Expat Focus International Healthcare Update May 2018

Depression #1 mental health issue for expats

A survey of mental health issues currently faced by expats found that the number one issue is depression. The findings from Aetna International highlight that there has been a 50% increase in cases being reported between 2014 and 2016.

In their report, ‘Expatriates' Mental Health: Breaking The Silence’, found that anxiety has seen a 28% increase.

Those most likely to seek treatment for their mental health worries are women aged between 30 and 49.The findings also highlight that before relocating, just 6% of expats were found to have mental health concerns.

Aetna’s medical director, Dr Mitesh Patel, said:

“The reason expats are susceptible to mental health issues is partly down to the absence of friends and family they rely on for support at home.”

He added: “By comparison, a quarter of expats are concerned about heart disease, diabetes, high blood pressure and cancer. We also found that expats on assignment expressed a reduced desire for taking action prior to arrival.”

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According to the firm’s analysis, between 2014 and 2016 claims for mental health issues grew the most in Europe by 33%, followed by the Middle East and Africa, by 28%. In the Americas, claims for mental health issues grew by 26% and in Southeast Asia by 19%.

The survey highlights that language barriers and missing home are the biggest challenges to an expat’s well-being and employee assistance programmes which offer telephone support for a range of worries might help.

The researchers also highlight that policies that will help support an expat’s work-life balance including on-site childcare and fitness facilities, flexible working schedules and programmes on stopping smoking and boosting nutrition will also be of use.

The top five pressure points for expats on an international assignment are challenges of the new job, 62.8%; inability to take part in activities that are available at home, 44.6%; loss of support network, 42.8%; language and cultural difficulties, 40.7%; expat spouse unable to find work, 37.9%.

iPMI will be ‘revolutionised’ by tech

Expats will see the provision of international private medical insurance (iPMI) being revolutionised with digital health solutions, a survey has revealed.

The Collinson Group questioned HR professionals, two in three of whom said that technological services are already having a significant impact on an employer’s duty of care when sending expats overseas.

The survey also highlights that 38% of HR specialists refer to medical and wellness information support and 15% refer to a medical provider’s information when dealing with an expat assignment.

The firm’s commercial director, Lawrence Watts, said: “Employers are demanding telemedicine solutions from their iPMI providers because it makes it possible to communicate and monitor with staff remotely.”

He added that the new technology enables quicker response in a crisis and helps employers provide a higher quality of care to their staff. Mr Watts said: “Insurers will, in future, be able to monitor an expat employee’s vital signs in real time and also intervene and alert clients as something, or before something, happens.”

He added that in future, increasing digitalisation will help health insurance firms personalise their iPMI policies to match an employee’s specific requirements and take into account their lifestyle and situation.

Expats in UAE will get free healthcare

The Ministry of Health in the United Arab Emirates, along with pharmaceuticals firm Novartis, will give expats free healthcare, it has been announced.

The initiative is aimed at helping those with no – or limited – health insurance coverage with up to a year’s worth of free treatment or medication now on offer. The deal will also see thousands of expats with chronic illnesses receiving the free health care coverage. The government says more than 3,200 expats will benefit from the agreement.

Potential expats who could benefit will be referred by their doctor and then assessed separately for treatment.

UAE announces healthcare development

Meanwhile, a new law in the UAE stipulates that the country will develop its medical services and products to meet international best practice.

The law also wants to develop health services as well as community welfare and to exploit the opportunities provided by medical tourism by offering Dubai as a global medical services attraction.

To do this, Dubai will develop the best healthcare facilities and services with the most advanced technologies and the best medical personnel available, which will see a demand for experienced expat professionals.

Oman unveils ambitious expat healthcare plan

Oman has revealed that it is planning to introduce private medical insurance for all private sector employees. While there is no date for the implementation of the scheme yet, the outlook is good for expats working in the private sector.

The government says that while lots of employers are providing healthcare insurance, small and medium sized firms are struggling too much with financial challenges to be able to do so.

New national health insurance scheme in Bahrain

Bahrain has revealed that it is going to launch a new national health insurance scheme in a bid to cut its medical spending costs.

The aim is to restrict spending by 2038 when the government will be spending BD 1 billion (£1.97bn/$2.66bn) under the current healthcare system. Instead, the move could see the country saving $530 million (£392M) every year.

Currently, the chairman of Bahrain’s Supreme Council for health says the country is spending BD 450 million (£886m/$1.12bn) on health with a government contributing BD 350 million.

It’s estimated that medical costs under a new health scheme would be between BD 300 (£591/$798) and BD 350 per person – including expats while expatriate homeworkers including drivers, nurses and housemates, will receive free health cover.

In other news…

The largest maternity hospital in Abu Dhabi, the Corniche, has opened for expats once more, four years after saying it had run out of room for accepting non-Emiratis for its services.

