How a typical nomad insurance claim works — from incident to reimbursement
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How SafetyWing US coverage works
SafetyWing's approach to US coverage is one of its most misunderstood features. Here's exactly how it works:
Non-US passport holders
- 30 days of US coverage included per 90-day period
- Part of the "home country" benefit
- Covered at same rates as international travel
- Still has $100 ER co-pay / $50 urgent care co-pay
- Beyond 30 days: add-on required
US citizens / residents
- US NOT covered in base plan
- US/Canada add-on required: +$48.16/4 weeks
- Can add/remove the add-on each period
- Still has $100 ER co-pay in US
- $50 co-pay for urgent care visits
Add-on pricing and total cost
| Plan | Base price (18–39) | US/Canada add-on | Total with US |
|---|---|---|---|
| Essential | $62.72 / 4 weeks | +$48.16 / 4 weeks | $110.88 / 4 weeks (~$120/mo) |
| Complete | ~$161.50 / month | +$122 / month | ~$283.50 / month |
The US add-on nearly doubles the base price of SafetyWing Essential. This reflects the dramatically higher cost of US healthcare compared to other markets. SafetyWing does allow you to add and remove the US/Canada add-on each billing period — so you can activate it when returning to the US and deactivate it when leaving, paying only for the periods you need it.
US co-pays — what you still pay out of pocket
Even with the US/Canada add-on, SafetyWing Essential has specific co-pays for US healthcare visits that don't apply to international treatment:
$100
Per ER visit in the US
Applied on top of the standard $250 deductible
$50
Per urgent care visit
For non-emergency US healthcare visits
These co-pays are in addition to the $250 deductible. So a visit to a US emergency room could cost you $350 out of pocket before SafetyWing covers anything ($250 deductible + $100 ER co-pay). For context, the average ER bill in the US is $2,200 — so after your $350 out-of-pocket, SafetyWing would cover the remaining ~$1,850.
Who needs the US add-on?
- You are a US citizen or resident
- You are a non-US citizen planning to visit the US for more than 30 days in a 90-day period
- You are transiting through the US and want to be covered during your layover
- You are a non-US citizen who won't visit the US at all
- You are a non-US citizen visiting the US for under 30 days per 90-day period (home country coverage applies)
Better alternatives for US coverage
For US citizens who spend significant time in the US, SafetyWing with the add-on (~$120/month) is one option — but not always the best one:
World Nomads Explorer
Good for fixed US tripsFor US citizens on a defined trip with a return date, World Nomads covers the US as part of its worldwide policy. Trip cancellation and baggage also included. Better for shorter, planned US visits than SafetyWing's rolling model.
Cigna Global
Best comprehensive US coverageFull expat health insurance with genuine US coverage — including access to in-network US providers, no ER co-pays, and routine care. More expensive (~$250+/month) but no coverage gaps or co-pay surprises.
IMG Global (Patriot America Plus)
Best for US-focused nomadsSpecifically designed for US citizens abroad who regularly return to the US. Strong US provider network, solid international coverage, and better value than SafetyWing+add-on for nomads who split time evenly between US and abroad.
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Affiliate disclosure: NomadShield earns a commission when you purchase through our links. Pricing and coverage details based on SafetyWing policy documents as of June 2026. Always verify current rates and terms before purchasing.