5 mistakes to avoid when buying international health insurance

Skip the guesswork and overpaying. With a trusted international health insurance broker you can get a plan that helps you avoid these 5 mistakes.

Making the right choices when buying International Health Insurance: My insurance broker Warren

Healthcare is so affordable in many parts of the world that expats, nomads and others living or traveling internationally can get away with a la carte visits to private clinics in cheap countries. For most regular checkups and treatments as a healthy individual, you can simply pay out of pocket in such places without much financial consequence.

But the fact remains that you never know when something truly catastrophic, like a traffic accident or severe long-term illness, may strike. It is foolish to think that you can get away with living uninsured just because the private clinic down the road in Nicaragua charges $30 to see the doctor. It is also foolish to buy insurance without doing research, thinking that international healthcare is all created equal.

It is easy to make critical mistakes when buying health insurance as a nomad, expat or traveler.

This is why I consult my insurance broker Warren when looking for coverage for me and my family as we live a life spread across continents.

Warren is my trusted broker for international health insurance

Get in touch with Warren

Transcript of “Mistakes to avoid when buying international health insurance“

LADISLAS MAURICE: Hello, everyone. Ladislas of The Wandering Investor. Today, we’re going to have a very unfortunate discussion on mistakes to avoid making when buying international health insurance. We’ll have this conversation with the Warren, who is an insurance broker specializing in international health insurance and who’s helped hundreds of expats over the years. Warren, how are you?

WARREN: I’m doing great, Ladislas. Nice to be here with you this evening.

Warren’s experience getting dental care in Romania

LADISLAS MAURICE: Cool, fantastic. We were having a short discussion before, you got a whole bunch of dental work done, and it cost you only $230 in Romania for root canal?

WARREN: Yeah, it was crazy. Yeah. From Romania, eight different visits, several root canals, but it came out to €280. And one of them was a December 31 emergency visit.

LADISLAS MAURICE: All right, cool.

WARREN: I’m sorry, €230, not €280. I don’t want to inflate the price and make people say, “Oh my gosh, it’s so expensive.” But yeah, €230.

LADISLAS MAURICE: Yeah. There are places in the world where there is affordable healthcare. But the reality remains that when you’re an expat or a full-time traveler, you need international health insurance to cover you across the world in case of catastrophe, emergency, etc.

Mistakes when buying international health insurance

LADISLAS MAURICE: Warren, what are some of the mistakes that people make when they buy international health insurance?

WARREN: Well, first, a lot of people don’t know what they need, and they are looking at the wrong products. Some people are looking at travel insurance, some people are looking at trip insurance, while others might be looking for expat coverage. And there’s a big difference, because if you are trying to get residency and you want to live in a location as a resident, and you’re showing up with travel insurance, that might slide you past qualifying by the bureaucrat looking at your paperwork as having adequate coverage. A lot of times, they’re going to tell you no when they see the travel insurance, but if you get by, the problem is the insurance company, when you try to file a claim, will say that we don’t cover you in the country that you’re a resident in. And so if you are on the wrong coverage, you’re going to find out about it later.

And trip insurance is focused on your plane flights, your cancelations, and has a medical component. And then, of course, your expat coverage will cover you in a country of your residency, and those are going to tend to be a little bit more expensive. You’re typically going to get those for a year at a time, can pay for them monthly or annually. But you need to know the coverage that you need. You have too many people that are out there with nomad coverage thinking that they’re going to get covered in a country that they’re going to have a residency. And there’s variations, and there’s small print, there’s language you have to be aware of that you are going to get coverage that will actually cover you in that country.

LADISLAS MAURICE: Yeah. Sometimes, you see insurance, they explicitly say, in the small print, if you spend more than X amount of time in whatever jurisdiction, then you’re not covered anymore. People really need to be very careful. And I think one important point, so I’ve dealt with international health insurance my whole life, so it’s a bit of a topic. I’ve become an expert in myself. And I’d say another mistake that people make is they’ll just go with the insurance that their friends are happy with, right? You speak to John, and John says, “Hey, I’ve had a great experience with this insurance. You should contact them.”

Comparison shopping for international health insurance

LADISLAS MAURICE: But the reality is, there are so many variables that go into the quote of an insurance company that you have to get different quotes from different companies. Because an insurance company may have very competitive pricing in a jurisdiction or for your particular family composition, but for someone else, it might be the complete opposite. It’s really, really important to compare. Do you have any insights you’d like to share with listeners?

