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While working or living offshore, North American expatriates are exposed to health risks equal to or greater than those at home. However, they do not have the benefit of their Canadian government health care system or American 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 an ironclad promise to be paid or an actual cash payment. As well, if while travelling outside your offshore country you happen to fall ill or injure yourself, you will require medical travel insurance or even evacuation if the facilities where you find yourself are inadequate. Some expatriates are able to become part of the local government health plan if they satisfy certain residency and immigration requirements. However, such government plans are often inadequate, rife with long waiting lists and in many cases cover only basic medical needs. Also, what happens to your coverage if you move, or if you want treatment in the United States or Canada? Several multinational and specialty insurance companies offer international medical coverage plans. Most plans cover inpatient (i.e., in-hospital) care and include hospital accommodation, and surgeon, anesthetist and physician charges. Consultations in radiology, pathology, oncology and radiotherapy are also covered. The more enhanced plans also provide coverage for some outpatient charges such as: specialist fees; therapies such as acupuncture, osteopathy, physiotherapy, homeopathy; and primary consultations and primary care including a certain amount of prescribed drugs. Local road ambulance is usually included in basic plans. Home nursing and emergency dentistry are usually options. These plans are called hospital plans because they usually cover only in-hospital treatment. For more comprehensive outpatient care there are plans that cover the expenses of: psychiatry, organ transplants, rehabilitation, home nursing, childbirth, home delivery, general practitioners consultations, eye and ear specialists, other specialists 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. If you’re used to using a government-sponsored plan such as Canada’s, you may want to purchase such a comprehensive plan. In terms of coverage, most plans cover 100 per cent of expenses. Others have the option for the insured to pay 20 per cent of the costs. Most plans have the option to include a $500 or $1,000 US deductible which also helps lower the premium costs. All plans have the option to add emergency travel medical and evacuation coverage for an extra fee. These options provide immediate transportation from any location in the world to the nearest centre of medical excellence for inpatient 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 an expatriate dies, physical remains can be transported home for no charge. All expatriate health plans have some restrictions and exclusions. Some common exclusions are for preexisting conditions known prior to being insured. If you have an expatriate plan already, and you have suffered a condition that may reoccur such as 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 clauses are not covered. 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. One caution: a complicated pregnancy is very expensive to self-insure. The obvious determinate of an expatriate’s premium is his/her age, not the sex of the applicant. Most plans have premium bands of 5 years, with coverage available up to age 100. Another factor in the price can be whether the expatriate wants worldwide coverage excluding or including the United States and Canada. Because of the high price of health care in the United States and in Canada if you’re not insured under a government plan, the price for expatriate coverage including these two countries can be as much as three times the cost of that without them. Such a plan is recommended for offshore residents who travel back to the United States or Canada for extended periods who would not be covered in the optional medical evacuation plan. Expatriates can obtain insurance information on the Internet, including sites such as <www.expatfinancial.com>. Read the fine print! Offshore residents know that purchasing health coverage is a vital part of their financial security. Neglecting such a vital safety net can result in financial ruin. David G. Tompkins, BA, CLU runs Expat Financial/Tompkins Financial Group Ltd., a local and international insurance agency. He can be contacted at: Tel. 604.351.5278 / 800.232.9415, E-mail <tompkins@expatfinancial.com>, |
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