My Strange, Crazy, and Smart Expat Healthcare Plan

Here is my current healthcare set-up for those who are interested.

  • Note: Ideally, this is for anyone who is an American citizen (or has a social security number), travels for business or pleasure at least one or two months a year, is generally skeptical of the current healthcare system and wants to empower themselves.
  • High-deductible Health Plan
    • I have a health insurance plan that covers up to $1 million in healthcare expenditures.
    • The deductible is only $750, which I find very reasonable.
      • That means that any expense under $750, I cover myself. Any single healthcare expense that goes above that, will be covered by the insurance company past the $750 mark.
    • The plan is tailored for “expats,” allowing me to use this plan internationally without restrictions, which is important for me considering how much I travel, and that I maintain residence abroad.
    • The company I currently use is Cigna International.
  • Direct Primary Care
    • I have a subscription to a direct primary care physician based in North Carolina. I cannot recommend this type of physician enough.
    • In a nutshell, a subscription with a direct primary care physician means you pay a monthly fee with your doctor rather than use insurance. Every procedure, scan, or test you may need is given to you at market rate and you pay cash (at significantly lower costs). The prices are transparent and on the website. My doctor is available 24/7, and I can easily text or FaceTime him when the need arises.
    • Because he doesn’t accept insurance, prices are low and fair. This removes the middleman of insurance companies and is the closest model to free-market prices that is available.
    • As an added bonus, you can now use your HSA (see below) to pay for your DPC subscription.
  • Health Savings Account
    • Something I signed up for recently is a Health Savings Account, which is a must for any U.S. citizen. This account was legalized by the U.S. federal government some years ago, and incentivizes you to set money aside for health expenses, tax-free.
    • For a self-insured individual, the maximum amount that can be put into the account per year is $3,500. But that $3,500 is offset against your taxes, meaning you’re getting incredible tax savings. And you’re free to invest anything in that account, whether it’s stocks, bonds, or ETFs. Do it.
    • The HSA I currently use, because it’s free and allows me to invest everything I put into the account, is Lively, an awesome start-up.
Yaël Ossowski is a journalist, writer, and consumer advocate. His writings and interviews have appeared in newspapers, magazines, and online outlets across the world in multiple languages. He is the founder and editor of Devolution Review and deputy director at the Consumer Choice Center. He was previously a national investigative reporter at He has a Master’s Degree in Philosophy, Politics, Economics (PPE) from the CEVRO Institute in Prague, and a Bachelor's in Political Science from Concordia University, Montreal. He currently splits his time between Vienna, Austria and Charlotte, North Carolina.
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