Health Insurance and Medical Care Plans for Expatriates

It is known that international medical insurance is expensive. In the Middle East, a middle-aged couple could be paying £5,000 a year for comprehensive cover and about £2,800 for basic cover. However, having the ability to call in medical assistance specialists, contracted to insurers, saves lives and long-term damage to health may be avoided or minimised by swift intervention, making insurance a very desirable asset to have.

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Basic, Comprehensive, De Lux Healthcare Plans

Insurance plans tend to fall into three different groups which are basic, comprehensive and de lux.

  • The basic insurance plan only provides hospital in-patient care
  • The comprehensive insurance plan includes hospital care and covers out-patient treatment such as consultations, diagnostic tests and primary care which is the normal things you would visit your family doctor for were you in Britain.
  • The de lux insurance plan is mainly used by the rich or for those whose insurance is purchased by their employer. This covers non-routine dentistry and unlimited amounts of post-hospital care or physiotherapy

Unfortunately not all plans fit into these three groups and to meet further demand, international insurers are increasingly going modular. These are a mixture of plans that offer a basic core and allow the buyer to add further benefits or modules that suit an individual.

Initial Stages Before Buying

Within the insurance industry, the executives and brokers agree that it costs to think in advance of purchase, therefore indicating that you should decide what cover you need before leaving the country thereby allowing you to seek the best deal. If your quotation surpasses your budget, options include:

Taking out an excess (for example, with motor insurance, you tend to pay the first part of the claim to a pre-agreed sum). The improved policies do not hit you with an excess on each of the claims once paid the excess sum within a year, however it will cover you in full until the end of the policy year. Ensure to check whether the excess is per policy year or per claim.

Be sure to pick a strictly modular plan, if you need cover for psychiatric problems, Emergency dentistry or Ambulance road transport etc. Brokers find that older women, who have had a family, tend to keep hold of their maternity cover.

Other Information To Consider

You should fully understand what isn’t covered as well as what is covered. It is important to read the small print especially if you are buying online.

  • Would you need rapid settlement, say within 14 days?
  • Wanting access to 24 hour helpline
  • Are accidents and injuries included?

Portability entails special consideration. This is cover that can be continued in another country without requiring re-underwriting. Many people who settle abroad don’t expect to revisit their home country but it can be important to make sure that the cover holds well if you were to move. If you’ve suddenly developed a long-standing or chronic condition, such as heart disease, arthritis, diabetes or skeletal injury, you may not be re-insurable after moving. Your condition may be deemed as being pre-existing and you will have to pay a heavy load on your premium.

Evacuation cover is a questionable expenditure in countries with good medical services. It is top of the “must” list in underdeveloped countries, where you’re inaccessible from medical services. Bills exceeding the limit of £50,000 are not unknown for medivacs, and there’s medical care on top of it. Unless you are very wealthy, without this cover you would have difficulty arranging air ambulances, hospitals to go to, arranging border crossings or arrange with a hospital for quick treatment on arrival. When ill, your ability to organise these things will be seriously reduced.

Purchasing protection in the UK

Those who are moving abroad should purchase insurance in advance, from a business which is regulated by British consumer protection rules. They are rated amongst the most consumer-friendly in the world. If a dispute occurs, the UK Ombudsman mechanism is as likely to satisfy the policy holder as most regulators. However, once you have adjusted to your new country, it may be slightly cheaper to buy a local policy providing you haven’t developed a chronic condition. Portability of cover should not be overlooked. You should ensure your translation of any foreign language policy is correct. Remember, a good source of advice can come from members of the local expat community.

Insurance Premium Tax

Insurance Premium Tax is a factor to consider as it varies according to the country, this means where you buy your insurance is important.

There are three different purchases routes, which are; online, broker and self insure.

