Health insurance for digital nomads and remote founders: 7 plans compared from their policy wording (2026)

The short answer

Most founders who live abroad for months at a time need international private medical insurance (IPMI), not just travel medical insurance. Travel medical insurance pays for unexpected emergencies while you're away. SafetyWing's own Essential description of coverage says it "is not intended to cover treatment of chronic conditions, and in most cases it does not cover pre-existing illness or injury". IPMI is renewable cover for the place you actually live. It costs more, usually asks health questions, and on some plans includes routine care.

The test is simple: if an illness that starts this year still needs treatment next year, will you be covered? SafetyWing's FAQ says that on Essential, new conditions "become pre-existing when the plan expires (max 364 days)", and that the plan "should not be used as ongoing health insurance". That's a fair summary of travel medical insurance generally.

Your visa can decide it for you. For Spain's telework visa, the Spanish consulate in Washington says "Travel insurance is not accepted", the policy must come from an insurer authorised to operate in Spain, and it "must not have a deficiency, copayment, or coverage limit". Check your visa's insurance rule before you buy anything (our digital nomad visas guide links each official page).

Travel medical vs international health insurance

Travel medical insurance is short-term emergency cover, while IPMI is ongoing health cover with underwriting. Here's how the two types differ in the documents we read.

SafetyWing Essential says outright that "We do not ask medical questions before you buy". The flip side is that it can't promise cover for anything you had before. Underwritten plans ask first, then tell you what's excluded, so you know where you stand before you need to claim.

Seven plans compared from the insurers' own pages

These seven plans each publish product pages and policy documents, so every figure below comes from the insurer's own page or wording, checked 26 Oct 2026. It isn't a ranking, there are no affiliate links, and a price appears only where the insurer prints one. All plans have more exclusions than fit in a table.

What sits behind each row:

• SafetyWing Essential: prices and the 30-day home cover are on the Nomad Insurance page. The wording says each period lasts 5 to 364 days and you can keep buying plans "until you turn 70 years old". The overall limit is US$250,000, with evacuation to a better-equipped hospital capped at US$100,000 lifetime.
• SafetyWing Complete: the health part is underwritten by VUMI Group, I.I., per the Complete description of cover, with a maximum of US$1,500,000 per policy year and an application age "Up to 64 years". It runs for 12 months and can be renewed.
• Genki Traveler: the insurer is Squarelife, and Genki is the policyholder and agent, per the product page. The insurance conditions set a €1,000,000 overall limit and a €50 deductible per insurance case, which doesn't apply to inpatient stays.
• Genki Native: the product page lists deductibles of €0, €500 or €1,000 a year, and a 12-month waiting period for pregnancy on Premium. The conditions say cover "does not end with a certain age or after a certain period".
• Cigna Global: the plans page lists Close Care at US$500,000, Silver US$1,000,000, Gold US$2,000,000 and Platinum "Paid in Full" per period of cover, for policies starting or renewing from 15 February 2026. Deductibles run from US$0 to US$10,000.
• Allianz Care: the plans page lists Care Base at US$1,350,000, Care Enhanced at US$2,700,000 and Care Signature at US$5,000,000. The benefit guide accepts new applicants up to the day before their 76th birthday with full medical underwriting (FMU), or the day before their 65th with a moratorium.
• IMG Global Medical: the brochure lists lifetime maximums of US$1,000,000 (Bronze), US$5,000,000 (Silver and Gold) and US$8,000,000 (Platinum), deductibles from US$100 to US$25,000 depending on the level, and full medical underwriting. It's carried by SiriusPoint Specialty Insurance Corporation.

World Nomads isn't in the table because it's built for people who still live at home. Its US digital nomad page caps single trips at 180 days and Annual Plan trips at 45 days, and its expat page says "you do need to come back to your home in the US in order to close out your trip".

The exclusions and traps people get caught by

Most claim problems come from six areas: pre-existing conditions, home visits, sports, plan length, paperwork and the US. Each one below is quoted from a policy document.

