One size fits all?
As you can imagine we spend a lot of time engaging with expat groups and forums. One question that we see on a very regular basis is “What’s the best health insurance for expats”. There are various versions of this question which may include “living in ………” or expats gets a nationality prefix. It doesn’t matter it’s still the same question.
People want reassurance, they don’t want to make a mistake. So we reach out to other people for advice hoping that we’ll get the benefit of their experience. If somethings has been working well for them then why shouldn’t it be the same for us, right?
Unfortunately, things aren’t that simple when it comes to health insurance. What’s working for them right now may not be a good option for you. Also a provider that they’ve had a horrible experience with in the past could be perfect for you.
Context is an important part of life, at times we ignore it to our detriment. Nowhere is this truer than when it comes to expats choosing health insurance. Your situation is unique, you have your own health issues and plans for the future. All this has an impact on the health insurance that you need.
So lets start here and look at how different factors that can impact the policy that’s best for you:
unfortunately things aren't that simple when it comes to health insurance
Every insurance company has an age group that’s their ideal target market. This varies from company to company. So what’s best for someone in their 50’s won’t be the same as someone in their 30’s.
When it comes to people who are approaching retirement the situation changes again. Some companies will stop providing cover at the age of 64. Other companies won’t take new applicants at age and if this is the case their premiums will tend to be higher. Other companies don’t have an age limit on when they accept new applicants. In most cases you’ll find that their premiums are more affordable.
If you’re 65 then you’ll end up paying more for private health insurance. That’s because the chances of you making a significant claim increases as you get older. Some companies are happy to take this risk on and cater to older clientele whilst others don’t.
This is an enormous influencer on the policy that you choose. As with age the cover that you get from each company will differ.
If you’re looking for major medical inpatient emergency care you may have a tight budget. Getting the most for your money is going to be important. Some policies will consider angioplasty or cataract surgery as outpatient procedures. This means that on this type of policy they won’t cover them and you’ll get stuck with the bill. In fact as medicine advances more and more procedures are going this way and may get excluded.
This isn’t true for every policy, others still pay for these procedures on an outpatient basis. Look for this type of policy if you want emergency medical cover because it is better for you. You’ll get more for your money and paying for this type of treatment out of your own pocket won’t be cheap. Even if you end up paying a few hundred dollars a year extra it will be worthwhile.
New Born Cover
If you have maternity cover on your policy then your new baby will get cover automatically. The timeframe will vary from 30 to 90 days depending on the insurance company. After this time you’ll need to add them to the policy by filling out an application form. They’ll also want a discharge report from the hospital. This provides them with the medical background for your new baby. Once accepted you’ll start to pay premiums and your new addition will get cover.
What happens if you have a child that’s got a congenital condition will it be that simple? Well that depends again on the insurer. Unsurprisingly, different insurers deal with this in different ways.
The vast majority won’t accept the child onto the policy after the initial grace period has ended. Some of this depends on what the condition is though don’t hold your breath.
There are some insurance companies that will guarantee to cover your new born. This is irrespective of any condition that they may have been born with. Your child will get cover as long as you apply and pay the premium before the grace period ends.
This is a phenomenal difference between the policies. So if you have a family history, are an older mum to be or fall into a higher risk group, this is something to look out for.
If you’re looking at including inpatient as well then this becomes almost a none issue. Having said this there are still some things that you should look out for.
Some policies will only include basic treatment options and put others as modules. Things like wellbeing or emergency evacuation could come as extras in the form of add-ons. Where as on others it will form part of the core benefits on the policy. Obviously the latter should be your preferred option.
Unwanted benefits can be an issue when buying a more comprehensive policy. For example getting dental cover may mean you have to take other benefits that you don’t want. Some policies include dental and maternity cover on the same cover package. If your a husband and wife with two boys then there are three people who won’t need maternity cover. Yet if you want dental cover you’ll have to pay for maternity cover to get it.
Maternity cover as we’ve just touched on is best as a modular option for those who’ll use it. There’s always a waiting option before you can make claims on a policy. This is at least 10 and more usually 12 months, so, if you’re planning on getting cover you’ll need to plan ahead. Set up your cover wait six months and then start trying.
The obvious thing to look out for are the monetary limits that the insurer will pay per pregnancy. You want to all the expenses with the exclusion of any policy excess. If a policy has a $10,000 limit and it’s going to cost you $20,000 for the whole pregnancy. Then this isn’t the best policy for you.
One thing that is less obvious to look out for are policy definitions. In particular complications of pregnancy which can have serious consequences for any couple.
