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International
Expatriate Benefit Plans
by David
Tompkins |
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| While working
or living offshore, expatriates are exposed to the same or greater health
risks that occur in North America. However, they do not have the
benefit of their Canadian Government health care system or U.S. private
health care plan. Falling ill in some far off land is distressing
enough without the worry of who is going to pay your health bills.
Such medical bills can run into the hundreds of thousands of dollars.
Some medical facilities are often reluctant to provide treatment without
receiving cash or an ironclad promise to be paid. Finally, if while
traveling from your offshore country you happen to fall ill or injure yourself,
you will require medical travel insurance or even evacuation if the facilities
are inadequate. |
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| Some expatriates
are able to become part of the local government health plan if they satisfy
certain residency and immigration requirements. However, as many
Canadians know, such government plans, especially in second and third world
countries, are often inadequate, rife with long waiting lists and cover
only basic medical needs. Of course, many counties which expatriates
travel to have no government health plans or in some cases not much of
a government. Self-insuring is impossible as even a small illness
or injury can bankrupt a person. All of the above points to the requirement
for expatriates to purchase adequate health and emergency medical evacuation
coverage that suits their needs and budget. |
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| Several
multinational and specialty insurance companies have met the offshore health
insurance needs of expatriates with international medical coverage plans.
Companies such as BUPA, ASN, SOS, Medex, Aetna, GAIN and Lloyds have developed
varying plans from basic to deluxe. |
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| Hospital
plans and coverage |
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| Most plans
will provide in-patient care, which is a technical term for in-hospital
treatment. Such expenses include hospital accommodation, surgeons, anesthetists'
& physicians' charges. Consultations in radiology, pathology,
oncology and radiotherapy can also be included. The more enhanced
plans include some outpatient charges such as specialist fees including
therapies such as acupuncture, osteopathy, physiotherapy, homeopathy.
Some plans also offer coverage for primary consultations and primary care
including a certain amount of prescribed drugs. Local road ambulance
is included in most basic plans. Nursing at home and emergency dentistry
are also options. These plans are generally called hospital plans
because they usually cover in-hospital treatment only. |
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| More comprehensive
plans are available to cover, in addition to the above, a wide array of
outpatient care. |
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| Such expenses
include: psychiatry, organ transplants, rehabilitation, home nursing, childbirth,
home delivery, general practitioners consultations, eye & ear specialists,
other specialist services such as dietetic guidance, vaccinations, lab
tests and analysis, x-rays, scans, EKGs, hearing aids, physiotherapy, chiropractor,
osteopath and a certain amount of prescribed drugs. Such plans are
usually just over double the cost of a hospital plan. Those who are
accustomed to using a government-sponsored plan as exists in Canada, may
want to purchase such a comprehensive plan. |
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| Wide array
of options |
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| In terms of
coverage, most plans cover expenses at 100%. Others have the option
to have the insured pay 20% of the costs. Most plans have the option
to include a $500 or $1,000 US deductible, which also helps to lower the
premium costs. All plans have a maximum coverage ranging from US$500,000
to US$1 million per year. |
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| The expatriate
plans generally have the option to add emergency travel medical and evacuation
coverage for an extra fee. This coverage is highly recommended and
the cost is quite reasonable. In one case, a Canadian client was
traveling in Mexico and suffered a heart attack. He was rushed to
the local medical facility to be stabilized and was then evacuated in a
specially designed medical jet to the United States for treatment.
After a few weeks and a successful treatment, the total cost was almost
$300,000 Canadian. The insurance company paid everything except a
very small portion which was paid by the province in full. |
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| Almost all
evacuation options include a global service network in association with
a specialist evacuation partner, such as SOS or Medex. The plans
provide for immediate transportation from any location in the world to
the nearest centre of medical excellence for in-patient treatment of emergency
conditions. The emergency evacuation plans usually cover the cost
of reasonable return fares to your own country of residence after recovery.
If the expatriate dies, their physical remains can be transported home
at no charge. |
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| Restrictions
and exclusions |
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| All expatriate
health plans have some restrictions and exclusions. Some common exclusions
are for pre-existing conditions which were know before being insured.
If you have an expatriate plan already and you have suffered a condition
that may reoccur, such as a back injury or cancer, you should avoid changing
your coverage. Other exclusions such as cosmetic treatment, naturally
occurring conditions like menopause, sexually transmitted diseases, abuse
of alcohol, intentional self-inflicted injuries and the standard war and
riot events are not covered. |
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| Most
plans do not cover maternity or childbirth. However, there are a
few health plans which will cover a normal or complicated delivery with
a waiting period of 12 months after the policy is put in force. Others
will cover maternity if the insured becomes pregnant after becoming insured.
An elective caesarean is covered up to a certain maximum. Of course,
if you are not planning to have any children in the future, then this exclusion
is of no consequence and you can enjoy the premium savings as a result.
One should note that a complicated pregnancy can be very expensive and
unwise to self-insure. |
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| Premiums
and fees |
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| The
obvious determinate of an expatriate's premium is his/her age, rather than
the sex of the applicant. Most plans have premium bands of 5 years
with coverage available up to age 100. Premiums for people over 65
are often priced on the basis of the application. Another factor
in the price can be whether the expatriate wants worldwide coverage excluding
or including USA and Canada. Because of the high price of healthcare
in the United States or while not insured under a government plan in Canada,
the price for expatriate coverage including these two countries can be
as much as three times the cost. Such a plan is recommended for offshore
residents who travel back to the USA or Canada for extended periods that
would not be covered in the optional medical evacuation plan. |
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| The
offshore applicant can easily add their dependents under his/her plan for
an additional charge. Some plans even cover children under age nine
for free with newborns covered from birth. The applications always
have medical questions to be answered. |
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| Administration
and service after the expatriate has taken out a plan are crucial elements.
The plans can be paid for using a credit card, cheque, wire or bank debit.
Most plan's premiums are payable in either UK Pounds Sterling or US Dollars
either yearly or monthly. A savings of up to 5% can be attained if
you pay annually. |
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| A four-month
waiting period may apply if you were not covered under another plan, except
in the case of an accident or an emergency. |
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| In the event
of a hospital claim, the insurance company should be promptly notified
using their 1-800 number. This helps prevent any misunderstandings
with regard to the coverage of the insurance. With other expenses,
original bills can be submitted directly to the insurance company.
The plans will cover almost any recognized medical facility and you can
choose any doctor you wish. Claims can be settled in any currency wherever
you are in the world. |
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| Conclusion |
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| Expatriate
plans are fully portable, except when you return to your originating country
of citizenship for a permanent relocation, such as the United States or
Canada. |
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| There are
very few plans that will cover you if you return to the US or Canada because
of the regulatory statutes and cost. |
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| Nowadays,
we all try to live a relatively healthy lifestyle while avoiding unnecessary
risks. Offshore residents, however, know that purchasing health coverage
is a vital part of their financial security. Neglecting such a vital
safety net can result in financial ruin.
For more information
you can visit my website at: www.expatfinancial.com |
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