Insurance built for people who haven't unpacked in over a year

You've been on the road long enough that "where do you live" stopped having a clean answer. Maybe you rotate between three or four base countries on a roughly annual cycle. Maybe you string together six-month stays. You probably still have a passport country and you probably still file taxes somewhere, but you haven't slept in that country for more than a few weeks at a stretch in over a year.

You're typically {{TOKENAGERANGE}}, work remotely or run your own business, and have settled into the rhythm. The early-nomad anxieties — finding co-working, picking a SIM — are behind you. The questions that actually matter now are slower and more structural: where do I see a dentist, what happens if I need an MRI, what happens if a parent gets sick and I need to be on a plane in 12 hours.

Generic travel insurance fails you for one reason: it's priced and structured around trips. It assumes a return date. It assumes a primary residence you're "traveling from." Once you've been out longer than 12 months, most policies either won't renew, won't cover pre-existing conditions that developed while insured, or quietly exclude the country you were actually in.

What you care about: continuity, real medical coverage (not just emergency evacuation), and a carrier that won't drop you the year you actually need to claim. What you don't care about: trip-cancellation perks, baggage delay reimbursements, or any product whose marketing leans on the word "adventure."

• IPMI, not travel insurance. International private medical insurance is built for people living abroad indefinitely. It renews annually, treats you as a continuous insured, and covers outpatient care, chronic conditions, and the structural medical stuff travel insurance was never designed for.
• Continuous renewable coverage. The single most undervalued feature: a policy that keeps covering conditions that develop while you're insured. Travel policies often reset every trip and exclude anything diagnosed on the prior trip. IPMI carriers like April International's MyHealth structure renewals so a condition that emerges in year two stays covered into year three.
• Geographic scope that matches your actual rotation. "Worldwide excluding US" is fine if you genuinely never go to the US. If you do — even for two weeks a year — the price jump is real and worth budgeting for honestly.
• Cashless or fast-reimbursement claims. When you're switching countries every quarter, you don't have a relationship with a clinic. Passportcard's cashless card model removes the upfront-payment-then-fight-for-reimbursement loop, which matters more the more you move.
• Realistic evacuation. Evacuation to "nearest center of medical excellence" sounds good until you read the fine print. For your geographic pattern — Southeast Asia, Latin America, parts of Africa — the realistic evacuation hub is Bangkok, Singapore, or back to Europe. Make sure your policy's network reflects that.
• A deductible that fits how you actually use healthcare. Higher deductibles cut premiums meaningfully. If you self-pay for routine GP visits in Thailand or Vietnam anyway (because it's cheaper than the deductible), structure the policy around what you'd actually claim for.

• Pre-existing conditions developing on policy. Read the renewal clause specifically. A policy that "doesn't cover pre-existing conditions" sometimes means conditions that existed before you bought the policy — and sometimes means conditions that existed before each renewal. The difference is enormous over a five-year horizon.
• US trips on policies that exclude the US. Even a 10-day stopover triggers an exclusion zone on many policies. If you're going to the US at all, declare it and pay the loading.
• Scooter accidents — the #1 claim driver. Most policies require a valid motorcycle license in your home country AND in the country you're riding in. An IDP with the motorcycle endorsement is non-negotiable. A claim for a scooter accident without the right license is the most common denied claim we see.
• Policy renewal continuity. Switching carriers resets the pre-existing-condition clock. If you've been on a policy for 18 months and a condition emerged in month 12, switching may mean that condition becomes uncovered on the new policy. Renew rather than switch where possible.
• "Home country" coverage limits. Most IPMI policies cap home-country coverage at {{TOKEN_DAYS}} per year. Stay longer and you may be uninsured for that overage period.
• Maternity waiting periods. If family planning is on the horizon, IPMI maternity benefits typically have 10-12 month waiting periods. Plan the timing accordingly.