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Health Insurance

Expat Briefing Editorial Team
30 January, 2015


Insurance is one of those things that everyone hopes they'll never need, and as a result, a frightening number choose to bury their heads in the sand, hoping that their luck will hold. However, by far the most sensible solution for those not willing to trust to fate, is to take out some form of insurance, to protect themselves and their dependants should the worst happen.


It’ll Never Happen To Me! Will It…?

According to MigrationWatch, in the year to June 2014, nearly 140,000 Britons chose to emigrate. Add in other nationalities which previously had settled or worked in the UK and the total rises to 323,000. Research amongst this group consistently shows around half move abroad without having first taken out international private medical insurance.

Debbie Purser, managing director of MediCare International, the UK based insurance provider, said: “Very often, when we speak to people who are planning a move abroad, they are surprised by the cost of an annual premium, which can be in the low thousands of pounds. However, once we start to discuss this with them and they realise the cost of treating a minor accident such as a broken limb can easily run into the thousands too, that is usually enough to persuade a budding expat that planning and buying ahead pays off when it comes to expat health insurance.”

Bad luck can and does strike anywhere, as MediCare International points out with two recent examples of clients they have looked after.

In the first case, an expatriate was booked in during January 2013 for an apparently routine umbilical hernia repair. However, around a week later, she was diagnosed with a post operation infection. By March, the infection was still present and the expat required further surgery. Total costs associated with all surgery and treatment is estimated at GBP11,800

The second example shows that even something as apparently everyday as back ache escalated into a series of costly treatments. The client in question was admitted for an MRI scan after complaining of persistent back pain. When the condition was eventually diagnosed less than a month later and a nerve root injection carried out, total costs were nearly GBP32,000.

One of the most alarming cases of what can happen to uninsured expats was that of a British couple holidaying in the United States, who faced medical bills reportedly in the region of USD200,000 when their son was born 11 weeks prematurely.

Even a “normal” birth can be a costly event for couples living abroad. A problem-free childbirth in the Middle East would normally be expected to cost around USD4,000, whereas in the USA, costs are more likely to start at USD15,000. Throw in complications, such as the requirement for a caesarean section and costs can easily rise by USD14,000 in many hospitals around the world, says MediCare International.

Managing director Debbie Purser urges families to think ahead, particularly if they are having their first child, where risks can be higher. “Given the high, predictable costs of childbirth, International medical insurance normally only comes into force once a potential mother has been enrolled in an international health insurance plan for a continuous period of 12 months prior to the birth. In practice, this means cover needs to be put in place well before falling pregnant.”


Health Insurance – The Basics

National health policies can vary widely from country to country, and the last thing you need, should you or a family member be taken ill, is to discover that as a foreign national you are not eligible for treatment, or that you must pay through the nose to receive it. In the vast majority of cases (with some exceptions, for example treatment of a pre-existing condition) an international medical insurance policy could be the answer. Private medical insurance is designed to ensure that you can obtain the treatment you need, whenever, and wherever you need it, and as an expat, this flexibility will be invaluable to you.

Your first decision needs to be whether you are interested in a basic scheme, which will usually cover emergencies, in-patient treatment, nursing at home and repatriation, or a comprehensive scheme which will usually cover you for all of the above, as well as out-patient care, specialist treatment, routine dental, and complementary care. Although obviously prices vary from provider to provider, it is probably wise to opt for the most extensive cover that you can reasonably afford, for greater peace of mind.

International insurance brokers will usually offer a wide variety of policies to suit the needs and pockets of most expats, including international medical insurance, travel protection plans, single and multi-trip policies, annually renewable international plans, and group plans from a variety of providers, with a wide range of online tools to help you choose the most appropriate one.

As mentioned previously, there are several conditions and situations not usually covered by health insurers (international or otherwise). Different companies may disallow slightly different things, but here are a few of the common ones:

  • Risks inherent in war, riots and insurrection are rarely covered. Very occasionally you will find a provider who will cover these risks automatically.
  • Drug abuse
  • Self-inflicted injury (and by the same token, injuries as a result of dangerous hobbies. If juggling knives helps you to relax after a hard day at the office, you are usually on your own…)
  • Cosmetic surgery
  • Pregnancy treatment, unless you have taken out a comprehensive policy which includes this.
  • Pre-existing conditions such as cancer, and HIV/AIDS, and conditions arising as a result of these.
  • Organ transplants, again unless you policy specifically includes this.
  • Preventative treatments
  • Sex change.

You also need to be careful about any possible geographical restrictions on the policy that you take out. US and Canadian citizens who are planning to expatriate need to be especially aware, as certain types of policy impose restrictions on the amount of time that they can spend revisiting their home country, whether for medical or non-medical reasons.

Cover is usually offered via premiums throughout three zones of the world, with Area 1 covering Western Europe, Area 2 offering world-wide cover (with the exception of the United States and Canada), and Area 3 offering total global cover. Some insurers and brokers offer world-wide coverage with all of their policies, but as previously mentioned, restrict the extent of US and Canadian coverage to accident and emergency treatment only, and the length of the stay to approximately 30 days.

Accident and illness can occur at any time, and in any country, and most of the circumstances covered by international policies are similar to those covered by domestic insurers; the policies just have the advantage of being 'mobile' in a way that domestic policies are not. However, there are some issues which are of particular importance to expatriates, and it would be wise to make sure that your international health insurance covers them.

Emergency help and the possibility of medical evacuation can sometimes be invaluable in time of crisis, and a good policy will provide you with access to high speed and quality international assistance.

If you will be expatriating to a difficult or inaccessible location, or are unsure of the standard of medical care available locally, it is highly recommended that you check that your preferred policy makes provision for this. Bear in mind, however, that the evacuation must be necessary, rather than just preferable; if there is no way that the emergency can be dealt with locally, then you will be evacuated to the nearest facility able to deal with it, rather than one of your choosing.

The majority of brokers and providers provide online quotes, or quotes by e-mail, and there is usually a facility for downloading application forms for policies, but having downloaded the forms, you may have to resort to slightly more low-tech methods to get the information to them.




 

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