You have decided to take the first steps towards your freedom. You’re either working hard to get your own clients and to finally quit your corporate job, or you’ve done it already and now you’re ready for the biggest adventure of your life. You pack your laptop, book your ticket and set off to Bali, or Thailand to live and work for a while.
Oh, but wait! What are you going to do when you get sick? Will you have to go back home? — or is there a different solution? Is there even such a thing as digital nomad health insurance? Don’t fret! I have some great advice to share with you!
I have lived and worked in a few countries in recent years. I taught English in Thailand and then became an online teacher. I moved to Vietnam, Germany, Poland and now I’m living in Portugal. My permanent residence is in the UK, where I have to go back every now and then to be eligible for the free healthcare and, later on in life, pension.
However, this hasn’t been easy, especially when I lived in Thailand. Going back to Europe wasn’t cheap, so I quit paying taxes in the UK for a while and bought an expat health cover privately. This again put a strain on my wallet and the medical insurance wasn’t really suited to my digital nomad needs. Only after a couple of years I got my head around it and figured out a way to be insured without paying too much.
If you are a digital nomad, you’ve probably noticed already that getting a good cover is not easy. There are government regulations that require you to stay in your country for a few months every year. Some private insurance companies don’t allow you to travel with a one-way ticket, so you need to plan your trip with a return flight. Above all, they are all very expensive. Paying so much money for a health cover might not be for everyone. I have acquired quite the expertise in the recent years, which I think is worth sharing.
Problems digital nomads face with medical insurance
Digital nomads have problems with getting good medical insurance. This is mainly due to government regulations of the countries they come from. Some of them require you to be in the country for 3 months a year without longer breaks. Only then you can pay the tax and use free healthcare insurance. These countries actually check whether you are at home during this time, or not. For example, Poland is very strict when it comes to taxes and how you pay them and Polish digital nomads have a lot of problems if they want to work and travel, but still keep their cover.
Many digital nomads choose to buy travel insurance, hoping that this will be enough. However, most of the travel insurance covers available on the market require you to have a return ticket home. That’s what happened to me when my phone was stolen. When I made my claim, I was asked to provide a proof that I would go back home. As you can imagine, it was a slight problem since I didn’t have a ticket at all.
Travel insurance doesn’t help you if you get seriously ill. It’s only a temporary solution and it’s great when you have an accident. If you need a long-term medical attention, you will need to buy a ticket home and go back. Sometimes, that’s not something you would want to do. Maybe the healthcare in your country is sloppy and it takes ages to get the help you need. Maybe going back wouldn’t be worth the effort. Imagine how much stress and money that would cost you. Very often it’s better to stay somewhere abroad. Private healthcare in countries such as Thailand is much better and cheaper than in the west.
There are some covers, like the World Nomads, that are targeted towards those working remotely and traveling full time. However, again, this is just a travel insurance and the only difference is that they don’t require a return ticket and cover you in every country you visit.
Expat health insurance is a good solution, but it often costs a lot of money. There are some private insurers that charge over $2,000 per year! That’s quite a lot for a digital nomad, especially if you’re just starting out.
What should you do then?
The best Digital Nomad Health Insurance solutions
Below you will see the options I have either used or seriously considered. Digital nomad health insurance is a complicated matter and only you know what the best thing to do is. One thing I would advise – never, ever travel, or live abroad, without the security of insurance.
Keep paying taxes and go back home
As a freelancer and an entrepreneur, you can register yourself as self-employed, or you can open your own business in your home country. Then you are eligible to pay taxes and your national insurance, which in return gives you the right to have free medical insurance. However, you need to be home for at least 3 months per year – that’s the rule for most of the countries. This means going back every now and then. If you get sick, you can buy a ticket and get the treatment in the place you’re a resident.
To avoid long and costly travel when you need medical attention, you can buy expat medical insurance (see below). Choose the in-patient care, which is normally really expensive, get the maximum deductible and co-pay to make the premium lower. This way you will be covered in case of long-term hospital stays. The other basic doctor’s visits you pay from your own pocket.
I normally add travel insurance on top of that, but only when I travel. I choose a basic cover, which is an additional protection in case my luggage goes missing, or my flight is canceled.
The advantage of relying on the your health system at home is that you know what you’re getting. You don’t need to worry that you won’t be able to communicate in the hospital, or that the hygiene standards will be bad. You know the healthcare in your own country.
