Expat Focus International Healthcare Update March 2019

Expats in the UK need to pay for healthcare

Expats, as well as visitors, heading to the UK will need to pay upfront for any NHS treatment they may need if they are not entitled to free healthcare. New rules have been unveiled in a bid to prevent medical tourism, so anyone accessing healthcare will need to show identification proving that they can receive it for free.The identification will be necessary for doctors, hospitals, NHS-funded charities and community health councils. For those who cannot prove they have a right to free healthcare, unless their medical situation is an emergency, then hospital staff will demand a fee of 150% of the medical treatment’s cost.

However, doctors say the new rules, which are now in force, could lead to seriously ill people not seeking treatment and an increase in the number of infectious diseases going untreated.

While NHS hospitals have been billing for treatment for several years, the bills are not sent out until after treatment is completed. This means that many of these bills have been unpaid, with patients skipping the country or refusing to pay.

James O’Shaughnessy, the health minister, said: “We’ve no problem with visitors from overseas using the NHS, so long as they make a fair contribution, as British taxpayers do.”

US business travellers given health and safety tips

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With 4.8 million US citizens travelling overseas for business reasons every year, a new travellers’ health update offering advice may help. Among the information from the Center for Disease Control and Prevention is advice on measures necessary before, during and after their business trip.

Business travellers should take a travel kit, including any prescription medicines and other medical supplies, but will need to be aware that some items may not be allowed in the country they are visiting. The advice also includes measures for minimising the effects of jetlag, keeping hydrated and avoiding caffeine and alcohol. To help avoid stress, business travellers should eat healthy meals, stay in regular touch with family and friends, and rest as much as possible.

Visitor health insurance required in Kuwait

Kuwait has now passed a law that compels foreign visitors to obtain health insurance cover for the duration of their stay before, or when, they enter the country. Access will be denied to anyone unless they have an have insurance policy in place, though there are no restrictions on how much the policy should cover.

One of the reason for the move is criticism from Kuwaiti lawmakers that expats and visitors are hoarding medicines they can access cheaply while in the country and then selling them at a profit when returning home.

Ratings for doctors in Dubai

A new online portal will enable expats to rate doctors in Dubai to help make the delivery of care services there ‘more transparent’. The scheme has been unveiled by the Dubai Health Authority and will also enable users to check out how much private treatment will cost them at a facility or hospital.

The idea is also to boost Dubai’s growing popularity as a centre for medical tourism, though all of the ratings for doctors will be vetted by regulators before being published.

European business travellers want more support

SAP Concur, a US-based firm providing employers with experience in travel management services, has carried out a survey of its European customers. Among the findings it is revealed that European business travellers would consider not travelling overseas if they considered the destination to be unsafe.

According to the survey, 23% of British business travellers said that last year they were involved in, or were close to, a critical incident while working away.

One of the issues highlighted is that 20% of business travellers believe their employer would not be able to provide any professional support should they be involved in an incident. Now the firm says that an employer’s duty of care is paramount and they should not send employees overseas without being able to locate and contact them when necessary to offer assistance should there be a medical emergency or a natural disaster.

Expats in Hong Kong get wider healthcare choice

Expats in Hong Kong will have access to 11 new health insurance firms from 1 April. The aim is to deliver affordable private medical coverage in a bid to relieve pressure on the public medical system. Among the insurers that have been approved are AXA, Cigna and Bupa.

Hong Kong also has a new voluntary health insurance scheme which offers participants a tax break per family member of HK$8,000 (£766/$1,019) every year for signing up to a private health plan. The new plans will offer cover to policyholders aged up to 100 with a compensation cap of HK$420,000 (£40,231/$53,502) every year.

South Korea unveils new expat healthcare rules

Expats living in South Korea will now be facing stricter health insurance rules, the Ministry of Health and Welfare has announced. The aim is to prevent abuse of the country’s national health insurance system, with the new changes being effective from July. That’s when all expats who have lived in South Korea for at least six months will need to subscribe to the country’s healthcare programme through a non-employer-sponsored plan and also pay premiums every month.

Previously, only expats with a salary needed to be registered, but growing numbers of foreigners who sign up to the programme after arriving in the country to access cheap or free medical care have led to difficulties.

The monthly premium also will also increase to 103,000 won (£68/$90).
The government has announced that from May, expats who are late paying their insurance premiums will be subject to visa-related penalties.

New virtual GP service

Punter Southall Health & Protection has announced that it is expanding its well-being insurance products and services for employers to include a 24-hour virtual GP service. Employees are able to speak to a qualified GP at any time from wherever they may be in the world. Users can also access the firm’s My Health service app to find nearby healthcare services when they are needed.

A spokeswoman for the firm said that the affordable GP service is an ideal way for employers to proactively look after their employees’ wellbeing and health.

