Last updated: April 2, 2026
Here’s something nobody talks about when they’re romanticizing the idea of quitting everything to travel the world: what happens if you get sick in Cambodia?
Not a cold. Not traveler’s stomach. I mean actually sick — a motorbike accident in Vietnam, a broken ankle on a hiking trail in Peru, a mystery fever in rural Turkey that lands you in a hospital where nobody speaks English. That’s the scenario you need to be ready for, and “I’ll figure it out when I get there” is not a plan.
I spent weeks researching sabbatical health insurance and long-term travel medical insurance for my 13-month trip, and I’m going to walk you through what I found — what the main options are, how they compare, and where I’m leaning. This isn’t a sponsored post. Nobody’s paying me to say any of this. I’m just a guy with a spreadsheet and a departure date trying to make a smart decision.
Why Your Regular Health Insurance Won’t Work Abroad
If you’re leaving a job to take a sabbatical — whether you resigned, got laid off, or negotiated a leave — your employer-sponsored health insurance is going away. If you’re wondering how to get health insurance during a career break, you’ve basically got three paths in the US — and two of them are dead ends for international travel:
COBRA. You can continue your employer’s plan for up to 18 months after you leave. The catch? You’re paying the full premium yourself, including the portion your employer used to cover. For most people, that means $500 to $700+ per month for an individual plan. And here’s the kicker: COBRA is designed for US-based healthcare. It doesn’t cover international hospitals, foreign doctors, or medical evacuations. So you’re paying top dollar for coverage that’s essentially useless once you board a plane.
ACA Marketplace plans. You can buy a plan through healthcare.gov during a Special Enrollment Period triggered by losing your job-based coverage. These are more affordable than COBRA, but they have the same fundamental problem — they’re built for the US healthcare system. See a doctor in Thailand? You’re likely paying out of pocket and fighting for reimbursement, if you can get it at all.
Neither of these solves the actual problem. COBRA vs. travel insurance isn’t even a fair comparison when you’re leaving the country. What you need for a long-term international trip is travel medical insurance — a policy specifically designed to cover you abroad, in countries where your domestic plan doesn’t reach. That’s a different product entirely.
The Three Main Options for Long-Term Travel Medical Insurance
When you start researching travel medical insurance for trips longer than 90 days, three names come up over and over: IMG, SafetyWing, and World Nomads. They each do something a little different, and understanding those differences matters.
IMG (International Medical Group)
IMG is the most established player in this space. They’ve been around since the early ’90s and they primarily serve expats, long-term travelers, and international workers. Their main product for someone like me is the Global Medical Insurance plan.
What makes IMG different is the level of customization. You pick your plan tier — Bronze, Silver, Gold, or Platinum — and then you choose your own deductible (anywhere from $100 to $25,000) and your own policy maximum (from $1,000,000 up to $8,000,000). That flexibility lets you dial in the exact balance of premium cost versus coverage that works for your budget.
What I like about IMG:
- Comprehensive coverage that goes well beyond emergency-only. We’re talking hospitalization, outpatient visits, prescriptions, preventive care, mental health, physical therapy, even organ transplants on the higher tiers.
- You can choose your coverage area — Worldwide, or Worldwide excluding the US/Canada and a few other high-cost countries. Excluding the US drops your premium significantly, which makes sense if you won’t be stateside during your trip.
- The plans are annually renewable, so you’re not locked into a rigid term. If your 13-month trip turns into 15 months, you’re covered.
- Emergency medical evacuation is included. If you’re in a rural area and need to get to a real hospital, this is the coverage that makes that happen.
- No co-insurance for treatment outside the US (on most tiers), which simplifies the math.
What to watch for:
- It’s more expensive than SafetyWing. You’re paying for more comprehensive coverage, but the monthly premium is noticeably higher.
- The application process is more involved than just clicking “buy.” You’ll need to provide health history and there’s an underwriting process.
- Pre-existing conditions are handled differently depending on the tier and your medical history. Read the fine print carefully.
SafetyWing
SafetyWing launched in 2018 and built its product specifically for the digital nomad crowd. Their Nomad Insurance plan is the most popular option for budget-conscious long-term travelers.