  • Online– the onlie purchase routine allows you to buy directly online from an insurer. This is a good idea if you are positive that it offers the correct deal needed. However buyers can also be let down, as medical insurance policies are more complicated than house insurance or motor cover. Exclusions can be overlooked or not understood. International plans unfortunately, cannot be assessed in a short amount of time and research has found that buyers like to talk with an insurance company to be sure about certain points. If the plan is moratorium based, it is important to understand how it works; any doubts can be cleared up by the provider over the phone or by reading the terms carefully. A moratorium requires that the policyholder stays free of the situation they have suffered in the past for two years; this tends to be after taking out the policy. Some moratorium plans states that the person must have been free of the situation for five years before the plan was bought.There are many foundations for different interpretations. The advantage is that those who suffered a serious illness can receive cover against any future event.
  • Broker – it often pays to see an insurance broker who specialises in international private health cover and has the necessary software, experience and skills. There are lots within the British domestic market and many will have expertise in overseas cover.It is important that you question their background and to beware of agents who sell only one company’s products. Be aware of commissions, as some insurers give brokers an ethically questionable 40% commission on the 1st year’s premium. Be sure that the broker adviser searches the market to get the best option available for you.
  • Self insure– the self insure purchase routine shows how there are reasonable options for people with healthy family medical histories in countries with good medical services to pay as you go. However there are risks that you may need sudden access to cash, as medicines are costly and ill-health can suddenly appear. This would be ill advised, even for the rich. if living in an under-developed country.

Using State Care Provision – EUROPE

Western European countries offer state-run health care to a standard many find acceptable and this is similar to Australia and Canada. However, waits for treatment are far from distinctively a characteristic of the British NHS. It has been known that lists are likely to increase as Western governments face high amounts of demands on their budget.

Expats access to state medicine varies in EEA countries and Switzerland but if you are over retirement age you are then usually entitled to the full care standard enjoyed by the local population, once formalities have been completed.

Routes To Get The Qualification:

  • European Health Emergency Card (EHIC), this is a must-have that has replaced EN “E” Form 111 in 2005. It is important for emergency medical cover, and is aimed at holidaymakers on short trips abroad. The EHIC will not get you home, as some countries will charge for picking you up via ambulance. The Department of Health says: “You are advised to take out comprehensive private insurance for visits to all countries, regardless of whether you are covered by the EHIC.”
  • E121 state pensioners must get an E121 from their UK local social security office before leaving Britain as a future expatriate in Europe. They should register with an appropriate authority with their passport in order to complete the formalities that can get them access to health care.
  • E106 Britons who have been employed or are registered as self-employed in an EU state for 2 years may extend their access to state care by the E106. Two years or two and a half years is the maximum extension.

Inactive EU Nationals Under Retirement Age

Non-working expats who are under pensionable age are entitled, in many states, to have medical cover. These states require cover of a certain level and are provided by a licensed insurer.
Spain is quite strict and acted after critics stated Britons were freeloading on health care whilst not working. The British embassy in Madrid has previously said “UK nationals living in Spain, but not officially resident, are not automatically entitled to health care in Spain at UK expense.” Using EHIC when not needed to get Spanish health care is fraud, it states that
“They may have no right to health care in the UK, as they are not ordinarily resident there.”
Good brokers will understand what policies and providers comply in Germany and France, where insurance is essential for any inactive EU expats under the retirement age.

Countries with large expatriate communities and where medical cover is necessary are; Australia, New Zealand, Canada, Saudi Arabia and Abu Dhabi. In Abu Dhabi holidaymakers may be required to show travel insurance cover. Foreign nationals have been barred by the emirates if they are without the correct paperwork from entering into the country.

It is known that America has the best and most expensive medicine in the world, meaning that private insurance is effectively needed.

Britons, who tend to spend less than six months a year in the UK but remain within Europe, are denied access to the NHS, excluding any emergencies. However tougher regulations apply to Britons outside the EU. They are generally not entitled to non-emergency treatment if they spend less than three months in the UK. It has been stated that any changes were not fundamentally targeting Britons, who might have paid a lifetime of National Insurance contributions and then moved abroad. This means they may have a risk of being caught out.

For those who are not able to pay for health care, insurance is the best option. However those with the correct international insurance cover will not need to worry and will be re-accepted as an NHS patient if on returning to Britain they can prove they are back for good and are renouncing their E121 card.

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