You’ve done the fun part already.

You booked the one-way ticket.
You downsized the apartment.
You’ve got a rough route in mind: maybe Lisbon → Medellín → Chiang Mai, with a side quest to Tokyo if the flight prices behave.

You’ve watched the “cost of living in…” videos, you’ve got your favorite café in Medellín starred on Google Maps, and you’re already mentally working from that balcony you saw on Airbnb.

But there’s one thing almost nobody wants to think about, and it’s the one thing that can wreck the entire adventure in a single night:

That’s where the question comes in:

Do you really need international health insurance?

The answer is not as simple as “always yes” or “you’re dumb if you don’t.”
It depends on how you travel, where you live, your age, your risk tolerance, and your financial cushion.

So in this article, we’re going to walk through the real decision-making process. I’ll break down what international health insurance actually is, who really needs it, when you might not, what it costs, and some smarter hybrid strategies that many long-term travelers and expats use.

By the end, you should have a clear sense of whether international coverage is worth it for you—not for Instagram, not for an insurance sales page, but for your actual life.

First, let’s clear up the single biggest point of confusion.

Most people start by asking:

Not necessarily.

Travel insurance is built for short-term trips. Think:

It usually focuses on:

In other words, it’s there for unexpected issues while you’re temporarily outside your home country. It is not designed to be your long-term, everyday health coverage.

International health insurance is different. Think of it as:

It’s meant for expats, long-term travelers, retirees abroad, and digital nomads who are living outside their home country for months and years, not days and weeks.

Typical features include:

It’s less about “you broke your leg on vacation,” and more about:

If you’re building a life abroad—not just taking a trip—international health insurance is the product that’s actually designed for that reality.

Let’s be honest: not everyone does.

But there are some very clear profiles where global coverage makes a ton of sense.

If your plan is to:

…then trying to enroll in each country’s national health system is basically impossible.

International health insurance gives you continuity. You don’t have to re-start paperwork every time you land in a new country. Your coverage follows you, not your address.

In theory, every country has doctors.
In practice, you don’t always know:

Most international providers give you:

When it’s 2 a.m. in a foreign country and something feels wrong, having a phone number you can call in English is not a small thing.

If your travels include:

…then one serious hospital visit without insurance can absolutely nuke your savings.

In these countries, international health insurance is less “nice to have” and more “do you want to avoid financial ruin?”

If you’re managing:

…then continuity of care becomes critical.

International policies are often better structured for that than constantly hopping between local systems. You’re more likely to:

Some countries simply don’t give you the choice.

Long-stay visas in places like:

…will require proof of international or private coverage. No policy, no visa.

In those cases, it’s not about “Is it worth it?”
It’s “You don’t get in without it.”

Now let’s flip the script.

There are plenty of scenarios where global coverage might be overkill—and your money may be better spent elsewhere.

If your plan is:

And that country has solid public or mixed systems (for example):

…then you may be able to enroll locally—either for free or for a modest monthly fee.

In these countries, private care is also relatively affordable. You might end up with a combo like:

In that scenario, paying for full-scale international health insurance forever might not be necessary.

In some countries, once you’re a legal resident, you can join highly comprehensive national plans—like:

Once you’re plugged into that, your main job is to fill the gaps with:

But you may not need a full-blown global health policy anymore.

This is the most controversial group.

Some younger nomads choose to self-insure, meaning:

Is this riskier? Yes.
Is it irrational? Not necessarily—if you understand the risk and can genuinely afford a bad outcome.

If you’re traveling for:

…and you don’t plan to turn that into a full expat life yet, then a good travel insurance policy with strong emergency medical coverage may be all you need.

The key is time horizon:
Short trip? Travel insurance.
Long-term lifestyle shift? Now we’re in international health insurance territory.

Let’s talk money.

International health insurance isn’t cheap—but it’s also not as astronomical as people imagine, especially if you’re young and healthy.

Rough ranges (these vary a lot by provider and region):

What drives the price?

Popular names you’ll hear in the nomad and expat space include:

Each has its own strengths and quirks, but what matters more than the brand is choosing the right structure for your situation.

Here’s where it gets interesting.

A lot of long-term travelers and expats don’t choose between only local or only international coverage. They build hybrid strategies that look something like this:

Result: You protect yourself from financial disaster, but you’re not paying high premiums to have every minor check-up covered.

Another smart approach:

This mirrors how many expats actually live:
The first year is chaotic. After that, people usually pick a hub.

You don’t need a perfect answer. You need a clear enough answer.

Here are the key questions to ask yourself:

If most of your answers lean toward:

…then international health insurance is likely worth the investment—even if it stings a bit each month.

If your reality is more like:

…then a combination of local coverage + travel insurance + savings may be enough.

Here’s how I’d summarize it:

At the end of the day, this is about risk management and peace of mind.

Moving abroad is already a big leap. For some people, knowing that a major medical event won’t destroy their finances is what lets them actually enjoy the freedom they moved for in the first place.

For others, especially younger nomads, that same premium might be better invested in savings, business, or just buying themselves time in a new country.

There’s no one-size-fits-all answer. There’s only the right balance for your life, your body, your age, and your appetite for risk.

And that’s the real point:
Don’t let the decision happen by default.
Run the numbers, think through the scenarios, and choose your level of protection on purpose.