The pitch is simple: travel medical insurance that works like a subscription. You sign up, you’re covered in 180+ countries, and it auto-renews every 4 weeks. No annual commitment, no complex application.
What I like about SafetyWing:
- The price — with a caveat. You’ll see $57 per 4-week period quoted everywhere, but that’s for travelers under 40. SafetyWing’s pricing is age-based, and the older you are, the more you pay. At 48, I’m looking at roughly $103 per 4-week period without US coverage — about $370 per month. Still cheaper than IMG, but not the $2-a-day bargain the marketing suggests. If you include US coverage, it jumps to around $191 per 4 weeks. Know your actual number before you compare.
- You can sign up after you’ve already left home. Most traditional insurance requires you to purchase before departure. SafetyWing doesn’t care — you can buy it from a café in Lisbon.
- The subscription model means you’re never locked in. Traveling for 6 months? Great. Extended to 9? Just keep it running. Coming home early? Cancel.
- It covers you in your home country for short visits — up to 15 days per 90-day period for US citizens. Handy if you need to pop back for a family event.
What to watch for:
- The coverage is thinner than IMG. The policy maximum is $250,000 (compared to IMG’s $1M–$8M range), and there’s a fixed $250 deductible.
- The Essential plan doesn’t cover pre-existing conditions, cancer treatment, or maternity.
- There’s a coverage limit per injury/illness, not just an overall policy cap. Read the schedule of benefits carefully.
- Dental is limited to emergency relief of acute pain only — no routine care.
World Nomads
World Nomads has been the default recommendation in the travel blog world for over a decade. If you’ve ever Googled “travel insurance for backpackers,” you’ve seen their name.
What I like about World Nomads:
- Adventure activity coverage is baked in. If you’re planning to go scuba diving, bungee jumping, rock climbing, or riding motorbikes, World Nomads covers a huge list of activities that other providers treat as exclusions.
- It’s easy to buy and easy to understand. Two plan levels — Standard and Explorer — and that’s it.
What to watch for:
- World Nomads is really built for shorter trips. Their policies max out at a certain number of days, and while you can extend, it’s not designed the way IMG or SafetyWing are for truly long-term travel.
- No coverage for pre-existing conditions. Period.
- The premium is notably higher than SafetyWing for similar or less coverage.
- You can’t customize deductibles or policy maximums. You get what they offer and that’s it.
Other Options Worth Knowing About
A few other names that come up in the long-term travel insurance space:
Genki — A newer European-based option popular with digital nomads. Similar subscription model to SafetyWing but with some different coverage specifics. Worth a look if you want to compare.
Allianz and GeoBlue — More traditional insurance companies that offer international plans. Generally pricier but may offer more robust networks and claims processes.
Local insurance in-country — In some destinations (Thailand is a good example), you can buy local health insurance or pay out of pocket for routine care at a fraction of US costs. This isn’t a replacement for travel medical insurance, but it’s worth understanding that a doctor visit in Chiang Mai might cost you $20, not $200.
Where I’m Leaning (and Why)
I haven’t pulled the trigger yet, but I’m leaning toward IMG.
Here’s my reasoning: I’m traveling for 13 months through 21 countries, including places with varying levels of healthcare infrastructure. Egypt, Bolivia, Cambodia — these aren’t countries where I want to be underinsured. If something serious happens, I want a policy with a high maximum, evacuation coverage, and the kind of comprehensive benefits that actually function like real health insurance, not just emergency-only coverage.
SafetyWing is tempting on paper, but once you factor in age-based pricing, the gap narrows more than you’d expect. At 48, I’m looking at about $103 every four weeks — not the $57 headline number you see on every travel blog. And the $250,000 policy maximum still makes me nervous for a trip this long and this remote. One serious medical event — a surgery, an ICU stay, an evacuation from a rural area — could blow through that limit fast.
The way I think about it: travel insurance is the one line item in my budget where going cheap could cost me everything. I built a 17-tab spreadsheet to plan this trip. I’m not going to undercut all that planning by skimping on the thing that keeps me safe.
