Expat Focus International Healthcare Update March 2018

Demand rockets for expat travel risk advice

Advice on the risks facing expats and executive travellers is growing quickly, say International SOS and Control Risks. The organisations say that over the last 10 years, demand for their specialist advice has gone up by 800%.In the last two years, the need for security advice has risen by 30% and the two companies, who are celebrating 10 years of partnership, have been supporting their membership with more than 5.3 million pre-travel advisories.

The chief executive of security services with International SOS, David Johnson, said: “The growing emphasis on duty of care has brought about the need for robust security risk management to the forefront of the corporate agenda and business leaders are increasingly aware that it is an essential aspect of business resilience.” He added that the companies offer a focus on technology with a specialist tool kit help to provide both medical response and security systems to expats and executive travellers.

How much does a broken leg cost around the world?

The cost of providing health insurance cover for expat employees has been highlighted with a survey revealing how much it will cost to fix a broken leg. While treatment standards vary around the world, the cost for those who are not insured for treatment does not.

Now international health insurer BUPA Global has looked at the figures and highlights, just in time for the skiing season, how much a broken leg may cost to fix. The figures make for interesting reading and highlight that breaking a leg in Canada will cost £5,097 ($3,655) more than it would in the UK.

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According to BUPA Global, Canada is in top spot with a £7,027 ($5,039) bill; Switzerland is in second place with a £6,691 bill and Germany is third where a broken leg will cost £5,465 to treat. Italy and Japan are the next most expensive followed by the USA with £3,723. In the UK a broken leg would cost £1,930 to treat.

A spokesman for BUPA said: “Our data shows the treatment costs will vary around the world and if you haven’t got the right cover then you could be out of pocket. Our experience shows that quality global health insurance, whether you are away or at home, is necessary to give access to the best possible care.”

Expats face high out-of-pocket costs in the US

Expats in the US who have private healthcare insurance may face high out-of-pocket fees to pay for an advanced imaging, according to a new study. Researchers found that 41% of plans required the patient to pay their co-insurance or a proportion of the fee. Just 10% of plans either had co-insurance or flat fees, while 8% of plans had both types of these out-of-pocket payments.

For expats who have imaging done at a facility outside of their health insurer’s network, 92% of plans require them to pay co-insurance.

Researchers say the cost of co-insurance has grown in recent years as insurance firms look to reduce unnecessary and expensive use of advanced imaging such as magnetic resonance imaging. They say the bills are often steep and can take patients by surprise.

Complaints about Australian health plans

Growing numbers in Australia are complaining about their health insurance cover to the country’s Private Health Insurance Ombudsman (PHIO).

The organisation says complaints rose by 30% last year and while not giving a reason for the growth, industry watchers say that there are issues over health insurance benefits and services as well as membership administration and verbal advice.

The PHIO has also published a report to help those in Australia, including expats, looking to switch insurance cover, or buy it for the first time, to compare the various health funds’ performances.

Expats in South Korea face health crackdown

Expats in South Korea are facing a government crackdown to make it more difficult for them to exploit the country’s healthcare system, it has been announced.

The move follows growing concerns over the number of non-Koreans who are said to be abusing the country’s healthcare system and undergoing expensive medical treatments while paying a fraction of the cost in premiums.

Now the Ministry of Health and Welfare says a review is under way to boost the subscription standards and they will look at overseas countries that have a state-run healthcare system to see what they can learn and close potential loopholes.

Expats in Kuwait with illness denied residency

Media outlets in Kuwait are reporting that expats who are suffering with diabetes, cancer, high blood pressure and other diseases which may not be contagious will no longer be able to gain residency permits.

The Ministry of Health says it has updated a list of 22 illnesses that will make potential expats ineligible to apply for permanent residency. The list includes vision problems and renal failure.

The Ministry says their list is in line with a GCC Council decision made in 2001. They are expecting their move to be criticised but state they want to reduce expat healthcare costs on the Treasury and help ensure that expats around the country are not only fit to work but do not carry infectious diseases.

MetLife offers a first for US expats

Financial services firm MetLife has revealed that it is the first world life insurer to couple with AXA and offer a telecoms medical advice service to employees from the US heading overseas. These employees can now access face-to-face virtual medical consultations.

MetLife’s small business solutions vice president, Jessica Mousa, said: “Employers recognise the demand for instant care as it will keep their overseas employees productive and happy and go a long way to attract and retain top talent.” The medical teams being accessed will be US-trained, with licensed physicians offering medical advice and treatment options.

Health at work survey results

A health survey of workers in the UK by insurer AXA has thrown up some interesting results.

Of those questioned, 41% say they have experienced mental health issues while at work – though most of those have not been able to discuss their problems with their employer.