Insurance companies take very different stances on this area. Some companies will not pay anything towards saving the foetus. Stabilising the mother and terminating the pregnancy is the treatment for any complications.
If the expectant couple want any other form or treatment then they will have to fund it themselves.
Other companies take a very different approach and will pay for procedures to save the baby. There will no doubt be a monetary limit on this, however, other options are available.
In every case the latter would be the cover option that expectant parents would want. Imagine being in hospital in this stressful situation, uncertainty and difficult decisions. Then you find out that your insurance company is only willing to pay for a termination of the pregnancy.
We’ve already mentioned that insurance companies go for specific market sectors with age. Well the same is true for families with some insurance companies being more generous.
Some companies will insure each child based upon their age and that’s it. If you have one child then there’s not really any difference from one provider to the next. If you’ve got 2,3,4 or 5 then some insurers will offer you discounts.
Some companies will insure each child based on their age and also give a percentage discount. This discount gets bigger with each additional child on the policy. The savings for a family from one insurance company to the next can be big, especially for larger ones.
Unwanted benefits can be an issue when buying a more comprehensive policy
International v's Domestic
We would always recommend that an expat has international policy over a domestic one. Your domestic policy may be very good yet there are still valid reasons for using an international one.
For starters you may not have the best treatment options available to you in the country where you live. Again this depends very much on where you are living at the time. Having said this even the most modern countries have limitations. We recently met someone living in Dubai who had to go to India for a procedure. This was because the technology was more advanced in India and his recovery was going to be better.
If you have a domestic policy then getting treatment somewhere else isn’t going to be an option. If you have an international policy then the choice of where you get treatment is down to you.
Where you’re living may have amazing health care facilities and excellent doctors. This doesn’t mean that the best treatment option will be available to you.
We knew someone in Malaysia who’s 5 year old daughter was diagnosed with a brain tumour. The doctors and hospitals were amazing though she needed specialist nursing. This wasn’t available in Malaysia and yet it was essential to her chances of beating this cancer. In Singapore these specialist nurses who were available making it the best option. Also she would be in a dedicated paediatric oncology ward which was also important. Her treatment would mean her immune system would be severely compromised. Other treatment options would have seen her placed on a general ward. This option was available to them because they had an international policy. It wouldn’t have been with a domestic one.
Another reason that an international policy is a better option for expats, is being able to go home. If you’ve got a serious illness that is going to mean a long and difficult course of treatment. You may want to be nearer your family and friends from back home. The extra support may make all the difference. An international policy gives you this option whereas a domestic one doesn’t.
If you have a domestic policy then getting treatment somewhere else isn’t going to be an option.
Where you live can have a big impact on what cover works best for you.
First off if you’re going to the States for a period then not all plans are going to extend cover there. If you want an international policy (and you should) then you’re going to need to find a specialist. The vast majority of providers will only give you cover for short stay trips if at all.
Other locations places that can prove difficult are Canada and the Caribbean. Some providers club them together with the US and won’t provide cover there or at best for a limited time. You’ll probably need to find a specialist international policy if you’re heading there.
Other places that tend to get singled out are Singapore, Dubai, China and Hong Kong. Some providers will charge a higher premium for these locations. This is because the cost of care is higher or there’s more chance of contracting something nasty.
Most plans have geographic zones that determines the premium that you’re going to pay. Again these will very from one insurance company to another. You’ll find that there’ll be areas where companies have a competitive advantage.
use a broker
One time that it is definitely better to use a broker is with health or travel insurance. It won’t cost you any more going through them than it does going straight to the insurance company. They’ll make sure that you get the best policy for your circumstances.
Whichever policy a broker uses for a client generally they’re going to get paid the same. This means that a good broker should be impartial and looking out for you.
They have market knowledge, which companies are the easiest to deal with. They’ll know which companies are most efficient when it comes to processing claims. They should also make sure that you set the policy up in the right way from the start. That means no nasty surprises when you come to make a claim.
When we say use a broker we mean a company that deals with more than one insurer. If there a tied agent and only represent one firm they’re not always going to have the best option available. They may be the nicest person in the world and yet what they have to offer won’t work for you.
putting it all together
These are just some of the reasons why health insurance is so personal from one person to another. What’s good for Tony in Bali could turn out to be terrible for you. The thing is most of the time you won’t find this out until it’s too late and you need to make a claim.
So if you know or think that you need health insurance do yourself a favour use a broker. You may want to try a few and see what they come up with find your best fit. Be clear on what you want and ask them to help you find the best policy for you.