The following transcript was generated by AI and may contain inaccuracies.
Hugo: So welcome to everyone. We’ll just give you all a couple of minutes to join. We’ve had lots of interest in this presentation, so we’ll just wait a couple of minutes and then get started. Joe, you were saying you’re in Boston and it’s cold, but not too cold. It’s warmed up a bit since a couple of weeks ago when the whole East coast was suffering.
Joe: Yes, it’s typically chilly here in Boston in the wintertime. I’m looking forward to the spring.
Hugo: Yeah, because you have hot summers as well, don’t you? You get both kinds of weather.
Joe: We do. Where I live, just a little south of Boston, we’re near the water, near the ocean, which keeps it a little bit more temperate, which is great. If it gets too hot, we can jump in the ocean.
Hugo: Yeah, sounds nice. In the UK we get a kind of medium, gray rainy climate year-round, slight ups and downs, but it’s pretty consistent.
So cool. How are we doing? Yeah, we’ve got lots of people joining. Just give it a minute more.
Joe: I think I may have fixed the full screen issue.
Hugo: Excellent.
Joe: Or improved it. Let’s see.
Hugo: Excellent. Cool. Okay. We’ve got a good number of people joining. I think it’s slowed down a bit, so let’s get started. Hello, everyone. Welcome to day one of the 2025 US Expats Financial Conference sponsored by Expat Focus, the web’s favorite destination for anyone moving or living abroad, and Wise, a leading provider of fast, low-cost international money transfer services and multi-currency accounts for individuals and businesses.
We have a fantastic schedule for you, consisting of nine sessions over three days covering multiple aspects of financial information for Americans living abroad, with perspectives from some of the world’s leading experts in their fields. Today is the first day of the conference, and this is our second session of the day.
I’m delighted to be joined by Joe Cronin from International Citizens Insurance, who will be discussing health considerations and solutions for US expats in 2025. Before we start, please bear in mind that the information presented is for general educational purposes only, and you should always seek your own personalized financial advice.
Also, while the conference is free to attend, if you’d like to leave a tip for the organizers, you can do so using the PayPal link I’ll drop into the chat window at the foot of your screen. Joe will be answering your questions at the end, so please add them in the Q&A pop-up at the foot of your screen throughout, whenever you think of them, and we’ll try to answer them all at the end, time permitting.
So without further ado, over to you, Joe.
Joe: Great. Thank you, Hugo. I’m just going to share my screen now with the presentation. Is that coming through?
Hugo: Yes.
Joe: Great. Welcome, everyone, and thank you for joining us today. My name is Joe Cronin, and I am president of International Citizens Insurance. We are a leading brokerage offering clients access to a variety of international insurance plans, including health, life, and travel.
Our team is global. We have people here in Boston, Tampa, but also in the Philippines and the Netherlands. And we’re continuing to grow. Over the next 20 minutes, I will introduce our company, the services and the plans that we offer. I’ll try to address some common questions regarding international health insurance, and then at the end, we can have some time for discussions and a more general conversation.
I’ll start with a brief introduction to our company. International Citizens Insurance was established in 2004. It’s now one of the largest expat health insurance brokerages in the world. We’re a top producer for Cigna Global and GeoBlue. We’re a platinum producer for International Medical Group. We’re a top two producer for UniShare. We work with 10+ different insurance companies, and that gives us the ability to give our clients options and a range of programs, service levels, and pricing costs.
Our clients are individuals, families, groups, students – anyone who lives or travels outside of their home country. And today our focus is on international health plans. As brokers, our team of licensed agents provides personalized advisory services to our clients via email, phone, and text to help them find the right plan.
We’re a dedicated resource for our clients from the initial research phase through choosing and purchasing. We remain available to assist you for the full policy period and assist with claims, plan questions, renewals – anything life throws at you during your international experience. So now let’s move forward with some common questions we get from clients.
