The Insider s Guide To. Buying The Perfect International Health Insurance Policy

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1 The Insider s Guide To Buying The Perfect International Health Insurance Policy

2 The Insider s Guide To Buying The Perfect International Health Insurance Policy This ebook provides an insider s perspective on the knowledge of how to make a well-informed choice when it comes to buying an expatriate international health insurance (IHI) policy. Whether you are in the market to buy a policy, are considering a switch, or are generally just looking to learn more, our goal is to provide you with the knowledge that is critical to ensuring that you have all the necessary information to make sure you re on the inside track. Besides providing you with an overview of the positive aspects of IHI, we ll explains some of the pitfalls which can occur and which tend not to be highlighted by Insurers, empowering you to avoid them. Worth reading? We think so. What our guide will not do is convince you of the merits of a particular insurance policy or insurance company. Instead, we will educate you on how you can find the best policy for yourself. By the end of this ebook you will be able to answer: What is international health insurance all about anyway? What are the answers to some of my FAQs? How can I choose and buy a policy that works for me? How do I get the best value for money? How can I protect myself against unpleasant surprises?

3 Table of Contents What is it? Key features Benefit options Insurance jargon Eligibility Buying IHI Going direct Step 1 First things to consider Step 2 Select a suitable level of cover Step 3 Go fishing for policies Step 4 Submit an application What s included in my membership pack? What happens if I m unconscious and I m rushed to hospital? Making a claim Will my premiums go up? How to keep premiums down Exclusions & limitations Annual limits Waiting periods Pre-existing conditions Developing chronic conditions while insured Differences between IHI, local and travel plans

4 Why Pay For International Health Insurance? It s all about certainty. Many people don t really understand the basic purpose of health insurance even after they have purchased a policy. Here are some reasons why subscribing to an international health insurance policy makes sense: Reduce financial risk Out of pocket medical expenses resulting from serious injury or illness can be devastating. Having a good health insurance policy can literally save you from bankruptcy. Receive World Class treatment Having a good international health insurance policy provides access to World Class provider networks ensuring that you are in the very best hands should you become ill. Worry less If the worst happens, you will have the peace of mind knowing that your future is not dependent upon state health systems or goodwill of family and friends. Be healthier Regular health checks are a common feature of international health policies. Identifying health problems early can help prevent serious issues developing. Isn t it too expensive to buy coverage? Not always. In fact, international health insurance can be surprisingly affordable. On average, BrokerFish clients pay as little as $158 per month. 4

5 Let s Get Started - What is it? Irrespective of nationality, gender or income, more and more expats recognize the need for an international health insurance policy. In essence, international health insurance (IHI also sometimes called private medical insurance PMI) is:..insurance that is designed to cover the costs of private medical treatment for expatriates overseas. A basic IHI policy, provides medical treatment and reimbursement of medical expenses in the event of disease, illness or injury and which aims to return you to the state of health you were in immediately before suffering from the incident. What are some key features of a typical IHI policy? Flexible Options Mobile Cover From budget emergency cover to hazardous BrokerFish health policies cover you wherever sports cover, BrokerFish plans are highly you are in the world and are available to people flexible and can be tailored to suit your lifestyle. from over 200 different countries. Provider Network Insurance companies have partnerships with thousands of hospitals and hundreds of thousands of doctors. Cashless Settlement Insurers will arrange for direct billing with major hospitals so that you don t need to pay out and then reclaim the cost of your treatment. 5

