Expat Focus International Healthcare Update 07 September 2016
Expats reveal the best countries for healthcare
A survey has asked expats around the world what they think of their experiences in their new countries for health care provision.
The findings from InterNations’ Expat Insider report reveal that Austria is the number one country for healthcare provision, with 82% of expats saying they are impressed with the quality of medical care.
In addition, 79% of expats living and working in Austria say that healthcare in the country is affordable.This is the third year for the report to be published. It looks at expat life in 67 countries, with 14,000 expats responding to the survey. They represent more than 170 nationalities who come from 191 territories.
In the survey, Austria is also praised for its clean air and water. Taiwan is placed second and is praised for its ‘stellar healthcare’ provision.
In third place in the ranking for health and medical care is Finland, followed by Japan, Israel, Denmark, Germany and then France, Costa Rica, and Spain.
Other notable countries for expats looking for health and wellbeing include New Zealand in 11th place, followed by Canada and Sweden with Australia in 20th position. Ecuador, a popular destination for US expat retirees, is in 21st place with Switzerland in 23rd, Bahrain in 27th, Singapore in 29th and Mexico in 30th place.
The UK is ranked in 32nd position. The USA’s expensive health provision places it in 43rd position, followed by Qatar with Russia in 47th place and Hong Kong in 48th.
While China is growing in popularity with expats, it’s ranked in 64th position to make it the fourth worst country analysed, followed by Tanzania and Mozambique with Nigeria in bottom place.
A spokesman for InterNations said: “The excellent result is tempered somewhat with Austria’s average result in the personal happiness and leisure categories, where it is ranked in 31st place and 22nd respectively out of 67 countries.”
US healthcare system for expats explained
One of the leading providers of healthcare insurance in the US has explained how the system works since it confuses many expats living there – and those who are planning to move for there for a work assignment.
The firm says a comprehensive health insurance plan is crucial for all expats who are moving to the US so they aren’t hit with huge hospital bills. Anyone without health cover may risk not receiving medical attention without having to pay in advance.
The insurance provider warns that if an expat needs emergency treatment and they don’t have healthcare insurance cover then they may have to pay a huge bill for their treatment.
However, there are different types of health insurance cover in America, with a wide number of insurance companies offering different products with various exclusions and conditions.
The recent healthcare reform, known as the Affordable Care Act, has helped more citizens and expats living in the USA to access healthcare and protect those who have pre-existing conditions from being denied healthcare coverage.
The insurer says that while the US offers a varied choice from health cover providers, there’s also a wide range of premiums and expats should examine carefully what they need cover for and be prepared to pay for a treatment bill if they haven’t planned effectively enough beforehand.
Expats, the firm says, need to be aware that there are two types of bodies who offer their own medical networks and discounted rates of treatment.
They are Preferred Provider Organizations (PPO) and Healthcare Management Organisations (HMOs), plus there are two federal government programs for those who cannot afford healthcare costs. Medicare helps retired citizens and Medicaid helps people who live on low incomes.
Expats who live in the US can opt to buy an international policy or choose cover from the various health insurance types available in the country.
Expats looking for help and advice when choosing a healthcare plan can use the Agency of Healthcare Research and Quality to make a decision.
However, most expats moving to the US for work will find that their employer’s group health plan can be extended, in most cases, to cover their family’s needs as well.
The advice from the expat health insurance provider also points out that individual private medical insurance policies are probably more suitable to expats than buying a local health policy since they are generally geared towards globally mobile people and will offer healthcare access in most countries.
Medical insurers exit ACA
The Affordable Care Act in the US is heading into trouble, according to some media reports, after revelations that some of the biggest medical insurers in the country have left state-run health exchanges.
The decision to do so is financial, with one insurer saying they are making a huge loss because of ‘higher than anticipated’ numbers of people needing high cost care.
ACA aimed to bring healthcare coverage to those who cannot afford the insurance costs of mainstream providers and there’s also been a problem that not enough younger, fitter Americans are signing up to balance the numbers of older members who need expensive care.
Many US citizens and expats alike have seen steep increases in health insurance premiums, and now critics of ACA say the whole scheme will come under pressure if more health insurers decide to bail out too.
Private Omani firms cut expat health cover
It might be a sign of the times to come, but private firms in Oman are said to be cutting health insurance cover for expat employees.
The country’s economy is struggling and the tougher conditions mean many employers are looking to save on their insurance costs.
As part of this move, they are excluding common and chronic medical conditions from the health insurance plans offered to employees.
One newspaper says that the number of staff health plans being renewed in 2016 has dropped and the firms who are renewing are reducing benefits.
One agent told the newspaper that this is a ‘worrisome trend’, with firms excluding cover for some medical issues such as diabetes and blood pressure which need constant treatment and medication.
Another agent told the newspaper that most employers are becoming cost conscious and are asking for reduced packages when compared to demands in recent years.
The worry for expats working in Oman is that employers are not required by law to provide health insurance cover for employees, though the government is consulting on whether to introduce mandatory health insurance.
A spokesman for the trade unions told the newspaper that the country’s new labour law should introduce mandatory healthcare cover to help firms protect their workers’ health.
The current low price for oil has hit many, with the government bringing in austerity measures and reducing subsidies and worker benefits while increasing taxes.
In addition, many private sector employers are cutting costs and so, according to media reports, are not paying the parting expats end of service benefits.
Expats launched crowdfunding campaign to pay hospital bill
An expat couple made headlines around the world after they were forced to launch a crowdfunding campaign after the birth of their twin daughters left them with an unexpected and very large medical bill.
American expats Erica Brüll-Reinhold and Bas Brüll were hoping to take their daughters home after a month-long series of surgeries after birth complications, but they were told the babies could not be discharged until the hospital bill was settled.
The teachers were informed that their newborns were not covered by Taiwan’s National Health Insurance (NHI) policy, which meant they had to pay the hospital US$41,000 before they could take their children home.
The issue arose after some procedures had been carried out and hospital authorities contacted Taiwan’s Bureau of National Health Insurance to check the couple were covered by insurance after issues with their alien resident certificates were uncovered.
Under regulations, foreign babies must be living in Taiwan for six months to be eligible for free medical attention.
The babies were discharged after news of their predicament became public and the couple were given five years to repay the bill but they opted to launch a crowdfunding campaign to help pay it. Apparently, one generous benefactor gave them enough to meet their target.
Chinese expats return home to boost private healthcare
A leading news outlet in China has revealed that growing numbers of Chinese expats are returning home and signing up for private healthcare insurance.
Affluent Chinese, particularly those who’ve lived and worked overseas, are looking for the convenience and quality of private medical care.
Their experiences overseas are pushing them towards taking up private healthcare insurance which comes with health check-ups, private doctors, international healthcare coverage and a tailored health management guidance offering.
Free healthcare offered to stranded expats in Saudi Arabia
An ongoing situation that has seen thousands of expats stranded in Saudi Arabia because they have been laid off by employers in the country’s construction industry has seen the government stepping in to offer free medical aid.
The government says it will now extend medical facilities to expat workers who need free treatment in government-run hospitals.
The move follows complaints that the expats have had their salary payments delayed. Many are in desperate need of medical care but cannot afford to pay for it and their employer-provided medical insurance no longer covers them.
The move follows news that hospitals in Saudi Arabia have been refusing to treat expat patients who are not part of the medical insurance system.
Now the government has told hospitals to admit expats who’ve been laid off by companies and to charge the government for the relevant bills.
The kingdom’s government is also providing food to those former employees who are stranded in the country.
In other news…
As US hospitals and healthcare providers increasingly pitch for expat patients from outside the country, a leading provider of cross-border payment systems says it is seeing a big demand for its pay platforms. Flywire says the international market for patient care is worth around $40 billion and is growing at a rate of up to 25% with patients willing to travel for expertise and the latest advancements in medical care. Hospitals in the US have invested heavily in providing services and marketing their facilities to international patients.
Media reports in the UK have focused on a growing issue of British expat retirees living in Spain who fail to meet new rules on healthcare to access what were formerly free services. However, they cannot return to the UK because they also fail National Health Service rules to receive treatment, as they must live in the UK for six continuous months before doing so. The issue is around the expat retirees signing a form saying they paid National Insurance contributions for three years or more, but this form was withdrawn on the 1st of July, leaving British expats in Spain in limbo. While many should have signed up for private medical insurance, most cannot afford to do this.
The International Hospital in Phuket has introduced an ‘expat privilege card’ and unveiled three new departments, including a children’s clinic. The expat card provides medical and healthcare privileges for expats living in Phuket and surrounding provinces.
The national health insurer in Abu Dhabi has announced it is dropping tests for vitamin D deficiency from its offering. Those who suffer from the condition will now not receive treatment. The decision affects only expats, since Emiratis can still claim for the tests on their Thiqa cards.
The government in Barbados has introduced a National Social Responsibility levy to invest in its healthcare system. The levy should raise $140 million, with a 2% surcharge on imported goods.
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