The first most important question is: why would I need an international health insurance plan? Not having the right insurance is a gamble on yourself to stay healthy. And it is a choice a lot of people do make. Some people self-insure, hoping that nothing major will happen. For others, deciding to protect yourself and your family against an unknown risk and the peace of mind that comes with it makes buying insurance the best choice.
Many clients feel the cost of health care in their host country is low enough that they can self-insure or cover all expenses that come up out of their own pocket. So they don’t need insurance. It’s something they’re planning, saving for, and have money set aside.
Others choose to buy a local plan offered by their host country. And finally, others seeking something more affordable may purchase a low-cost travel insurance plan. All are reasonable options and will potentially save you money in the short term.
For those who self-insure, there are risks that if you have a severe illness and the costs are more than expected, or if you want treatment in a facility that you can’t afford. If you are considering self-insuring, we usually recommend a basic plan with emergency-only inpatient care, also known as a catastrophic plan. These plans won’t cover a lot of the expenses that you might incur, but if something significant happens, that’s when it will start to come in and pay for long-term hospital stays or major illness.
For those considering buying local insurance plans, you need to check the requirements and eligibility, such as being a full-time resident for a period of time or having to pay taxes locally. Not everyone is eligible. And more importantly, local plans come with some limitations. For example, they only cover you in your host country in most cases. So you cannot seek treatment at home in your country of residence or citizenship, or in another country. If you’re living in a country with lower quality doctors or hospitals and you want to go to the neighboring country for health care, a local national plan won’t provide that option.
However, a more common complaint with local plans is longer wait times and limited access to private hospitals and/or other limitations on benefits or coverage options.
For those considering travel insurance as an alternative, we’ll discuss a little bit more of that in a few minutes.
So then, what are the primary reasons to buy international health insurance? First and foremost, these plans provide comprehensive worldwide benefits in any country, including your country of citizenship. They provide access to a wider range of doctors and hospitals, public and private, with shorter wait times. They also provide 24/7 emergency medical assistance in your language to help you find the best facilities for your care, and also facilities that they have a direct relationship with so they can pay any medical costs directly so you don’t have to pay anything out of pocket.
And finally, they provide more comprehensive health benefits if you choose, with some plans including medical evacuation, vision, dental, repatriation that may not be available in local plans or travel plans. Of course, the downside of these international plans is their costs are a little bit or sometimes significantly more expensive than a local plan or a travel insurance plan.
Those costs can be managed – we’ll get into some of the details of that – but you can choose different levels of coverage, selecting higher deductibles, or excluding certain benefits such as vision and dental.
So what is covered and what do you get for your money? There are generally six major benefits most international health insurance will include or offers as optional benefits.
The first is inpatient care. It’s basically standard with all the plans that we offer. And that is simply defined: if you get admitted to a hospital for an extended period of time, typically for at least one night, it’s inpatient care.
Outpatient care is included, and it’s care outside of the hospital, typically in a doctor’s office for things like physical therapy, a rolled ankle, needing an x-ray but not an overnight stay at the hospital, or cutting a finger, if you get sick, etc.
Plans offer medical evacuation, so if you’re in a remote area and the local hospital or doctors are unable to treat you, they will cover transportation from where you are to the nearest hospital that is qualified to treat your illness or injury.
Repatriation is returning you or your mortal remains if you should pass away to your home country.
Health and wellbeing benefits are for routine exams, checkups, tests – for example, an annual physical or a mammogram – and can include other benefits such as mental health services.
Vision and dental is usually an optional add-on with most plans, and it can provide coverage for routine or preventative care, for example, exams, glasses, contacts, or cleanings.
Finally, maternity benefits cover pre and postnatal care along with delivery. Most plans, though, just to be aware, will typically exclude maternity benefits for the first year of the policy. They don’t want someone who got pregnant yesterday and then comes in and buys the policy only to cover their maternity, so you have to plan ahead in that case if you’re planning on having children.