WARREN: You’re 100% correct. You’ve got to look at your friend’s demographic. How old are they? Do they have a family? Because I’m going to look at different products based on somebody’s age, as well as where they’re going, how long they’re going to be somewhere. What is their tolerance for a deductible? What somebody else might tolerate as an out-of-pocket costs and their expenses might be different than yours. And I’d like to say that there’s a square peg for everybody, but, sometimes, you’re trying to find a square peg to fit in a round hole, and you’ve got to get as close as you can to make that fit. Maybe you’ve got preexisting conditions and your buddy doesn’t, and you need to understand where you have your weaknesses and where you need to have those weaknesses protected.

And some coverages will be a lot less expensive for a family, others are going to be astronomically high. And if you’re over 65, some places aren’t going to cover you anymore. Sometimes, you get cut off at 69 or 79, so depending on your age, you might not be able to have the same coverage as your friend is recommending to you.

LADISLAS MAURICE: Yeah. I’ve had a lot of expat health insurance companies approach The Wandering Investor, trying to partner with the company, offering affiliate agreements. The commissions are quite interesting, I’ll be transparent, but the reality is, I just don’t feel comfortable recommending a single health insurance company, because, again, it might be great for John, living in Hungary, but for Kevin, living in Brazil, it might be terrible, because that health insurance might be more competitive in one jurisdiction than another. It’s really–

WARREN: I’m going to tell you, I will recommend a different company for France residency than I am for somebody that’s going to be applying for it in, say, Ecuador, or if they’re trying for Montenegro, or they’re trying for Bulgaria. They’ll have different requirements. I’ve got a company in France I deal with that is specialized just for France, and another one in Spain for Spain. You need those types of tailor-made products, sometimes, to fit the criteria for that country. Sometimes, it will be a Cigna, sometimes, it’ll be an IMG, or a GeoBlue. But you’ve got different countries, different companies that will fit the needs, especially if you’re looking for an expat residency, that will be really specific to that country.

LADISLAS MAURICE: Yeah. And sometimes, people can play with the fact that they have multiple residencies by saying, “Hey this is my residency.” A lot of people out there are stacking residencies, they have two, three four active residencies, and then you can get different quotes and see, okay, cool, maybe I should attach my health insurance to this residency. And then, you being the very same person with the same travel schedule by choosing a jurisdiction as opposed to another one, the difference in pricing could potentially be massive at times.

WARREN: Well, one of the programs that I deal with, if you have one of the eight high-priced countries, you might see your cost for your premium go up by 50% or 30%, in some cases, it will double depending on the country you’re looking at. But the high-priced countries are, typically, you’re looking at the United States, Canada, Singapore, Macau, Japan, China, Taiwan. I’m missing one in there, I think. But you’ve got these countries that, if you’re focusing on those countries, you’re going to pay a higher premium in many regards, depending on the company. And if you’re looking for worldwide coverage, or you’re looking at excluding some of these high-priced countries, it will make a difference in your premium.

LADISLAS MAURICE: Yeah. And even just normal countries, I remember looking at quotes for exactly the same coverage between declaring a residency in Hungary versus declaring a residency in Montenegro, and the Delta was approximately 30%, 40% for the same thing. Really, even within continents, the differences can be massive.

Where can I be treated with international health insurance?

LADISLAS MAURICE: And also for people who travel a lot, for example, I travel a lot, people know this, and a criteria that was really important for me, but which not all international health insurance has, is that I can choose where I get my treatment. Let’s say, I need to get surgery. I catch cancer, whatever, I need to go get treatment, I can choose the jurisdiction in which I’ll get my treatment. The health insurance says, “Yeah, you can go get treated in Malaysia. You can go get treated in Mexico. It’s fine. You can go wherever. You’ll just need to pay for your own flights, but once you’re there, we’ll cover it.”

This is really interesting, especially if you get something, and you need a specific type of surgery, and you identify that the best surgeon, the best hospital is in Turkey, for example, or in Colombia, for whatever reason, then you can just choose to go there. But other health insurances, you don’t have this sort of flexibility. And those are the sorts of things when you just go online and use these online tools. Because I know a lot of people say, “Oh, I just go online and I use these, like, international health insurance.com,” I don’t know if that exists, and then you compare. You won’t get that sort of information. It’s only later, when reading into the fine print, that you find out that, yes, you can do this, that. That’s why using a broker like Warren, who’s a family friend, is very, very helpful, because you help people look into the fine print.

