Expat Focus International Healthcare Update 02 August 2016

British expats fail to prepare for their healthcare needs

Just 42% of British expats planning an overseas work assignment arrange their healthcare provision before moving abroad, according to a survey.

AXA PPP International says that six in ten expats do not prepare and just 42% arrange health care cover before moving abroad.As a result, says the healthcare insurance provider, many expats ignore the potential consequences that may result from not having healthcare insurance in place – despite 80% of British expats saying they were concerned about the quality of healthcare overseas.

AXA says that the number of people moving overseas to work and live is growing with the main driver for the move, for 56% of expats, being the search for adventure.

However, 40% of expats said they were looking for a better work-life balance, and for 19% an overseas assignment offered better career opportunities.

The research also reveals that the move overseas for expats brings a range of concerns that many are not preparing to deal with.

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For example, more than 80% of expats said they worried about how they would find a good doctor, while 42% said they would organise healthcare when they arrived. The survey also revealed that 19% said that their travel insurance would cover their healthcare costs.

Rewards and benefits of expat life

The managing director of AXA, Tom Wilkinson, said: “Expat life can bring many rewards and benefits but expats should prepare themselves for the basic aspects of life such as healthcare and financial management which often are different in other countries.”

He added that one big issue was for those expats who are used to having a state health service, who therefore may not appreciate that everyday issues such as visiting a doctor or having a prescription may carry a cost.

Indeed, many expats appear to be unaware that in some countries their emergency services, including using an ambulance, have a cost that needs to be paid upfront.

Many expats- around 88% – believe that they will have a healthier lifestyle while working overseas with better weather bringing the biggest health benefits.

Mr Wilkinson added: “It’s important also for employers to support employees and offer a healthcare package which meets their needs.”

The world's most expensive health care insurance

An annual report that looks at how much it costs expats for International health insurance plans has revealed the most expensive country for healthcare cover is the USA.

Pacific Prime puts together the report by looking at 95 countries to find the most expensive and the cheapest for medical insurance.

This year the firm has looked at expat health insurance with three levels of plans that are offered by leading insurers – and just 10 insurance firms represent 70% of the world’s health insurance market.

The average cost of cover is a revelation, with prices in the USA ranging from US$7600 to US$17,335. Mali offers the cheapest cover.

The largest increase in the rankings has been seen by expats in Dubai, which is now the world’s sixth most expensive location for health insurance cover; one reason for this, says the report, is the growth in claims from expats living there.

However, regulations to the healthcare market in Dubai means everyone now needs healthcare cover, which has led to it becoming the most important and fastest growing international health insurance market in the world.

Surprisingly, Canada has also leapt up the rankings and now replaces Israel to become one of the most expensive countries to get health insurance. Japan enters the top 20 for the first time – it is now in 17th place, up from 23rd.

The report also highlights that health insurance premiums around the world have risen by nearly 14% and are now closing the gap with America.

The most expensive countries for healthcare insurance provision for expats are: USA, Hong Kong, China, Canada and Singapore. The top 10 is made up of Dubai, Israel, Russia, UK and Mexico.

The cheapest countries for expats health insurance are: Mali, Angola and Ethiopia, Poland and Madagascar.

International health insurance products boosted by Blue Cross

The number of international private medical insurance products being offered by the Blue Cross Blue Shield Association has been boosted.

The plans are aimed at individuals and multinational employers for those who travel the world.

The Chicago-based association says the plans will include their Global Traveller and Global Expats plans.

The plans provide cover for US employees who are working and travelling in other countries as well as foreign nationals who are working or travelling in America. The plans also cover non-US expats who are travelling and working in countries other than America.

A spokeswoman for the firm explained: “We have put together a suite of international medical insurance products that will meet the growing needs of individuals who travel globally and multinational employers.

“Travellers can now benefit from the stability and security that Blue Cross and Blue Shield members have relied upon.”

The Association also points out that they will be announcing further international travel insurance products for students and individuals in the near future.

Visitors to Kuwait may need health insurance

The Kuwaiti government is proposing that everyone visiting the country on a visitor’s visa will need to have mandatory health insurance to gain access.

The government is proposing the move for visitors in a bid to cut costs and reduce pressure on the country’s public hospitals.

The plans also call on sponsors who apply for a visitor visa to attach a valid health policy to show that the visitor will receive private healthcare while in the country. There is no set date yet as to when the new proposals will take effect.