6 What are the typical benefit options of IHI policies? In-Patient Out-Patient The most basic form of international health Out-Patient refers to treatment provided in the cover, In-Patient refers to treatment received practice or surgery of a medical practitioner, in a hospital where an overnight stay is therapist or specialist and does not require the necessary. patient to be admitted to hospital. Maternity Provides cover for medical costs incurred during pregnancy and childbirth, including hospital charges, specialist fees, pre and postnatal care, midwife fees as well as newborn care. Well being Encourages good health through early detection of serious illnesses. Includes things like cancer screening, vital signs tests and cardiovascular system testing. Evacuation Evacuation covers you for transport costs to the nearest suitable medical centre, when the treatment you need is not available nearby. Long-term care Care for people that suffer from chronic illness or disabilities and who cannot care for themselves for long periods of time. Dental Routine dental includes an annual dental checkup, simple fillings related to cavities or decay and root canal treatment. Complex dental includes gum disease treatment, orthodontics and dental prostheses. Vaccinations Refers to immunisations and booster injections in addition to the cost of consultation for administering the vaccine. Repatriation Repatriation, allows you the added benefit of returning to your home country to be treated in familiar surroundings. Optical Includes things like laser eye surgery, eye tests, spectacle lenses and contact lenses. 6

7 Need-to-know insurance jargon Premium The money you pay to the insurance company. Premiums are paid monthly, quarterly, semiannually or annually. Deductible / Excess The amount of money that you must pay before the insurance company will start paying for medical expenses. They can be per incident, per insurance period or per year and applies separately to each person insured by the policy. Not all policies require a deductible, but choosing a policy with a higher deductible will lower your premium. Lifetime Maximum The Lifetime Maximum is a cap on how much the insurance company will pay for your claims over the total duration of your policy. Co-Insurance Refers to the shared amount of money that you are obligated to pay for covered medical services/treatment. In the table of benefits, you may see something like: Dental - 20% Co- Insurance. This means that you must share the cost of dental treatment costs with the Insurer where you will pay 20% of the bill and the Insurer will pay the remaining 80%. Moratorium Cover Sometimes, pre-existing conditions are initially excluded, but can be covered after a set time (the moratorium cover period), provided you ve not suffered any symptoms or needed any medical advice or treatment relating to the condition. Policy Wording The policy wording is the legal description of the insurance policy and explains the full terms and conditions of the coverage provided, including all applicable exclusions, conditions and limitations of cover. I have more jargon questions. Where can I find more definitions? Refer to the BrokerFish.com glossary for jargon-busting definitions on over 150 IHI terms. Click here 7

8 Who is eligible to buy international health insurance? International health insurance policies are open to expatriates of all nationalities. Professionals, students, teachers, diplomats, retired couples and businesses are typical buyers of international health insurance. IHI is designed for those living and travelling away from home. Some Insurers do have age restrictions depending on the particular policy in question of around 64 years old but there are providers that will insure people as old as 120! How Do I Buy International Health Insurance? Via an Insurer If you buy direct, you will be advised on their range of products only so you could easily miss out on buying a far more suitable plan. You will also not receive any independent help Via an Agent Agents are usually able to provide more options than by going direct to only one Insurer, however, agents are typically tied to a small number of providers and can therefore only advise across Via a Broker In additional to offering unbiased guidance and information on a huge range of IHI options, brokers can also serve as advocates if you bump up against the system and don t know if you have any problems with a limited range of companies where to turn. claims, service or any issues that may arise. products. 8

9 How does an insurance company decide how much to charge? Insurance companies will take into account a variety of factors to try to work out the correct price for a policy. Typically, age is the most important factor, but a whole host of variables will be considered. Gender Age Area of cover Payment frequency Country of residence Premium Price Pre-existing conditions Benefits excess / deductible Can I save money if I buy direct from the insurance company? No. Insurers use brokers to market their products and will not discount their prices for customers that go to them directly. In fact, if anything, going to a broker ensures you will get the best deal available. Insurers know that a broker will advise their customers based upon a comparison with other plans in the market and therefore try to ensure that their prices are extremely competitive. If they didn t, they would never get any business from brokers! So if it doesn t Brokers receive a commission cost me anything, from the insurance company then how do you for any policy they put in make money... place for you. 9

