Your understanding of the need for health insurance (or sufficient assets) is correct. World Nomads won’t cover you once they transport you back to the US.
Oddly, I’m pretty interested in this topic and have thought about it quite a bit. Thanks for giving me a chance to write this stuff down and sort it out for myself -
I’ll tell you how we look at it and what we’ve decided to do for ourselves. Hopefully, that will help you as you make your decisions.
Personally, I think you should only insure yourself for things you can’t easily afford to deal with on your own. That’s a starting point. Don’t worry about insurance if the loss wouldn’t impact you significantly, especially if the loss isn’t very likely. There’s no point wasting money on insurance if you don’t need it. Think about what that means for you. Should you pay to cover your camera or laptop or should you just be prepared to buy a new one in the event of loss? That depends on your circumstances and varies by person.
My impression of World Nomads is that they offer limited coverage (read the policy carefully). I get the sense that many people see “travel” insurance and make assumptions about what will be covered that may be more comprehensive than what is actually specified in the policy. World Nomads policy is drafted narrowly and only provides coverage in certain circumstances. Much of what they cover isn’t, for many nomads, all that important/valuable, i.e. trip cancellation, interruption, delay, etc - this stuff doesn’t matter to many nomads. Baggage delay coverage and baggage loss coverage isn’t likely to happen if you’re using a carry-on and isn’t all that expensive a loss if all you have are t-shirts and shorts. But, WorldNomads is inexpensive, so if you think buying a lottery ticket makes sense then this makes even more sense and you might get “lucky” and have a flight delayed or lose your bag.
World Nomads is careful to eliminate pre-existing condition coverage. That ache you’ve been ignoring which turns out to be something may be excluded if you “exhibited symptoms which would have caused one to seek care or treatment” could be the reason you’re denied coverage.
If, however, a “sickness” arises during the course of your trip then World Nomads covers “emergency treatment” of the sickness which means “Emergency Treatment means necessary medical treatment, including services and supplies, which must be performed during the Covered Trip due to the serious and acute nature of the Sickness.” Ongoing treatment, after the emergency is resolved, appears to be your responsibility. I suspect, with many types of “sickness” the treatment will not take place until after the evacuation and, thus, won’t be the responsibility of the carrier.
World Nomads also covers a number of issues caused by an “accidental injury”. An “Accidental Injury means Bodily Injury caused by an accident (of external origin) being the direct and independent cause in the loss.” Falling off a motorbike is an accident (and that’s a risk I’m avoiding by not riding on motorbikes). And, it appears, they won’t pay much for the damage to your teeth (limited dollar coverage) when you fly over the handlebar, nor will they pay at all if you were impaired by alcohol/drugs. You are absolutely correct that World Nomads will not cover your ongoing care once they drop you off after evacuation. You’re on your own (again, read the policy because coverage varies by US State).
Also, examine your policy limits carefully with respect to “hospital advancement”. Your coverage may be minimal with their policy and you’ll want to be prepared to pay a foreign private hospital, immediately, in advance of treatment. World Nomads won’t be sending a big payment to the hospital immediately and you’ll need access to funds in order to get treatment in many countries.
World Nomads offers some value. But, there’s a reason it’s inexpensive. They don’t offer comprehensive coverage in all situations and they won’t solve all of your problems. It’s better than nothing, but it might not be all you’d hoped for in the event of a major loss.
Here’s what we’re doing instead (and it’s not inexpensive because we want to cover these risks and are willing to pay for that benefit) -
Health Insurance - we have a Blue Cross Blue Shield policy that provides for treatment anywhere in the world. They will reimburse most of the cost whether we’re in the US or in some other country. Healthcare can be really inexpensive in some countries, but it can be very expensive elsewhere. The US is not the only expensive country for treatment. The policy has no lifetime limit (many expat or non-US heath policies have lifetime limits and pre-existing condition limitations).
Evacuation Insurance - we’re using MedJet now. We’re going to switch to Global Rescue or Ripcord shortly when our MedJet policy expires. There are issues with renewing MedJet if you’re continuing to travel after your first year of coverage expires.
Property Loss/Liability - we’re paying for renters insurance. We don’t rent or own a home but our policy covers our personal possessions, damage to the place we’re renting and liability. We’ve got minimal coverage for property loss because we don’t own much property. We’ve got a few valuable items in storage and they are covered by a separate personal articles policy. What about liability for injury to others? Our renters insurance covers us for non-automobile liability up to a certain limit. If we harm someone we are covered for their claim against us for their loss.
Excess Liability - we have added liability to cover any injury we cause that exceeds the limits of our renters insurance and auto insurance so that we’re covered in the event of causing a catastrophic loss. This policy is commonly referred to as an “umbrella policy”.
Automobile (inside US) - we don’t own a vehicle so we have a non-owners auto policy that covers us for property damage and liability up to the limit where our umbrella coverage kicks in. This policy covers us for property damage to others, damage to the vehicle we’re driving and liability to others for claims beyond property damage. The auto coverage does not cover us outside of the US. It costs us about $24 a year. Our non-owners policy is through USAA (and many state, non-discrimination in auto-insurance laws, allow non-USAA members to buy from USAA). I have read that GEICO, Progressive, and Allied Insurance also offer non-owner policies.
Automobile Property Damage (outside US) - we have coverage from our credit card if we’re renting the vehicle. Be careful to read the policy. Our policy limits us to 30 day rentals and there are limits on certain countries, types of vehicles and total damages.
Automobile Liability (outside US) - this is not covered by our auto coverage and thus we have a gap in coverage here. This is resolved by mandatory or included coverage for rental cars in some countries. If the coverage is not included automatically by the rental agency there is often a supplemental policy you can purchase. Interestingly, all US states require the rental car companies to provide the minimum level of liability coverage mandated by state law.
I hope that helps you figure it out. Buying coverage is a personal choice and requires thinking through and predicting the likelihood of a claim. It’s tricky and you can’t be certain you’re doing the right thing until after the fact. There are no perfect answers in these situations.
Good luck and enjoy your travels. Maybe we’ll cross paths on the road.