange (depending on your state).

A quick check on the cheapest bronze plan with minimal use of a doctor in my state is almost $200/month.

EDIT: just read that in a short term gap in coverage (less than 3 months) you don't have to buy health care, and you won't get penalized for not having a health care plan. Just don't get in an accident within 100 miles from your (US-based) home on a World Nomad plan...
(This post was last modified: 12-01-2015 02:51 PM by CleanSlate.)
12-01-2015 02:39 PM
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262 Offline
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RE: International Health Insurance
Yeah unfortunately $200/month sounds about right. Back in 2012 Mr Money Mustache paid $237/month for himself, his wife, and their baby, and premiums have gone up since then.

http://www.mrmoneymustache.com/2012/11/0...ance-plan/

Also I believe that the less than three month gap only applies if you have qualifying insurance before and after the gap. My guess is the IRS will say you didn't have anything before, and if it's been more than 30 days, they'll deny the foreign exemption too.

One other thing may help in the US with WorldNomads is using an address where you'll never be within 100 miles of it. As I mentioned on my relocation thread, I use a mail scanning service in Houston, and my policy is set to that address - but I have almost no reason to be within 100 miles of Houston Wink
12-01-2015 06:23 PM
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presidentcarter Offline
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Post: #22
RE: International Health Insurance
Check out Cigna Global.

"...it's the quiet cool...it's for someone who's been through the struggle and come out on the other side smelling like money and pussy."

"put her in the taxi, put her number in the trash can"
12-01-2015 07:26 PM
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RE: International Health Insurance
At least I'm finding out about all this now, rather than blindly winging it and getting a nasty surprise from the IRS.

Have you ever put in a claim with World Nomad? If so how did you like them?

Also checking out Cigna Global (thanks presidentcarter), seems to be on par with World Nomad if not a bit more expensive for anything higher than the silver plan.
(This post was last modified: 12-01-2015 07:31 PM by CleanSlate.)
12-01-2015 07:27 PM
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presidentcarter Offline
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Post: #24
RE: International Health Insurance
Cigna Global has an option to add US coverage for peanuts (like $12 a month if I remember correctly).

Not sure if the other mentioned have that.

"...it's the quiet cool...it's for someone who's been through the struggle and come out on the other side smelling like money and pussy."

"put her in the taxi, put her number in the trash can"
12-01-2015 10:08 PM
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RE: International Health Insurance
I've never put in a claim with WorldNomads. Hopefully the reviews online that they're good are correct ...
12-02-2015 02:23 AM
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