10 How do I choose and buy the right policy? If you re confused when it comes to health insurance, believe us when we say that you are not alone! There are dozens of different insurance companies, hundreds of different policies and literally thousands of different policy options, all wrapped up in cryptic insurance language which can be time-consuming and confusing to figure out. It s no surprise that many people tend to put sorting out their health insurance on the back burner, even though they know it is hugely important. In this section we ll try to make your life a little easier by coaching you on how to select a policy that s right for you. Let s get started! Step 1 - First Things To Consider The best place to start is with yourself. What we first want to figure out is exactly what you need from an international health insurance policy. This will tell us a lot about what kind of cover you require. How? Make a list of your priorities What should your policy cover? What kinds of things are absolutely necessary and what are luxuries? Maybe you want to ensure you re covered for hazardous sports. Perhaps maternity cover is a priority. Or you may want a policy that is geared towards emergency cover rather than day to day coverage. Who s applying? Who do you want to cover? Will everyone be living in the same country? Will anyone on the policy require coverage in the US or Canada? Health & lifestyle Are you healthy? How often did you visit the doctor last year? How much did you spend on health care last year? Does your family have a trend of medical illness? What is your medical history? Do you have pre-existing or chronic conditions? Money matters What is your budget? Would you prefer to pay monthly or save money by paying annually? Would you want to lower your premium by choosing a policy with a high deductible? Or one with a high level of coinsurance? 10

11 Step 2 - Select a Suitable Level of Cover Traditionally, insurance companies offered various levels of cover with names such as Standard, Intermediate and Comprehensive. Although this format is still common, nowadays some insurers will also allow a level of customisation across their policies which enables you to tailor something more closely to your needs. To keep things simple, let s look at the traditional levels of cover and what they typically provide. Standard Cover Standard insurance policies typically provide cover for In-Patient costs only. This means cover for staying overnight in a hospital when it is deemed a medical necessity. In-Patient normally includes things like emergency care, diagnosis and nursing costs. Standard cover is ideal for people on a budget or who want to provide cover for catastrophic situations rather than for day to day issues. Some standard policies will also include cover for day-patient treatment. This is when you receive treatment which requires a supervised recovery period, but does not require an overnight stay. Hospital costs vary widely depending on where you are based in the world. Even a few nights stay can incur large costs, so making sure your basic policy provides good In-Patient coverage is vital. Also, check that the Annual Plan Limit (which is the maximum the insurance company will pay out during a year of coverage) is sufficiently high. On entry-level plans this can often be quite low and may not be enough for your country of residence. If I buy a standard policy now, can I change my level of cover later? If after some time you find that you need more or less cover, you can change when you renew your policy. 11

12 Intermediate Cover As well as In-Patient cover, Intermediate plans will add Out-Patient Cover. This is treatment which does not require an overnight stay or a supervised recovery period. A common example would be a consultation with a doctor. Intermediate plans will also offer increased plan limits over Standard plans. There is a lot of variety between plans in terms of what is / is not covered. Your list of priorities will help you to work out which plans are likely to be the most suitable. Comprehensive Cover These top of the range policies provide the greatest levels of cover and the highest plan limits. In addition to In-Patient and Out-Patient cover, they will often include things such as maternity, complex dental and optical cover. Extra Modules For your convenience, some insurers allow you to choose to add certain modules to enable you to tailor your level of coverage. Examples will include modules for travel insurance or for personal accident expenses. Policy Options These are variables that you can control in order to further sharpen the match between your requirements and the policy. Typical choices here include things like: How much excess / deductible you want to pay; If you would like to co-pay for benefits and on what terms; Hospital accommodation; The hospital-network you have access to. Are policy Yes, correctly configuring your options really policy options to match your important? requirements can have a huge impact on the cost of your policy 12

