Expat Focus International Healthcare Update December 2018

HR departments need to 'address expat risks'

Expats working overseas are facing specific risks that HR managers should be addressing, says Helix International. The firm, which provides healthcare and risk management solutions around the world, says that any difficulties an expat may encounter can be mitigated by HR departments carrying out a detailed assessment of their suitability for the post. There is also a need to carry out a thorough preparation for the individual before they head overseas.The firm’s head of medical communications, Dr Simon Worrell, said:

"Living away from familiar places and people can be a challenge and these challenges can be exacerbated for those workers who have pre-existing psychological issues. The negative aspects of working overseas can be more pronounced for those with mental health issues. However, HR professionals can do a lot to support people to make a successful move."

Helix says that one important step before an employee moves abroad is for a medical assessment to be carried out that includes their physical and mental health well-being. It’s this medical clearance process that will help ensure that the employee is suitable for the post and also pick-up any medication requirements since some medicines will be unavailable in some countries.

Dr Worrell added: “Working overseas can bring rewards but also present significant challenges so effective HR intervention will help staff prepare for any difficulties that may occur and offer them support.”

Online counselling for expats

Online counselling is being added to the private medical insurance offering from AXA PPP Healthcare.

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The firm says that its worldwide and UK insurance plans will now include a live web chat service to enable employees to talk over their concerns in private and in confidence with a qualified counsellor.

The firm’s mental health lead, Eugene Farrell, said:

"Counselling works when callers are comfortable. Talking to a stranger about what can be deeply personal and sensitive matters is not easy, and some people prefer talking on the telephone. The online counselling service offers a choice that makes it easier to find someone to help them deal with the pressures in their life."

Kuwait to introduce mandatory health insurance

News outlets in Kuwait are reporting that the National Assembly has proposed a new law that would establish a mandatory health insurance scheme for all expats working and living in a country. The Assembly’s Legal and Legislative Committee is also said to have agreed to impose higher charges for medical services on all expats seeking treatment at Kuwait’s public hospitals.

Currently, expats pay 50 dinars (£130/$164) annually when renewing their residence permit and also partial fees for some health services in Kuwait’s hospitals. However, the committee has also introduced a new measure that could see the introduction of mandatory health insurance being imposed on all foreigners who visit Kuwait. It looks likely that in future a visa will only be issued on proof of a health insurance policy being attached to the visa application.

Hospitals in the country have also received a circular from the Health Ministry demanding that expats who cannot afford to pay for their treatment in surgeries or hospitals must have a guarantor who will commit to paying their medical costs.

The ministry says that this commitment should include all information about the guarantor and patient and an agreement will need to be signed before any patient is admitted to a hospital.

Meanwhile, Kuwait has unveiled plans to make the country more attractive for international investors with the aim of providing the best levels of healthcare. To that end, the government will encourage the investment and establishment of factories to manufacture medical equipment and medicine.

The government also hopes to contract with international firms delivering medical services and consultations to offer its citizens and expats the most comprehensive healthcare service possible.

Collaboration offers high-risk destination advice

GWS has teamed up with health insurer Chubb to develop an e-learning solution that will be used as a smartphone app. The move will see anyone heading to a high-risk destination for business being able to take an interactive course to boost their understanding and knowledge of a country before heading overseas.

Employers will also be able to monitor which of their employees have completed modules before travelling. The app is available in a range of languages including English, French and Italian.

A spokesman for Chubb said the e-learning app will provide clients with the skills and knowledge to improve their situational awareness and then identify proactively any threats so they can avoid danger while staying safe while travelling.

“The e-learning function will help employers show their duty of care, commitment and also take steps to manage any reputational and financial risks when preparing their employees for overseas travel.”

Meanwhile, Chubb has unveiled a new terrorism offering for middle market and multinational firms. The terrorism risk evaluation service offers clients access to global security risk assessments and catastrophe modelling.

The new offering has been developed after client feedback highlighted a need to boost their understanding of political and terrorism-related risks for their operations around the world so an employer can evaluate any issues and expat employees they have in place.

Growing numbers of US expats retire overseas

Growing numbers of Americans have either moved or are considering moving overseas for their retirement, with healthcare costs and facilities an increasingly influential reason for moving. A feature in Forbes highlights that the number of expats retiring overseas has risen by 40% over the last 10 years and the country’s Social Security Administration has recently reported it sends pension payments to 700,000 expats overseas.

As result, the magazine looked at the best destinations for US expat retirees and recognised that while many will cluster in some specific destinations, other locations are also suitable.

