I go back and forth on the question of medical insurance. Over the past 7.5+ years of travel I've not had medical insurance for the majority of my travels though I admit I have been lucky enough that my injuries and illnesses were not major. At most, one night in the hospital.

Ignore catastrophic injuries for a moment. For routine health issues, I find medical insurance and medical care in the majority of the world has generally fallen into one of these two categories:

1. Insurance with a low deductible covers a portion of the bill but is so expensive that medical care + insurance costs significantly more than the total medical bill with no insurance.
2. Insurance with a high deductible does not cover anything because medical care is so inexpensive, even including hospital stays and surgery.

End result: For anything up to minor surgery, insurance costs me more money than it saves, though at times I might be flying to a different country for my medical care (which I have found often is a good idea). I have found the above to be true even in the EU, where I had surgery in Germany

This leaves the rare cases of major surgery on up through life changing catastrophic events. This is where the medical bills can add up fast in a way other people on this thread are describing. For these types of scenarios, I have seen that it is all too often insufficient to have only evacuation insurance with good after-care. Others in this thread (above) have given sufficient examples of how this can be problematic so I won't belabor the point further other than to say that my own experience confirms what they are saying.

All this has left me with a simple philosophy: while I continue to travel, I will never buy medical insurance for anything up through minor surgery. If I consider my risk of major injury is significant (such as in motorcycle travel), I will buy the highest deductible plan I can find with good evacuation coverage and after-care. This keeps my medical insurance costs to a few hundred dollars a year maximum and overall has saved me a lot of money. When I am not traveling on a motorcycle I often do not have any medical insurance at all.

msamsen, I see you live in the USA. You might look into HCC Atlas Travel Insurance. You can get a high deductible plan at a reasonable price that covers motorcycle travel, includes evacuation insurance and covers the costs incurred before you can evac as well as followup care afterwords.

Good luck and enjoy your travels!

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Traveling The World Since: 2011
Blog: The Seductive Life (General Travel)