13 Excess / Deductible An excess / deductible is the amount of money that you must pay before the insurance company will start paying for medical expenses. They can be per incident, per insurance period or per year and apply to each insured member of the policy separately. Choosing a policy with a higher deductible will lower your premium. Selecting a deductible Brian loves underwater diving. He s a fit lad and rarely gets sick. Looking back over the previous year, he finds that he only went to the doctor once to cure a bad flu. He wonders what kind of policy and deductible would be sensible to keep his premiums low while still being covered for serious injury due to a catastrophic diving accident. Upon investigation, Brian chooses a Standard plan and then has the option to significantly increase the deductible. Looking at the table of benefits and premium rate table PDFs he finds the following information: Maximum Sum Insured $2.7M In-Patient Treatment Full Cover Monthly Premium ($0 deductible) $ Monthly Premium ($1,500 deductible) $88.74 Brian now has to decide whether to accept the high deductible in return for a much lower premium. By choosing the high deductible he would save nearly 50% of the premium, but if he does suffer a severe medical emergency, he would have to fund the first $1,500 of any claim himself. 13

14 Step 3 - Go Fishing for Policies Now that you have a good idea of your needs, it s time to go out and find what is most suitable. And this is where the services of a good broker or agent really come in. A specialist s knowledge of a wide range of IHI policies will really cut down the time that you spend finding potential policies and they may find policies from insurance companies that you missed altogether. They can also review your requirements and circumstances to ensure you ve not missed anything and point out any shortcomings in the plans that you may be considering. Using a specialist like BrokerFish will provide you with a selection of the most suitable plans, laid out in a way that makes them easy to compare. Take a deeper look: Get personalised quotes sent to your inbox now by visiting our quotation page Example of a quote comparison from BrokerFish 14

15 Step 4 - Submit an Application From here, we can submit an application form to the insurance company. Sometimes this can be done online, but more often than not, it will mean completing a paper application form. Submitting an application does not necessarily mean that your application will be automatically approved. Instead it will go through an underwriting process where the insurance company will look at your case and determine if, according to their risk policy, you are insurable. If required, a broker such as BrokerFish can help you to complete the application at no extra charge. After a few days to a few weeks, you will receive one of the following responses: You re approved! Most of the people who apply through BrokerFish are approved. Once approved, your health insurance coverage will begin on the effective date as confirmed by the insurance company. You re approved, with conditions. The insurance company may offer you coverage but limit benefits for specific conditions based on your medical history. Or, the insurer may offer to include certain medical conditions by charging a higher premium. More information is required. Sometimes, the insurance company will ask for more information regarding your application, and may request medical records from your doctor before coming to their final decision. Your application is denied. Although rare, applications are sometimes denied. If this happens, there may be a reason to appeal the decision. If not, we can help you to apply to a different insurance company or we may be able to recommend alternative health care solutions. 15

16 So, now you re covered! What s included in my membership pack? Paper or digital, and either posted or downloaded, the insurance company will provide you with: Your Membership Card; Your Insurance Certificate; A Table Of Benefits detailing what kind of benefits that you are entitled to and their limitations; Medical provider network documentation; A Membership Guide; A Treatment Guarantee Form; A Claim Form. What happens if I m unconscious and I m rushed to hospital will I always be treated / covered? If you are insured there should be no problem. It s very important to carry your insurance membership card with you at all times. Keeping it in your wallet or purse will make it easier to find if medical personnel need to locate your personal details so they can liaise with your Insurer in an emergency situation. 16

17 What if I need to make a claim? Always make sure you understand what is, and is not, covered; If the treatment is on an In-Patient basis give the Insurer sufficient notice so they can approve and put in place a treatment guarantee (direct payment arrangement) with the hospital/clinic; Always carry your IHI card on your person. If a patient is admitted in a critical condition and cannot communicate, they will be searched for identification. In some countries and hospitals, having your insurance card in your wallet can also help to ensure that you receive the best treatment; Make sure that you are not excluded from cover on the basis of a pre-existing condition or you are still subject to a waiting period ; Make sure that you have not exceeded your benefit limit; Be honest and disclose fully when applying for your Insurance. If you try to conceal a previous or existing condition and the Insurer finds out, they may not only reject the claim you are making but can also void your policy. This means they could ask you to repay any previous amounts paid under the policy, or take steps to recover from you any such payments. For out-patient treatment, check whether your insurer has a direct billing arrangement in place with the hospital or clinic; Always keep your original receipts and ensure that, if you need to complete a claim form, all sections are completed, the treating Doctor has signed where necessary and the form has been correctly stamped and dated. 17