In general, the plans come with core coverage or basic coverage and allow you to pick and choose optional add-ons. So study the plan table of benefits when you’re looking at different plans and try to understand what comes with the core coverage. And then you can choose coverage limits for various types of benefits and which benefits are optional that you can add or not add as you choose. Take time to research the plans and use all of the resources available to you. Ask questions in advance, and you should know what you’re getting before you purchase the policy.
All the plans will ask you to choose an area of coverage for your policy. So if you’re a US citizen moving to Europe, you typically get two options. You can choose to have coverage that includes worldwide, so you’d be covered in Europe, back in the United States, but anywhere you may be traveling or living during the coverage period.
The other option would be coverage throughout the world, excluding the United States. As healthcare costs are higher in the US, you can save money by choosing to exclude coverage in the US for your plan. You forego your option of getting the most benefits in the US.
Other select plans will have additional areas of coverage that you can choose from. We have a plan that offers coverage for Europe only. So if you are living in Europe and you might want to go to a doctor or hospital in another country in Europe, you’d still be covered, but you wouldn’t be covered outside of Europe. And then another plan offers coverage in two countries: your country of residence and your country of citizenship.
So there are various options. And then, in terms of what combination of benefits are right for you, every person and situation is unique. For some, just having inpatient coverage is fine, as outpatient care and health checks are affordable where you may be living. In other countries, a more comprehensive plan might be necessary or desired.
We think this is where our agents can make the most difference for clients – picking the right combination of benefits, as different insurers offer a variety of different options, coverage areas, benefits, and deductibles. So having an expert licensed agent to help you with that decision is advantageous.
And just as important, you also need to understand what might not be covered. Every insurance plan has a list of exclusions – those would be benefits or treatment that would not be covered under the policy. This list will be provided to you at the time of your policy purchase. You can ask for it beforehand when you’re reviewing it, and typically if you get it afterwards and you see something in there, you have typically 14 days where you can cancel the policy and get a full refund, no problem.
Most of the policies actually offer flexible cancellation policies. As long as you haven’t made a claim – once you start making claims, the insurance companies expect you to pay. These policies are typically annual policies, so they’ll expect you to pay for the full year.
Some examples of things that might be excluded would be injuries sustained while committing an unlawful act. Some plans exclude contraception or birth control drugs. Others exclude treatment for undisclosed pre-existing conditions.
Regarding pre-existing conditions, they are treated differently by all insurers. The best way to find out how your insurance will treat that is to apply. However, regardless of the plan, all clients go through a process of what’s called medical underwriting when you apply, where each applicant will complete a questionnaire regarding their medical history.
If you have no major pre-existing conditions, your application can be approved without further review. Applicants with a medical history may have to provide additional information, such as a recent physical exam, in order to get approval.
Depending on the information provided and the severity of any pre-existing conditions, the underwriters will typically do one of four things: If it is a minor pre-existing condition, then they’ll generally accept the application and cover the condition as any other illness. If you had a broken leg last year, for example.
For other more significant pre-existing conditions, they may approve your application but exclude benefits relating to that specific condition, or they may cover the condition with what they call a “rate up” – an additional charge for that specific coverage. And/or they may add additional limits on claims relating to that specific condition. So the policy would get approved, it would be more expensive, and there may be some limitations added.
And then finally, significant pre-existing conditions can result in denial of your application. So we encourage everyone to read the policy certificate and any exclusionary riders. And again, all plans can be canceled within that free look period of typically 10 to 14 days with full refund of your premium after the policy is approved.
Speaking of premiums, what does it all cost? It varies. As you maybe can tell from the previous conversations, we’ve sold policies as low as $1,000 per year, and we’ve sold policies over $30,000 per year. Budget concerns are definitely an important factor in designing a plan for your specific situation.
You need to be able to afford the plan as part of your overall budget. A good thing for US citizens is that global plans are typically less expensive than US health insurance plans. A factor in that is most people getting treatment or care outside of the US, which is significantly less expensive.
Some other things to consider: our average policy size is $5,500, maybe $6,000 per year per person, less for children, and the costs are dependent on a variety of factors. A big one is your age – it’s more expensive for older applicants. The number of people on your policy – so a married couple with two children is going to be more expensive than a single person.
