Why there is no health insurance for digital nomads (yet)

Christoph looking at the stunning landscape of Madeira island with binoculars

As a digital nomad, you enjoy a variety of freedoms that stationary citizens can only dream of. On a daily basis you are able to decide where, how and also with whom you want to spend your life. Should you stay another night in Hanoi, or do you take the next train heading South?

However, these freedoms often come with a cost: Health insurance. Most international health insurance plans only cover emergencies, or their premiums skyrocket once you reach a certain age. Therefore, many nomads remain dependent on the public health insurance of their origin country and will need to return for medical treatments regularly.

It does not have to be like that. Let me walk you through the topic and help you find the ideal solution.
While there is still no perfect one-size-fits-all coverage available on the market there are still good concepts to set up your health insurance globally for long-term location independent lifestyle.

Why there is not global health insurance for digital nomads (yet), explained by our Christoph Huebner

Definition: What is a digital nomad?

First, let us explain what we understand a digital nomad is and who we try to address. A digital nomad is not somebody who travels the world for a semester or does a sabbatical year with the intention to return to their home country afterwards. Instead, we see digital nomadism as a long-term lifestyle that offers unlimited mobility and the chance to call every new place your home for a week, a month, or for the foreseeable future.

If you rather identify as a “winter nomad” who has a steady home base for most of the year but flees to work remotely during the nasty winter season: things are easier for you! As you don’t cut ties with your home country and have a comprehensive health insurance there you can get sufficient coverage with a long-term travel insurance plan for your escapes.

Christoph Huebner, insurance broker for digital nomads

Accordingly, you don’t want your health to restrict your global independence and return to your country of origin regularly for medical issues, treatments of a chronic disease, prescription of drugs, and more. Instead, we want to make your nomadism sustainable and help you receive the same health care across the globe.

Why is there no life long global coverage?

To understand why there is no solution to a seemingly simple problem, we must understand how health costs are accumulated over a lifetime. Apart from the early childhood, health costs remain relatively stable throughout your adult life. This makes it easy for insurance companies to calculate your risk and ask for a realistic premium. However, there is a tipping point at around age 60 to 70, as statistically in our last two years, circa 50% of a typical life’s health costs are generated. Global healthcare providers calculate this into their prices, and from a certain age you will end up with premiums that reach up to 2,500 Euros per month. That is not affordable if you haven’t budgeted for it in your wealth planning!

State health insurance does offer a calculable coverage at all stages of life. While this model works well for regular inhabitants, this is not a good solution for digital nomads either, as you remain dependent on a specific country. The exceptions to this are the European Social Security Agreements, which allow for emergency treatment in different European countries. However, non-emergency cases are not included, and their range is limited to Europe. Read more on how EHIC, the European Health Insurance Card, can work for digital nomads.

Yet there are some other solutions that address some of these issues.

Travel Insurance for Digital Nomads

The first and cheapest solution is travel insurance. Travel insurance coverage is sometimes even included in your credit card, mostly for journeys of up to 30 days, with premium cards up to 90 days. Why that’s not a sufficient solution for digital nomads is obvious.
There are also options for long-term travel insurance for nomads that range from several months to five years. But keep in mind that travel insurance

  • excludes all pre-existing conditions and
  • generally can’t be extended on the end of the contract duration.
  • only work on top of your existing comprehensive health insurance and only aim at emergency situations. With chronic diseases and for regular treatments, you will need to return to your home country.

Therefore, travel insurance is not the right solution for digital nomads who want to commit to this lifestyle in the long term. Find a good comparison between health insurance and travel insurance for digital nomads here.

International Private Medical Insurance (IPMI)

Another option available on the global market is the category of international private medical insurance (IPMI). One of their strengths is their global validity. Nevertheless many insurers divide the world into different pricing zones in which they group countries with similar health care costs levels. That makes a truly mobile, nomadic lifestyle rather exhausting and painful as you’d have to adjust your pricing zone regularly – or pay for the higher tier all the time.

However, IPMIs are not necessarily designed for digital nomads either, as their target groups are expats: People who relocate to a specific region for predefined periods. Think of a diplomat or an engineer on an oil field who are deployed for a period of four or five years. Therefore, IPMIs don’t offer aging reserves and once you are beyond the expected working life, premiums shoot up and become unaffordable. Or plans just end at age 65, like with some American providers.

Innovation to better accommodate digital nomads is happening in the space of IPMI: An Israeli provider named PassportCard offers a MasterCard as their client card. This allows to pay for (outpatient) treatments right away without any out of pocket expenses.
A step further is a brand new solution by COVRD.EE which fully integrates a digital booking platform for doctors, clinics and medical practitioners of all kind. All diagnosis and treatments booked through that will be directly billed and paid for by the insurance company. Also they have simplified the global pricing zones to just two: The world with or without USA and Canada.

