It’s insurance season in the US. As full-time travelers, we have to review our options every year for two reasons: the insurance products change and our location also changes. As we navigate our decision for this year, here’s what we’ve done in the past. We make recommendations, as well, to the providers we’ve used and liked.
Note: This post is geared toward Americans, yet it might have tips that are helpful for our non-American readers. Also, I’m not an insurance agent; this is from our personal experience.
Year One: No Insurance in the US, Need Full-Time Global Insurance Abroad
Our first year of nomad life created a different scenario than any other year of our nomad life. The major issue was that we had loads of income and didn’t qualify for any credits with Obamacare (Affordable Care Act) in the Market Place. Additionally, we were not going to be in the US for any length of time and didn’t need coverage in the US. Thus, our first year looked like this:
Steve’s employer-provided insurance covered us through July, then Cobra covered us through September. We left the US and started with IMG Global. In underwriting with IMG Global, they identified my pre-existings and excluded them, putting me into their Silver Plan. Steve had no pre-existings and joined the Gold plan.
Monthly cost for 2: $250, Annual deductible: $5000 each. No claims.
Year 2: No Insurance in the US, Need Full-Time Coverage Abroad
In our second year, we still didn’t qualify for Obamacare due to taking money out for tuition for our daughter and elevated withdrawals to fund our second year of travel. So we continued with IMG Global, but the rate increased.
During this year, I had knee surgery in Kuala Lumpur, Malaysia, and IMG actually reimbursed me for most of it, minus the $5000 deductible.
Monthly cost for 2: $250, Annual deductible: $5000 each. I filed a claim for my knee surgery for $10,000, which ultimately cost me $7500 out of pocket; IMG paid $2500.
Year 3: Obamacare in the US, Need Coverage in Australia
In our third year, we finally qualified for “free” Obamacare because our income was low enough for Market Place shares. During this year, we spent 6 months in the US and 6 months in Australia. Obamacare covered us for the time in the US. We picked up GeoBlue’s Travel with Medical policy for our time in Australia.
Monthly cost for 2: $200, Annual deductible: $500 each for Geoblue, $10000 for Obamacare. No claims.
Year 4: Obamacare and Medicare in the US, Need Coverage Worldwide
In our fourth year of full-time travel, Steve aged into Medicare Part C and D Advantage Plan that has a Giveback plan. He picked a plan that had international catastrophic care that would relocate him to the US if necessary. I stayed with “free” Obamacare and added Genki. Genki covers me mostly everywhere but the US.
Genki has two versions of insurance, one that competes with IMG where you can get full medical coverage worldwide called Genki Native, and one that is Travel Medical Insurance called Genki Traveler, which is the one I use.
Monthly cost for 2: $125 Medicare + $125 Genki. Annual deductible: $7,900 Medicare, $10,000 for Obamacare and $65 co-pay for each incident at Genki. I made a claim to Genki for 4 eye appointments which was 1 co-pay of $65, and they reimbursed me $400 for the eye care.
Year 5: Mondial and Medicare in the US, Schengen Coverage, Greek Coverage, No Obamacare
In our fifth year, things got a bit nutzo. The American Big Beautiful Bill (which wasn’t) increased my Obamacare to $200 (a 20,000% increase). Steve’s Medicare increased, too. Because we applied for a Greek one-year visa, we had to have a Schengen policy. In addition, we applied for a Greek Golden visa, which required a specific Greek insurance policy outside of the Schengen policy we had already purchased. In addition, I turned 59 which put me in a different pricing category for many insurers.
I decided to drop Obamacare, as it’s a policy I can only use in Texas, and it supposedly had a catastrophic international coverage, but I never claimed against the $10000 deductible. So I picked up Mondial’s Global Coverage. It’s $250 a month to cover USA/Canada, and it drops to $132 a month for global coverage outside of USA/Canada.
Monthly cost for 2: $135 Medicare + $132 Schengen (I’ll replace with with $250 global for the three months I’m in the USA/Canada) + $20 Greek insurance. Annual deductible: $7,900 Medicare, $10,000 for Obamacare and $65 co-pay for visits with Mondial Schengen Insurance.
An Insurance Decision Flow-Chart
I know this can be a bit complicated, so I did a video about it, showing the flow-chart we go through each year to decide which insurance we should get. You can watch that video here.
What are you doing for your insurance? Please share any tips or companies you’ve found that are good, affordable, and reliable!
I have shared in my Substack my approach to insurance, now that I am outside the US nine to ten months. I have a Medicare Advantage plan that is only good in the US. I self-insure when using the medical system wherever I am traveling, since costs are so much cheaper than in the US. For any major issue, I have EA+ a AAA program for RVers or International travelers that will repatriate me to the US, and provide help in making the arrangements. That is important since I am a solo traveler. It cost less than $300 per year. I have traveled two months a year outside of the US for over ten years and, after the Covid break, have been traveling the last three years for nine to ten months a year. I have been to an Emergency Room in Spain ($75) and an Emergency room in Portugal (free, very minor issue). A aggressive infection came up quickly a month or so ago when in Montenegro. I realized it could conceivably progress enough to needing IV antibiotics. As a solo traveler, I decided to get a quick flight back to where I stay in the US (with my daughter and her family) and, of course, I am using my Advantage plan. It will double in cost next year, but that should still be manageable. I am using the time in the US now also to get cataracts taken care of, a likely hand surgery (Dupuytren's), routine Primary Care exam, dental cleaning, dermatologist annual exam, spend time with my grandchildren, visit my siblings (ages 91, 93, and 96 all still sharp and mobile), and visit in-country friends. I am sort of in for repairs on this break. Assuming all goes well, I plan to get on the road again as soon as possible after the first of the year.