Travel Insurance vs International Health Insurance

Travel insurance covers a defined trip and then stops. International health insurance is the contract you keep while you live outside the United States. As of October 2026, SafetyWing lists Nomad Insurance Essential at $62.72 every four weeks for ages 18 to 39, with a maximum of 364 days, and Nomad Insurance Complete at $177.50 a month for the same ages on a 12-month lock-in.

Thirteen of those four-week Essential payments come to $815.36 if you hold the plan for the longest term it allows. Twelve Complete payments come to $2,130. The extra $1,314.64 buys routine visits, maternity, and cancer care that starts after the policy begins. It does not buy coverage for an illness you already have. That split is the expat health insurance decision that actually changes what you pay when a clinic asks for a card.

Is travel insurance the same as international health insurance?

No. The Centers for Disease Control and Prevention treats them as different products. In the 2026 Yellow Book, posted 23 April 2025, travel health insurance is short-term supplemental cover for care you receive abroad, and the chapter says people planning more than a year abroad may need something other than those short-term policies.

A trip plan is priced and capped around a departure and a return. A residence plan is priced around a year of ordinary medical life: checkups, a specialist, a prescription, sometimes a birth. Buying the cheap one for a move is how people discover, in an emergency room, that routine care and an old diagnosis were never in the contract.

Question	Trip medical policy	International health plan
How long it lasts	World Nomads single-trip plans: up to 180 days. SafetyWing Essential: 5 to 364 days.	SafetyWing Complete: 12-month contract. Cigna Global: from age 18 with no upper age limit, while you keep paying.
What a serious bill can hit	World Nomads Standard emergency medical $125,000. Essential overall maximum $250,000 per active period.	Cigna Silver inpatient maximum $1,000,000. Gold $2,000,000. Platinum inpatient care paid in full.
Routine care, maternity, cancer	Essential excludes pre-existing conditions, maternity, and cancer treatment.	Complete includes routine visits, maternity, and cancer testing and treatment that is not pre-existing. Cigna Gold routine maternity is $7,000 after 12 months.
Evacuation	World Nomads Standard evacuation is a separate $400,000, not the medical cap.	Cigna evacuation is an optional module, paid in full up to that plan's annual maximum.
Published price, ages 18-39	Essential: $62.72 every 4 weeks. World Nomads quotes a trip price; it does not post one rate.	Complete: $177.50 a month. Cigna quotes a premium; it does not post one monthly price.

Data note: insurer prices and caps were checked in October 2026. World Nomads limits can differ by state. Cigna premiums depend on age, deductible, and area of cover.

How long does a travel medical policy last?

For a US resident, a World Nomads single-trip plan runs from 1 day to 180 days, and the trip has to be more than 100 miles from home. Standard, Explorer, and Epic each stop at 180 days. The annual multi-trip plan can cover many trips, but each one is capped at 45 days, and you cannot upgrade after you buy. If your return is inside 180 days, a trip policy can fit. If you are signing a lease, it will expire while you are still there.

World Nomads splits the medical cap from the evacuation cap

On plans purchased after 23 October 2024, emergency medical maximums are $125,000 on Standard, $150,000 on Explorer, $250,000 on Epic, and $100,000 on the annual plan. Evacuation is larger on the single-trip plans: $400,000 Standard, $500,000 Explorer, and $700,000 Epic. The annual plan's evacuation maximum is $100,000, the same figure as its medical maximum.

The CDC puts a distant or remote evacuation over $250,000, and a transfer inside North America from $25,000. A Standard medical limit of $125,000 can be spent on the hospital while the separate $400,000 evacuation benefit is still unused. World Nomads excludes pre-existing conditions, with a possible waiver only on Explorer or Epic if you buy inside their time-sensitive window. File within 20 days after a loss, or as soon as reasonably possible. That page also says 27% of claims across US travel insurers in 2024 were accident and sickness medical bills.

SafetyWing Essential stops at 364 days

Essential is travel medical for an unexpected emergency outside your home country, from 5 days to 364 days on the wording updated in February 2026. The recurring plan bills every 28 days, with the charge taken 3 days before the next cycle, and it still ends at day 364. Paying the whole term at once is 10% off the 28-day total.

