I turned 40 and decided I was done with “Nomad Insurance.” I wanted a policy I could keep until I was 90, that covered cancer, heart attacks, and routine checkups. It came down to the two titans: Cigna Global and GeoBlue Xplorer. Here is the showdown.
Key Takeaways
- US Coverage: GeoBlue Xplorer is unique because it offers an “unlimited” US network (Blue Cross Blue Shield). It functions exactly like a high-end US plan when you are home. Cigna Global has a limited US network and is weaker there.
- Underwriting:
- Cigna: Can exclude specific conditions (e.g., “We cover you, but not your right knee”).
- GeoBlue: Pass/Fail. They either accept you 100% or deny you 100%. No exclusions.
- Cost: GeoBlue is generally more expensive, especially for older travelers. Cigna allows more customization (Silver/Gold/Platinum) to lower the price.
- Portability: Both travel with you. You can move from Bali to Lisbon to London, and the policy stays valid.
The “Why” (The Trap)
The trap is “Future Insurability.”
If you stay on SafetyWing until you are 65 and get diabetes at 55, you are uninsurable when you finally try to switch to a real plan. You need to lock in a “Global Health” plan before you get chronic conditions. These plans are “guaranteed renewable” for life.
The Investigation: I Called Them
- GeoBlue Xplorer Premier:
- Pros: No waiting periods for preventative care. Access to best US hospitals. 9 months in the US allowed per year.
- Cons: Strict medical underwriting. If you have a BMI over 30 or anxiety history, they might reject you instantly.
- Cigna Global Gold:
- Pros: Flexible. You can strip out “Maternity” and “Vision” to save money. They are willing to insure people with pre-existing conditions (with exclusions).
- Cons: US network is smaller (UnitedHealthcare usually). Claims processing is slightly slower than Blue Cross.
Comparison Table: The Titans
| Feature | GeoBlue Xplorer Premier | Cigna Global Gold |
| US Network | Blue Cross (Best) | UnitedHealthcare |
| Pre-Existing | Accept/Reject | Exclusion Riders |
| Time in US | Unlimited (must be abroad 3 months) | Limited (usually 180 days max) |
| Cost (Age 40) | ~$450/mo | ~$350/mo |
| Renewability | Lifetime | Lifetime |
[IMAGE: Side-by-side logo comparison. GeoBlue logo over a map of USA. Cigna logo over a map of the World]
Step-by-Step Action Plan
- Apply While Healthy: Do not wait. Apply in your 30s or early 40s.
- Choose GeoBlue IF: You spend 3-6 months in the US every year and want the best American coverage.
- Choose Cigna IF: You rarely visit the US (exclude it to save ) or have a minor pre-existing condition you don’t mind having excluded.
- Pay the Deductible: Choose a high deductible ($2,500 or $5,000) to slash the premium by 40%. You want this for catastrophe, not for sniffles.
FAQ
Can I keep this if I move back to the US permanently?
GeoBlue: Yes, usually.
Cigna: No, they will eventually force you onto a domestic US plan.
Do they cover pregnancy?
Yes, after a 10-12 month waiting period.
Are these plans tax deductible?
Usually yes, for self-employed expats (see the Taxes article).