The Office for National Statistics says that those with private health insurance in the UK are having to fork out £29 billion every year on their out-of-pocket health expenses. The average cost per person in 2017 was £2,920 for private insurance, including NHS coverage. Of that, 15% – or £438 per person – accounts for their out-of-pocket expenses.

Allianz Care has unveiled a range of international health products for the Russian market. The plans include worldwide comprehensive healthcare cover for groups and individuals including unrestricted access to healthcare facilities in Russia and other countries.

International private medical insurance provider Now Health has opened a 24/7 flexible service based in Dubai which will form part of its worldwide expansion plans. The in-house team of experts will deliver customer support to clients around the world.

Aviva has teamed up with Now Healthcare to offer a digital GP service which will give clients access to more than 1,000 doctors. The service will offer remote diagnosis, video consultation and the offering of advice. There’s also choice of a male or female GP with the service being delivered in 12 languages.

Expats in the US will not be surprised that American media has focused on the fact that the latest child of the Duke and Duchess of Cambridge, Prince Louis, cost less to deliver than most American births. According to the Economist, the birth will have cost around £5,670 or $8,900 in June with the average cost of a birth in America, according to the International Federation of Health Plans, being $10,808 (£8,000). That’s without pre-natal costs which can push the total above $30,000.

A new affordable health insurance product has been unveiled by the Qatar Insurance Company. The product, Anaya, is available to expats and citizens living in the country and will cover health service charges for health centres, hospitals, private clinics, pharmacies and dental centres.

Aetna Internal has announced it is expanding into Thailand, with its first health clinic opening in Bangkok. The clinic is open to Aetna members and also patients covered by other health insurance providers. Aetna has also announced it has teamed up with Humanis in France to offer French expats and large corporations access to efficient global healthcare solutions.

Japan has unveiled plans to prevent medical tourists and expats from entering the country who may be deemed a risk for not paying their medical bills incurred while staying there. Foreign nationals will be refused entry after growing criticism over the number of tourists who leave without paying for their medical services. The government will in future make visitors take out private medical insurance and increase the use of medical institutions accepting credit cards for payment.

According to Pacific Prime, iPMI inflation fell last year to 7%.The medical insurance brokers says that is down from 2016’s figure of 9.2%.

In a bid to attract more international students, Turkey has announced that all students and graduates will receive free health insurance without having to wait three months first, and they will also enjoy permission to work in the country. Turkey currently attracts 115,000 students – it’s among the world’s top five destinations – with an ambition to attract 350,000 overseas students over the next few years.

The United Arab Emirates has carried out a health survey of 10,000 families, including expats, with the results being announced later this year. The aim is to boost the UAE’s health offering and to introduce various strategies to boost delivery and introduce a health database.

Nursing leaders in the UK say that healthcare fees for non-European Union staff should be scrapped. The current NHS surcharge of £200 is set to double and this is levied on all migrants, but now the Royal College of Nursing says all non-EU nursing staff should be exempted. The college highlights the case of a Kenyan nurse who faced having to pay £3,600 for herself and family to remain in the UK.

Vietnam has announced that it will issue electronic health insurance cards in a bid to beat fraudulent activities and boost supervision. The new cards will give access to treatment and examinations to residents and expats alike.

Conflicting reports in Kuwait have led to the government instructing hospitals and medical centres that medical fees for expats have not been increased recently. Fees rose last October and in a circular, the health ministry makes clear that drug prices for expats, and other charges, have not been put up. Also, the circular makes clear that only doctors can prescribe medicines and their quantities to expat patients.

An optional upgrade for small to medium-sized enterprises who have employees based overseas has been unveiled by AXA-Global Healthcare. Those members who renew or purchase a comprehensive level of cover under their international health plan have the option to grade to get full refunds on diagnostic tests, consultations and outpatient drugs.

A new health insurance scheme has been launched for Indian expats living in the UAE. My India Care has been designed to deliver lifelong health insurance cover for expats while in India.

All expats being employed by hospitals in Fuji are facing a 15% withholding tax. The move follows confusion over whether short term expat employees pay tax while full time workers do. The country’s law requires an expat to be resident for 183 days to be considered as being resident for tax purposes.

The Qatar Insurance Company has unveiled what it calls a unique health insurance product for the middle east. The healthcare is available for expats and citizens at a low price and covers cosmetic and dental insurance and other services that most insurance firms do not provide cover for. The insurance company says it wants to provide products that are more inclusive without restrictions on age to help fulfil a need. The premium version of their Anaya insurance is QR499 per person per year (£101/$137). The move has been followed by Bahraini insurer Tasheelat Insurance which has unveiled its low cost Am Fit product which is aimed at expats and Bahrainis alike.

Saudi Arabia’s Council of Cooperative Health Insurance says that the number of complaints it receives has rocketed by 907% over the past year. The council says it received 53,000 complaints last year, compared with 5,283 in 2016. They point out that the rise in complaints is a reflection of growing awareness among those in the kingdom about health insurance, including expats, who are increasingly likely to complain if they have not been dealt with adequately by their health insurance company or health care provider.


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