Health Insurance for Expats & Digital Nomads: What You Need (2025)

Why You Need International Health Insurance

Healthcare costs abroad can be financially devastating without proper coverage. A hospital stay in the United States can cost tens of thousands of dollars. Even in countries with affordable healthcare, a serious injury or illness can generate bills that disrupt your finances and plans.

Beyond the financial risk, many countries require proof of health insurance as a condition for visa approval. Digital nomad visas in Portugal, Spain, Croatia, Estonia, and others all mandate valid health coverage. Without it, your visa application will be denied.

Finally, your domestic health insurance likely does not cover you abroad, or provides only limited emergency coverage. Relying on it while living overseas is a significant gap in protection.

Types of International Health Coverage

Understanding the differences between the main categories of coverage helps you choose the right option for your situation.

Travel Insurance

Travel insurance is designed for short trips, typically up to 30-90 days. It covers emergencies like accidents, sudden illness, trip cancellation, lost luggage, and emergency evacuation. It does not cover pre-existing conditions, routine medical care, or ongoing treatment.

Best for: Vacations and short business trips. Not suitable for: Long-term expats or digital nomads who need ongoing healthcare access.

Expat Health Insurance

Expat health insurance (also called international private medical insurance or IPMI) functions more like a traditional health plan. It covers routine doctor visits, specialist consultations, prescription medications, hospitalization, maternity care, mental health, and sometimes dental and vision. Plans are available annually and can be renewed long-term.

Best for: Expats on long-term assignments, families moving abroad, anyone who wants comprehensive ongoing coverage. Drawback: More expensive than travel insurance, with annual premiums often ranging from USD 1,500 to USD 8,000+ depending on age, coverage level, and included regions.

Local Health Insurance

Some countries allow (or require) expats to enroll in the national healthcare system, either through employment or by purchasing a local private plan. This is often the most cost-effective option for long-term residents.

Best for: Expats who are settled in one country and have legal residency. Limitation: Coverage typically ends when you leave the country.

SafetyWing Nomad Insurance

SafetyWing has become one of the most popular insurance options among digital nomads and remote workers. It is designed specifically for people who move between countries.

Key features:

• Monthly subscription model: Pay month-to-month with no long-term commitment. Coverage starts at approximately USD 45/month for those under 40.
• Global coverage: Covers you in most countries worldwide, with limited coverage in your home country (up to 30 days per 90-day period for US citizens; 15 days for others).
• What it covers: Hospitalization, outpatient care, emergency medical evacuation, emergency dental, travel delay, lost checked luggage, emergency response and natural disasters.
• What it does not cover: Pre-existing conditions (within the first 6 months), routine check-ups, mental health outpatient care, maternity care (on the base Nomad Insurance plan).
• Age range: Available for ages 18-69. Children under 10 can be added for free with a paying parent.

SafetyWing also offers Nomad Health, a more comprehensive long-term health plan that includes outpatient care, prescriptions, and preventive services. This is closer to traditional expat health insurance and carries a higher premium.

Disclosure: The SafetyWing link above is an affiliate link. See our disclaimer for details.

World Nomads

World Nomads is a well-known travel insurance provider that caters to adventurous travelers and shorter-term nomads.

Key features:

• Trip-based coverage: You purchase a policy for a defined trip period, typically up to 12 months.
• Adventure activities: World Nomads covers a wide range of adventure sports and activities (hiking, scuba diving, skiing, etc.) that many standard travel insurance policies exclude.
• What it covers: Emergency medical treatment, emergency evacuation, trip cancellation, gear and electronics, and personal liability.
• What it does not cover: Pre-existing conditions, routine medical care, dental (except emergency), long-term health maintenance.
• Flexibility: You can extend your policy while traveling if your plans change.

World Nomads is generally better suited for travelers on defined trips rather than indefinite nomads. If you are traveling for 3-6 months with a return date, it is a strong option. For open-ended travel, SafetyWing’s subscription model may be more practical.

Disclosure: The World Nomads link above is an affiliate link. See our disclaimer for details.

Country-Specific Healthcare Systems

If you are settling in one country, understanding the local healthcare system is important:

European Union (EHIC/GHIC)

EU/EEA citizens can obtain a European Health Insurance Card (EHIC) or its UK equivalent (GHIC), which provides access to state healthcare in other EU/EEA countries under the same conditions as local residents. This covers necessary medical treatment during temporary stays but is not a substitute for comprehensive health insurance. It does not cover private healthcare, repatriation, or non-emergency treatment.

United Kingdom (NHS)

The NHS provides healthcare to UK residents, including some categories of visa holders. If you hold a visa that required payment of the Immigration Health Surcharge (IHS), you are entitled to NHS care. However, visitors and short-term visa holders may be charged for treatment.

Canada

Each Canadian province operates its own health insurance plan. New residents typically face a waiting period (often 3 months) before provincial coverage begins. During the waiting period, private insurance is essential.

Spain

Spain’s public healthcare system (Sistema Nacional de Salud) is available to legal residents who are employed or self-employed and contributing to social security. Private health insurance is widely used as a supplement and is often required for visa applications.

Portugal

Portugal offers public healthcare through the SNS (Servico Nacional de Saude) to legal residents. Quality is generally good in urban areas. Many expats complement this with private insurance for faster access and English-speaking providers.

What to Look for in a Policy

When evaluating any international health insurance policy, consider the following:

1. Geographic coverage: Confirm the policy covers all countries you plan to visit or reside in. Some policies exclude specific regions (notably the US) or charge significantly more to include them.
2. Inpatient vs. outpatient: Basic plans may cover only hospitalization (inpatient). If you want coverage for doctor visits, specialists, and prescriptions, you need outpatient coverage as well.
3. Deductibles and co-pays: Higher deductibles reduce premiums but increase your out-of-pocket cost when you do need care.
4. Pre-existing conditions: Most travel and nomad insurance plans exclude pre-existing conditions. Comprehensive expat plans may cover them after a waiting period or with a loading on the premium.
5. Emergency evacuation: If you are in remote areas or countries with limited medical infrastructure, evacuation coverage is critical. Verify the coverage amount (USD 100,000+ is common).
6. Mental health: Coverage for mental health varies widely. Some plans exclude it entirely; others cover inpatient psychiatric care but not outpatient therapy.
7. Maternity: If relevant, check whether maternity is covered and what waiting periods apply. Many plans require 10-12 months of continuous coverage before maternity benefits activate.

Compare Your Options

For a broader comparison of travel insurance providers, see our Best Travel Insurance guide. Use the Visa Checker to confirm whether your destination requires proof of health insurance for entry or visa approval.

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Insurance products, coverage terms, and pricing change regularly. The information in this guide is based on publicly available details as of early 2025. Always read the full policy documentation before purchasing, and verify that coverage meets the requirements of your specific visa or destination.