That said, I haven’t bought yet. I’m still comparing quotes, reading policy documents, and talking to other long-term travelers about their claims experiences. When I make my final decision, I’ll share the full breakdown — what I chose, what I’m paying, and why.
What You Should Do
If you’re planning a sabbatical or extended career break, here’s my advice on the insurance piece:
Start early. Don’t leave this for the week before you fly. Some policies have waiting periods, and the underwriting process for comprehensive plans takes time.
Read the actual policy document. Not the marketing page. Not the summary. The actual terms and conditions. Look for coverage limits per incident, exclusions for specific activities or countries, and how the claims process works.
Understand the difference between travel insurance and travel medical insurance. Travel insurance covers trip cancellation, lost luggage, and flight delays. Travel medical insurance covers you when you get hurt or sick abroad. For a sabbatical, you need the medical side. Trip cancellation insurance on a 13-month journey with dozens of bookings doesn’t really make sense.
Factor in your route. If you’re only traveling in Western Europe, your risk profile and costs are different than someone crossing Southeast Asia and South America. Your coverage area selection directly affects your premium.
Budget for it. In my sabbatical budget spreadsheet, insurance is its own line item — not buried in “miscellaneous.” Know the number and plan for it. It’s a real cost, but it’s the cost of traveling with peace of mind.
What Comes Next
I’ll be sharing my final insurance decision once I’ve locked it in — including the actual cost, the plan details, and the reasoning behind my choice. If you want to follow along, subscribe so you don’t miss it.
And if you’re earlier in the sabbatical planning process, start with the budget. That’s where all of this begins.
Frequently Asked Questions
Do I need health insurance for a sabbatical?
Yes. Your domestic health insurance — whether it’s employer-sponsored, COBRA, or an ACA plan — is designed for US-based care. If you’re traveling internationally for months, you need travel medical insurance that covers foreign hospitals, emergency evacuations, and outpatient care abroad. Going uninsured on a long trip is a financial risk that can end your sabbatical overnight.
What’s the difference between travel insurance and travel medical insurance?
Travel insurance covers trip-related disruptions: cancellations, lost luggage, flight delays. Travel medical insurance covers you when you get hurt or sick abroad — hospital stays, surgeries, prescriptions, evacuations. For a sabbatical, the medical side is what matters. Trip cancellation insurance on a 13-month journey with dozens of separate bookings doesn’t make much sense.
Can I buy travel medical insurance after I’ve already left?
With some providers, yes. SafetyWing lets you sign up from anywhere in the world. IMG and World Nomads generally require you to purchase before departure, though policies vary. Start early to give yourself the most options.
How much does sabbatical health insurance cost?
It depends on your age, coverage level, and whether you include the US. SafetyWing starts around $57/month for under-40 travelers but jumps to ~$103/month at age 48. IMG’s Global Medical plans cost more but offer significantly higher coverage limits and more comprehensive benefits. Budget anywhere from $100 to $500+ per month depending on your needs.
More from The Sabbatical Files
- How to Budget for a Sabbatical: The Method That Gave Me the Confidence to Go
- What I’m Packing for 13 Months in 21 Countries
- Top 10 Tips for Planning a Sabbatical or Career Break
Frequently Asked Questions
What is the best health insurance for a sabbatical?
For a year-long international trip, IMG Global Medical is the most comprehensive option. SafetyWing is more affordable and works well for budget travelers comfortable with higher out-of-pocket limits. World Nomads is a strong middle-ground that also covers adventure activities.
How much does travel health insurance cost for a year abroad?
Roughly $1,000 to $2,500 per year depending on the provider, your age, coverage level, and deductible. IMG tends to run higher; SafetyWing is typically the most affordable.
Does IMG Global Medical cover pre-existing conditions?
IMG offers plans with varying levels of pre-existing condition coverage. The higher-tier Platinum plan includes some coverage; the standard plan typically excludes them. Read the policy carefully and contact IMG directly if you have ongoing conditions.
Can I buy travel health insurance after I’ve already left home?
Some providers allow this; others require purchase before departure. SafetyWing is known for flexibility around enrollment timing. Check each provider’s current terms before assuming.