Expat Focus International Healthcare Update 19 October 2016

Code of practice to protect expat travellers

A new code of practice has been launched to help employers manage the health, security and safety risks of their expat travellers around the world.

The guidance advises organisations on how best to manage and address these issues for employees who travel regularly for work purposes.It’s been developed by the British Standards Institution (BSI) and International SOS and helps employers develop and implement their approach to health and security policies, hazards and threat identification, risk assessment as well as travel safety. There is also help on incident management and prevention strategies.

The unveiling of the code comes after a study by Ipsos Global Advisor which revealed 71% of senior executive travellers said they had experienced a medical issue while overseas.

Also, 80% of travellers said they had felt that their personal safety could be threatened while working overseas.

The chief executive at BSI, Howard Kerr, said: “The risks must not go unchecked and there may be a big difference between an assessed security risk and assessed medical risk for a given location. It’s these differences that highlight the complexities facing organisations when preparing their workers for travel.”

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Employers can use the guidance, PAS 3001, to integrate into their career health and safety management arrangements.

Spain warns UK over expats healthcare bill

Brexit negotiations have not even begun and Spain is already warning the UK that it must pay for its expats’ healthcare bills once the country leaves the European Union.

The warning comes from the country’s foreign minister Jose Garcia-Margallo who was speaking at a conference and said Spain was hoping to reach a deal that would help pay for the healthcare of around 800,000 British expats currently living there.

Currently, British expats can access Spanish healthcare services on an equal footing with Spaniards and those who are working in the country and pay social security costs have their medical bills covered by Spain.

However, under EU agreements, a pensioner’s healthcare bill must be met by the United Kingdom and in 2014-15 this amounted to £223 million.


Kuwait launches new health insurance schemes

In a bid to clamp down on expats in Kuwait accessing free healthcare, the country is bringing in compulsory healthcare insurance.

The Ministry of Health says the new scheme will provide medical insurance and healthcare for expats living there.

The move to bring in a new scheme comes after the government banned non-nationals from accessing public healthcare services with this restriction being implemented within the next two years.

Currently, expats working and living in Kuwait pay for an annual health insurance cover that gives them subsidised healthcare though Kuwait still provides free medical services to its citizens.

With more than three million expats living in the country – around two million of them are working in the private sector and one million are in the country’s public sector – only those working in the private sector will only be able to gain treatment in expat-only hospitals.

To that end, Kuwait has built three new 700 bed hospitals to provide an expat healthcare service in the country and expats will have to buy specific health insurance to be treated at these new facilities.

Healthcare insurance industry experts say expats should be prepared for their health insurance premiums to treble over the coming years.

The process for expats working in Kuwait’s public sector has not been ratified as yet though they will still be able to enjoy treatment in private hospitals and clinics.

Kuwait is moving towards universal health insurance coverage for all of its citizens, though this does not cover medical treatments being sought abroad.

Kuwait has also announced that its retired citizens are eligible for free health insurance, but this does not extend to expat retirees living in the country.

Abu Dhabi wants a 'viable healthcare' sector

Expats and Emiratis living in Abu Dhabi are facing extra health insurance costs from the Health Authority Abu Dhabi (HAAD) which says the money will help create a healthy and viable healthcare sector.

However, the change in health coverage is not affecting every expat or Emirati since only expats and their families who have cover from the Abu Dhabi Basic Plan and are seeking treatment at a private hospital will be paying more. Public hospital treatment costs are not going to be affected.

Emiratis holding the Thiqa card will now see their subsidy falling from 100% to 80% and that will fall further to 50% for any medical care taken outside of Abu Dhabi.

Expats aged over 40 may be subjected to an additional 50% surcharge on their health insurance premium – this is optional and depends on whether their employer decides to collect this.

Media outlets are reporting that many employers are considering imposing the surcharge though many are also said to be considering health insurance co-payment as an option.

In addition, expats will also have to pay extra for health premiums to cover their wife and up to three children under the Basic Plan though extra children and parents will not be covered.

Employers fail to engage with staff on healthcare benefits

Even though healthcare provision is a top benefit for expats, employers are still failing to engage with their staff on the wider healthcare benefits available, according to a survey.

Jelf Employee Benefits says firms that communicate the health benefits of their provision see a greater take-up of them from employees.

While employee assistance programmes and cash plans are popular with employers, this level of enthusiasm is not shared by their staff, says Jelf.

Indeed, the consultancy says that most employees do not know the healthcare benefits even exist.