The level of coverage you choose – do you want a policy with high maximum medical benefit limits and comprehensive coverage, or do you want a basic inpatient plan with limitations on how much is covered? Then also, you can choose a deductible amount. So the higher the deductible, the lower your monthly or annual premium would be.
Additionally, sometimes the country you’re moving to will have an impact on your price as well. You typically will have the option to choose different plan levels, so one provider has plans they call bronze, silver, gold, and platinum, while other plans might be either basic or premier.
Bronze level plans will have fewer benefits, lower limits on the benefits provided, while platinum level plans have the most benefits with the most amount of medical coverage available. And silver and gold level plans will fall in between these two.
You can also choose to include or exclude optional add-on benefits. And as I said, the deductible, the optional benefits such as vision and dental will increase the cost, and adding higher deductibles will lower your monthly premium.
You may be thinking this is expensive. Are travel insurance plans a good option? In many cases, they are a good option for some clients. The primary benefit of these plans is coverage for emergency medical situations, should you get sick or injured, up to a preset limit chosen at the time of purchase. Additional travel insurance benefits like coverage for lost luggage and trip interruption are included.
They work well for someone who is on a tighter budget or is abroad for shorter periods of time and/or needs a plan to meet visa requirements in the country they are moving to before they get on maybe a local plan. So you might consider travel insurance if you’re keeping a domestic health insurance plan in place and traveling back and forth from your host country on a regular basis, if you’re younger, more cost-conscious, or if you’re planning to get on a local plan in three to six months.
The downside of travel plans when compared to international health plans are that travel plans provide little to no benefits for outpatient care except for medical emergencies. They don’t provide health and wellness checkups or vision and dental care. Pre-existing conditions are generally excluded on travel plans. Coverage in your home country of citizenship is limited if you decide to travel home. And they are renewable – some for one year, some are renewable for two or even up to three years – and then any illness that occurs during the initial policy term, if after that initial policy term ends, would be excluded as a pre-existing condition, whereas international health plans are annually renewable, so any medical issues that come up in year one would be covered five years later if you remain on the plan.
So there’s definitely a good place for travel insurance plans, and we offer many. As with most decisions, there are pros and cons to each, and we feel strongly that you should have some type of coverage in case you do get sick – and we all get sick.
Regardless of the plan type you choose, you’re going to need help to get treated when you’re in a foreign country, and your insurer can provide that. All insurers provide a 24/7 medical assistance hotline, so you can call into the insurance company. You should call the insurers as soon as you get sick and think that you might need to see a doctor. You need to let them know you’re seeking care.
They’re there to help you through this process and find the best care, including qualified doctors at a facility they have a relationship with so they can pay the provider directly, and they’ll also help find doctors who speak your language. Whatever country you may be in, if you go to a provider that does not have a direct pay relationship with the insurer, then you might have to pay the bill and submit a claim to the insurance company to be reimbursed for any of those eligible charges after deductible.
Claims can be submitted electronically, and they typically reimburse within 5 to 30 days after your complete claim has been received. Just make sure you have copies of all documents, bills, and receipts. The insurance companies do want you to get quality care as soon as possible. It costs them more if you wait too long, have a lingering issue, and don’t get it treated early. So use their resources as often as possible to get the most out of your plan.
So that’s it. That’s a quick review. I hope it was helpful, and I want to thank you for your time for joining us today. You can imagine there’s a lot of information to take in. Again, our team is available to provide more specific guidance based on your unique situation. We rarely get two clients who are alike.
I love this business. It’s really interesting – clients from all around the world. We do work with a lot of US citizens moving abroad, but we’re global so we can work with any nationality moving to any country worldwide, with some limitations – maybe on 10 to 15 countries. And our goal is to find the best plan for your needs and for your budget.
And for now, I’m happy to answer any questions that you may have. So thank you. Appreciate it.