The sales page lists up to 30 days of care in your home country and a $250,000 overall maximum. On the 364-day prepaid option, the help center is tighter if the United States is home: 45 days of US coverage in each 180 days. Other home countries on that prepaid plan can use up to 179 days, with each visit capped at 90 days in a row. US citizens can buy Essential. They cannot buy the add-on that covers treatment in the United States. That add-on is only for people who are not US citizens and not US residents.

The plan also skips Cuba, Iran, North Korea, Puerto Rico, Syria, Russia, Belarus, and the Ukrainian regions of Crimea, Luhansk, Donetsk, Kherson, and Zaporizhzhia. Emergency dental on the sales page is up to $1,000. Cancer treatment, maternity, and pre-existing conditions are out.

What does an international health plan pay for?

It pays for the care a resident actually uses, inside a contract that is meant to last a year or longer, and it still has exclusions. SafetyWing's help center, updated against the February 2026 Essential wording, calls Complete global health insurance in more than 175 countries: accidents, illness, cancer testing and treatment, routine doctor visits, and maternity, plus some travel benefits such as delayed luggage and trip cancellation.

Complete is $177.50 a month and locks for 12 months

The sales page says ongoing coverage you can renew, with no home-country restriction of the kind Essential has. The help center is the operational rule: the contract locks for 12 months, you may pay monthly or annually, underwriting can take up to 10 days, and the start date can only be the 1st or the 15th of a month. If you need cover on the 20th, you are waiting.

There is no deductible and no coinsurance on covered treatment. You can still pay if the care is excluded, if the bill is above usual and customary rates for that city, or if you skip a required pre-approval. Planned treatment of $250 or more can be direct-billed. Anything estimated over $500 needs pre-approval, and skipping it can cut the reimbursement by 30%. In an emergency over $500, notify them before treatment if you can, and within 72 hours if you cannot.

Complete still does not cover a pre-existing condition. SafetyWing defines that as anything that existed before the start date, showed symptoms before the start date, or had not yet been diagnosed. A cancer benefit helps a diagnosis that happens after you are on the plan. It does not rewind a diagnosis you already have. The detail on how insurers treat old conditions is in pre-existing conditions on expat health plans.

Cigna posts ceilings, not a single monthly price

Cigna Global Health Options enrolls from age 18 and does not set an upper age limit. Use the table for the big ceilings, then look at the lines a family actually hits. Routine maternity waits 12 months: nothing on Silver, $7,000 on Gold, $14,000 on Platinum. Optional outpatient cover caps the year at $15,000 on Silver and $35,000 on Gold. Pre-existing outpatient care inside that module is $500, $1,500, or $3,000 at age 60 or older. From 40 to 59, Silver and Gold list no coverage and Platinum lists $2,000. Evacuation is optional and, if you add it, paid in full up to the annual maximum.

The February 2026 brochure lets you choose a deductible of $0, $375, $750, $1,500, $3,000, $7,500, or $10,000. On Cigna's own example, a $1,200 claim with a $375 deductible means you pay $375 and the plan pays $825 for that period of cover. Once you know you need a residence plan, the brand differences are in SafetyWing, Cigna, and Allianz side by side.

Does Medicare cover care if you live abroad?

In most cases, no. Medicare will not pay for care outside the 50 states, the District of Columbia, Puerto Rico, the US Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands, except in narrow situations.

The three foreign-hospital exceptions are geographic, not a retiree lifestyle. Medicare may pay if you are still in the United States when the emergency happens and the foreign hospital is closer than the nearest US hospital that can treat you. It may pay if you are driving the most direct route between Alaska and another state, without unreasonable delay, and a Canadian hospital is closer. It may pay if you live in the United States and the foreign hospital is closer than the nearest US hospital, even when it is not an emergency. A rented apartment in Lisbon is none of those. Part D does not pay for drugs you buy outside the country. On a cruise, Medicare does not cover care when the ship is more than six hours from a US port.