Along with medical care, the destinations are also ranked on healthcare insurance, which is generally cheaper than the health insurance the expats previously had to pay for in the US. The survey rated Spain and Malta as excellent destinations for their quality of health and medical offerings, while for the lower cost of living, destinations such as Belize, Chile and Croatia were highlighted.

Employers can access travel and security intelligence services

International medical group IMG has unveiled a tie-up with WorldAware, a global risk management firm, that will see travel and security intelligence services being offered within the firm’s products.

From January, customers will be able to access destination reports with data of political upheaval and other security issues plus natural disaster alerts that could impact on an employee’s overseas trip. A spokesman for IMG said: “By offering our clients security assistance services, we can help minimise their global risks by serving and protecting them while away from home.”

Japan looks to restrict expats’ access to healthcare

The Japanese government is looking at ways of tightening expats’ access to the country’s medical facilities to stop abuses. Media in the country have in recent months been highlighting abuse by foreigners of insurance cards which give access to medical and healthcare for free.

One issue is that medical centres and hospitals find it difficult to check the validity of insurance cards and now the government is proposing to have photographs or microchips on the insurance cards for expats to use in a bid to reduce the instances of expats accessing free or cheap healthcare.

Expat relatives will need health cover in Australia

The Australian government is floating a proposal that tourists and expats can no longer expect their families to enter the country if they do not have health insurance coverage.

In recent months, there’s been a big push for the move and in New South Wales taxpayers are spending AU$100 million treating injured or sick tourists who have been hospitalised. However, it appears that Australians are taking out health cover for their visiting relatives to help them.

While Australia has reciprocal healthcare agreements with a number of countries for its citizens to enjoy free healthcare, including New Zealand, the UK, Sweden and Italy, the country’s healthcare insurance premiums are very high and hospital costs can be expensive.

Expat benefits platforms grow offerings

A report from the international employee benefits venture between AXA and MetLife, Maxis GBN, has highlighted that key data and digital developments will help boost the future of global employee benefits. They include growing numbers of employers adopting a global benefits platform to help centralise benefit management and employee enrolment and deliver accurate data along with health and wellness technologies to boost expat take-up of their wellness programmes.

The report also highlights that expats should look forward to the development of artificial intelligence as part of future health innovations to help them.

Expats may have to pick up medical bills in Ireland

A growing issue in Ireland has seen private hospitals warning patients, including expats, that they may have to pick up treatment bills because health insurers are increasingly refusing to pay. One chief executive of a health group says insurers are challenging policies and querying the length of time patients are spending in hospital.

Health insurers are also questioning a patient’s pre-existing illnesses in a bid to reduce their exposure to claims.

The chief executive says that many private hospitals have absorbed these costs when insurers refuse to pay a medical bill. However, he says that this is no longer sustainable and he told one news outlet: “We cannot guarantee customers will not be forced into negotiating with insurers about their shortfalls after treatment.”

In other healthcare news

AXA has unveiled plans for a new international healthcare offering for employers with expat workers in Saudi Arabia. From January, both multinational employers with employees working in the kingdom, as well as businesses based there, can access the new Prestige and Prestige Plus plans that are designed to meet local needs.

International students at the University of Texas are increasingly confused about their health insurance coverage, according to the university’s student newspaper. Apparently, the students are finding it difficult to find an affordable healthcare plan if they do not want the $2,500 health insurance plan they are automatically enrolled onto every year. The students say the offering is pricey and they would like more options as their automatic offerings.

The US-based technology firm Agile Health Insurance has announced plans to extend its product portfolio and offer short-term health insurance coverage with a maximum duration of up to three years for its cover. This will help employers and expat employees from having to reapply for health insurance coverage every year. The firm says it is among the first to offer a 36-month option for online applications.

A fourth new health centre aimed only at male expats in Qatar has been opened by the Minister of Public Health. The new centre will deal with up to 20,000 patients every month and offer healthcare facilities services around the clock with specialist clinics available most mornings and evenings.

Expat retirees in the UAE are to be offered health and social care packages by one health insurer. The move follows visa changes for retirees and Manzil Healthcare Services says it will expand its offering to those expats living and working in the Emirates, along with visiting elderly tourists. Among the services being provided will be grooming services, bingo games and day trips for those who sign up.

The growing threat of kidnapping for expats and travelling employees has led to a new partnership being formed between crisis law firm Schillings Critical Risk and speciality insurer Brit. The firms are offering a comprehensive insurance package that will cover the kidnap and ransom of employees. A spokesman says that with growing numbers of employees being sent overseas by employers means more are entering potentially dangerous locations and increasing their exposure to risk.


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