Health insurance - How much is enough? Part 1

Almost all expats need some sort of medical cover. The old expression, you have made your bed now lie in it, feels somewhat curmudgeonly. And yet, provided the terms and conditions are fully understood, there is no reason not to make a good bed from your policy selection. The following principles could bring greater certainty and peace of mind to your selection process.

Five golden rules

* Read up about the general issues surrounding health and medical insurance for expatriates and familiarise yourself with the types of cover available within the local and international sectors.

* Double check with your employer on the extent to which you may be already be covered for healthcare insurance. Once you are aware of all the different types of cover you believe will be necessary for you and your family, concentrate on selecting top-up cover to obtain those benefits not included in the employment contract.

* When researching policies, always compare like with like in order to judge accurately maximum levels of medical charges. To do this make sure the policy labels relate to the same level of cover. For example, some will cover sports injuries and others will not.

* Equally, when comparing premiums, only look at plans which apply to similar geographical zones, age bands, benefits. Remember to compare the costs of including other family members.

* Select policies which are most suited to your circumstances. For example, if you know you will never need maternity cover or will never take up complementary therapies, these inclusions will be a waste of your money. But be careful not to throw the baby out with the bath water. By pushing aside what could be coined ‘fringe benefits’, you could end up throwing away essentials such as emergency evacuation or other vital necessities.

Five basic terms

Ceilings: A ceiling refers to the maximum amount of money the policyholder is covered under any one benefit. There will also be a per annum ceiling for the policy as a whole. Were you, as a patient, to incur a bill above the ceilings it would be up to you, as the policyholder to fund the difference. It is worth comparing benefit ceilings of several plans. Some are generous with cover, matching the sum offered to the current cost of medical care, while others offer ceilings which are decidedly pinched.

Excesses: Excesses are the percentage of expenses, or one-off deduction, that a policyholder elects to pay under any one benefit claim heading. It is quite usual for plans to have a claim excess where the first ฃ50 of any benefit is paid for by the policyholder and not the insurer. Policyholders sometimes elect to pay increased levels of excess in return for a discounted annual premium figure - up to fifty percent reduction with certain providers.

Exclusions: The term ‘Exclusions’ refers to a list which will be written in the small print of every healthcare insurance policy. This will itemise what is not covered by the Policy under any circumstances. Exclusions may refer to medical conditions or certain types of benefits which will not be included in the cover. For example, under the former category expect to find psychiatric illness, drug or alcohol abuse and HIV-related illnesses. Under the latter category do not be surprised to find the following exclusions listed: alternative medicine, infertility, GP fees, cosmetic surgery and sight tests.

Moratorium: A moratorium refers to a defined time which may have occurred before, or will occur after, the policy commenced. A moratorium usually relates to a pre-existing condition with the policyholder. Say a back problem after falling from the roof or some medical condition which exists before or at the time of taking out the policy. A moratorium can stretch up to two years or more. If, within this period, the pre-existing conditions flare up, causing a problem which requires medical attention/treatment/surgery, you will not be covered. However, once this period has passed without a problem then the condition is generally never mentioned or referred to again. If the old injury was in the back, problems occurring thereafter in this region will be viewed as new and should be eligible for cover. Any policy which includes words along these lines, ‘all conditions pre-existing before enrolment are excluded in perpetuity’ is not offering a moratorium.

Fifth and final term next week when we continue…

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Graham Macdonald on [email protected]