I f*cking hate health care. Like, legit. The US literally has the worst health care system in the developed world. Come on, Uncle Sam, get your shit together.
Ever since deciding to uproot and depart for New Zealand over a year ago, health insurance has been the bane of our nomad-ish existence, and for some reason, there doesn’t seem to be that many resources out there for people in our situation. I’m hoping that by sharing our experience (which is continually evolving), it may help others in the same boat… but also, if anyone reading this has any better suggestions, PLEASE, share them in comments!
Our Health Care Situation.
So, here is our sitch… We are a couple of US citizens in our late 20’s/early 30’s who have no permanent residence, both with differing pre-existing conditions and who need coverage both inside the US and worldwide. All of these elements make it fairly complicated to find insurance.
First off, here’s a rundown of our pre-existing conditions.
Jason has a history of seizures. He takes daily medication to keep them under control, and, thankfully, they are not a regular occurrence. His last seizure was in March of 2014. So long as he takes his medication correctly (i.e. twice a day at 12 hour intervals) and gets enough sleep, he’s all good.
A few months before we left for New Zealand my doctor found a lump in my left breast. It turned out to be a benign fibroadenoma, however, with my family history of breast cancer, it is something I need to keep an eye on.
Ok, so that is our deal.
But, What Are Our Health Care Options?
Government subsidized health care is pretty much a non-starter, as what you get and where you can use it differs depending on the State you live in, and it typically does not cover you outside the US (sometimes not even outside the State in which it is issued).
If we were still 26 or under, we would just continue to be covered under our parents’ insurance and have a travel insurance policy for emergencies abroad. Did you know that you can stay on as a dependent when you’re under 26, even when you’re married? Thank you, Obama.
Don’t start your trip without travel insurance! We always have coverage with World Nomads!
So, basically private insurers are our only option, and we have done extensive research trying to find the best one.
Here’s What We’ve Learned.
Where you claim residency affects the companies that can insure you. If you have permanent residency in the US your options are more limited.
If you live (or “live”) outside the US, a lot more options become available.
Year One: GeoBlue
Blue Cross Blue Shield has a global policy called GeoBlue…. but it is VERY expensive, and if you want to be covered in the US and Canada as well as worldwide, it almost triples the cost.
For our year in New Zealand, we had a GeoBlue policy covering us everywhere except the US and Canada. We never used it. Unless you know you’ll be traveling or living in countries with high healthcare costs and will be needing a lot of medical care, I cannot recommend this insurer. Furthermore, they decided to drop us after after a year. They suck. I was already looking for a new provider, GeoBlue, so there. You can’t drop us… we’re dropping you.
The only reason we went with the GeoBlue policy was because it covered prescription costs, not something we came across often. We initially believed the best option for us would be a policy that cut down on J’s medication costs.
We have since learned that it actually is more practical to simply pay out of pocket for his medication than to pay exponentially more money for a policy that undercuts the cost. The cost of our 12-month GeoBlue policy (that didn’t cover us in the US) was more expensive than a 12-month supply of his medication, paid out of pocket. We didn’t need coverage for anything else that year, so that was an unfortunate (and pricey) lesson to learn.
In fact, unsure if we could even get his exact medication in New Zealand, we ended up getting a full year supply before we left the United States. We also carried a letter from his doctor with us, stating what his exact prescription is and why he needs it, just in case we needed to get a local prescription. At the very end of our time in New Zealand, J did go see a doctor to get a refill, but it turned out that his exact medication was not available in New Zealand, anyway. Luckily, he had enough to cover him until we arrived back in the States.
Year Two: Seven Corners
We are now on our second year dealing with this issue and have gone with another US based company, Seven Corners. They are primarily a travel insurance company, but also have medical policies.
It is not like your standard health insurance in that any regular doctor’s visits and medications are not covered. As we intend to spend most of our time in countries whose health care costs are cheap, we don’t see this as an issue. We will simply be paying out of pocket for those costs.
This policy does, however, cover any unusual or unexpected medical costs, anywhere in the world (except Iran and Syria). It also covers the costs up front – we have physical medical insurance cards. The only negative is that it will only cover up to $20,000 for new conditions linked to any pre-existing condition.
The benefit is that the policy is much more affordable AND for every 30 days of coverage purchased for outside the US, we get 5 days of coverage inside the US. This gives us 60 days of coverage in the US per year – perfect for coming home for the holidays and any short stopovers.
We have only just gotten this policy, so I will have to give an update once we test it out.
Integra Global seems to be a great option for those that do not live (or “live”) within the US. They are a UK based company that has several levels of coverage available for digital nomads and expats. However, if you have a pre-existing condition, their underwriters may decline covering you – as they did with us.
Aliera Health Care is another option for those who will be traveling long-term within the United States. This is a Health Care Cost Sharing program, so a bit different than traditional health insurance. I have not done much research into this provider, however, I do know someone who had a policy with them while doing an extensive road trip in the US. The benefit they found was that it covered them in every State that they would be traveling through.
Last Bits of Advice.
Before applying to any providers, figure out exactly what you need out of your policy, whether that’s worldwide coverage, prescription costs covered, chiropractic visits, whatever.
Have all your necessary medical records saved in a file on your computer or external drive. Trying to get medical records (including any prescriptions) when you are half-way around the world is a headache.
Be patient and crowdsource info if you get stuck!
Anyone else find it difficult to get decent info on getting coverage as an expat/digital nomad with a pre-existing condition? Let me know your story in the comments!