Bahrain releases National Health Insurance cards

Plans to distribute the first batch of Bahrain’s National Health Insurance Cards have been unveiled. The cards will provide health cover for expats and Bahrainis alike. Bahrain is introducing compulsory medical insurance to provide cover for everyone in the country, called Sehati.

The first phase will see 150,000 cards being distributed and these will enable the holder to access some medical services for free when attending a government-owned health facility. If they attend a private hospital or clinic, then they will pay no more than 40% of the total cost with the government paying the balance.

Expats will still need to contribute to their medical costs, including primary and some secondary health care, in some categories as well as emergency admissions. Expats will pay for their health insurance when renewing work permits.

The world's healthiest country

Expats heading overseas may be interested in a survey from Bloomberg to find the world's healthiest country to live in. In the survey, Spain takes top spot as the healthiest country in the world, overtaking Italy.

Compulsory health insurance market 'overcrowded'

Fitch Ratings says that the compulsory health insurance market in the UAE and Saudi Arabia is ‘overcrowded’ and pressure on profits will see weaker players being forced out. The countries are the two largest and fastest-growing markets in the Middle East but the move to compulsory health insurance coverage for citizens and expats has led to new entrants moving into the sector but most are struggling to make a profit.

Fitch is now predicting that several of these insurance firms will cease operating or merge their operations with rivals in the next few years. Meanwhile, one health authority official also says that UAE’s health insurance market is in need of ‘rationalisation’.

He told a healthcare conference that there are too many insurance providers competing for a low share of the market; delegates heard that some insurance providers have just 0.01% market share and the authority says there will be some consolidation with some providers leaving the market.

Mental health concerns for trailing spouses

The issue of mental health for trailing spouses has been the focus of attention by media outlet Al Jazeera. One woman explained that she lost her sense of self-worth and experienced loneliness when following her expat husband from London to India.

The article looks at several spouses and how they coped with the transition and dealing with anxiety and depression – with a thriving local expat community being key to helping a trailing spouse adapt to their new lifestyle and avoid health issues.

US expat retirees want cheap healthcare

Growing numbers of US expats are attracted to the idea of retiring overseas, and one of their main reasons is to enjoy good quality healthcare that will cost a fraction of US prices according to Kathleen Peddicord, the founder of Live and Invest Overseas.

Peddicord told one news outlet that growing numbers of Americans are curious about the prospects of moving abroad and that healthcare in many places around the world offers a good service and in some places it’s better than can be found in the US.

However, Don Murray from International Living says that while low-cost quality healthcare is attractive to US retirees, it’s not usually the main reason why they move overseas. Since many Americans are wanting to retire before they are 65 and eligible for Medicare, the US health scheme for senior people means they can move overseas to buy cheaper healthcare and enjoy their retirement cheaply.

El Niño may affect expat health

It may not be the first issue expats consider when it comes to diseases, but NASA says that El Niño is responsible for triggering disease outbreaks around the world.

In the first survey of its kind, NASA says that changes between 2015 and 2018 in land surface temperatures, precipitation and vegetation helped to facilitate the conditions for transmitting disease, leading to cases of plague and hantavirus in New Mexico and Colorado, dengue fever in Southeast Asia and Brazil and cholera in Tanzania. The report highlights that the relationship between El Niño and disease underscores the importance of seasonal forecasts and that there is a time lag of between two and three months between, for example, mosquito-borne epidemics and weather changes.

In other news…

Expats living and working in Latin America and the Caribbean are being warned they should prepare for a potential dengue outbreak, the Pan American Health Organisation warns.

A new brand offering enhanced services for international patients has been unveiled by the insurance firm BDU International. They say that they have evolved into becoming a major health insurance sector player delivering affordable products to people in the Middle East, Europe, Asia and Africa and their new brand Further will help them achieve and deliver more.

A new medical facility has opened at Abu Dhabi’s International airport. The new isolation rooms are among the first in the region and will help with the airport’s preventative and precaution measures. The aim is to deal with those passengers arriving at the airport who may have communicable diseases to help ensure the safety of other passengers and staff.

Google has revealed that its users are asking 1 billion health questions every day from around the world. The search engine now wants to harness the questions being asked to help provide better healthcare. Google says that 7% of all searches carried out every day are health-related, which equates to 70,000 requests every minute with users asking about medical conditions, symptoms, medications, as well as health insurance coverage.

Industry body Group Risk Development says that employers need to take more responsibility for their employees’ welfare and health needs. One reason for this is a growing expectation from governments for employers to help with staff welfare and help with mental health as well as their physical problems.

Kuwait’s Ministry of Health has revealed that in the last 12 months, expats have paid more than 110 million dinars (£271.6mn/$361.2mn) in health insurance coverage. Of these, 62.5 million dinars was handed over in cash, with another 41 million dinars of coverage was paid through stamps at machines available in various health insurance centres.


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