Petition calls for British expats’ healthcare to be retained

A new petition on the UK government’s website is calling on Brexit negotiators to recognise that British expats who were living in the EU at the time of the referendum vote will retain their healthcare rights post-Brexit.

Since the relationship between the UK and the EU is still up for discussion, the petition says it’s crucial that expats who currently live in the EU will still be offered free health care.

The petition comes close on the heels of a legal opinion that British expats are wrong to rely on the 1969 Vienna Convention to retain their healthcare privileges, since it will not cover British pensioners having their healthcare needs paid for by the UK government in their EU country of residence.

Without a guarantee from the UK government, expats living in the EU will have no choice but to take out their own private health policies, which can be a prohibitive cost for pensioners.

Those behind the petition also point out that UK expats will not be entitled to free emergency health care by using the European Health Insurance Card (EHIC).

The petition calling for UK expats healthcare rights to be protected in the EU is located on the government website. If it gains enough signatures, it may be debated in Parliament.

Losing employer-provided health insurance

As people leave the world of work and head into retirement, the loss of employer-based health insurance in the US may affect former employees’ physical and mental health, according to a study.

Georgia State University says there is an impact on levels of depression for those who lose their healthcare insurance, as well as on their ability to function, with daily activities such as shopping and even getting dressed becoming problematic.

The findings reveal that private health insurance is a crucial factor for the health and wellbeing of early retirees.

However, when retirees did seek health insurance the result did not offset the negative results of living without employer-based health insurance.

One of the researchers said the reason is that non-employer based health insurance is “not quite as good” and with lower quality insurance, people tend to suffer more when they retire.

The research predates the introduction of the Affordable Care Act (ACA) but researchers say the findings will give an indication of how the lack of insurance may affect someone in the years leading up to Medicare eligibility.

Growing issue of healthcare provision in the United States

The findings also underline a growing issue of healthcare provision in the United States, with 47% of men and 60% of women leaving the workplace before they become eligible for Social Security benefits. Around half of workers move from full-time employment to early retirement between the ages of 51 and 61.

However, fewer employers are offering retirement health benefits, which means this shift to more people retiring early is leading to serious health implications for retirees.

A spokeswoman for the researchers explained that losing health insurance perhaps creates a small trauma for early retirees which then triggers depression and other ailments.

Saudi employers must now provide healthcare cover

Expats working for employers in Saudi Arabia must now be provided with health insurance cover, says the Ministry of Labor and Social Development.

Failure to comply with the new rules could see the employers being banned from further recruitment and face a fine that equals the cost of the insurance.

There’s also a new set of inspection teams being created to ensure the new laws are being followed.

The laws also affect Saudi nationals, so expats who needed health insurance in place before they could apply for a visa will now find that the visa will automatically have healthcare insurance provided with it.

To access healthcare in Saudi Arabia, expats will only need to show their residence permits or a national ID card.

The new rules are being phased in over four parts and the first has already been implemented.

The system will be digital and run by the Council of Cooperative Health Insurance (CCHI) so violations will be easier to monitor.

However, one issue being highlighted is that of employers providing healthcare cover for domestic workers which varies hugely depending on their medical history.

Apparently health insurance premiums vary from between SR2,100 and SR4,300 – though employers with more domestic workers can get cheaper rates.

The other worry highlighted in a media report is that the domestic worker must detail an extensive medical history, which could see their insurance cover being refused and jeopardising their employment prospects.

In other news…

UK life insurance companies are withdrawing from the market, so Brits who live abroad can now receive quotes from just 16% of insurance firms. The findings come from Unusual Risks, an insurance firm, which highlights that last year 33% of life companies were prepared to offer cover to British expats living overseas. Of those that do offer cover, just 8% will offer critical illness cover – and often only under certain circumstances.

A new healthcare facility has opened in Doha’s industrial area to cater for the needs of expats who work and live in the area. The new medical centre can deal with up to 24,000 patients every month, according to Qatar’s Health Authority. More importantly, the centre is aimed at low-income workers who currently have a difficult time accessing healthcare.

Aetna International, an expat health insurer, has revealed it is now offering specialist mental health services with its healthcare plans. The firm has offices around the world and says most of its insurance plans will now give expats access to counselling services in more than 200 countries.

The Australian health and accident market has a new player in Berkshire Hathaway. The firm says it is offering a full range of accident and health insurance products, including expat insurance and inpatriate insurance. Berkshire says it wants to offer employers added value to the healthcare insurance offering they make to employees.


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