18 Will my premiums go up? As people get older they typically need and receive more medical treatment and, as such, premiums for IHI tend to increase with age. In addition to this, premiums are likely to increase due to: The steady year-on-year trend of more and more people making claims; The increasing sophistication and cost of treatments; Increasing wage growth in the healthcare sector; Increasing losses suffered by insurers due to fraudulent claims being recovered by increased premiums across the board; Are there ways to keep my premium costs down? There are several things that you can do that can help to keep down the cost of your insurance. Don t claim! Some Insurers now offer a no-claims discount policy. Investigate this with your insurance company to see if you are eligible. Go back to basics Are you paying too much for benefits that you don t really need? Consider switching insurer A lot can change in a year. On renewal, take some time to investigate if switching to another insurance company or policy is wise. Policy options Increasing your excess / deductible or increasing your co-pay options can save you up to as much as 60%. Can you enrol in a group scheme? Joining or creating a new group scheme can often significantly reduce the cost of insurance for each member of the group. Pay annually Insurers offer significant discounts for yearly payments. 18

19 What your IHI policy will not pay for All IHI policies come with a list of things that will not be covered (exclusions) and a list of restrictions on the benefits. Common to many IHI policies are the following exclusions: 1. Treatment outside the geographical area of cover. 6. Treatment for sexually transmitted diseases Over the counter drugs such as vitamins, minerals or dietary supplements. Medication that can be purchased without a doctor s prescription. Plastic or similar surgical procedures carried out for wholly cosmetic reasons Self-inflicted injuries which can also include alcohol or substance related abuse. Experimental medications and experimental treatments. Investigations into, or treatment of, sleep disorders, including apnea and insomnia. 5. Injury, accident or illness resulting from natural disaster, war or terrorism. 10. Medically unnecessary treatment. 19

20 Before you take the plunge.. When considering IHI policies, there are a number of things to bear in mind. Annual Limit All IHI policies will have a total policy payment limit. Once you reach this limit, no further reimbursements will be available. If you haven t got a sufficiently high annual policy limit, you could be caught out: Bitten by a dangerous spider in Bali! Anne has a basic policy with a $50,000 annual limit. On holiday in Bali she gets bitten by a dangerous spider! The nearest quality medical facility that can provide the vital treatment is in Singapore and as such she needs urgent medical evacuation. Medical support in Bali: $10,000 Air ambulance $25,000 Medical treatment in Singapore $20,000 Annual Limit - $50,000 Anne pays: $5,000 The medical expenses in Bali, the evacuation costs and resulting treatment in Singapore exceeds the $50,000 annual cover limit meaning that she needs to pay for costs in excess of her $50,000 annual limit. Buy a policy with a reasonable annual limit to help avoid such scenarios. 20

21 What are Waiting Periods? Some policies apply a waiting period for specific benefits. This simply means that after you buy a policy, cover for certain benefits will only be available after the waiting period has expired. Typical examples of waiting periods for IHI plans are: Maternity months Dental Well being Pre-existing conditions 6-9 months 12 months 24 months Meet Angela & Denis Angela and Denis are uninsured and are planning to start a family in the near future. Should they take out a policy today to cover pregnancy or should they wait until Angela becomes pregnant? Buy now and become Angela is covered for the entire pregnant months later duration of her pregnancy Buy later when Angela is 6 Angela will not be covered for the months into her pregnancy entire duration of her pregnancy As you can see, in order to receive full maternity cover you would need to put the policy in place before becoming pregnant. 21