Medigap is the add-on people hope will fill that hole, and it is still a travel benefit. Plans C, D, E, F, G, H, I, J, M, and N can cover foreign emergency care up to a $50,000 lifetime limit. They pay 80% of the billed charges for certain medically necessary emergency care after a $250 deductible for the year, and only if the care begins in the first 60 days of the trip and Medicare is not already paying. Plans E, H, I, and J are no longer sold. You can keep one only if you bought it before 1 June 2010. A Medicare Advantage plan follows the same outside-US baseline unless that specific plan added a travel benefit, so the plan document is the only place that answer lives.

Foreign hospitals do not have to bill Medicare for you. If you are in one of the three exceptions, you submit the itemized bills. A national health system also does not have to cover a nonresident, so public hospitals in your new country are not a substitute for a policy.

What does a full year of cover cost?

Say you are 34, a US citizen, and you will be outside the United States long enough that a 180-day World Nomads plan would expire in the middle of the stay. You are inside the 18-to-39 price band SafetyWing publishes. You do not have a condition that predates the policy. Two paths use only the listed prices.

Path one is Essential for the full 364 days on the 28-day price. That is 13 payments of $62.72, or $815.36. Paying the year up front takes 10% off that total, which is $733.82. You get emergency treatment, a $250,000 overall maximum, limited days back in the United States, and no routine care, maternity, or cancer treatment. The policy cannot be stretched past 364 days.

Path two is Complete for the required 12 months at $177.50, or $2,130. You can start only on the 1st or the 15th, so you apply at least 10 days before that date. There is no deductible on covered care. Routine visits and a new cancer diagnosis are inside the benefit list. A condition you already have is not. You owe the year even if you fly home in month nine.

For a short vacation, the Yellow Book says a comprehensive policy can cost up to 8% of the trip when cancellation is for a listed reason, and up to 15% for cancel-for-any-reason. On a hypothetical $4,000 prepaid trip those ceilings are $320 and $600. That is a CDC ceiling, not a World Nomads quote. A credit-card benefit is not a substitute, and the insurer, not you, decides whether an evacuation happens.

What should you check before you pay?

Match the end date of the policy to the end date of the stay, then read the exclusion that would actually hit you. The order below is the one that prevents the expensive mistake.

1. Write the day you will still be abroad. If it is inside 180 days and you live in the United States between trips, price a World Nomads single-trip plan and read the medical line and the evacuation line as two numbers.
2. If the stay runs toward a year, stop looking at 180-day products. Essential can reach 364 days at $62.72 every four weeks in the 18-to-39 band. Complete is the 12-month contract at $177.50 a month in that same band.
3. Circle pre-existing conditions. Essential and Complete both exclude them. Cigna's optional outpatient amounts for old conditions are hundreds or a few thousand dollars, not the $1,000,000 Silver inpatient maximum.
4. If you will fly back to the United States, read the home-country day limit. Essential's sales page says up to 30 days. The 364-day prepaid rules say 45 days per 180 days when the United States is home. US citizens cannot buy the US add-on.
5. For Complete, pick a 1st or a 15th that is more than 10 days after you apply, and treat the 12 months as money you will spend.
6. Ask who pays the hospital. Many travel policies reimburse you after you pay. Complete can direct-bill planned care of $250 or more, and it wants pre-approval above $500.
7. If you are on Medicare, keep the Medigap foreign benefit in its box: 60 days, $250, then 80%, lifetime $50,000. It is not a residence health plan.

Sources checked

Prices and rules below were read in October 2026. A state-specific World Nomads certificate can differ from the national summary. SafetyWing's sales page calls Complete renewable, and the help center calls it a 12-month lock-in. Both are quoted above. This is not insurance, tax, or legal advice. A qualified professional or the policy wording controls a real claim.

• Medicare coverage outside the United States (publication 11037), including the Medigap foreign-travel rules.
• Medicare travel page on care outside the country.
• CDC Yellow Book on travel health insurance versus evacuation, 2026 edition, posted 23 April 2025.
• CDC travelers' health insurance page.
• SafetyWing Nomad Insurance prices and Essential exclusions.
• SafetyWing Essential versus Complete, including the 12-month lock-in.
• Cigna Global Health Options benefit maxima.
• World Nomads single-trip limits for US residents.

If a number on a checkout screen does not match this page, use the checkout screen. Age bands above 39, deductibles, and the country you list as home all move the premium, and none of those variants were guessed here.