What happens to your health insurance when you leave the United States?

What happens to your health insurance when you leave the United States?

As an American considering moving abroad, this is the hardest question for me to grapple with. Health insurance is already a pain point for most Americans—couple that with the thought of leaving the country entirely, and I don’t know where to start.

If you’ve been following Instagram, you know that my partner has started applying for Mexican citizenship. We don’t have a moving date set yet, but we are weighing our options and figuring out what this will look like in real life for us.

I’ve spent over 20 years traveling internationally, but there’s a big difference between a two-week trip and actually moving your life to another country.

So when I was trying to make a real decision, I did what I always do: I researched thoroughly, talked to professionals, and talked to people who had actually taken action.

What I discovered surprised me in many ways and made my decision much clearer than I expected. Here’s a look at what U.S. health insurance will actually look like after you leave, and what we plan to do about it.

What happens to your health insurance when you leave the United States?

Does U.S. health insurance cover you abroad?

This is the part that many people don’t understand at first.

Most domestic health insurance plans are designed for the United States. Employer plans, marketplace plans, even Medicare—they’re all designed around a domestic network, and when you’re away from it for an extended period of time, you’re basically on your own. Some plans technically offer international emergency coverage, but in practice that often means paying out of pocket first and then applying for reimbursement, with no guarantee of what you’ll actually get.

I’ve talked to a few people who have moved abroad, and one thing that comes up time and time again is that there is no one-size-fits-all answer to health care.

Most expats end up purchasing an annual policy based on their specific situation and place of residence. No one is still trying to make their American plans work in another country. They all moved on to something that was truly built for their lives.

What happens to health insurance when you move abroad?

If you have health insurance, it’s even simpler—and not in a good way. With rare exceptions, Medicare does not cover medical services outside the United States.

You can keep your Medicare coverage while living abroad, but it will not pay for care you receive in another country. If you’re approaching 65 and planning to move, it’s still worth signing up for Medicare Part A, as most people qualify for free premiums, but you’ll need to buy separate international coverage for any actual medical care you receive abroad.

This is one of the most common questions in the expat community, and the answer is very consistent: health insurance only covers you while in the United States.

What we decided to do for overseas health insurance

What is expat health insurance?

Expat health insurance is insurance specifically designed for people living abroad for an extended period of time – not just a visit, but an actual relocation. Unlike standard travel insurance for short trips and emergencies, expat health insurance is designed to be more like your coverage at home: daily care, ongoing prescriptions, preventive visits and long-term health management.

The main difference is that it goes with you. Whether you live in one country or move between several, a good expat plan can keep you covered without being tied to a domestic network that doesn’t exist where you live.

Travel Insurance vs. International Health Insurance: What’s the Difference?

This is where a lot of people get confused, myself included.

Travel insurance is designed for travel. It covers emergencies, unexpected illness, trip cancellation, lost luggage and other issues that may arise while on vacation. It’s not designed for people living abroad full-time, and most travel insurance plans have time limits that make them impractical for long-term relocations.

International health insurance (or expat health insurance) is established for people who are physically moving. It covers routine care, ongoing health conditions that arise after policy inception, and preventive visits. It functions more like a regular health insurance plan.

The reason this distinction is important is that your correct answer depends entirely on where you are in the process. If you’re still in the planning stages and need to travel back and forth, travel medical insurance makes sense. Once you decide to move permanently or semi-permanently, you will want to consider appropriate international health insurance.

Why we use SafetyWing

I’ve been familiar with SafetyWing for years – it’s constantly mentioned in nomadic and expat circles, and I’ve used it myself on shorter international trips.

When we started getting serious about long-term relocation options, I went back to see what they had to offer. They have two plans: Nomadic insurance essentials and Nomad Insurance Complete. Depending on where you are in your journey to move abroad, one will make more sense than the other.

Nomadic insurance essentials Is travel medical insurance for people who live or travel outside their home country. You can purchase terms as short as 5 days or run as an ongoing subscription for terms up to 364 days. It covers emergency medical care, unexpected illness and travel accidents with no deductible.

For families traveling with children: One additional child under 10 years old can be added free of charge per adult (up to a maximum of two children).

As a U.S. citizen, you can purchase as long as you live or travel outside the United States. This is the right choice for us currently in the planning and transition stages. It’s flexible enough to cover the interim period without locking us into a full annual commitment before we actually take action.

Nomad Insurance Complete is a different category. This isn’t travel insurance – it’s closer to actual health insurance for movers. In addition to emergency coverage, it adds routine care, annual checkups, vaccinations, and treatment for conditions that arise after the policy begins. It also covers your situation in your home country with no time limits, which is important when you live abroad full-time and return home to visit family.

One important thing to know: The full plan is not available to U.S. residents. You are eligible once you have established your primary residence abroad and reside outside the United States for more than six months out of the year.

How much does health insurance cost abroad?

This is usually what surprises people the most because it’s so much cheaper than what most of us are used to paying in the US.

for safety wing Nomadic insurance essentialsrates start at $62.72 per four weeks for travelers ages 10 to 39. For travelers aged 60 to 69, expect to pay more than $218 per month—still competitive with most other options. this Nomad Insurance Complete Plans start at about $177.50 per month, with costs varying based on age and any add-ons you choose, such as dental coverage or electronic theft protection.

To put this into context: The average health insurance premium in the U.S. market is several hundred dollars per month before taking deductibles and copays into account. The idea of ​​getting solid international coverage for $60 to $177 per month takes some getting used to, but that’s what movers always pay, and it’s often one of the reasons Americans actually decide to move abroad.

Pricing varies based on your age and length of coverage, so SafetyWing has a quote tool on its website that allows you to see the exact figure for your situation before making any decisions.

What would I suggest based on your location?

After all the research, conversations with professionals, and talking to people who have been through these things – here is my advice:

If you’re in the planning stages, still figuring out the logistics of moving, or simply spend a lot of time internationally and haven’t found a permanent base yet, start with a basic plan. It’s flexible and affordable, and you can adjust it as your situation changes.

If you have moved or are about to move permanently and you are not a U.S. citizen or resident, please review the full plan. The difference between travel medical insurance and actual health insurance is important once you live somewhere full-time.

Anyway, get this out of the way before you go. This may feel like something you can figure out later, but it’s definitely something you should factor into any budget plan for eventually moving abroad.

I will be documenting our entire journey moving overseas, starting with my partner’s journey to Mexican citizenship. If you want to follow along, Subscribe here So you won’t miss any of it.