What to do about Health, Travel and Car Insurance while living as a Digital Nomad

I've been traveling and living outside of the U.S. for the past 10 years, and here's a big secret, I've saved a ton of money by not having health insurance this entire time. A lot of people don't realize but a huge benefit of traveling full time is being able to get away with not having to pay insurance. I've added it up, and I've saved close to $10,000 a year by simply not paying car and health insurance. That means that during my travels I've saved up over $100,000 by simply not needing insurance. But here's the thing,  you only need insurance when something bad happens, and maybe I just took the biggest gamble of my life by not having it?

In this blog post I'm going to break down exactly how I limit my liabilities while saving a ton of money by not needing to pay for insurance every month. I'm also going to talk about other hacks like catastrophic plan insurance, medi-share, medical tourism, cash payments and using travel insurance as a hack to save money while covering yourself in case of emergencies. I've also talk about what I do about insurance when I go back to the U.S. and need to cover myself while I drive, and in case of emergency during my time back in the states and what you can do as well. Here's everything about health, travel, car, and other insurance for digital nomads and long term travelers.

Health Insurance?

If you're not from the U.S. most likely you're already covered by some form of national health insurance that's affordable enough to just keep year round while you travel. But if you're American, you might be paying $450 a month or more for something you probably won't be using or needing while living aboard. If you're part of a family plan, just because your parents are paying for it, doesn't mean that they're not wasting money that could be used towards something else, maybe even your travels or a family vacation for all of you to meet up somewhere in the world. If your employer is paying for it and you're working remotely, you're lucky, just remember that if they weren't paying for your health insurance premiums they'd would have been able to pay you a higher salary.

But this part is really for people who are either self-employed who either need to pay out of pocket or skip health insurance completely. For me, the first few years of travel, I took the gamble, I didn't have any money in my savings, and couldn't afford health insurance anyways, so I just hoped for the best. When I was living on a $600 a month budget, the idea of needing to spend more than half of it didn't make sense, especially since I couldn't afford the $7,000 deductible anyways so I figured if something happened, I'd go bankrupt either way so I took the gamble. I got lucky that nothing ever happened, but now that I know there are alternatives I would have done things differently.

For those who spend 330 days a year or more living in another country you can qualify for a health care exemption and not pay any fees or fines under Obama Care. If you spend more than a month a year in the U.S., the cheapest option would be some type of Medi-Share program which keeps costs down by being an alternative to traditional insurance, which we all know is a broken system in America. You'll want to look into the pros and cons of Healthcare sharing ministries in general before signing up. I looked into the options for myself I'd personally sign up for Aliera Health as they are the least religious of the Christian Health Share Ministries which means there are the least amount of downsides and limitations. Here's a video on how it works.

Luckily now there is Safety Wing Remote Health insurance specifically designed for Digital Nomads.  

Travel Insurance? 

Since I don't have health insurance, I've been using annual travel insurance as a hack to save me money while still keeping myself covered. I first signed up for it when I started my divemaster training in Thailand and was required to have some sort of dive insurance, which as an option allowed me to sign up for travel insurance as an add on.  Good news for adventure travel junkies is the fact that most things are covered in the standard travel insurance plans such as scuba diving, surfing and paragliding, but double check your insurance options for things like outdoor rock climbing as it may only be covered in higher plans.

Since I'm also a scuba diver, I get annual travel insurance through DAN (the diver's alert network) and am currently on their Explorer plan for $319. That covers up to $100,000 in Medical expenses for any injury or sickness that first begins while on an overnight trip with a destination of at least 100 miles from my primary residence. That means that since my primary residence in Texas, I can use my travel insurance as emergency medical insurance when I'm visiting friends and family back in California, or traveling anywhere else in the world but there are limitations especially when staying for more than a month.

If you're traveling for less than an year and just want trip insurance, I've heard good things about World Nomads in terms of reimbursing travelers for claims. Personally I've never filed a claim for trip cancellation or delays, but it's good to know that if my luggage ever gets stolen or goes missing I'll be able to make a claim for it. But for me getting travel insurance is more emergencies like if I broke my leg during my trek in Nepal and needed to get a helicopter to lift me back to a hospital in Kathmandu. The only downside is the price, at almost double the price as I was quoted for Safety Wing below.

For digital nomads who want longer term coverage, Safety Wing is the first plan specifically designed for long term travelers like us, and their big selling point is that they give you both travel insurance and travel medical insurance. At around $40 a month, they're an easy choice to sign up for and something that I'd recommend everyone without travel insurance to sign up for. Even better is that Safety Wing now offers actual health insurance, and not just travel insurance through their Remote Health Program which is true global health insurance suitable for digital nomads, solo entrepreneurs as well as teams.

digital nomad travel insurance
Digital Nomad Travel Insurance by Safety Wing

I chose the middle Explorer Plan from DAN

Medical Tourism?

