Health insurance for digital nomads: types of cover and how to choose

Four ways to be covered

When you work from another country, medical cover usually comes through one of these four routes:

• Travel insurance. Covers emergencies and unexpected events during a trip with a return date. It usually has a maximum length, and many policies require you to be resident in your home country. It is for travelling, not for living somewhere.
• International health insurance. Designed for people living outside their home country. It covers several countries at once, often including check-ups and routine care, and is paid monthly or yearly. Some versions for nomads are sold as a subscription.
• Local private insurance. A policy bought in the country where you live, from an insurer authorised there. This is usually what visas that require insurance accept.
• The public system. If you join the social security system of the country where you live, you generally get access to its public healthcare.

They are not mutually exclusive. Many people combine two: cover for the country they live in and cover for their trips.

First, what your visa requires

The policy that lets you live with peace of mind is not always the one the authority accepts. Some examples:

• Spain, non-lucrative visa: public or private health insurance, with an insurer authorised to operate in Spain.
• Spain, digital nomad route from inside the country: if you register with Spanish Social Security, you do not need separate insurance. If you keep your home system under an agreement, you need insurance equivalent to the National Health System. Travel, reimbursement-only, co-payment and waiting-period policies are not accepted.
• Italy: the digital nomad visa requires health insurance.
• Estonia: the D visa for teleworking requires travel medical insurance.

If you are applying for a visa, start with the consulate's official list and only then compare products. Travel and residence insurance explains how to read that requirement.

• Migraciones · Hoja informativa 6 ↗
• UGE · Documentación del titular (teletrabajadores) ↗
• UGE · Preguntas frecuentes de teletrabajadores ↗
• Consolato Generale d'Italia a New York · Digital nomad / remote worker visa ↗
• Välisministeerium · Application for a long-stay (D) visa ↗

What to check in a policy

Before you buy, ask for the full terms, not just the brochure, and check these points:

• Territory. Which countries it covers and whether it includes the United States, which usually raises the price.
• Your home country. Whether you are covered when you go back to visit, and for how many days.
• What it treats. Only emergencies and hospital stays, or also consultations, tests and medication.
• Co-payments and excess. How much you pay out of pocket each time you get care.
• Waiting periods. How long you have to wait after joining before you can use each benefit.
• Pre-existing conditions. Whether conditions you already have are covered, and on what terms.
• Exclusions. Mental health, maternity, high-risk sports and dental care often have their own rules.
• Evacuation and repatriation. Whether they are included and up to what amount.
• Length and renewal. The maximum number of months, whether it renews without a new medical assessment, and what happens if you stop paying.
• Residence. Whether it stops applying once you become resident in another country, or excludes residents of some countries.

Common combinations

• First year, still on the move: international health insurance covering the countries you will pass through.
• On a visa in a country that requires a local policy: the local insurance the visa requires and, if you travel often, travel cover for trips abroad.
• Registered with social security where you live: public healthcare day to day and travel insurance for trips.
• If you have pre-existing conditions: prioritise a policy that accepts them in writing, even if it costs more, over the lowest price.

How to choose without getting lost

Start with three facts: where you will live, where you will travel and what your visa requires. With those, rule out the products that do not fit and compare two or three options on the same terms. Look at the total cost for the year, including co-payments and excess, not just the monthly premium.

Travel and health insurance sets out the criteria we use and the insurers we work with.