Hugo: Thanks very much. Excellent presentation. One question I have is, I think, is it true in your experience that some countries require expats to have private insurance when they move there? Because I think there are some countries in Europe where when you’ve been there a certain amount of time, you can access the kind of local health care system, but to begin with, under visa rules, you’re required to take out private insurance. Is that right? You’ve got many of those clients?
Joe: Yes, yes, for sure. And it’s tricky. So a lot of times our agents will get specific visa questions, and we wish we could help, but we can’t be experts on visas – we’re experts in health insurance. We’re experts on the health insurance plans, so we encourage our clients to check what the visa requirements are.
And oftentimes there will be set requirements for the insurance that they have before they enter the country in order to qualify for that visa. And most of the insurance companies that we work with will be able to provide a policy certificate, a visa letter in some cases as needed to document that the proper insurance is in place at the time of the visa application.
Yeah, there are some countries that require plans that have unlimited benefits. So a plan such as maybe a bronze plan that I mentioned has limits up to maybe a million dollars per year in medical benefits. That might not work for Spain or Portugal. I think it’s Spain that requires expats moving there to have a policy that has unlimited coverage.
And some countries require zero deductible plans when they’re either visiting or even moving to that country, depending on the visa. And countries have a variety of different visas that people may apply for, and the different visas may have different insurance requirements. If clients understand what their visa requirements are, then we can find plans that have the proper coverage to meet those visa requirements.
Hugo: We’ve got quite a few questions. Keep those coming. So let’s kick off. Corinne says: “My parents live in France and are 80 years old. If they decided to move to the US, would your insurance cover them in the US?”
Joe: Yes. Again, our plans are global. So we work with about half our clients who are US citizens moving to live in foreign countries. About 15 percent of our clients are foreigners moving into the US. And the rest are globals – could be from the UK moving to Mexico, could be from Mexico moving to Canada. And yes, our plans would cover foreign nationals coming to live in the United States.
Hugo: When you mentioned earlier that there are certain countries you don’t cover, those are presumably the ones that are typically difficult – the North Koreas and the Venezuelas, and those kinds of countries.
Joe: Correct. Correct.
Hugo: OFAC countries?
Joe: Iraq.
Hugo: Karina asks what an estimated premium would be. I think that’s probably – you probably want to get in touch via the website because I think they probably have to know more specific details and all sorts of things.
This next question is: “What is an example of a significant pre-existing condition?”
Joe: Good question. It’s fair. Someone who has advanced cancer, typically. AIDS is something that would – someone who has AIDS would be another one. And so anything that typically would cost the insurer significant amounts of money to cover and treat that person going forward would be considered a significant pre-existing condition as a general rule.
And again, different insurers will have different criteria in terms of what their medical underwriting guidelines are. Some are more flexible than others. So our agents can help determine which insurer to apply with if there are pre-existing conditions – they might recommend you apply with one insurer versus another.
Hugo: Somebody says: “What is the advantage of going to you rather than directly to a firm like Cigna?”
Joe: Oh, that’s great. Thank you for that question. One, the plans cost the same. There’s no difference in the cost. And so we work closely with Cigna as the example. And oftentimes the client will come to us, get multiple quotes, and then they can apply directly with Cigna if they want.
We’ll have one of our agents sometimes help the applicant through the application process. But the biggest assistance that we can provide is providing a variety of different options for the wide range of people who are coming to us who need them. So Cigna can talk to you all day long about their plan. They don’t necessarily have insight into other plans and how one plan compares to another plan.
So as we talk to our clients, we would recommend – Cigna’s a great option. We sell a lot of the Cigna plans, but for some people – so for US citizens moving abroad, but they want the most coverage in the United States – GeoBlue offers nine months of coverage per year in the US, while Cigna offers six months of coverage in the US, and that’s important to some people, so it’s a consideration.
Also, GeoBlue is more flexible on underwriting guidelines. So someone with a pre-existing condition – our agents can provide expert advice on a variety of different plans and fit the clients into the best plan for their specific situation. And again, they cost the same if you buy with us or direct with the insurer.
