Healthcare: claims handling, settlement and service

Health insurance can be a tricky issue for expats. After relying on the safety net of the British NHS for so long, you might feel like paying into a scheme is tantamount to wasting money, but your health is something you should definitely take seriously when living abroad
The government strongly advises British expatriates to take out health insurance at some level, and today’s policies cover everything from a pesky throat infection to the type of ongoing treatment you would need if diagnosed with a serious illness like cancer.

How important is insurance though?

One of the main concerns about health insurance is the ‘money down the drain’ aspect, especially for younger expats. However you would be forking out a good deal more in medical expenses without it. France and Spain have a state funded healthcare system similar to the NHS but with equally long waiting lists, while countries like Germany, the USA, Hong Kong and the Caribbean charge extortionately high fees for treatment.

According to Andrew Apps, global sales and business development director for Goodhealth Worldwide, buying the insurance is the easy part: “It’s all very well having health insurance, but when you start to live further afield in places like the Middle East and the Far East that you need to know exactly what your policy covers you for.”

You should already be familiar with the types of ailments yours includes, as when it comes to seeking treatment you need to know the small print inside out. For most insurers, the issue of evacuation or repatriation cover is normally offered as an add-on at an extra cost rather than as standard, as not all policyholders will require it.

Another factor to bear in mind is that existing chronic conditions are not normally covered by the policies so beware a flare up. Pregnancy is also an issue as there is a high chance the insurer will have to pay out before an equal amount of money is generated by the annual premiums.
If you have to make a claim, you want to be sure the service you receive matches up to both your outlay and your expectations. When suffering from an illness, you’re in a vulnerable position, and when outside of the UK you want to be 100 per cent sure that you receive a speedy, considerate and efficient service.

Be familiar with the ‘what if’ circumstances

When it comes to the issue of treatment itself, all good expat health insurers will operate a flexible, if not 24-hour, telephone help-line to aid confused policyholders. Some, such as Goodhealth, will ask you to call in advance of any inpatient treatment with the details, so that they can then arrange direct settlement of your bill, while others like BUPA already have rolling accounts with certain larger hospitals so there is no need for prior warning. Either way, expats barely have to lift a finger, let alone get their wallet out in the hope of securing a reimbursement further down the line.

You only really need to be concerned with the upfront involvement of your own money when it comes to outpatient care. Accounting for around 75 per cent of all claims, the tag ‘outpatient’ covers all kinds of ailments for which you do not need to occupy a hospital bed – from getting your bandages changed by a nurse to having an X-ray. These types of claims are normally fast-tracked as an insurer’s first priority, at which point they will them reimburse you personally – although make sure you receive your compensation in your own currency.

However, depending on the company and your country of residence, this scenario may never actually arise. Goodhealth provide their policyholders living in the Gulf and Far East with a ‘Gold Card’, allowing the patient to go into one of 400 hand-picked doctors, and on production of this card, the bill will go directly to Goodhealth.

Should I be more wary of certain illnesses?

One of the main questions as far as treatment is concerned is whether it is country specific, as the amount claimed from country to country can be anywhere between £5 and £500,000. BUPA carried out a survey of its customers who had made claims during 2004, an exercise which turned up some interesting results.

Throughout the world, the one procedure carried out more than any other was a colonoscopy, with more carried out in Europe alone than in Africa, Asia and the Middle East combined. The second largest procedure was having a caesarean, which are 30 per cent more likely for expats in Africa, hearkening back to the issue of underwriting pregnancy.

Service with a smile

Finally, if you are worried that compromising on price means compromising on service then think again. Expats can be assured that almost all insurers offer service at a first class level. Instead, the way in which premiums will differ is in terms of the benefits policyholders receive and the range of conditions each policy covers.

Policies aside, Apps has some lasting words of advice for expats across the globe: “Make sure your provider is truly international. They key thing is the locations – make sure that they have offices on the ground locally, ideally within your region.”