Expat Health Insurance: How I Pay $120/Month for Better Coverage

I pay $120/month for private health insurance in Colombia. It covers doctor visits, specialists, hospitalization, and emergency care. The same level of coverage in the US would cost me $450-1,500/month — and that's before the deductible, copays, and out-of-pocket maximums that make American healthcare the most expensive in the developed world. This isn't an anomaly. It's the norm for expats worldwide. Here's the complete guide to health insurance abroad — what it costs, what it covers, and why it's almost certainly better than what you have now.

The US Healthcare Cost Crisis

Let's start with what you're escaping:

Average individual premium: $450-700/month (employer-sponsored) or $500-1,500/month (marketplace)
Average family premium: $1,400-2,400/month
Average annual deductible: $1,750 (individual) / $3,500 (family)
Average out-of-pocket maximum: $8,000-9,000 (individual)
Americans who delay care due to cost: 38% (Gallup)

The US spends more per capita on healthcare than any nation on Earth — over $13,000/person/year — yet ranks 37th globally in the WHO's healthcare system efficiency. Colombia ranks 22nd.

Related: medical tourism guide

Your Options Abroad

Option 1: International Health Insurance

SafetyWing Nomad Insurance — The digital nomad standard:

Cost: $45-85/month (age-dependent; ~$45 for age 25-29, ~$73 for 40-49)
Coverage: $250,000 max, $250 deductible
Covers: Hospitalization, urgent care, emergency dental, some outpatient
Doesn't cover: Routine checkups, pre-existing conditions (first 6 months), mental health
Best for: Digital nomads, short-term expats, visa requirements

Cigna Global:

Cost: $150-500/month depending on plan and age
Coverage: Comprehensive including inpatient, outpatient, wellness
Best for: Long-term expats wanting full coverage with worldwide network

Option 2: Local Insurance (My Recommendation)

Most countries offer excellent private health insurance at a fraction of US costs:

Country	Private Insurance Cost	Doctor Visit	Dental Cleaning
Colombia	$80-325/month	$20-50	$15-30
Mexico	$50-200/month	$25-60	$20-40
Thailand	$40-250/month	$15-40	$15-35
Portugal	$100-300/month	$30-60	$30-50
Vietnam	$30-150/month	$10-30	$10-25
Malaysia	$80-200/month	$15-40	$15-30
United States	$450-1,500/month	$150-300	$100-300

Option 3: Pay Out of Pocket

When a doctor visit costs $20-50 and a dental cleaning costs $15-30, many expats skip insurance for routine care entirely and only carry catastrophic/hospitalization coverage. This is a viable strategy in low-cost countries.

Related: cheapest countries guide

Medical Procedure Savings

Procedure	US Cost	Colombia	Thailand	Mexico
MRI	$1,000-3,000	$100-250	$150-300	$150-350
Root Canal	$700-1,500	$100-200	$80-200	$100-250
Knee Replacement	$30,000-70,000	$5,000-10,000	$8,000-15,000	$7,000-12,000
LASIK (both eyes)	$4,000-6,000	$800-1,200	$1,000-2,000	$1,000-2,000
Dental Crown	$800-1,500	$150-300	$200-400	$150-350

Critical: Medicare Does NOT Work Abroad

If you're approaching 65 or already retired: Medicare does not cover healthcare outside the United States (with extremely rare exceptions in border areas). This means retirees abroad need either international or local insurance. The good news? It's still dramatically cheaper than US coverage.

My Setup in Colombia

I use a combination approach:

Prepagada (local private insurance): $120/month — covers doctor visits, specialists, hospitalization, emergency
SafetyWing: As a backup for emergency evacuation and coverage when traveling outside Colombia

Total monthly health cost: ~$170/month for comprehensive coverage. That's less than most Americans pay for dental insurance alone. For the full breakdown of Colombia's healthcare system, ColombiaMove's healthcare guide covers EPS enrollment, prepagada options, and hospital recommendations.

How to Choose

Short-term nomads (under 1 year): SafetyWing is the simplest option
Long-term expats (1+ years): Get local private insurance in your country of residence + SafetyWing for travel
Families: Cigna Global or local insurance (many countries cover dependents cheaply)
Retirees: Local insurance + comprehensive international policy as backup

The bottom line: You can get better healthcare coverage abroad for $100-200/month than most Americans get for $500-1,500/month. That savings alone — $4,000-16,000/year — can fund a significant portion of your life abroad. Pro tip: Health coverage is sorted — now stay connected too. Saily eSIM gives you instant mobile data in 200+ countries (from $1.79), so you can access your insurance portal, telehealth apps, and emergency contacts the moment you land — no local SIM card required. Read my complete expat tax guide for how healthcare costs interact with your tax situation.

Disclaimer: This is informational content, not medical or insurance advice. Coverage details, costs, and availability vary. Always verify current pricing and coverage before purchasing insurance.