In their report, Jelf says it’s important that employers don’t simply have healthcare benefits in place but communicate with their staff about the positive reasons for engaging with these benefits and a company with a culture of supporting health and well-being sees a positive response in return.

Netherlands healthcare insurance set to rise

Healthcare insurance premiums look set to rise in the Netherlands after the first insurer DSW announced a 10% hike in premiums with other insurance firms looking set to follow suit.

By tradition, the DSW is the first insurance firm to publish its premium plans for the coming year which sets a trend for others to follow. It’s rare that health insurance rivals publish lower price rises.

The health ministry had forecast an increase of €3.50 per month but the new rise is much higher and takes the monthly premium to €108.

One patient’s organisation has already declared that the announcement is a ‘cold shower’ for the plan’s members and the Health Minister has said that she hoped health insurance firms would dip into their billion euro reserves to keep premium rises this year to a minimum.

DSW says its health insurance policy needs to cover the rising cost of medicines and deal with price and wage rises.

Health and wellbeing smartphone app launched by Cigna

Popular expat healthcare benefit provider Cigna has unveiled a new health and well-being smartphone app for employers to help their workers improve their health.

Cigna Virtual Health provides coaching to help proactively manage the employee’s health and includes a symptom checker as well as access to a virtual GP from Dr Now.

Cigna says it has developed the app because employees want to boost their health and well-being but find it difficult to get started and their app will help track health improvements.

Their survey also revealed that 68% of employees say they are interested in other healthcare provided tools such as turning data from wearable devices into a more detailed picture of their health.

The managing director of Cigna UK Phil Austin said that healthier employees drive a healthier business.


High Risk Voyager Travel Insurance unveiled

A travel insurance product aimed at those who are heading to areas considered to be of high risk has been unveiled by Voyager Insurance Services.

The High Risk Voyager Travel Insurance is aimed at employees and travellers heading to danger zones from the UK, EU and overseas dependent territories where those areas are so dangerous that a typical travel insurance policy would not provide cover.

These areas would include crisis and conflict zones as well as humanitarian aid and disaster relief areas.

The insurance firm says that many travellers may be putting their health at risk without realising that their government may have issued a travel advisory notice which would restrict the cover provided by traditional travel insurance.


Expats in France can access quality healthcare

One of the world’s best healthcare systems is now easier for expats to access.

The rules covering France’s Protection Universelle Maladie have been changed to become more affordable and accessible for expats.

Essentially, the new healthcare system gives an automatic right to access the medical system for those who are legally living in the country in a ‘stable and regular’ manner.

In essence this means that an expat needs to have lived in the country for three consecutive months as a permanent legal resident which is defined as living in France for at least 183 days a year.

France has an easily accessible and affordable healthcare system that is not just high quality but ranked in first place by the World Health Organisation.

Previously to the rule change for many expats, particularly those who were looking to retire to France, is that they were not able to apply for health coverage until they had legally resided in the country between one and five years.

While waiting for legal residency status, expats had to buy private healthcare insurance for their medical needs. Also, under the previous system, expat retirees had to visit a medical centre every year to prove they were still entitled to access healthcare but they will no longer have to do this.

In other news…

Fears that New Zealanders living in Australia are being denied access to Medicare when renewing their visas are unfounded, says a government spokesman. The Australian government has responded to claims that growing numbers of Kiwis are being refused healthcare but the government says this is an administrative requirement that is triggered when someone changes their permanent residency status and they need to prove their eligibility once more within 30 days for coverage to continue.

The UAE government has moved to clarify a law it brought in earlier this year and confirms that expats with communicable diseases such as TB will not now be automatically deported and they can still sponsor children or spouses who have old TB scars. However, an expat diagnosed with TB must report to a primary healthcare centre and follow a prescribed treatment.

A survey of patients in Kuwait has revealed high levels of dissatisfaction with healthcare treatment in hospitals with many complaining of poor diagnosis and even poorer treatment in the country’s public medical facilities. Of those questioned, 30% said their treatment and diagnostic experience was ‘lacking’ and 24% of people said they would choose to go overseas for treatment if they had a major condition.

It’s a situation that self-employed expats around the world are probably aware of but a survey of the self-employed in the UK has found that just 7% of them have critical illness cover. This means they have no back-up plan should they be unable to work and they would not be financially secure, says Scottish Widows which carried out the survey. However, just 9% of employees have critical illness cover.

A new medical tourist scheme for those needing treatment has been unveiled by Thailand. The country is seeing a steady growth in demand for its healthcare facilities, particularly from the Gulf region since health insurance providers will pay for treatments there. The scheme enables someone to stay in the country for 90 days without having a visa.


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