22 What is considered a pre-existing condition? The BrokerFish definition as it relates to IHI is as follows: Medical conditions or any related medical conditions for which one or more symptoms have surfaced prior to commencement of cover. Can I get cover for pre-existing conditions? In the past international health Insurers have excluded cover for pre-existing conditions. However, there are now some Insurers that will look at medical history on a case by case basis and will try to cover preexisting conditions. Expats with pre-existing conditions can consider the following options: Excluding the condition from coverage; Moratorium underwriting (waiting period until the condition subsides); Premium loading; or Medical history disregard. Having pre-existing conditions does not necessarily mean that your insurance rates will be higher. But, if the pre-existing conditions fits into a company s definition for such, it may mean that those conditions will not be covered by your insurance or in return the Insurer will typically increase your premium cost ( premium-loading ) to cover their costs. If the condition is to be excluded from coverage then this means that you will not be able to claim for treatment of that condition or any related condition. What happens if I don t tell the Insurer about my pre-existing conditions? If not declared it may be that not only your pre-existing condition is not covered, but the insurer refuses to pay for other issues due to the dishonesty of the application! 22

23 What happens if I develop a chronic condition while insured will they refuse to cover this condition in future years as it is by then a pre-existing condition? Some Insurers will provide full cover for chronic conditions as long as you remain insured with them, whereas others will have restrictions and limits. Chronic conditions can become very expensive and as the level of cover varies greatly by insurer, always make sure you understand what cover is provided. If this is an important consideration for you then speak to a broker before you take out a policy so they can short-list suitable plans. What are the major differences between IHI, local and travel policies? This table compares IHI, local and travel policies. Please note that due to the range of plans available, the table gives an overview of the typical cover that each type of plan will provide: International Policies Local Policies Travel Policies Designed for Level of cover Maximum benefit limits Premium costs Area of cover Benefit options Hospital accommodation Expats High High High Worldwide Many Private Locals Medium Medium Medium Limited Few Public / Private Holiday Makers Low Low Low Trip Specific Few Semi-Private Full In-Patient Treatment Yes Limited Yes Renewability Premium cost on renewal Hospital network Exclusions Pre-existing conditions Language support Life Standard Worldwide Some Some Multilingual Per Year Standard Country Specific Many Excluded Local Per Trip Standard Worldwide Many Some Multilingual 23

24 Further Resources Get Quotes Now Articles FAQs Glossary BrokerFish we re here for you Contact BrokerFish for any assistance that you need. Whether you want impartial advice and assistance in finding the right policy, need help in cutting through the jargon or even need assistance in resolving a dispute with an insurer, we re here to help. Our focus on providing cost-free, impartial advice, coupled with our outstanding customer service, is why our clients love BrokerFish and why we continue to succeed. Contact us BrokerFish Helpline: 19A-LGF-1, UOA Centre Call us: Jalan Pinang Call back: click here Kuala Lumpur Malaysia Limitation of liability BrokerFish Buying The Perfect International Health Insurance Policy and the brokerfish.com Website contain information regarding product benefits, prices and other product information. In no event will BrokerFish be liable for any damages, including without limitation special and/or punitive damages and / or consequential damages and / or losses or expenses arising from, out of or in connection with this document or the brokerfish.com website. The information contained herein or any linked site or use thereof or inability to make use thereof by any party, or in connection with any failure of performance, error, omission, interruption, defect, delay in operation or transmission, computer virus or line or system failure, even if BrokerFish or any agents and / or representatives thereof are advised of the possibility of such damages, losses or expenses. About us BrokerFish is a brand of Direct Health, a division of the Tenbridge Group Limited, a licensed International insurance broker regulated by the Labuan Financial Services Authority, registered in Labuan at Brighton Place, No U0215, Jalan Bahasa, P.O. Box 80431, Labuan, Federal Territory of Malaysia, Registered No. BS Tenbridge Group Limited is also a member of the Labuan International Life Insurance Association, Registered No The correspondence address for BrokerFish is 19A-LGF-1, Lower Ground Floor, UOA Centre, 19 Jalan Pinang, Kuala Lumpur Copyright 2010 Tenbridge Group Limited. All Rights Reserved

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