Is self insuring an alternative to travel health and travel medical insurance for Americans?

Paying cash for medical care is an alternative to travel health insurance and travel medical insurance. But it's not one we are comfortable with.

Self Insured Cash Option Travel Health Insurance for Americans - and Others

Self Insured Cash Option for Travel Health Insurance for Americans

One approach to health and medical care for full time travelers is the self insured cash option.

One of the questions friends and family asked us most often when we told them about our plans to become digital nomads was, ‘What about health insurance?’

We always heard about and understood that the cost of healthcare in the US is out of control. But, like many Americans with good insurance through work, we never actually felt that ourselves.

So it was a good and a fair question: what about health insurance?

We had heard and read that health care is cheaper just about everywhere else in the world. But what if one of us got really hurt, or really sick?

Here is our Guide to Travel Health Insurance for Americans (and Other Nationalities Too!)

Self Insuring – Using Cash To Pay for Medical Travel Mishaps

Matt hurt his ankle in Southern California just before we spent 6 weeks digital nomading in Chiang Mai Thailand.

It was our friend Martin’s birthday weekend and Matt decided that a dance party was in order. By the end of the evening he was limping badly and complaining about the pain the back of his left heel.

Doesn’t Look Like Much, but Apparently it Hurt!

He’d been limping on it for about 3 weeks.

And given the fact that he had his right achilles surgically repaired after a sports injury about 15 years ago, he finally decided to go to the Chaingmai Ram hospital in Chiang Mai to have it checked out.

Walking to the hospital we were filled with a sense of dread.

The irony that we had lost our amazing health insurance when we adopted a life of full time affordable luxury travel and were now heading to the hospital was not lost on us.

However, our research had clearly shown that we should have no issue self-paying in much of the world, including Thailand.

Our Experience Paying Cash for Medical Care While Traveling Full Time

Bearing in mind that Chaingmai Ram is the ‘expensive’ international hospital in town, here is our experience with the Thai healthcare system:

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4:29 pm – Walk in door. Immediately greeted and asked why we are at the hospital. Given form to fill out

4:34 pm – Matt is still filling out form but is ushered to new patient registration (which is a very civilized desk area with comfy seats, not a standing counter behind a screen)

4:43 pm – Registration complete, he is taken to the ‘vital sign room’ for blood pressure etc

4:53 pm – Matt is sent to (comfortable, quiet) waiting lounge

4:56 pm – Nurse collects Matt and takes him back to see doctor

5:02 pm – Matt is finished seeing doctor.

Diagnosis is Tendinopathy – good news: no tear, just inflamed and needs time and some anti-inflammatory meds to heal. Doctor says he can go get an MRI if he wants and bring it back for the doc to look at but that it would be a waste of money (an MRI would have cost ~$250-$300US vs. the average cost of an MRI in the U.S. which is ~$2,600).

5:05 pm – nurse collects Matt again to take him to the cashier department to fill hsi prescriptions and to pay

5:09 pm – Matt pays the fee of 1506 Thai Baht – approximately $49 US – in cash and we leave. Still time for our afternoon pool visit!

Breakdown of Costs for Hospital Visit

Here is the breakdown of costs for this hospital visit:

$16 for ‘total doctor fee’
$28 for 2 medications
$4.50 nurse/hospital fees

40 minutes and $49 dollars in a pleasant, calm, state of the art hospital.

The Self Insured Cash Option for Travel Medical Insurance Works – But it’s Not for Us

So yes, you CAN pay cash rather than carrying travel medical insurance from a company like SafetyWing or Oh Yeah! Our Allianz Travel Insurance!

The next day we remembered that we had signed up for Allianz Travel Insurance.

And although we later learned this coverage only lasts for 90 days after you leave home we were still in that window!

So we submitted the $49 claim to our Allianz travel insurance policy.

A day later we got an email saying the claim would be paid directly to our checking account.

Bottom Line – Self Insured Cash Option for Travel Medical Insurance for Full Time Travel

We were not comfortable relying on self-pay for medical care during full time travel.

Although medical care in much of the world is less expensive than in the US, the point of insurance is to protect against the worst case scenario.

So we analyzed SafetyWing travel medical insurance and analyzed World Nomads travel medical insurance and then picked the one that was right for us.

And we backstopped that coverage with a high deductible health insurance plan in the US to ensure that major surgery or treatment for a chronic disease in the US would not be catastrophic to our finances.