The other benefit is that we have a customer resolution team here. So if the client is having issues with renewals or payments or claims and the insurance company is hard to get in touch with, they can come back to us and say, “Listen, I’ve submitted my claim two weeks ago and I haven’t heard anything.”
So we have really strong relationships with all these insurers and we know who to talk to, who to go to, to get our issue resolved, and we do that for our clients, and that sometimes is the biggest value.
Hugo: Thank you. Anthony says: “The most significant factor for health insurance is how easy it is to process claims. Which company scores the highest for client satisfaction regarding settlement of claims?”
Joe: I like GeoBlue. I actually was in Spain in November and I had a great experience. I got sick. I needed to go to the doctor. I went on the app and found a doctor that was eight blocks away from my hotel. I called, they spoke English, and made an appointment for four hours later.
I walked in. They said, “You need a guarantee of payment from GeoBlue.” You can either do that via the app or – in my case, I called, and within 15 minutes, GeoBlue issued a guarantee payment, both to myself and to the provider. And they took me in 10 minutes later and I paid nothing. It was great. Really easy.
Cigna is great. IMG is much better than they were a few years ago. And they continue to improve and they’re heavily investing overall in their international health plans. So we’re excited for those improvements.
Hugo: Next question is: “Are there age limits? For example, people over age 70 wouldn’t be covered?”
Joe: Yes, with some insurers, and with others, there are no age limits. So again, if you come to us, we can recommend the plans that are more flexible or available to people depending on their age.
Typically, if you apply before you get to an age cut-off, you may be able to stay on that plan for life as long as you’ve applied before the age of 65 or 70, whatever the cutoff may be with that particular insurer. Other plans will, after you turn 70 or 75, put you on what they call a senior plan, and that would have more limited benefits.
So we can – a lot of times people say, “This plan is great, and it’s much more affordable than this other plan.” And we can tell you that’s true, but when you turn this age, the benefits will be limited. Or oftentimes the premiums increase every five years.
So the insurance has age bands. So from 55 to 60 might be one premium. And then when you turn 61, the premium jumps more significantly than you would expect, based on being on the policy for the previous five years. Sometimes that’s an issue. And so someone will say, “This is great,” but our agents can tell you, “Next year, the premium is going to be 20 percent more instead of a typical 5 to 7 percent increase because you’ve moved into a different age band.”
Hugo: Okay. Mark says: “I live in Japan where 70 percent of costs are covered by Japan’s national health care. Would it make sense to bundle up international assistance insurance with my current Japanese national health plan?”
Joe: It again depends. If that provides everything that you need, then that’s pretty good. But you can bundle it with an international health plan. And that would give you full comprehensive coverage in Japan, but also global coverage so you could get treatment in your home country or wherever you might want to.
And so it’s case by case basis. The short answer is yes, and different people have different situations. We have clients who live four months in the US, four months in Costa Rica, and four months in Europe. So there’s a range of clients.
Hugo: Sounds like a nice way to live.
Joe: I know, doesn’t it?
Hugo: “I see from your website that GeoBlue excludes certain US states for its expat insurance, e.g., Washington State. Is that temporary or is there something fundamental to insurance regulations in those states that means it’ll never happen?”
Joe: It’s driven primarily by insurance regulations in those states. So if someone is moving to New York State, there are fewer options available, which is frustrating because it limits the options that people have who want to move to that state. But we do have plans that would cover people moving to any states that one of our insurance providers might not cover, and we have other options for those people.
Hugo: Thanks. “Do you have internal plans that work with Medicare?”
Joe: They don’t work with Medicare. So they would be supplemental. If someone’s on Medicare in the US, what we might see is that they would purchase an international plan that excludes coverage in the US, and so if they wanted to get treated in the US, they could come back and be covered with Medicare, but if they want to be treated in their country of residence, wherever they may be living, then the international health plan would cover that.
