Digital nomad insurance for people with no fixed base

The base layer of most nomad plans is emergency medical: an accident, a sudden illness, the hospital admission that follows. That is the expensive scenario and the right one to cover first.

What varies between plans is everything underneath it. Routine GP visits, specialist appointments, scans and physiotherapy sit in outpatient cover, which on cheaper plans is either missing or capped low enough to run dry inside a single injury. Anyone who has needed a couple of months of physio after a bad landing knows how fast that cap arrives.

Decide which side of that line you want before you compare prices. A plan without outpatient is not a cheaper version of a plan with it, it is a different product, and putting their premiums side by side tells you nothing useful.

Most travel policies require you to be in your home country when you buy, or at least on the day the trip begins. That rules them out for the person who left two years ago and has only now got around to sorting out cover.

Nomad plans are built to be bought from wherever you happen to be. In practice that is why people end up on them, more often than any feature comparison.

There is a waiting period attached, a short window after purchase during which claims are not paid, and it exists precisely so the product cannot be bought in the taxi to the hospital. Anything that starts inside that window can be treated as pre-existing from then on. Buying while nothing is wrong is not tidiness, it is the difference between having cover and having a receipt.

Laptops, cameras and the rest of a mobile working setup are rarely covered as standard. Where they are, it is through an add-on with a per-item limit that often sits well below what the item cost, and theft from an unattended vehicle or an unlocked room is excluded almost everywhere.

Activities are the other regular surprise. Diving past a certain depth, motorcycling, climbing, skiing away from marked runs: each is either excluded outright, restricted by conditions, or sold as a named add-on you have to ask for.

Read the activity list against the year you will actually have, not the one you intend to have. Renting a scooter in Southeast Asia is the most common uninsured injury there is, and it is uninsured because the licence clause goes unread until the claim is already filed.

Nomad plans usually include some cover in your home country, capped at a set number of days per policy year. It is there for visits, not for moving back.

Knowing that cap precisely matters, because it is counted across the whole year rather than per visit. Two weeks at Christmas, a month in summer and a fortnight for someone's wedding adds up faster than anyone plans for, and the day you cross the line you are uninsured at home while still paying the premium.

If you are going back for longer than the allowance, the plan has stopped being the right tool for that stretch. Domestic cover for the period you are there, with the nomad plan running underneath it, is the arrangement that actually holds together.

Age moves it most, in steps rather than smoothly, and the steps get steeper the later they come. Your deductible moves it next. Whether the United States is inside your area of cover moves it a great deal. Adding outpatient moves it more than adding gear cover does.

What barely moves it: the particular countries you name, provided none of them sits in the small excluded set, and how long you commit for, since these plans are monthly by design.

So the comparison worth making is not between two quoted premiums. It is between two plans configured identically on deductible, area and outpatient. Skip that and you are comparing a plan with the US in it against one without, then concluding the cheaper one is better value.

Chronic conditions are the clearest limit. These plans handle acute problems well and ongoing ones poorly. A condition that needs permanent medication or regular monitoring is usually either excluded or covered at a level that does not match what living with it costs.

Maternity is the second. Where it exists at all it carries a waiting period long enough that it has to be a decision taken well in advance, not one made when it becomes relevant.

And once you stop moving, the logic inverts. After most of a year in one country, expat cover gives you deeper medical benefits and a hospital network you can physically reach, often without costing more. Nomad cover is priced for mobility. If you are no longer using the mobility, you are still paying for it.

Medical evacuation is the line item that separates plans that look similar on price. It pays to move you from wherever you are hurt to somewhere that can actually treat it, which in much of the world means a flight rather than an ambulance ride.

The distinction to look for is where the plan will take you. Evacuation to the nearest adequate facility is the common version, and adequate is doing a lot of work in that sentence: it can mean the regional hospital two hours away rather than the one in the capital you would have chosen. Repatriation to your home country is a separate benefit, sold separately on plenty of plans, and it is the one people assume they have.

The other thing worth knowing before you need it is who decides. Evacuation is almost always subject to the insurer's assistance team agreeing it is medically necessary, arranged through them rather than by you. Book your own air ambulance and you have bought yourself an air ambulance, not a claim. The emergency number belongs in your phone, not in a PDF on a laptop in another country.