The nice thing about traveling to places like Thailand is the fact that you can just pay cash for most things like going to the pharmacy to get antibiotics to cure strep throat for less than $5. Or even when I tore a calf muscle while doing Crossfit in South Africa I was able to pay just $130 cash to visit the Emergency Room to get an ultrasound and half cast put on by a Doctor. When I got back to Thailand to get a follow up and the cast removed, the total cost was just $40 making the entire ordeal not even worth claiming on my travel insurance.

Going to the dentist has also been extremely cheap as you can get a clean up, teeth cleaning and an x-ray for around $50. In fact, the medical tourism industry exists because it's often cheaper to fly to Thailand pay cash for dental and medical procedures than it is to just pay the copay and deductibles back home even with insurance. The quality of care in hospitals in Thailand especially at places like Bumrungrad, Bangkok Hospital or even Chiang Mai Ram, are on par or even better than the best hospitals and doctors in America. The main benefits are the facilities themselves where you'll feel like you're staying in a private room in a nice hotel with restaurant room service and a personal nurse, and the fact that your English speaking, Western trained Doctor will actually have time to talk to you and properly diagnose the problem over an hour instead of being rushed in and out within 15 minutes like you would in America or needing to wait months to even see a doctor in the first place in some places in Canada or the U.K.

Flying from South Africa to Thailand with a broken leg

Long Term Medical

One big issue that I travel insurance doesn't cover is the need for long term care in case of chronic illnesses such as cancer or diabetes. This is going to be a complicated subject that is going to be vary on a personal level. A few people mentioned that they are scared of not having health insurance in case of getting a life long medical disease that could potentially bankrupt them. I've thought a lot about this and know that I'm putting myself and my financial stability at risk by not having health insurance. The good news however is with Obama care, insurance companies now are banned from denying coverage for  pre-existing conditions. This is actually a terrible idea for insurance companies as financially it doesn't make any sense to insure someone against something they already have, but since it's in the law books as an option, it also lets me rest at ease not having insurance as I know I can sign up for it any time in the future if and when I actually need it. (This is just one of the reasons why medi-share programs are half the price of traditional insurance.)

Also more controversially, I don't believe in most medical treatments of major or long term illnesses. Knock on wood, but if I ever got cancer, I most likely won't get chemotherapy, especially for the cancers that have a low effective rate. Instead, I focus on prevention, and would change my diet, lifestyle, and find ways to actually solve the acute problem whatever it was instead of just maintaining it. I'd look into ways that other people have beat cancer without chemo and do my due diligence on finding the natural cures that actually work, while ignoring the fluff that also comes with it. I'm a huge fan of western medical for emergency room visits, fixing broken legs, and other things that it does very well, but I'm not a believer that anyone should take pills or treatments for the rest of their lives just to manage it. That being said, I've always known I wanted to have some type of emergency insurance just in case, but I'm also okay with not having traditional health insurance. This is going to be a tough personal decision however, but especially with Obama Care, financially it makes sense to opt out, especially if you don't smoke, and live a healthy lifestyle.

Car Insurance?

The nice thing about selling my car before I started traveling was being able to save $185 a month on auto insurance which has saved me $2,220 a year just by not having a car. That added with the money I'm saving by not needing health insurance saves me over $12,000 a year in insurance alone. But what's really great is by not owning a car, I'm actually saving around to $800 a month by not having car payments, maintenance, depreciation, and having to pay for gas. Instead, I get around by public transport, uber, and quite often by foot as I normally choose to live in the city center so I can walk most places. In Chiang Mai I use a combination of the above as well as ride a scooter which barely costs anything to own and fill up so my monthly transportation costs usually average $45 or less including the occasional Uber rides.

When I do go back to the U.S. I usually borrow a friend or family member's car which covers me under their insurance. If something did happen while I was driving their car, I'd insist on paying the deductible. I also sometimes rent cars for up to a month at a time while back in the states. Instead of paying the overpriced insurance through the rental company I simply make sure it's covered by either my travel insurance or credit card before booking it. For whatever reason my Visa cards all cover rental cars up to 30 days, but my Mastercards only cover rentals up to 15 days. Also my travel insurance would normally cover up to $35,000 in "collision damage waiver" expect if I'm a resident of Texas which I am. Also my cards cover world-wide international rentals aside from renting a car in Ireland or Jamaica for whatever reason. We also have to remember that "collision and loss damage waivers" only covers damage to the car, not to you or to the other driver. That means that I also get something called "temporary car insurance" if I'm in town for more than a month, something I actually bought through AAA when I was planning to do a road trip a few years ago.

Other alternatives to renting a car include car sharing apps like Turo or Getaround which both have insurance included.

Renting a Ferrari to drive around Barcelona, Spain!