The clear disadvantage of this is the high cost of traveling, if you are far away. If you have an accident, or are unable to travel on your own, then your insurance from home won’t cover you for any additional cost. You will need to pay for extra medical care from your own pocket. In this case, you can just buy travel insurance and hope that it will be enough to help you out in crisis.
Before you make your decision to pay taxes in your country, consult a good accountant, who has experience with people, who lead a lifestyle similar to yours.
In Europe – Use an European Health Insurance Card
As a European Union citizen, you can apply for an EHIC (European Health Insurance Card) in your home country. The card is sent to you by post and it’s either free of charge, or you need to pay a small fee.
It doesn’t give you the right to fully use healthcare in the other European Union countries, but it makes your life a little easier. For example, in Portugal, using the card, I can go to the hospital, or to the doctor’s, in an emergency. The visit is sometimes free and sometimes I need to pay a small amount of money. If I ever get seriously sick, I will need to go to the UK.
Please note, that you can only use this card if you are a citizen of one of the European Union countries and you’re abroad for a short amount of time, usually less than 3 months continuously. The staff can refuse to see you for free if you’re on the territory of their country longer than that. If you stay somewhere for more than 3 months, you need to register for taxes and insurance and then you can use the healthcare system free of charge.
The advantage of this is that most of the time, you don’t need to pay for emergency treatment. This means that you don’t have to buy travel insurance. It’s also a good solution for digital nomads that are constantly on the move and go back home every now and again.
Buy medical health insurance for expats
To me, it’s one of the best options and quite often very affordable, if you know which one to choose.
Expat medical insurance is for those that live abroad and don’t have the government insurance. It’s especially good for self-employed, retired, or those that work for international companies away from their home countries. It covers you in case of emergencies, as well as compensates you for annual check ups, ad-hoc doctor’s visits and long-term hospital stays and major surgical operations abroad.
There are many options on the market. You can buy it from companies, such as Bupa, which is one of the most famous insurance companies. You just choose the countries you will be residing in and buy the policy. Problem? It’s very, very expensive!
When I was in Thailand I was diagnosed with melanoma – skin cancer. This kind of thing is very dangerous and if not treated, it can kill you within a few weeks. I couldn’t go to the UK nor to Poland. It would have been a waste of time. I had to decide to have it removed there and then. I didn’t have any insurance (don’t be me, don’t be stupid, always have insurance, always!), but if I had had an expat medical insurance, it would have probably covered the $300 I had to pay for removing the mole.
Long story short, I was survived and straight away, after getting the ‘all-clear’, I bought medical insurance in Thailand. I discovered that I could buy health insurance from a company in Asia, which was much cheaper.
As I have an account in Thailand, after my little melanoma incident, I could buy a policy from my bank, which cost me 20,000 Baht for a year. In Asia there are also companies that sell insurance to expats and not requiring them to have an account in the local bank.
In Thailand, you have Luma, which offers comprehensive and affordable health insurance in Thailand (and a few other countries) to expats and digital nomads residing in South East Asia. You have to live in one of the countries within your coverage for 185 days a year and the policy is also valid worldwide (exc. USA) for up to 90 days at a time. The cost is around $1000 per annum. Not bad at all!
As with the other options, I always add travel insurance on top, if I travel somewhere. It makes me feel better to know that my luggage and valuables are also safe and insured.
Prevention is the key!
It doesn’t matter whether you live in Thailand, Cambodia, or Portugal if you decide to travel all the time, or you prefer to stay somewhere longer, staying healthy is very important. Not even the best medical insurance in Thailand can save you if you don’t look after yourself.
So, here are a couple of things to do on a regular basis:
- Get up from your computer and stretch once every hour.
- Do some sports, even walking is better than sitting all day.
- Eat healthily: if you’re in countries such as Thailand, you have a lot of fresh fruits and veggies on offer.
- Sleep well and don’t party every day.
- Drink plenty of water.
- Use free apps. There are insurance companies, such as Luma, that focus on prevention and help their members to lead a healthy lifestyle through their articles and applications. Use that!
Becoming a digital nomad is a great step towards something really exciting. It gives you so much freedom! You will be able to enjoy your life even more if you don’t have to worry constantly about what to do if you get sick. I hope that my advice on digital nomad health insurance helped you a little and you are now going to be prepared even better for your adventure. Take care and enjoy yourself and if you have any questions, let me know in the comments!