WARREN: Well, let me speak up to, you’re talking about traveling to go get healthcare. Depending on how bad your situation is, many of these policies will have the ability for you to basically get a medical flight that they’ll pay for your flight to go somewhere where there’s going to be better care. If you’re in a place where the coverage is inadequate, if you have the proper coverage, you can be transported somewhere to a better facility, whether that’s to your home country or to a better facility nearby, maybe you need to jump a border somewhere. It’s not always that you would have to pay for yourself to go there. You find yourself in a medical situation that’s requiring you to be medically taken out of the location you are for that treatment, a lot of the insurances that we deal with can provide a benefit to basically evacuate you just to a better location.

Many of these programs will also give you the opportunity to bring a family member in, while you are going through care, to come sit at your bedside. They’ll even give a hotel stipend and let you have somebody there to help take care of you, so that you’re not alone in a strange land. There’s different parts of a policy, different parts of a program, that will help not just take care of you while you’re in a facility, but that you have a support network nearby as well at least for a period of time.

Buying add-ons for international health insurance

LADISLAS MAURICE: What about all these add-ons? Because I feel when people go online and they go directly to the health insurance or use these online tools, people just get pushed all of these add-ons. What’s your line of thought on these?

WARREN: Okay. I, typically, don’t push these, unless somebody feels a real need to have some of these add-ons, whether that’s dental, vision, different life insurance. I look at it from the standpoint of, I want insurance, at least on my side, that’s going to cover my butt when something really bad happens. A lot of medical care is so inexpensive in so many places that I do have a deductible when I’m traveling and I’m okay with paying that deductible to keep the premium down low. To me, that’s the most important part, is having that cover-your-butt type of coverage, so when you have a huge catastrophe.

As far as the add-ons, I really, really don’t push them. If you want an add-on, if you want to cover your laptop, if you want to cover dental, vision, those programs are out there as well. I normally am not going to be a guy trying to upsell you on that, but if that’s what you want, there are those programs available. I just feel it’s not the best use of your dollars or your euros when you’re putting in towards some of these add-ons. But it’s up to you.

LADISLAS MAURICE: I mean, there’s a reason all these health insurance companies are pushing add-ons, because they’re high margin. They’re extremely high margin for them.

Buying international health insurance through a broker

WARREN: It would help me on a commission. And by the way, my involvement with any case does not change anybody’s rates, it’s already built into the pudding. I don’t change your rates at all, I just try to give you my advice and my knowledge from helping hundreds of different expats, nomads, and travelers, whether they’re on vacation or moving abroad.

LADISLAS MAURICE: Yeah, I think this is a really important point. There’s the misconception that using an insurance broker is more expensive because he’s making money out of it. Yes, Warren is making money when he sells you insurance. That’s what he does, he’s an insurance broker. But if you go directly to the website or use some online tool, the only difference is, either the online tool is going to make that commission, or if you go directly to the health insurance, they’re going to make the extra margin. There’s really no downside to using a broker that has a lot of experience and that can veer you away from all of the unnecessary add-ons, and that can point you towards the right insurance for your particular situation.

International health insurance for Americans

LADISLAS MAURICE: Warren, let’s discuss the US, because whenever you sign up for international health insurance, there’s always a US option, a non-US option. Can you elaborate a little bit on this?

WARREN: Yeah. Obviously, the United States is very expensive for medical care, and international coverage, international carriers want to avoid as much of that risk as possible. If you’re looking at adding the United States onto your coverage, oftentimes, it will be limited to six months out of the year that you would be allowed to be in the United States. There are a of couple programs that, if you are not an American and you’re going to reside in America, then there’s programs for you, specifically that you can have to go into the United States for the full 12 months.

If you’re coming from India and you’re going to go live in America for 12 months, yes, there’s an international program for you. But if you’re a typical person that’s not going to live in the United States, there’s going to be time limitations, quite often, on how long you can be there. And if you’re an American, a lot of these programs are not going to cover you in the United States, unless you’re on an expat type of policy, then they’ll have a program that will give you up to six months. Some programs for nomads will cover you for maybe a month every six months, or seven weeks every six months, so there’s some different variations out there.

But the United States, if you’re going to try to build that into your policy, sometimes, you’re going to see it double in cost, if not more, considering your age and your risk.

LADISLAS MAURICE: Yeah. I think that the main point is, even if you choose a non-US policy, in most cases, you’re still covered in the US up to a certain amount of days. It’s really important to count your days, when you go to the US as a tourist, or to go see family, because if you exceed those days–

WARREN: That is always a question I ask, especially if it’s an American reaching out, because I want to find out, are you expecting this to cover you in the United States? Now, if somebody is from France asking me, I may not ask them that if they’re going to tell me where they’re going, what they’re doing, but if the United States is part of the game plan, it changes the equation.