Pre-existing conditions

Every travel plan here excludes them, and the lookback periods differ. SafetyWing Essential uses 180 days before the start date, counting advice, changed medication or symptoms "that would prompt a reasonable person to seek medical attention" (FAQ). Genki Traveler excludes anything with symptoms, advice, diagnosis or treatment within one year, plus known chronic or congenital conditions (conditions).

SafetyWing Complete has the broadest definition: "Any illness or injury for which you received treatment or diagnosis in your life", plus symptoms in the last two years. Its section 7.33 says the health plan "does not provide coverage for any pre-existing condition", but section 4.16 says conditions "disclosed in the Application may receive coverage" unless excluded by amendment. If you have a history, get SafetyWing's answer in writing.

Underwritten IPMI works differently. Cigna's Policy Rules exclude conditions you were "(or should reasonably have been) aware" of when cover started, unless Cigna "expressly agreed to provide cover". Its underwriting guide describes an 18-question medical questionnaire. Allianz's moratorium only covers a pre-existing condition after "a continuous 24-month period" without symptoms, treatment or advice. Not disclosing is the worst option everywhere: IMG's brochure lists non-disclosed conditions as "No Coverage" on Silver and Gold.

Home-country visits

Most nomad plans treat home as the place you're least covered. SafetyWing Essential gives up to 30 days per 90-day period (15 if home is the US), and "If you stay in your home country longer than 30 days (15 for USA), your coverage is paused until you leave" (FAQ). Genki Traveler only covers emergencies that start within 6 weeks of arriving home, after at least 4 weeks away.

IPMI isn't automatically better. Cigna's rules say the policy is "only offered to beneficiaries who are expatriates" and covers your country of nationality for no more than 180 days in aggregate per period of cover. Genki Native Basic covers your countries of nationality for 182 days after at least 91 consecutive days away; Premium has no further restriction. Allianz covers your home country if it's inside your chosen area of cover.

Adventure activities

Read the sports list against how you actually live, because "surf and climb on weekends" is where many policies stop. Cigna's Policy Rules exclude hazardous activities including "surfing or kitesurfing", rock climbing, motorsports, solo scuba diving and diving past 30 metres without the right qualification. Allianz's benefit guide excludes rock climbing, paragliding, mountaineering above 3,000 metres and motorsports racing.

SafetyWing Essential doesn't cover activities at 4,500 metres or higher without its adventure add-on, and even with it excludes whitewater rafting, off-piste skiing and anything above 6,000 metres. It also requires a helmet on a moped or motorcycle and a valid licence where one is required. Genki Traveler covers diving to 30 metres if you're certified, and excludes BASE jumping, hunting and a short list of others. IMG offers a sports rider on Gold and Platinum for "adventure sports (normally excluded by insurers)".

Maximum trip length and renewals

Travel plans end, and what happens next matters more than the price. Genki Traveler "ends normally one year after the Start Date". SafetyWing Essential lasts up to 364 days, and its wording says that when you buy a new plan, anything you had before the new start date "will be deemed a pre-existing illness or injury". Its FAQ adds one exception: after 364 consecutive days of cover, new illnesses that haven't been seen by a doctor can carry over, unless they're expected to get worse over time.

Renewable plans can still change. SafetyWing Complete's insurer can change rates on each anniversary "according to the inflation of medical costs". Genki Native's price rises with age, and the insurer can adjust prices for all customers yearly. Cigna says a decision not to renew won't be based on your claims history, but "We may apply new special restrictions, exclusions and/or adjust premium" if you change your policy at renewal. Allianz says it won't add personal exclusions for conditions that started after inception, as long as you gave the information it asked for and haven't applied to increase your cover.

Claim documentation and time limits

Late or thin paperwork turns a covered claim into a denied one. SafetyWing requires claims "within 60 days of the end date of your active insurance period", and says you need "a medical statement from those who treated you. Make sure to ask for this before you leave." For claims about the first 72 hours after purchase, it may ask for records showing when symptoms began.

