Health insurance is something that concerns all of us, regardless of age, status and how healthy we are. In this guide, I share my own strategy and review the most popular options for location independent individuals.
To buy or not to buy
Health insurance is one of the most controversial topics within the location independent community. There are three camps: the well-insured, the ones with dodgy policies and the ones who are not insured at all. The well-insured argue that the cost of health insurance is outweighed by peace of mind and a reduced risk of ruin. The ones with dodgy policies (credit card policies, high-deductible policies, unstable insurance companies etc.) argue that all they need is a basic policy and that they are better off self-insuring the difference. The uninsured argue that health insurance is an unnecessary expense for someone who is healthy and that the pay-as-you-go model is the option that suits them best.
I myself belong to the well-insured camp. My reasoning is that the cost of health insurance is insignificant when compared with the cost of medical care in most countries. One stay in a hospital will often be equivalent to decades of health insurance payments. Having insurance also makes the process of acquiring new residencies easier. In my mind, it really is a no brainer.
Back when I was living in Canada, I was covered under a multi-trip annual policy. It included up to 60 days per trip, was valid in most countries and was really cheap (around a hundred CAD per year).
When I became location independent, I bought an all-inclusive policy with Allianz Worldwide Care. The cost was around 110 USD per month and the policy included pretty much everything except for outpatient visits and dental care. A few years in I got a great deal with Integra Global for their core plan and decided to switch. Now I am paying around 90 USD monthly and I am very happy with this policy and with Integra Global. They even have an app that lets you submit claims directly on your phone, monitor your medical file (updated every year at the checkup), talk with their “best outcome” team in the US and integrates with Apple Health. I also have a SafetyWing policy as it was only around 40 USD monthly and allowed me to raise my deductible significantly with Integra Global (resulting in hundreds of dollars in annual savings) in addition to providing me with useful travel benefits (late flight, lost luggage etc).
Location independent insurance
Given the ever-increasing number of location independent individuals, it was only a matter of time before a dedicated insurance product was launched. SafetyWing, launched by a team of Y Combinator graduates, costs around 40 USD per month and includes a lot of features for that price. In fact, it includes nearly everything except for outpatient care and long-term illnesses (cancer, HIV etc). This makes it a fantastic option for those who are eligible for socialized medical care in their home country (or home base) and only need private insurance when travelling. It also can be used in combination with another policy, as explained above.
Stand-alone health insurance
Integra Global offers one of the best insurance products out there. Unlike many other insurers, their approach is to bundle everything in so that you do not have to worry about what is covered and what is not. This sometimes makes them look more expensive than their competitors but when you compare apple for apple, they are very competitive. I absolutely recommend them especially if you care about direct billing and coverage in Asia.
Cigna Health Insurance
Cigna is one of the world’s largest insurance companies with over 60 million members. They offer access to over 900000 hospitals and clinics, many of which are in their direct billing network. Cigna’s reputation concerning claim payments is good and their prices are usually competitive. They are a good choice for American citizens who often face price discrimination from other insurers.
Allianz Worldwide Care
Allianz is one of the world’s top insurance companies as well as one of the most solvent. In my experience, their main advantage is ease of use. If you fall sick, all you need to do is open a claim using their app (Android and iOS) and go to the nearest hospital in their “direct billing network”. They will contact the hospital right away and pay them directly so that you do not need to pay for anything out of pocket. Considering how expensive hospital bills can be, this is a great feature (many insurers offer direct billing but Allianz’s large partner network gives them the advantage). Price-wise, they are competitive on their in-patient plans but not as much on their out-patient plans.
Bupa is one of the largest expat-focused insurers with over 200000 members. Its reputation tends to be good however there has been some controversy over refused claims and unexplained increase in premiums in recent years. Their network is extensive especially in Asia and Europe. Cost-wise, Bupa tends to be at the top end of the price range.
This is an insurer I recommend to those on a budget. Because the limits on their policies are lower and because of higher deductibles (1000$US), they are able to offer coverage at ridiculously low prices (in my case they quoted around 30 USD monthly for global coverage). Their policies can also make a lot of sense if you travel mainly to lower cost countries (where hospital bills are unlikely to go into the six figures).
World Nomads is a famous insurer but their reputation is far from stellar. Their prices also tend to be rather high for the coverage offered. In my opinion, their only advantages are that you can buy a policy during a trip (with most insurers, you need to buy the policy before your departure) and that their travel benefits are fairly good. Do read the fine prints before buying and only buy if you have coverage in your home country as that is a condition for World Nomads.
Allianz Travel Insurance
As mentioned in the previous section, Allianz is one of the world’s top insurance companies and one of the most solvent. Their travel insurance product covers all the basics including emergency medical expenses, trip cancellation, lost baggage etc. Unlike their Worldwide Care product, however, it is not meant to be used as a standalone policy and will only provide cover until you are fit enough to travel back to your home country.
While I would not recommend using their money-exchange service, Travelex offers very decent travel insurance policies. They cover all the basics although their limits tend to be lower than those of World Nomads and Allianz Travel Insurance. On the upside, this means that their plans are very cheap, perfect for low-cost destinations (Thailand for example) and for travellers who already have some coverage (via a credit card for example).
Credit card / bank travel insurance
It has become fairly common for credit cards to offer some form of travel and health insurance benefits. While in some cases they are solid, in most they are not. As a result, it would be very imprudent to rely on your credit card company for your insurance needs. If you plan to do so anyway, at the very least take the time to review the details of your policy to fully understand what is covered and what is not.