LucieCare: Health Insurance for the Big Trip

3 Jul

Yes, this is a headache.  Comparing all of the policies, plans, options, riders, and exclusions is mind-numbing.  Running your mind through all the morbid possibilities in which you may need health insurance: worse than mind-numbing.

[Disclaimer up front: I personally compiled what follows, based on Internet research and phone calls with insurance reps.  Of course, it’s entirely possible that I got something wrong, and, if so, I apologize.]

There is no plan designed specifically for one-year RTW trips a la the Big Trip; you’re caught between buying travel insurance (meant for students on holiday and/or globe-trotting business execs) and buying long-term global medical insurance (meant for expats, missionaries, and the like).

The Coverage I Want:

I went back and forth on what sort of coverage I wanted.  I took some heat from my Dad.  Ultimately, I decided:

  • If something really bad happens, I want health insurance that will evacuate me back to the United States and pay for my treatment here.  [Whether or not you want coverage in the U.S. is perhaps the big question in the health insurance equation.]
  • Even in the event of something more garden-variety (i.e., a broken leg), I still want to have the option to come home and get surgery/treatment here.
  • I also want some reasonable coverage for a few months at the end of my trip after I return home but before I become employed again.
  • I’m not particularly interested in travel insurance (i.e., trip cancellation insurance and baggage insurance).  I’m not buying a RTW plane ticket, I’m not booking expensive advance reservations, and I’m not traveling with expensive stuff.

Barring the really bad happening, I don’t intend to rely on my health insurance much.  I’m lucky to be 26, healthy as a horse, and the recipient of great medical care heretofore.  Because of that, and because preventative and routine medical expenses are cheap in the developing world, I’m comfortable with a high deductible.

[Click below to keep reading…]

The Providers I Considered:

1. World Nomads (1-888-381-2449) (a.k.a. Bare Bones)

  • No deductible; $100k medical expenses cap.
  • No domestic coverage within 100 miles from home.
  • Excludes pre-existing conditions.
  • For the year, $913 for “standard” coverage; $1211.78 for “explorer” coverage.

2. IMG (1-800-628-4664) (a.k.a. Middle of the Road)

  • Provides two options:  a plan for short-term travel insurance (Patriot International) and a plan for long-term global medical insurance (Global Medical Insurance).
  • Patriot International offers only incidental domestic coverage; Global Medical Insurance allows you to select between worldwide coverage and worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan.
  • Patriot International excludes pre-existing conditions; Global Medical Insurance is medically underwritten.
  • For both plans, you can select among various deductible amounts and various coverage amounts.  For Global Medical Insurance, evacuation expenses are not included in deductible.
  • In addition, with Patriot International, a number of special riders are available, including ones for adventure sports, “evacuation plus,” and terrorism.
  • Pricing varies depending on your selections.  As a sample, for Patriot International: $316.80 for $1k deductible and a $500k maximum coverage limit, including 2 months of end-of-trip domestic coverage.  With the evacuation plus rider (covering evacuation for non life-threatening conditions and natural disasters), the cost is $856.80.  For Global Medical Insurance with worldwide coverage, $764 for $1k deductible with $5 million coverage limit (or $663 for worldwide coverage excluding the 8 countries listed above).

3. HTH (1-888-243-2358) (a.k.a. The Whole Enchilada)

  • Offers Global Citizen (worldwide coverage) and Global Citizen EXP (coverage everywhere but the U.S.).
  • Both are medically underwritten.
  • You can select among various deductible amounts; coverage is pretty much unlimited.
  • Evacuation expenses and beside visit expenses (to fly a loved one out to visit you) are not included in the deductible.
  • Pricing varies depending on your selections.  As a sample, $2,100 for Global Citizen with a $1k deductible outside the U.S./$2k deductible in-network in the U.S./$4k deductible out-of-network in the U.S.  Cost drops to $1,008 for Global Citizen EXP with a $1k deductible.  A middle ground option for catastrophic coverage might be $1,416 for Global Citizen with a $10k deductible (if you have a safety net — fund or person).

My Decision:

Ultimately, I decided upon IMG Global Medical Insurance because:

  • I plan to be abroad for six of the next twelve months (a requirement of the plan).
  • For a reasonable price, I can get domestic coverage as a just-in-case measure.
  • I don’t have any pre-existing conditions that I’m particularly worried about.
  • I plan to be employed shortly after I get home (and so will get on my employer’s health care plan); thus, I’m not terribly concerned with enrolling a plan that I can keep indefinitely.

My Thinking/Advice for the Next Person:

I would buy World Nomads if:

  • I was going on a short(er) trip (less risk and it’s easy to extend coverage).
  • I had other health care insurance, particularly domestic coverage that I could rely on in an emergency and/or when I got home.  [This plan provides no domestic coverage within 100 miles of home, and it won’t pay for your care in the U.S., even if you’re evacuated here.]
  • I was a risk taker.  [This plan has a $100k medical expense cap, which is on the low side of things.]
  • I was planning on getting a lot of little sicknesses (unrelated to a pre-existing condition).  [There is no deductible and no coverage for pre-existing conditions.]
  • I needed some nominal travel insurance (trip cancellation, baggage loss/theft/damage).  [This plan provides some travel insurance, and the claims process seems easy.]
  • I didn’t take any prescription drugs.  [On this plan, there’s no coverage for anything you’re already taking, including birth control.]
  • I was lazy.  [The contract is not medically underwritten so the application process is a cinch.]