Other people in those situations might buy a travel medical policy that would cover them outside of the US for the period of time that they’re abroad. But you have to buy one every time. If you’re three months in the US and then you go to Italy for nine months, you buy a travel plan for the nine months you’re in Italy and come back to the US. And then you’d have to buy another nine-month plan the next time you return to Italy.
Hugo: “Ecuador requires expats to have health insurance in order to obtain temporary and permanent visas.” Okay, there’s no question there. “If a person gets covered by the expat country before one year, can you then cancel private insurance?” So I guess that’s when you can access the local healthcare system after a period of time.
Joe: So most of these plans, you can purchase as an annual plan. So if you purchase it January 1st, it would cover you for the full year. And if at some point you found another alternative, you can request cancellation of your policy because you have another plan, maybe a local plan, or you purchase a different plan. And typically that’s not an issue if you haven’t filed any claims.
But as soon as you start filing claims, then it’ll be more difficult to cancel that plan because the insurance company wants to be reimbursed, at least for the full policy one-year policy period to cover the costs that they incurred when they covered your claim.
Hugo: “Do you have guidance on pre-existing macular degeneration that requires monthly injections? Whether they are ever covered?” It’s quite specific.
Joe: Right. So the specific pre-existing questions are difficult to answer because, again, different insurance companies will handle them differently. What we recommend to clients is if they want to find out if it will be covered or not, then to submit an application. There’s no cost to apply. And you’ll get an answer on how that insurance company would handle that pre-existing condition.
They don’t disclose externally, even to us, what their medical underwriting guidelines are. It’s proprietary to each insurer, and it would be helpful if they did, but generally, to get specific answers, submitting a free application takes 15-20 minutes and would get that answer.
Hugo: Gillis: “When you mentioned pre-existing, significant pre-existing conditions, AIDS is a much less common state than HIV positive, which many people live healthy, normal lives with. Do the insurance providers acknowledge the difference?” I guess HIV and AIDS is the question.
Joe: I think the easy answer is no. But there may be cases, and we can work with individual applicants to help them figure that out.
Hugo: Dave: “What about insurance for expats who normally live abroad, who travel back to the USA for a couple of months or so? Is it better to take out a policy or get travel insurance for the trip back to the US?”
Joe: So you can buy a comprehensive health insurance plan with worldwide coverage, and it would cover you in your country of residency as well as back in the US for the full 12-month policy period, but it will be more expensive.
So what some people do is they will buy international health insurance excluding the United States – it’s less expensive – and then they’ll buy a travel insurance plan when they visit the United States. You can get a good travel medical plan that will cover medical emergencies that occur while you’re visiting the US. And it’s just – you can’t go then to your doctor for an annual physical with a travel medical plan.
So if you have a local doctor in the US that you want to come back to for a physical or treatment for different things, then you’d have to buy an international plan with coverage including the US.
Hugo: Thank you. So a couple of good questions here. Somebody living in the UK who’s covered by the UK state health service is wondering if they can purchase a policy that gives them cover for serious situations where they’d normally use the national health service in the UK, so they could get treatment quicker if something serious happens?
Joe: Yes, that’s fine. They can buy these plans and it will cover them. And a lot of times what will happen is the international health insurance plan, not always, but would work with the local plan and then they would cover anything that wouldn’t be covered by the local plan.
Hugo: Yeah, that makes sense. And then the second half of that question: “Would they see different doctors depending on the insurance provider when you’re abroad, or do they have some of the same doctors?”
Joe: So generally with all these plans, you can choose to go see any doctor or go to any hospital, and they typically will have a list of preferred providers. And generally those are higher quality hospitals or doctors, and a lot of times they’ll speak English or you can find doctors that speak whatever language you speak.
Also, they have specific relationships with specific doctors and hospitals where they’re able to communicate with them and pay those providers directly. So it’s easier – you don’t have to file a claim later.