Replacing existing international health insurance policy

LADISLAS MAURICE: Yeah. Yeah, really, really important. And can you tell us about people that already have an existing insurance and who are shopping around, are wondering if they can get a better deal? Is this something that you can help with, or do you only help people that are about to embark on their journey?

WARREN: Yeah, if you have a policy already, if you’re already out there traveling, you’re on a policy, and you want to do some shopping around, I’ll be glad to try to do a comparison and see what you have and compare it to something else. And if you’re with the program that I represent, because I do represent eight different programs out there, if you want to switch over to have me as your agent, if I’m part of that program, then that’s great. If you have the best program available, I’ll let you know. It’s not going to do me any good. I won’t sleep well if I try to tell you to go somewhere to come to me, just so I could be your agent. If you’re already on a good product, and if I don’t represent that product, I will tell you to stay where you are.

I will give you an example. I had a gentleman from Thailand looking for coverage. He’s in Thailand currently, and we were looking at the different residency types of programs and packages I can offer for him. I, basically, let him know, if he’s going to travel outside of Thailand, we’ll hook him up with some travel coverage, but for what he needs for his residency, the small, cheap policy that he was able to get in Thailand just to qualify for his residency was going to be the better program for him, cost wise, than what I was going to be able to do with some of the other carriers. So take that local one, even if it just covers you in Thailand to get your residency squared away, but when you’re leaving the borders, yes, let’s hook you up with a different type of travel coverage or different type of nomad plan that will cover you outside of your resident country. I’m not going to BS somebody to come to me if I’m not going to give them the best opportunity.

A little bit of background of why I’m doing this, because I kind of consider myself early retire. I’m an insurance executive. March 2020, my wife and I, we decided to travel. I picked out an insurance program for myself. I wasn’t expecting to ever use an insurance license again when I left. I ended up having so many people asking me about what I’m doing for my coverage, and I kept referring people for no profit for myself. I, finally, had an aha moment. Said, “You know, Warren, I’m giving all this business away. I bet you I can get appointed with these companies because I’m an insurance executive.” I start reaching out and yes, and so that’s kind of how this morphed.

It wasn’t an intention that I was going to get involved with international insurance, because I’m like a lot of your folks, I’m traveling. I’ve been to 49 countries. I’m living abroad with my wife and my two dogs, traveling, trying to have my best life, see the world. And part of this is important to know, because if you are trying to reach out to me, please, give me 24, 48 hours, sometimes, to get back, because I don’t know what time zone I’ll be in, and I don’t know if I’m traveling between locations, so there can be a lag. And so, please, be patient and not walk away because I’m not a desk jock.

Buying international health insurance as an employer

WARREN: And another thing that we ought to just bring up really quickly, because not everybody might be here just to look at things as an individual. There could be people here that are employers, maybe they’ve got a staff that’s living overseas in one specific country, or they have a staff of freelancers around the world. If they have employees, we can put together a package to cover their entire staff so that they have a group program as well, so that you’re not just out there as an individual if there’s an employer that is interested in covering multiple people. Of course, individuals is what I typically hear from, but there are employer groups that we can try to work something out for as well.

Impact of life events on international health insurance

LADISLAS MAURICE: And one point that I would like to add, which is really important, is life events change things. If you change countries, that’s a life event, that’s a policy event. If your family composition changes, for example, in the next few months, I’m expecting number two, so this means that family composition changes, I’ll be contacting Warren, and I’ll be saying, “Cool. Hey, there’s another kid in the picture. Can we look at options?” Because these really have a big impact on your insurance. Whenever you change countries, whenever your family composition changes, you want to look around and make sure that whatever insurance you have is still appropriate for you. Because again, insurance companies may be great for one situation, but not optimal for another.

WARREN: And you bring up a great point about maternity. If you’re in that age bracket and you’re looking for maternity care, there’s a lot of the programs out there either won’t cover it, or there’s a wait time. You might have to wait 10 months till you’re going to be covered with maternity care. If you’re in the thought process of having kids, you want to plan this out 10 months ahead of time with your insurance coverage to make sure you’ll have insurance coverage if you are planning to be abroad, and needing to use a hospital, and think you’re going to need medical care.

Contact Warren to learn more about international health coverage

LADISLAS MAURICE: Fantastic. There’s a link below with more information, and you can use this as well to get in touch with Warren. He can help you with all your international health insurance matters from A to Z. He’s really competent, he’ll have options, and give you a proper analysis. Warren, thank you very much for your time, really appreciate it. And I will personally be in touch with you in the coming months.

WARREN: Super. As always, great to talk to you again, Ladislas.

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