Christoph Huebner, expert broker for digital nomads health insurance

A very special type of Private Health Insurance in Germany

Lastly there is something which is from our observation of the global market quite exceptional: German Private Health Insurance. Germany is the only country in the world that the one side has a universal public health insurance system for everybody but on the other hand offers the alternative to fully opt out of the public system and go fully private (if you meet certain criteria like being self-employed or earn above a defined threshold). This means private health insurance in Germany is fully integrated in the public health care system and thus highly regulated. It’s also embedded into European social security frameworks which means insured individuals can receive a document equivalent to the A1 form, called “certificate of entitlement“. With this they are exempt from social security contributions in all other EU member states.

At the moment, it’s the only available category on the global market of long-term private health insurance that provides you with a worldwide coverage with a constant premium over the years. In this model, you pay more during your working adult life, however, you keep the same rate once you reach a certain age, whereas international insurance companies would ask you to pay a much larger sum. Therefore, you have more security to plan your life and keep access to affordable global healthcare in old age.

A disadvantage is its accessibility: As the name suggests, you need to be a German resident or at least have a German legal address. But thanks to the free movement in Europe, it is quite easy for European Union citizens to get a German address and enjoy the benefits of German Private Health Insurance for their lifestyles as digital nomads.

Among the roughly 30 insurance companies that offer private health insurance in Germany all of them provide unlimited coverage all across the European Union. But only 3 (and a half) actually grant unlimited global coverage.

Conclusion: Today you need to build your concept yourself

Digital nomads still aren’t catered for by the international insurance market since they don’t fall into the framework of their usual target group of expats. Thus the selection of the best health insurance for digital nomads depends a lot on individual factors like citizenship, residency, destinations, scope of plans etc.
Oftentimes the right combination of domestic health insurance and a long-term travel insurance plan does the trick – or an international health insurance plan for nomads combined with personal financial planning to take precautions for the unavoidable price increases at higher ages.

As more people decide to live a life as a digital nomad, the demand for matching global health insurance is growing. Thanks to our good relationships with insurance companies, we are working with some of them to fill the gap between the growing demand and the lacking supply of reasonable global health insurance. Until the perfect product exists, we help you as your reliable partner in finding the best available product that suits your specific needs.

Let us help you find the best insurance for your nomadic life

We are specialized insurance brokers for global health insurance aimed at the mobile remote work force of the 21st century. As digital nomads ourselves, we have over 40 years of combined experience in health insurance.

Based on this experience and industry expertise we are happy to navigate the jungle of options together with you!

F.A.Q.: International health insurance for nomads

What’s the best health insurance for digital nomads?

The best health insurance for nomads is the one which meets all your personal criteria. Make sure these at least include the following:

  • A coverage level that makes you feel comfortable
  • A contract duration that matches your plans to settle or return back home – or an unlimited duration
  • A plan for you to be able to finance it at later stages of your life
  • A scope of coverage that does not limit you in your curiosity to explore

What is ageing reserve in health insurance?

There are two ways to calculate health insurance as a actuary:

  • As damage insurance: You combine the cost ratio of a certain group – here: age groups – and assign them with a price. In health insurance that means young age groups are cheap, older ones get more expensive due to their increased use of medical care.
  • Like life insurance: You consider the statistically assumed life expectancy of an individual, sum up the expected medical expenses until then and divide the sum by the number of months until then (simplified). This way you achieve a stable premium that will only change if your calculation base changes (medical inflation or significant change of life expectancy). You will then need to establish a system to invest and manage the money paid by your younger crowd on top of the actual medical cost and make sure it’s used to stabilize the premiums over a long period of time.
    This is what health insurance providers in Germany do – with billions of Euros invested in those ageing reserves. Currently this type of health insurance calculation is nowhere else to be found on the global market.

For how many years can I be a digital nomad?

The limit beyond your own curiosity to explore this beautiful planet is only your health and your financial situation. If you manage those two factors early in your life and take precautions to be able to sustain a location independent lifestyle in the long-term then you can by a digital nomad until you find your last rest somewhere in a hopefully very distant future.
We are here to help with your planning that. Just book a free consultation and we’ll find your perfect setup.

author avatar
Christoph Huebner Chief Nomad
Christoph, an entrepreneurial spirit and avid traveler, has been a leading insurance industry expert since 2010. Founding a remote insurance brokerage, he turned into a perpetual traveler by 2017. Today, he's a top authority in global health insurance for digital nomads.