Also, 51% said they would use wearable tech in helping to detect early symptoms of illness or disease. However, the device would need to be provided for free by their employer for them to use it.

Expats and tourists may have been defrauded

Expats living in Spain may have been alarmed to read a Spanish newspaper report that International Care Patient Assistance (ICPA) – previously called Gestitursa – have been accused of adding an extra fee when handling tourist and expat patient bills when they were being treated in two of the main public hospitals in Barcelona.

The newspaper says that the bills of more than 1,600 tourists and expats may have been affected, generating around €852,000 (£751,135/$1.04m). While some money was returned to the hospitals, ICPA retained around nine euros in every 10.

Aviva offers specialised mental health service

Aviva has announced that its large corporate PMI clients are being offered access to a specialised mental health service to give clients an assessment within 48 hours and access to a dedicated case manager.

The plan is available for clients holding the Optimum health insurance product which includes links to a range of specialist services including psychologists, psychotherapists and counsellors. A spokesperson said: “We have been recognised for the mental health support that is offered to our staff and we now want to use this experience to help employers to better support their workforce.”

In other news…

Digital nomads can sign up for health insurance cover that is provided by SafetyWing to keep them safe and protect them should they need urgent medical care. The worldwide urgent care package will cost from $37 a month for those who are living outside of the US. For nomadic expats working inside the US, there’s an $30 add-on fee.

Aetna International has announced that it has acquired a licence to offer health insurance cover in Hong Kong after acquiring Canadian Insurance Company Limited. The move will also see the global healthcare benefits provider offering services and products under its own brand. The firm says it will offer high quality and affordable healthcare to local citizens and expats in Asia.

The American Medical Association says that the levels of healthcare spending in the US is of growing concern and is higher than other high-income countries. There’s also little evidence that the reform of the country’s healthcare delivery will reduce future costs and spending. The report from the association highlights that in 2016, the US spent nearly twice as much on medical care than other countries while performing worse for health outcomes.

A survey by Vitality Health in the UK reveals that 78% of those with private health insurance want to see their increasing physical activity being reflected in lower policy costs. The report highlights that healthy behaviour, medical history and age are issues that insurers should consider when it comes to pricing and renewing a premium. Now 53% of consumers say their health and diet should also be considered when their premiums are calculated.

Nearly three million Brits have let their European Health Insurance Cards (EHIC) expire over the past year. The EHIC entitles the holder to discounted or free medical treatment at hospitals across the European Union. According to figures obtained under the Freedom of Information Act, nearly nine million EHIC cards have been allowed to expire since 2014 and expats and regular travellers are being warned to take the relevant steps to renew their cards or buy insurance cover.

Fears are growing that the Canadian province of Manitoba will remove universal healthcare access for international students. The government says it will save around CA$3.1m (£1.7m/$2.4m) by doing so. Universal healthcare in the province was introduced for international students in 2012.

Work on a second hospital that will be used solely by expats has started in Kuwait. The two hospitals should be ready for their first patients in 2020. The aim is to reduce pressure on other Ministry of Health facilities by offering hospitals solely for use by expats.

US expats and travellers can access a new medical insurance plan from Peterson International Underwriters called USAway Major Medical. The coverage can be bought for one day or up to 11 months for all medical-related treatments. The new plan is available in most US states.

A Colombian health insurance company has unveiled a portfolio of plans aimed at meeting the needs of global travellers and executives. Seguros Bolivar has teamed up with BUPA Global and Blue Cross Blue Shield with a range of tiers based on price and coverage. The health insurance provider says their plans will offer Colombian expats and employers the best quality healthcare whenever and wherever they need it.

Visitors and expats heading to Ecuador will need mandatory health insurance cover from May. The requirement was unveiled last year, but worries over implementation has seen the original start date of 6 February being pushed back to 1 May.

A new Middle East and North Africa operational base has been officially opened by Cigna in the Dubai World Trade Centre. The office is looking to boost its regional presence and offer long-term health insurance value for customers, including expats in the region.

When the BBC sends its staff overseas, they will be able to access medical advice and assistance from Healix should they be involved in a medical emergency. The firm will also deliver pre-deployment reports in those areas where personnel are being deployed and highlight the local risks and give helpful emergency information.

Counselling support provider Unum says that 92% of corporate client employees who used the employee assistance programme did so to access help for mental health issues. For 66% of those contacting the organisation, depression and anxiety were the most common conditions followed by relationship issues for 13%. The firm says its offering is often the first line for employees and line managers can help protect their staff’s well-being, particularly with relationship, debt and mental health worries.

The Dubai Health Authority has unveiled a partnership with the General Directorate of Residency and Foreign Affairs that will link health insurance with visa applications. The aim is to ensure that everyone in Dubai is covered with health insurance, since having appropriate cover is now mandatory.


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