But if you choose to, or in some situation where there’s an emergency and something happens and you have to go to the emergency room and you end up staying for a week or two, you don’t have a choice of where you’re going. And the insurance would cover you regardless of the hospital or doctor that you go to.
Hugo: “Do the insurance you represent utilize managed care to adjust claims?”
Joe: I’m not sure what the intent of that question is.
Hugo: Yeah, I didn’t understand that. I thought it might make sense to you. That’s from Daniel. Daniel, if you want to rephrase that, drop it in and we’ll get to it in a minute.
So Thomas says: “I’m 74 and planning to retire in Punta Cana, and I think that’s Dominican Republic. I won’t be living there full time, so what kinds of coverage should I get? In the US I’m covered by Medicare and UnitedHealthcare.”
Joe: So that’s an open question and everyone’s going to have different priorities. Probably a good option would be an international health insurance plan that excludes the US, and it would cover anything that would come up in terms of medical issues that need to be taken care of in the Dominican Republic or wherever you choose to get treated. Then if you wanted or needed to come back to the US for care, it would be covered by Medicare.
But if you’re in the US for nine months and you’re three months in the Dominican Republic, then you might buy a travel medical plan for just the three-month period that you’re abroad, and you have good coverage in the States.
Hugo: “How many insurance companies do you work with that provide health coverage in Portugal?” I assume they all would.
Joe: They all do. More than ten.
Hugo: “GeoBlue website explorer policy is said to cover applicants up to age 74. Do they provide coverage for those over 74?”
Joe: That, I don’t know the exact answer to that question. My understanding is as long as you’ve applied before that age, the policy can continue, but if anybody wants to follow up, they can email me directly. So my email is joe@internationalinsurance.com, just J-O-E at internationalinsurance.com. And I can get that question answered definitively if anybody wants it.
Hugo: That’s useful. I think there were quite a few questions about very specific circumstances. And yeah, just follow up with Joe by email. And the website is internationalinsurance.com and joe@internationalinsurance.com.
A nice question: “If you’re traveling around the world without fixed itinerary or country for a year, what plans would you recommend?”
Joe: One of my favorite clients that I was talking with a few years ago – their children graduated college, moved out of the house, they sold the house and bought a sailboat. So they’re sailing around the world for two years. Great life. And so yes, these policies would be available for that situation or for people who travel – again, the example of people who are in the US for four months, Costa Rica for four months, and Europe for four months. That’s not a problem – providing worldwide coverage is what they do.
Hugo: Even on the Pacific islands though, in their sailboat, they’d find coverage. It’s global coverage, so there’d be whatever.
Joe: Yeah.
Hugo: Fantastic. “Does the US have the most expensive policies relative to other G7 countries?”
Joe: The policies we offer are global policies, so they’re not really US policies, and typically US domestic health insurance plans provide little to no international coverage. I don’t know if that answers the question.
Hugo: Okay. And then there are last questions that are fairly personal. If it’s about your specific situation, reach out to Joe via email as he says.
“Do companies typically give a discount for paying a year up front as opposed to monthly payments?”
Joe: Good question. Some companies will have discounts if you pay up front – the whole amount – and you’ll get a discount. It might be a 12 to 15 percent discount if you pay the full premium up front. They also offer quarterly and monthly installments as well. And so for quarterly payments, the discount would be a little bit less, and monthly it would be zero. So that is an option, but not with all insurers.
Hugo: Right. Okay. I think that is the majority of them. A few personal ones there – reach out to Joe at joe@internationalinsurance.com.
Joe, thank you very much for that fantastic presentation and for answering all those questions. Our next presentation starts in about an hour, just over an hour’s time, which is on transforming the expat tax experience from compliance to empowerment. So we hope to see you there.
If you haven’t already registered, you can do so at usexpatconference.com. Joe’s website for insurance questions is internationalinsurance.com. And otherwise, thank you, Joe, very much for the presentation. Thank you to everyone who’s attended, and we look forward to seeing you all soon.
Joe: Thank you everyone. I appreciate your time. Thanks, Hugo. Great job.