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I am taking a long-term international trip of around 11 months. I am quitting my job, and so will lose my health insurance.

I am looking at different travel health insurance plans such as World Nomads and HTH. I will likely not have any domestic health coverage.

My concern is that when I return from the trip, whether or not US Insurers will recognize my travel health insurance as "credible coverage" and not as a gap in insurance (for which I could be excluded from coverage for certain conditions by a future insurer under U.S. law)

Does anyone have experience with this, returning from a long-term trip and trying to get insured?

UPDATE:

After researching World Nomads, IMG Global, and HTH Worldwide, I ended up selecting the highest possible deductible ($25,000) plan with HTH. This gave me a global health insurance plan (incl. USA) that cost about the same as the World Nomads plan, but without any of the additional travel coverages like trip cancellation, interruption, baggage coverage, etc. This plan counts as "creditable coverage" by US standards and is the least expensive plan I could find if your goal is just maintaining "creditable coverage".

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Caveat up front: I have not yet actually done this, but I am planning a long trip of this sort myself and have been researching this question in depth.

The key thing to know is that there is a significant difference between "travel" health insurance and international health insurance.

The former is designed as a supplement to the full coverage you have at home, to cover emergencies such as sudden illness or accidental injury, evacuation to a hospital, travel back to your home country, etc. It is not a "full" health plan. You can't walk into a clinic in Paris for an annual maintenance check-up with a low co-pay. That's not what these plans are for, and based on what I have learned so far, it looks like if this were your only health insurance during your travels, it would not be considered as credible coverage by a new insurer when you return.

Another "gotcha" with these "travel" plans is that often the coverage automatically terminates when you set foot back in your home country. So even if you have paid for 11 months, if after month 6 you decide to come home for a week to attend a friend's wedding and kiss your mom on the cheek, your policy ends and you need a new one.

What you are likely to need is genuine health insurance with an international network. There are many providers, including HTH, ihi Bupa, Cigna and many others. Most of these also have travel insurance options so it is important to be careful about what you are purchasing. e.g. ihi Bupa has a Travel Insurance page and a Health Insurance page. With HTH, there is a Travel Medical page and an Expat Medical page. Very different products. Caveat Emptor - be very sure that you are signing up for a plan that will cover you fully, not just a "travel" plan.

This page has a pretty complete list of insurers who can offer expat/long-term traveler health insurance to US citizens. That's a good place to start.

Bon voyage, and have a great trip!!

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  • Thanks for the info, however that is bad news for me. A plan like World Nomads came highly recommended by pretty much everyone I have talked to. It also fits nicely into a backpacker's budget, whereas the others seem to be quite expensive for benefits that I will not need...
    – jjeaton
    Dec 14, 2011 at 4:37
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    I hear you, but those cheap plans are cheap for a reason. Assuming a new administration doesn't repeal the health care reforms, starting in 2014 adults won't be able to be denied coverage for preexisting conditions. So at least this is a temporary problem. Look into what it would take to get minimum-coverage credible health care here at home and supplement that with a travel plan for your year abroad...maybe that will work out cheaper than doing one of the "expat" full coverage international plans. You'll lose access to non-emergency care while abroad but that trade-off may be worth it to you.
    – Jonathan Van Matre
    Dec 14, 2011 at 14:04
  • I didn't know if that was feasible, but I'm definitely going to look into a minimum-coverage plan. Thanks for that idea! Good luck to you on your trip also!
    – jjeaton
    Dec 14, 2011 at 18:49
  • Speaking more on Johnathon's note about understanding the difference between travel insurance and international health insurance I would check out this video which may help: International Health Insurance vs Travel Insurance vs Local Health Insurance (4 min)
    – mjason79
    Dec 15, 2011 at 11:23
  • One thing to add...if you do go for a "travel" plan, because of the "return to US" termination clauses I spoke about be sure to read the fine print. And try to books one of those that allows you to extend your coverage while abroad. Then you could just extend it once a month, say, so if you do decide to visit the US you're not out much cash.
    – Jonathan Van Matre
    Dec 15, 2011 at 16:23
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Look for an international major medical policy and find out if they will issue a certificate/document of credible coverage. You should do this before you apply. I took a 14 month trip 3 years ago and had the same issue. I ended up with an international citizens policy also known as citizen secure. I ended up getting back on with my former employer thankfully, however I had the certificate they issued just in case I needed to get health insurance on my own through blue-cross.
Good luck in your travels!

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