Pre-Existing Medical Conditions and International Health Insurance - The Facts

Pre-existing medical conditions are perhaps one of the most important areas of International Private Medical Insurance (IPMI) and quite often one of the most overlooked areas of IPMI.

What is a pre-existing condition?

Put simply, it is any condition, illness or injury that you have ever been treated for in the past or are currently receiving treatment for now.

Crucially, this also includes conditions that most people may not consider are existing conditions – those that are well controlled by medication such as hypertension. Many people think that as a condition is managed by medication that it is not a pre-existing condition – this is NOT the case, this IS a pre-existing condition to an insurer.

Can I get my pre-existing condition covered?

Until recently it was a fact of IPMI that individuals and small corporate plans would usually be issued with exclusions of pre-existing conditions.

However, in the last couple of years, several plan providers have approached underwriting from a different angle. We now have plans that will look at your medical history and your pre-existing medical conditions and will try and include them in cover, albeit with a potential premium loading if they do.

What if I take a plan that excludes pre-existing conditions?

Where a provider excludes your pre-existing condition they will also exclude any consequences of the condition also. For the example of hypertension (or high blood pressure) an exclusion would not just exclude your relatively cheap medication but also any related treatment. You would find yourself faced with a whole host of exclusions on your policy, such as Angina, Aneurysm, Heart Attacks, Stroke, