International Healthcare As A Nomad
When we dream about exploring the world we envision dramatic landscapes, crystal clear blue waters, dolphin swims, and exotic foods. Not broken ankles, food poisoning, or dengue fever.
So, what happens if you get deathly ill at sea? Or have a serious injury on a remote island? What do you do about regular doctor’s visits while in a foreign country?
All good questions. Because most domestic health programs and traditional health insurance are tied to one specific country. Which won’t do you any good once you leave that country.
We sailors, perpetual travelers, and digital nomads don’t live in a world built with us in mind. Because while some countries may have universal health coverage for their citizens, that doesn’t mean they will fit the bill for us travelers, in most cases, they won’t.
Thankfully, as our community grows, so do our options. There are now plans tailored for all types of traveling lifestyles. And we are not talking about old-school travelers’ insurance aimed at the typical vacationer. We’re talking legit global health plans.
I recently had my first surgery in a foreign country after more than a decade of being a perpetual traveler and digital nomad. I also filed my first claim with my international health insurance. So, it feels like a good time to cover the subject of healthcare abroad. The costs, quality of care, and in general share what we’ve learned over the years from our smattering of global medical experiences.
Watch the video first! We show a lot of medical offices from around the world.
Quality of Care Abroad
Overall, we’ve been able to find caring, knowledgeable, and experienced doctors throughout our travels. In some places, like Panama, South Africa, and here in New Zealand, we have experienced an incredible quality of care at a fraction of what it would cost in the USA.
Research the country you are headed to next. It’s the key to setting realistic expectations and planning out routine appointments. There will be a few countries, or remote areas, you’ll want to be self-sufficient and avoid medical services. But there will be some countries you will want to get everything taken care of and then some!
- Check your local government sites and the country you are visiting for any advisories:
- IAMAT has a lot of good information – https://www.iamat.org/general-resources
- The CDC lists a lot of resources: https://wwwnc.cdc.gov/travel/page/travel-information-centers
- Ask your fellow travelers. May seem obvious but it’s also a great way to get a recommendation for a good doctor.
- General internet searches like “health care as a traveler in (country you are traveling to)” can also be revealing.
Medical For Extreme Remote Travel
For some of the extremely remote islands we’ve been to, the services and facilities have been bare bones. On some islands, there is nothing…because there are no people. In these cases, we have our satellite communications and make sure to come fully prepared to take care of ourselves.
We have insurance that includes emergency evacuation and repatriation. We have taken first-aid classes and have had some additional training on severe wounds.
We have an extensive medical kit specially designed for sailors who might not have access to a hospital or trained medical personnel. These kits can be purchased online or at boat shows. They are great for most situations and you can always add extras to suit your needs.
- Our Adventure Medical Kit: https://amzn.to/3tbiW3t
- Variety of Medical Kits (including ones for pets): https://amzn.to/3Ly91Lx
If you want to really kick it up a notch, some companies specialize in offshore medical training, telemedicine & custom kits used by cruisers and professional Yachts. Like these:
FREE Ships Captains Medical Guide
If nothing else (or in addition), download the Ships Captains Medical Guide. It is put together by the UK government for practical medical guidance (non-doctors) working onboard a ship. It covers just about everything including basic first aid, poisoning, sexually transmitted diseases, and how to deal with a burial at sea.
You May NEED Proof of Insurance to Travel
More and more, it’s becoming a requirement to have international health insurance to enter certain countries. Especially as sailors or anyone applying for visas. For example, Panama and New Zealand both requested we have proof of health insurance before they approved our visa.
Murky Waters of Global Health Insurance
There are a lot of different options out there and they are NOT created equal. It’s all in the details and what your specific needs are. But it’s also about the reputation of the insurer. No point in paying for insurance if they don’t pay the claims.
There are websites like TrustPilot that have reviews but navigating the murky waters of health insurance isn’t my forte. This is why we use an agent. Having an agent doesn’t cost us anything extra, but it means we can get quotes from multiple companies all at once. And, we have someone who can help guide us to the right plan based on our style of travel, locations, and needs.
