I had a severe panic attack in my Tokyo micro-apartment. I couldn’t leave the room for three days. I booked an emergency Zoom session with a US therapist ($250). When I submitted the invoice to SafetyWing, it was rejected. “Mental and Nervous Disorders are excluded unless hospitalized,” the email read.
Key Takeaways
- The “Inpatient Only” Rule: Most nomad travel insurance (SafetyWing, World Nomads) only covers mental health if you are admitted to a hospital (psych ward). They pay $0 for therapy, psychiatrists, or meds.
- Acute Onset: Even if they cover it, it must be “acute” (new). If you have a history of anxiety, it’s a “Pre-existing Condition” and excluded.
- Genki’s Advantage: Genki World Explorer is one of the few “travel” style plans that includes limited outpatient mental health coverage (usually for acute incidents).
- BetterHelp/Talkspace: Insurance almost never reimburses these platforms directly.
The “Why” (The Trap)
The trap is “Travel vs. Health” again.
Travel insurance is for physical accidents. They view mental health as a maintenance issue. In 2026, despite the “mental health awareness” marketing, underwriters still treat anxiety like a pre-existing back injury: uninsurable on cheap plans.
The Investigation: I Called Them
- SafetyWing: I read the 2026 policy. “Mental health disorders are excluded… unless hospital confinement is required.” So, unless I’m a danger to myself or others, no coverage.
- Foyer Global Health: This is a comprehensive plan for expats. They cover therapy! But the plan costs €150/month, not $45.
- Genki (Resident): They cover outpatient psychotherapy, but there is a cap (e.g., 10 sessions) or it requires a referral from a GP.
Comparison Table: Mental Health Coverage
| Feature | SafetyWing / World Nomads | Genki Resident | Foyer Global Health |
| Therapy (Zoom/In-person) | NO | YES (Limited) | YES |
| Inpatient (Hospital) | YES | YES | YES |
| Medication (Xanax/SSRI) | NO | YES | YES |
| Cost | Low | Medium | High |
[IMAGE: Photo of a laptop screen showing a Zoom therapy session with a ‘Claim Denied’ stamp overlay]
Step-by-Step Action Plan
- Don’t rely on Insurance: For therapy, budget out of pocket. Use platforms like “It’s Complicated” (therapy for nomads) where prices are adjustable.
- Check “Trip Interruption”: If a mental health crisis forces you to fly home, some premium policies (like Allianz) might cover the flight if a doctor certifies you unfit to travel.
- Use “Remote Health” Plans: If you need regular therapy, switch to SafetyWing Remote Health (not Nomad Insurance). It’s a different product that includes wellness and therapy.
- Bring Meds: Don’t count on filling prescriptions abroad. Japanese customs, for example, ban many ADHD and anxiety meds (Adderall/Xanax).
FAQ
Does insurance cover me if I need to be evacuated for a mental breakdown?
Rarely. Medical evacuation usually requires a physical need (e.g., you can’t walk).
Can I get ADHD meds covered?
Only on full Global Health plans (Cigna/Bupa). Never on travel insurance.
Is “burnout” covered?
No. Burnout is considered an occupational issue or lifestyle issue, not a medical emergency.