I flew back to Ohio for my sister’s wedding. I kept my SafetyWing subscription active, thinking I was covered. I got a sinus infection and went to urgent care. Bill: $250. SafetyWing paid $0. I forgot the “Incidental” rule: US coverage is often for accidents only, or requires you to be in the US for a specific reason.
Key Takeaways
- The “Home Country” Void: Most travel insurance policies automatically terminate when you enter your country of citizenship.
- The “Incidental” Exception: Some nomad plans (SafetyWing, Genki) allow 15-30 days of coverage at home, but usually not for the US unless you specifically paid for the “Include US” upgrade.
- Accident vs. Illness: Even if you have home coverage, it might only cover accidents (breaking a leg), not illness (flu/infection).
- The 90-Day Rule: To unlock home country coverage, you often must have been abroad for 90 days prior. You can’t just buy the policy, fly home a week later, and expect coverage.
The “Why” (The Trap)
The trap is “Citizenship vs. Residency.”
If you have a US passport, the US is your “Home Country” to the insurer, even if you haven’t lived there in 5 years. US healthcare is the most expensive in the world. Insurers do everything possible to avoid paying claims there. If you didn’t toggle the “Include USA” switch (which almost doubles the price), you have zero coverage the second you land.
The Investigation: I Called Them
- SafetyWing: “For US citizens, home country coverage applies for 15 days per 90 days. BUT, you must have the US add-on if you want full coverage.” Without the add-on, it’s virtually useless in the US.
- Genki: “We cover home country visits up to 6 weeks, but not for US citizens in the US if that is their domicile.”
- IMG (Patriot America): This is a specialized plan for US citizens living abroad who visit home. It works like a temporary PPO.
Comparison Table: Visiting the USA
| Feature | SafetyWing (w/o US Add-on) | SafetyWing (w/ US Add-on) | IMG Patriot America |
| Accident Coverage | NO (in US) | YES | YES |
| Illness Coverage | NO | YES | YES |
| Duration | 0 Days | 15 days / 90 | Up to 6 months |
| Price Impact | Base Price | +$40/mo | Separate Policy |
[IMAGE: Map of USA with a ‘Coverage Restricted’ caution tape graphic]
Step-by-Step Action Plan
- Check Your Add-Ons: Log in now. Does your plan say “Include US coverage”? If not, turn it on before you book the flight.
- Buy Short-Term US Health Insurance: If you are visiting for <30 days, it’s often cheaper to buy a “Short Term Medical” plan from a US carrier (e.g., Pivot, United) than to upgrade your nomad insurance.
- Use Travel Insurance (Incoming): If you are not a US citizen, buy “Visitors Coverage” (Inbound travel insurance).
- Don’t Go to the ER for Flu: Urgent Care (CVS MinuteClinic) is $100. ER is $2,000. Pay cash at Urgent Care if you are uninsured.
FAQ
Does the Affordable Care Act (Obamacare) apply?
No. Visiting for 2 weeks does not trigger a special enrollment period unless you are moving back permanently.
Can I travel to the US just for medical treatment?
No! That is “Medical Tourism,” which is strictly excluded by nomad insurance.
What if I have a layover in the US?
Technically, you are “in” the US. If you slip in the airport, you need US coverage.