by clicking the arrows at the side of the page, or by using the toolbar.
by clicking anywhere on the page.
by dragging the page around when zoomed in.
by clicking anywhere on the page when zoomed in.
web sites or send emails by clicking on hyperlinks.
Email this page to a friend
Search this issue
Index - jump to page or section
Archive - view past issues
Expat Investor : July August 2007
Counting the cost of international healthcare cover Expat Investor's annual survey of healthcare insurance policy premiums brings readers up-to-date with the costs and assesses the impact of medical technology, research and the latest treatments. Carefully consider the benefits that you want based on your country of residence or areas that you will be travelling to and the needs of you and your family. For example, if you are not planning on having a baby, there is no point paying for a plan that includes maternity cover. It may be better to choose a plan where maternity cover is available as an optional add-on. Similarly, if you will not be going to the US, where medical treatment costs are high, it is probably not worthwhile purchasing a plan that includes the US in its area of cover as the premium is likely to be much higher than for a plan that does not include the US. Select a voluntary excess. InterGlobal offers voluntary excess from £50 to £5,000 per medical condition per plan year on Select, Comprehensive and Plus plans, IHC is a broker which specialises in providing independent advice on healthcare plans for companies and individuals. It devises tailored plans that are both fit for purpose and cost-effective. Expat Investor asked Katrina Osman, IHC's international business associate, to address those issues currently facing expats looking for the best possible healthcare policy deals. Here's what she advises. "The cost of an individual expatriate policy can vary depending not only on the age of the member and the level of cover chosen, but also on the country of residence or area of the world the cover is for. Premiums will increase on an annual basis in line with a member's increasing age, but also as a reflection of medical inflation and claims incidence. Increasing regulation in areas of the world such as the UAE (United Arab Emirates) and the Far East may also play some part in increasing premiums, as insurers may have to pass on these costs to the consumer as a direct result of legislative or policy changes." Reducing costs "Expatriates can reduce the cost of international medical insurance by ensuring the careful selection of an appropriate policy. "When looking at the types of policy available, it is always useful to initially look at the cost of local outpatient treatment, such as doctors' fees which in some countries are minimal. If the expatriate is happy to cover these small costs themselves, the level and cost of the cover can be reduced to hospital or basic cover only. "Premiums can also be reduced by increasing or including a plan excess, which can be set at any number of varying amounts from Paula Covey, head of marketing, BUPA International, reminds expats of the reality that each year health insurance premiums rise because of medical inflation and claims costs. In fact, she adds, the rate of inflation for health care goes up between 10-20% every year, with many factors attributing to this. "Firstly, over the next few years, prescription drugs are projected to grow both in numbers and in cost by as much as 20--30% annually. New technology and treatments also come at a high price and both society and especially the health insurance companies face the challenge of paying for these, which inevitably leads to premium rises." Ms Covey's top tip to expatriates wishing to reduce the impact of premium increases is to choose to pay a deductible excess. "With BUPA International, for example, members can pay an excess of £100, £200, £500 or even £1,000 which would cut their monthly premiums according to which deductible they wish to take." AXA PPP Healthcare says that it is aware that a balance needs to be struck between keeping the cost of high quality healthcare affordable, and improving the scope of cover to provide access to advancements in healthcare provision. "By listening to feedback from our customers, we HEALTHCARE expatinvestor.com 16 EXPAT INVESTOR July/August 2007 believe we have achieved this. Our customers really value our 'up to two months free' introductory offer and, over the last five years, we have restricted annualised price increases to a range of 5-6% (excludes factors such as age or excess)." International private medical insurance (IMPI) premiums are based on two criteria, explains InterGlobal. The first is the cost of medical treatment, and the second, is the value of claims that the company predicts it will have to pay out. InterGlobal goes on to confirm what other healthcare insurance providers report which is that medical treatment costs are currently increasing faster than