I would buy IMG Patriot International if:

  • I was going on a short(er) trip (less risk and it’s easy to extend coverage).
  • I wasn’t super concerned about being sick/injured and stuck abroad (i.e., maybe if I had family abroad or a Dad who wasn’t a worrywart).  [This plan provides no coverage in the United States, even if you are evacuated back here.  That was the real sticking point here for me.]
  • I wanted a little buffer zone coverage at home in the United States.  [World Nomads provides none.  With this plan, you get two weeks of “incidental coverage” if you return home mid-trip and for every 5 months of coverage abroad, you can buy 1 month of end-of-trip home country coverage.]
  • I took a few, cheaper prescription meds.  [There is no prescription coverage, but there is an Rx discount plan.]
  • I was lazy.  [The contract is not medically underwritten.]

I would buy HTH Worthwide if:

  • I had a trust fund.  [It is the pricey.]
  • I had a pre-existing condition for which I wanted coverage.
  • I wanted super comprehensive coverage (i.e., I was doing dangerous stuff or was a nervous Nellie).
  • I was worried about being the victim of a terrorist attack.
  • I was not sure how much of the time I would be spending abroad.  [There is no requirement to spend a certain amount of time abroad.]
  • I didn’t have a job lined up when I got back (i.e., I needed an insurance plan I could stay on indefinitely when I got back home).

Other things you might consider:

  • COBRA insurance from your (former) employer (especially if you get hurt/sick early in your trip because you have a few months to enroll, maybe more under ObamaCare).
  • Your parent’s insurance, if you are under 26 (cheers, ObamaCare).

Interestingly, you cannot apply through IMG until 30 days from your requested effective coverage date (which has to be on or after your departure from the U.S.).  Thus, I can’t apply until, at the earliest, August 4, 2012.  I’ll update this post after that date, when I’ve gone through the whole process and (hopefully!) been approved.

7 Responses to “LucieCare: Health Insurance for the Big Trip”

  1. evan1026 November 17, 2012 at 6:59 pm #

    ThNks cor posting this has been really belpful

    I think the one thing missing re IMG global medical is the qualification of the sports rider. IMG tiers their global med packages into silver, gold, platinum. Unfort the sports rider (which provides coverage if injured doing things normal backpackers do such as scuba) is only available w Platinum. The platinum plan w sports rider and $10000 (!!!) deductible (highest) is nearly $200 month.

    That said, I’m personally starting to lean towards nomad and a $5000 deductible for a domestic US plan which would be about $145/ month for both with a much lower deductible.

    Before I do that, going to have a look at the IMG patriot to see if that will suit my needs better.

    Thanks again for this post, it certainly helped guide my search and make sense of some of this stuff.

    • Lucie November 17, 2012 at 10:43 pm #

      Good point, Evan. I decided to take my chances without the sports rider, but I’m not sure I would recommend it. Looking seriously at all of this insurance stuff and thinking of all the “what ifs” will totally wig you out. For instance, no one covers drug and alcohol-related injuries or illnesses.

      At the last minute, I ended up also buying a cheap 6-month World Nomads plan for $291 and, so long as they pay out my claims, I think I’ll be happy I did — to get a little bit of travel insurance (I lost $130 in bookings when my Jetstar flight was diverted) and for medical expenses below my $1000 deductible (my 6-week-old sprained ankle is getting ultrasounded on Tuesday). I’ll let you know what my claims process ends up being like.


      • evan1026 November 18, 2012 at 11:18 am #

        Holy S, I just looked at one of your blog posts. Absolutely historical. Magical, if I must :p.

        Good point re: injury/alcohol. Hmmm. I guess nothing is covered?!

  2. evan1026 November 19, 2012 at 8:22 pm #

    Lucy, thanks again for the post. Super helpful.

    Just looked at my message below and noticed some crazy iPhone typing.

    Anyway, after angsting over insurance all day saturday, I called in my secret weapon tonight. Mom! Think we sorted it all out. Nomad explorer plan which is about $100/mo plus a primary care plan w high deductible for emergencies. That will be another $100 or so. Certainly didn’t expect it to cost this much but feel good about the decision should something happen.

    Happy travels.

    • Lucie November 20, 2012 at 1:13 am #

      Yep, yep, that’s pretty much what I ended up with. Good luck! I bet it feels good to have the decision behind you.

      Before I left, I was pretty miserly about insurance — my secret weapon (Dad) had to twist my arm to get me to buy what I did. But, now that I’m on the road, I’m happy I spent every penny, if only for peace of mind. [Just wait until you hear other travelers’ horror stories.] Your health is important; it’s totally worth it!


  3. go to my site February 4, 2013 at 1:03 pm #

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  1. Staying Healthy While Abroad, Part II « Lucie on the Lam - August 9, 2012

    […] preparation (vaccines, meds, insurance, […]

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