How does health insurance work for Americans traveling abroad or even living in a foreign country? There are a few aspects regarding this unavoidable fact of life you should be aware of. Your first basic choice is whether to buy local insurance or go through an international insurance group like BUPA. For example, a comprehensive local policy in Panama could cost as little as $100 monthly. The risk you assume going this route is that the local insurer goes out of business. Then you’re back shopping for insurance again. By going through BUPA, you pay a little more, probably closer to $150 monthly but can be fairly certain the company will be around when you need them. Over the age of 74, you’re out of luck. Neither BUPA or a local insurer will assume the risk. Depending upon where you’re traveling/living, another option is to go without insurance. Jetsetter does not necessarily endorse this view but it is an option. Take into account whether you’ll still be able to sleep at night. If the cost of medical care is low enough, you should be able to handle the expense of normal care and even the occasional emergency. What’s more, in some countries you become eligible for free healthcare after becoming a permanent legal resident. Ireland is an example. All residents get free universal healthcare. Policy options vary dramatically from country to country. Ask questions so you know exactly what you’re buying.