Final Thoughts

I'm assume that for most people, insurance isn't fun to think about and it's something that we either just buy because it's required, or choose to ignore until we actually need it. I got lucky traveling without insurance before being forced to buy it through scuba diving. On the flip side, I know a lot of travelers who are wasting thousands of dollars a year by hanging onto their health and auto insurance policies even though they are traveling long term and not living back home. Quite often the insurance is either being paid by the parents or automatically taken from their accounts so they don't even notice. Either way, if you're planning to be out of the country for more than 11 months of the year, you can save yourself $4,000 to $10,000 by simply canceling any insurance that you don't need and getting either travel insurance or temporary insurance when you actually do.

Aside from not paying for insurance, legally moving to Texas before I started traveling full time has been another huge money saver as now I don't need to pay California state income tax. That on top of taking advantage of the FEIE (Foreign Earned Income Exclusion) which makes it so I don't need to pay Federal Income Tax on the first $102,100 I make per year, allows me to save close to $35,000 a year in expenses that I'd have if I lived back in America. That money put into investments has allowed me to not only save up for my future retirement but also earn money passively through investments. If you're not from the USA the exclusions will be different but I encourge you to look into your own countries loopholes as I guarantee there'll always some type of benefit of living overseas and not using your country's resources. For those reading who are American, think about what you can do with an extra $35,000 every year.

Watch this video for a full explainer of everything talked about above.

Let me know in the comments below what your thoughts are, what the savings are like where you're from, and how much you're currently paying for insurance where you live.

Warm Regards,

Johnny FD

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  1. Yeah, when I was in Ukraine, I had to go to the ER once. The only hospitals that take insurance at all are the public ones in the city which are the ones you don't want to go to in the first place. They're crowded, have corrupt doctors, and dirty. The private hospital was decent and ended up at roughly 300$ USD total. It was a bit more than Phuket International hospital, but still affordable.

    1. Hey Zak, thanks for sharing your experience. I agree that in a lot of countries you won't want to use their public hospitals anyways. Paying $300 out of pocket for an ER visit ends up being a great deal actually, especially since that would be just one month's premium.

  2. Reading complaints against DAN which allege that DAN does not pay medical expenses unless you have hospital stay of at least 2 days. Don't know if this is true or not. But, as you've said, you don't need insurance until you need it. But what if you need it and they don't pay??

    1. I haven't heard that but haven't had to use them either. But if anything, the longer visits are the ones I'd need to make a claim for anyways, so I'd be happy if they paid for my 2+ day hospital visits even if they for whatever reason wouldn't pay for the day visit.

  3. Car insurance £240($340) a year. 24 year old semi classic turbo diesel Peugeot 205. My 1963 Land Rover is about £80($112)a year.
    Gold standard annual travel insurance, up to 90 days away about £80

    1. That's really cheap. Is that for comprehensive auto insurance, as in does it cover your car being paid for if it's damaged or stolen? As for travel insurance, I'm assuming you're not traveling for more than 90 days at a time, or is it per year?

    2. Yes comprehensive. Full no claims bonus.
      £80 is the cost of the annual policy. 90 days is max trip length. IIRC it excludes the USA. Most annual travel insurance policies have a max trip length clause.

  4. I'm paying too much for health insurance for what I'm getting and way too much for living in Chiang Mai. About $2000 per year for worldwide comprehensive coverage ($1000 deductible). I had a lot of health issues at the beginning of the year and they did pay for most of a hospital stay but the hospital won't direct bill for everything. I have reimbursement claims as far back as Jan 5 that they still haven't processed. I'll be looking for alternatives next year.

    1. Hey Terry, sorry to hear about the health issues, I hope they all got sorted out. How much do you think you saved last year by having health insurance vs. if you paid everything out of pocket?

  5. Glad I found your post - good to learn something new, DAN insurance in this case. I didn't know about it, but it looks interesting. I've been on the road for the past 5 years (been a digital nomad or location independent whatever anyone prefers to call this lifestyle). I had a few health issues in different places around the world (Tbilisi, Sicily, Stockholm, Lisbon) with most serious being a flu+pneumonia last year (luckily, no hospital stay). I was amazed that the whole ordeal(tons of tests, multiple X-rays, 4 doctors visits, 2 courses of antibiotics) cost under 300Euro in Portugal. I can't even imagine how much it would cost in the US without insurance. Similar to you, I do have concerns about the possibility of life-threatening illness. Interestingly, I also chose prevention (i.e., healthier lifestyle) vs. paying an arm and a leg on a yearly basis.

    1. Hey Elena, thanks so much for sharing your experiences! It's crazy how affordable out of pocket cash payments are even in Europe for all of that doctor work! It's insane to think, it's literally just in America I'm scared to go to the doctor.

  6. I use Cigna and pay around $120 a month. The rules are, however, I have to be out of the USA for at least 6 months a year for that rate.


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