Arno has been our agent for years now. He is a fellow traveler and sailor who makes it his business to know all the plans, which company has a good reputation, and which doesn’t. He helps travelers from all over the world. A quick glance at his website will give you an idea of some of the companies and services out there. We don’t get anything if you click…but if you reach out, tell him we sent you.
Some things to consider
- What countries are covered? Some companies are specific to a handful of neighboring countries while others cover practically every country except a handful of ones where health care is more expensive, such as the USA. (For example, our insurance works anywhere in the world except the USA). To include these, you can expect an additional cost or you may be required to purchase another plan entirely to cover that one “special” place.
- Types of Coverage: Most policies will have a huge list of treatments that are both covered and not covered. If service is not covered automatically, you may be able to add it such as dental, vision, maternity, physical therapy, and mental health services.
- Sports/Diving? Sports can be something as benign as hiking – you don’t want to find out you’re not covered after you break your leg on a tree root.
- Emergency health coverage, evacuation, and repatriation.
- Pre-Existing and chronic conditions: I don’t have a lot of experience with this, but I have heard both good and bad stories. Read the fine print and understand exactly what you are covered for and if there are limits or special requirements.
- Telemedicine: Access to doctors through phone, email, or video. Very handy in remote areas or when there are limited healthcare facilities.
Our Health Insurance
We are currently under a grandfathered plan that is no longer offered, so I am not going to mention the name or the price. Because you can’t buy the same plan, it doesn’t help to share the details. Should we decide to switch, we will most likely move to a similar plan from Cigna.
Our insurance plan is catastrophic, meaning it covers emergencies or major medical procedures. Catastrophic plans are the most affordable because we pay out of pocket for general care. Which outside of the USA isn’t a big deal because, in comparison, it can be very affordable!
Our insurance works worldwide (excluding the USA). If we spend time in our home country, we may get a USA-specific plan.
Some of the big highlights for us are:
- Comprehensive medical evacuation and repatriation
- We have free choice of which doctors and hospitals we go to
- Comprehensive hospitalization coverage
- Preventive, rehabilitative, and therapeutic services
- Emergency dental coverage
The premiums for international health insurance vary dramatically. Because there are so many factors like age, location, medical history, and coverage needs. There is no such thing as a straightforward comparison of plans because no two plans are the same. Different levels of coverage, limitations, and exclusions, each of which affects the overall cost of a plan.
So, take these numbers with a grain of salt. Here are our (2 healthy adults) quotes for switching to Cigna:
- A similar plan to the one we have now with a $5000 deductible came in at $6500 a year.
- A plan with $5000 deductible that only covers hospitalization, ER, and Cancer is $3500 a year.
Similar to our Sailboat Insurance there is one guarantee: Prices will continue to rise every year. And bonus…as you reach milestone birthdays (like turning 40) your reward is a BIG increase 🍾
We’ve found Meds and prescriptions are easy to get, and easy to stock up on as we travel. It’s common to have a doctor write an extra prescription, or even recommend ones as a precaution for our travels. Especially as offshore sailors. If you are headed into an area with malaria or want some broad-spectrum antibiotics or steroids to keep on the boat, just ask.
Anytime we schedule a consultation with a doctor, we check our medical kit and make notes on what we need to update. We tell the doctor about our situation, where we’re sailing and what the scrips are for. So far we’ve never been told “no”. For safety at sea, we keep a wide variety of prescriptions in our kit with notes on what they treat such as “bacterial infection” or “severe sinus infection”.
We’re not experts and can only speak from our own experiences. But from our 10+ years of travel, we’ve found healthcare abroad can be great…as long as you’re prepared and do a little research on the area you are visiting in advance.
If you have questions or want us to elaborate on something, drop us a note down below. I can’t promise I will have the answer, but we’ll do our best. If you have any tips you want to share with us or the community, please do! We’ll update this post as we gain new information or if anything big changes with our approach.
This article and video are made possible because of you! If you like what you see, there are lots of ways you can show your support.
🎥 CAMERA GEAR USED TO FILM THIS VIDEO
🎶 MUSIC IN THIS VIDEO
- Get 2 Months for FREE: https://bit.ly/artlist-GWTW
- Artists – Straight White Teeth, Omri Smadar