International Health Insurance

[lauren quinn]

Moving abroad can be so overwhelming. You have to essentially start from scratch. But if you are relocating to a country without a Social Healthcare System that fits your needs, you will want to find the right Expat International Insurance. But with so many options available, finding what is right for you can be daunting! 

While the country you are residing in might vary, the International Insurance Plans will all be similar. The formula is to choose your individual plan and then add options. Having recently gone through this process, I will highlight the basics to save you hours of research.

 

MY EXPERIENCE

I am an American (U.S.) living in Brazil. I wanted access to professional & clean hospitals in both countries. Health Insurance in Brazil is very expensive & is difficult to buy if you are single or not part of a company with more than 3 total employees. If I were to sign-up for a Brazilian plan, there is also a long waiting period before I could access the health services I was interested in. After extensive research, I decided an Expat International plan would be ideal because it would cost me the same as a ‘Brazil-only’ plan and would cover me anywhere in the world including my preferred doctor in the U.S..

WHY CHOSE AN EXPAT HEALTH INSURANCE VS. A LOCAL POLICY?

1. You are ineligible for local coverage.
2. Local insurance is expensive.
3. You want to be insured anywhere that you travel.
4. You want to be covered in your home country and where you are residing, in case of emergency, pregnancy, pre-existing condition or peace of mind.

WHAT TO LOOK FOR

1. Price

Deductible: This is a fixed amount, regardless of how much your bills are, that you must pay before your insurer will cover a claim. Technically, the total amount to come out of your pocket every year should not be above this figure. A deductible can range from 0 to thousands depending on how high your monthly payment is. 

example: If your annual medical bills total $20,000 but your deductible is $500, than you will pay only $500 for the entire year in addition to your monthly payment. 

Co-insurance: This is a common form of deductible where you are responsible for a % of the claims incurred up to a fixed maximum amount. 

example: If you have a 20/80 plan, you pay 20% of the cost of your claim for any given service and your insurer pays the other 80%.

Co-pay (Cost Share): This is also a fixed amount that you pay every time you receive a service or prescription. Essentially, you are paying a portion of the bill and your insurer pays the rest. Your co-payments generally do not count towards your deductible, but it does count towards your total out-of-pocket costs.

example: You have a $30 co-pay when you visit the doctor on Monday. When you return for a check-up on Thursday, you pay an additional $30 because it is another service.

Out of Pocket Cost: These costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren't covered. There will be a maximum limit.

Premium: You will have the option to pay for your health plan monthly, quarterly & annually. There is often a discount of 3-5% for plans paid in a single annual payment.

Your health plan cost will be based on: gender, age, citizenship, geographic area of coverage, country of residence, deductible, pre-existing medical conditions, policy coverage

2. Hospital Services

Inpatient: This refers to the care received inside of a hospital (ie ambulance, surgery, hospital room, etc). Some insurers charge separate costs for inpatient and outpatient services. 

Outpatient: This refers to the care received outside of a hospital (ie medical check-ups, x-rays, prescriptions, etc). 

Hospital Rooms: You will have the choice between how many other beds (patients) will be sharing a room with you, in the event you are hospitalized. Choices are usually: Semi-private (2-4 beds) & Private.

3. Coverage

Hospital Coverage: Every insurer has a list of hospitals within their network that you can visit. For excellent carriers, you have access to any provider or clinic in the world.

Emergency U.S. Coverage: Adding full coverage in the States (and sometimes Canada and Japan) can end up bumping your monthly cost up by 2-3 times the total value. However, if you will be living abroad for the majority of the year, there are options to add more affordable part-time U.S. coverage. 

example: My insurance plan allows me full U.S. coverage for up to 6 months/year for everything from childbirth to visiting my childhood Doctor. I need authorization for outpatient services over $500, but all in-patient is billed directly.

4. Plans

Upgrading/Downgrading: Generally speaking, you can upgrade or downgrade at anytime.

Example: If you are on a plan without a specific option and want to upgrade, only from the point of upgrade will your waiting period begin.

Canceling: The majority of providers offer cancellation at any time, given you have not prepaid. 

example: If you pay for the entire annual fee during the first month, and you decide to cancel after 6th months, you can rarely receive reimbursement for the remaining 6 months.

Making Claims: It is important to check if your hospital/doctor is a part of your network. A good insurer will have operators who speak the local language in order to facilitate direct payment. This will avoid you making upfront payment for the insurer’s portion and waiting for reimbursement. A good provider will also offer online or mobile submission.

Automatic Renewal: Standard procedure is that you will receive notice of the end of your coverage year with option to renew.

5. Options

Dental: This option often has a waiting period of 6-12 months before treatment of pre-existing dental conditions. Unfortunately, most conditions are considered pre-existing.

Maternity Coverage: Almost every insurer has a waiting period of 10-12 months of being fully insured with their company before you can make a claim for childbirth or pregnancy related services.

example: For waiting periods of 10 months, if you conceive at the time of 4 months of coverage, you can begin making claims during your 6th month of pregnancy because you will then have been fully covered for 10 months. Claims can not be made retroactively. 

Emergency Evacuation: Most insurers will provide emergency evacuation and repatriation as an affordable option or even include it as a standard benefit. If you are living in a country where treatment is below the standards you need, it is highly recommendable that you add this option.

Pre-existing Medical Conditions: Some plans will cover pre-existing medical conditions after a waiting period 2 years. Even so, the coverage is picky and most often the medical condition has to remain completely symptom and treatment free during that 2 year waiting period.

War & Terrorism/Kidnap & Ransom/Casualty Insurance: Optional for those in effected areas.

For more on living abroad & Brazil lifestyle, check out the Bromelia Rio Blog.

My Personal Claim: I do not work for nor have any affiliation to an insurance company. This information has been compiled to help my fellow traveling peers and has been gathered from extensive personal research. If you find an inaccuracy, please feel free to contact me directly and I will be happy to investigate further.