average £100 to £10,000. This can bring in a maximum premium reduction of up to 40%, depending on the insurer and policy concerned. "Alternatively, some insurers offer a no claims discount facility, which allows members the opportunity to claim up to a 20% reduction in premium, following a period of three years, where claims have not been made against the policy. The no claims discount facility is still not considered common practice within the international individual market, as the vast majority of countries do not have a National Health Service, as we do in the UK, and therefore treatment must be paid for, thereby reducing the no claims discount's usefulness." Policy flexibility "Some insurers are able to offer expatriates a greater flexibility in the product they choose, by breaking the policy into separate elements or modules, such as inpatient, outpatient, dental and pregnancy. This allows prospective members to tailor their policy to meet their own requirements or situation. This is especially useful when looking at maternity benefit, which is not required by older or male members, but is often included as standard within a number of policies on the market. "In these two instances, this is obviously a benefit that is being paid for and will never be utilised. In allowing members to choose the benefits they require, members are not paying for cover they simply do not need. "There are a number of different insurers within the market, all with different benefit propositions and cover options and there is usually something suitable for everyone, although it can be difficult knowing where to start." InterGlobal's tips for cutting cover costs Plans to make healthcare cover available to a wider audience. leading to premium discounts of up to 40%. If you only need international private medical insurance for legal reasons or for peace of mind but feel you are unlikely to claim it is worth choosing a provider that offers a no claims discount. InterGlobal offers a discount of up to 20% for 3 years' no claims. If you have children, look for a provider with family friendly rates. InterGlobal only charges for one in four children under 18 on a single policy. If you can afford to, pay your premiums yearly as additional costs are usually incurred for paying monthly or quarterly. For example, InterGlobal's premiums are approximately 7.5% higher if you pay quarterly and 12% higher if you pay monthly. Company Plan Premiums Renewed Single Male, aged 30 Single Male, aged 65 Couple, male 40 and female 35, with two children, 10 and 7 years Europe Middle East North America Europe Middle East North America Europe Middle East North America AXA PPP Healthcare Comprehensive April and October £563.12 (6) £675.94 £1,753 £1,592.47 (6) £1,911.53 £4,957.67 £1,941.54 (6) £2,330.54 £6,044.39 BUPA International (10) Classic Level April and October £1,196 £1,121 £3,911 £4,175 £3,914 £10,564 £3,987 £3,745 £12,067 InterGlobal UltraCare Comprehensive (8) (9) January £913 £1,013 £2,160 £3,254 £3,615 £7,696 £2,759 (7) £3,069 (7) £6,545 (7) MediCare International (3) Executive International Beg. July £1,262 (1) £3,134 £6,213 (1) £15,222 (2) £5,198.40 (1) (3) £12,523 (2) (3) William Russell (5) Gold (11) January £1,246 £1,246 £1,246 (4) N/A N/A N/A £4,095 £4,095 £4,095 (4) Notes: (1) Area One (worldwide, excluding USA, Canada and Carribean), (2) Worldwide. (3) No excess. (4) Canada. There is no cover available for residents in the USA, but William Russell can cover for limited trips at an increased premium. (5) There are child discounts available - 2nd child pays 25%, 3rd child onwards pays 50% of the premium. (6) Including UK. (7) Only one in four children on a policy is charged a premium. On this quotation, 2nd child free of charge and the premium would be the same whether there were one, t wo, t hree or four children on the policy. (8) InterGlobal's standard excess is £25 per medical condition per plan year. The premiums quoted have the excess deleted and so have a loading of 10% on top of the published premiums. (9) Insurance premium tax may apply in addition to these premiums, depending on the country of residence. (10) No different premiums for smokers and non-smokers. Premiums priced for the individual. (11) £30 excess. Healthcare providers' premium tips Expat Investor asked the top providers of international healthcare cover for their best premium-saving tips. inflation due to technological advancements. New treatments, drugs and technologies are more expensive when they first come onto the market causing IMPI premiums to rise. Improvements in technology and increased choice for patients mean that customers are more likely to make claims on their international healthcare policies. An increase in claims inevitably leads to an increase in premiums. Certain benefits specific to IPMI also make the premiums seem expensive to some customers. Emergency evacuation and repatriation, for example, is costly but potentially life-saving. "For this