If you're an expat, you really need one of those insurance polices in addition to regular US insurance, as you'll discover when you try to claim. My colleague

If you're an expat, you really need one of those insurance polices in addition to regular US insurance, as you'll discover when you try to claim. My colleague spent weeks on the phone arguing with the insurance company while debt collectors from the hospital hounded him after a simple ER visit. In the end someone at the insurance company paid his bill with their corporate credit card because they couldn't figure out a way to get it paid through the system. This despite the fact that the insurance company claimed to have a 'network'-type relationship with the hospital (which the hospital denied any knowledge of). They stopped offering coverage for the US altogether after that because it was too expensive. My parents are still trying to get their travel insurance to reimburse them after an ER visit while on holiday. Basically everyone is being had.