Allianz Care's deadline is "no later than six months after the end of the Insurance Year". Cigna's is 12 months from the treatment date. Genki Traveler requires an itemised cost estimate at least 5 days before treatment costing €1,000 or more, or "only 50% of what would otherwise be covered will be reimbursed"; Genki Native sets that threshold at €2,000. IMG cuts eligible expenses by 50% if pre-certification requirements aren't met.

The US and waiting periods

US cover is usually excluded or limited unless you pay for it. SafetyWing Essential doesn't cover trips to the US without its add-on, and the add-on isn't available to US citizens or residents. Genki Native only covers US medical emergencies, with a €250,000 (Basic) or €500,000 (Premium) yearly cap there. Genki Traveler covers only emergencies in the first 14 days if you're already abroad without prior cover.

How to choose

Start with where you live and for how long, then match the plan type. These are general patterns from the documents above, not a recommendation for your situation.

• A trip of a few months, with home cover still in place: travel medical insurance usually fits. Check the home-country rule if you'll fly back mid-trip.
• Living abroad for a year or more, with no public cover at home: look at renewable IPMI or a long-term nomad health plan, so a new condition stays covered next year.
• You have a health condition: an underwritten plan tells you up front what's covered. A no-questions travel plan will almost certainly exclude it.
• You need a visa: the visa's insurance rule comes first. Spain's telework visa rules out travel insurance entirely.
• Planning a family: waiting periods apply. SafetyWing Complete's maternity cover has a 10-month waiting period, and Genki Native Premium a 12-month one.

Checklist before you buy

Work through these with the policy wording open, not the sales page.

1. Write down where you'll live for the next 12 months, including time in your home country and the US.
2. Check the insurance rule for any visa you hold or plan to apply for.
3. Decide whether you need emergency cover only or ongoing health cover.
4. List every condition you've had symptoms of, seen a doctor for or taken medication for, and compare it with each plan's lookback period.
5. Read the home-country clause and count your expected days at home.
6. Compare your sports and transport (scooters, diving, surfing, altitude) with the exclusions list.
7. Note the claim deadline, the cost-estimate threshold and the pre-approval rules, and save the assistance number in your phone.
8. Read what happens at renewal: can the insurer change terms, and does a new plan reset pre-existing conditions?
9. Check the deductible and whether it applies per case or per year.
10. Disclose everything the application asks, and keep a copy of what you submitted.

Common mistakes

Most of these come down to buying on price and reading the wording after something goes wrong.

• Using travel insurance as permanent health cover. Each new plan can turn last year's illness into a pre-existing condition.
• Assuming home is covered. It's usually the most restricted country on a nomad plan.
• Not disclosing a condition. On underwritten plans, it can void cover for that condition or the policy.
• Skipping the cost estimate. Genki halves reimbursement on large costs without one; IMG cuts it by 50% without pre-certification.
• Leaving the clinic without paperwork. SafetyWing asks for a medical statement from whoever treated you.
• Missing the deadline. SafetyWing's is 60 days after cover ends, which is easy to miss if you change plans.
• Comparing headline limits only. A US$1M limit with your sport excluded pays nothing for that injury.
• Trusting affiliate tables. Their prices often aren't the insurer's. Use the insurer's page and note the date.

Can your company pay for it?

Usually it can, but it's normally treated as pay or a taxable benefit to you, so it isn't free money. In Australia, for example, the ATO lists "health insurance premiums" among common expense payment fringe benefits, and the taxable value is generally the amount reimbursed or paid. Other countries treat it differently, so ask your accountant before the company pays your premiums.

For a team, there are group options. SafetyWing's Remote Health FAQ for companies says you can cover contractors and freelancers, that "group pricing (40% discount) is available only to plans with 5 or more members", and that you must offer it to everyone in a given category. If you hire through an employer of record, health benefits sit with the EOR: our international hiring guide notes that EOR fees exclude benefit premiums, that Deel lists healthcare among its benefits, and that Oyster sells benefits as a separate add-on.

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