If you are living and working in Latvia, you will need to consider your healthcare options. For example, what are the associated costs when it comes to health insurance?If you are making contributions into the Latvian national healthcare scheme, you will be entitled to a range of primary and secondary healthcare services in the public sector. However, the World Health Organisation (WHO) has not deemed Latvian healthcare to be of a very high standard. The public health sector has suffered from budget cuts, caused by the 2008 downturn, and has still not bounced back.
Therefore, many expats opt for private insurance, alongside having national health insurance, to cover them during their time in Latvia. We will look at some of your options below.
Personalising your health insurance cover
If you are a permanent resident in Latvia, you will be eligible for state-funded healthcare under the same conditions as Latvian nationals. Health insurance is applicable to all employees and those self-employed persons who have made mandatory contributions. This will entitle you to a range of primary and secondary healthcare, and this is reasonably extensive. However, as noted above, the quality may not be high, and the system is overstretched and overcrowded.
You can also pay out-of-pocket expenses in both the private and the public sector. Remember, however, that costs can escalate rapidly if you have a chronic condition or need to see a specialist. Most expats resident in Latvia therefore opt for private health insurance.
Selectable options
Check the small print of any private health insurance policy to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care. Latvia is increasingly becoming a destination for medical tourism, including for dental treatment.
You may also want to consider a medical evacuation clause. This could be to cover you for treatment in your home nation, or you may want to seek treatment in one of Latvia’s European neighbours.
Remember to check whether your potential policy covers pre-existing conditions; the definition of a pre-existing condition will vary between insurers. Usually, the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits on when the diagnosis must have been given.
You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer, in addition to pre-approval. Again, Latvia has provision for medical tourism, and you may want to check out some comparative costs while you are in the country.
Take a good look at your potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant, then you may wish to reduce your policy costs by having such options removed.
Cost sharing
You may also be able to reduce the cost of your premium through cost sharing. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.
Co-pay: where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
Co-insurance: where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your co-insurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
Deductibles: where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your GP for 11 visits (€1000/€85 = 11.8), after which your insurance would pay out to the doctor directly.
You may also need to take a look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met.
Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. You will thus pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1,500 minus the deductible of €1,000), or about 29 more visits (€500/€17 = 29.4). At that point (40 total visits in a year), you would pay nothing more for the remainder of the plan year.
It’s worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
As so many variables have an effect on the cost of international private medical insurance, it is very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US, then the premium could increase to almost double that amount.