10 tips for getting the most out of your expat health insurance

‘Health is wealth’, they say. And now, as we face a pandemic with no end in sight, that’s true more than ever before. I’m grateful for many things here in Chile, and top of the list comes my expat health insurance.

For anyone wondering about how expat health insurance works, I thought to put my personal thoughts down here. What is the best expat health insurance? Do I need international health insurance? What is global health insurance anyway and do I really need it?

Here are my top ten tips for navigating the oh so complex world of expat health insurance.

1. Evaluate your personal needs. The best expat health insurance might not be the same for everyone. If you have a preexisting condition, if you need any specialist treatment, if you’re pregnant (or are planning a family), then find a policy that will work for you. Some policies will offer coverage only in the expat host country, others will offer global coverage. Many policies exclude any treatment in the US. Evaluate your personal situation and what you really need, either as an individual or a family.
2. Research the level of service. A key difference I’ve found between health insurance providers is their service. Sometimes in the past I’ve struggled to get a response from the bigger providers when I’ve had a simple query. Some health insurance providers claim to cover everything, but in reality it can be near impossible to get your money back. Ask around friends and colleagues in your host country and research on expat forums for the best personal service. Foyer Global Health are focused on high end, service oriented plans with a more personalised response than some of the bigger outfits.
3. Consider the insurer’s outreach. It’s worth considering the global outreach of the health insurance company. My family is now insured with Bupa through my husband’s employment contract. It’s a huge company and the clinic we attend here in Chile has a direct relationship with them. Previously I had to liaise to and from the health insurer and the clinic, but now I can generally let them deal directly.
4. Investigate the system in your host country. Every country has its own quirks and even if you think you have comprehensive insurance, your host country might do things a little differently. Here in Chile for example, it’s complicated. While we have global health insurance which covers most bases, most expats here opt for the private Isapre system. Members pay at least 7% of their earnings into this fund, and then any extra to cover additional benefits. There are many different Isapre companies out there and they each offer different coverage in terms of the clinics and treatments available. If you needed treatment, you’d have to see what proportion of the costs your Isapre would cover, and at which clinic. It’s a case of shopping around, switching clinics and a lot of research.
5. Don’t confuse travel and global health insurance. Expat health insurance and travel insurance are not the same thing. As an expat living abroad I would not be eligible to travel insurance, but I might need additional travel insurance on top of my global medical insurance if I wanted to travel. Some medical policies are exclusively for travellers, and so they won’t work if you’re an expat or decide to stay on long term. Some policies need to be updated with every country move. A new insurance scheme called Remote Health by Safety Wings offers coverage whether you are in your home country, a new country or traveling nonstop, and you can buy it either at home or already when abroad.
6. Beware – the cheapest policy might not actually be the cheapest. Expat health insurance costs vary wildly depending on your personal health, lifestyle, where you’re living and the scope of coverage you’re after. You might opt for a more basic package which you would need to top up in the case of the treatment required. In the case of emergency treatment, this could be hugely expensive. Many providers are not insuring against coronavirus, or with strict exclusions. Safety Wing’s new Remote Health covers against COVID-19, whereas its Nomad Health policy is aimed more at short term travellers and does not. Equally, Foyer Global Health offers limitless coverage and reimbursement for COVID-19. If your insurance is funded through your employer, be sure to ask questions and ensure you have the best policy for you. If you’re insured via your employer, Human Resources might be open to adjusting your policy or even changing providers if you’re not satisfied.
7. Check if health insurance is actually necessary. In my personal case, I have three small, accident prone children and health is an absolute priority. When my husband was negotiating his new employment contract for Chile, expat health insurance was a deal breaker for me. I had also been warned from friends on the ground in Chile that the public health system was under considerable strain and private health insurance would be a smart move. Having said this, some countries, such as the UK, have a public national health system, and you might not need private insurance. I appreciate the British health system (NHS) has a terrible reputation and I have firsthand experience of its failures. Nevertheless, there are not always private options available, even if you have a private insurance policy. For example, the top British doctors and surgeons invariably work for the NHS, and take great pride in their work. In some circles there is stigma for going private, in rural regions you might not have access to private care and in the case of emergencies, cancer treatment and any complicated surgery, chances are the best doctor will attend you through the NHS. Another point to mention is that you need to check you’re not duplicating policies. In Belgium I was put under pressure into buying additional local medical insurance on top of the (expensive) global coverage I had already set up. An additional policy just wasn’t necessary, but we received threatening emails from insurers suggesting we were breaking the law (we checked with our relocation agent and we weren’t).
8. For high risk countries, consider a specialist insurer. When volunteering in Lebanon and (pre civil war) Syria I needed to prove to my charity that I had health insurance before I could participate. Most major policy providers explicitly excluded these ‘at risk’ countries or were prohibitively expensive. At the time I used ACE travel insurance (which has now merged with Chubb). While I haven’t used them myself I did some research and also found High Risk Voyager – a specialist medical and travel insurance company designed for journalists, interpreters and emergency charity workers in high risk regions, such as Iraq, Syria and Afghanistan.
   
9. Check for yourself, don’t assume. Expat health insurance is a complex affair, and it’s always better to check for yourself than assume. Some insurers will only allow you to set up a policy before you move, others will only you to do this when you arrive. Some will request a health check up before offering a quote. Always read the small print, don’t trust information on a call alone. In Chile, for example, expat parents insured through the Isapre systems can see a reduction of their fees when their children turn two years of age. This reduction of costs isn’t automatic though, you’ll need to request it in writing, perhaps twice. Equally, don’t assume your medical insurance provider will always know best. While they may have great contacts, always trust your gut and get a second opinion if you’re in any doubt.
10. Utilise your benefits. When living in Switzerland I developed horrible back ache. Under my medical insurance policy I was entitled to free osteopathy treatment. When I looked, sports massage, eye check ups and many more extras were included too. Equally, when I lived in Belgium and was about to move to the UK, I decided to ‘cash in’ dental check ups for myself and the family. In Belgium private dental care was included in my medical insurance policy scheme, whereas in the UK I’d have had to pay out of my own pocket. It’s worthwhile double checking what you’re entitled to and cashing in benefits before the deadline or a move abroad.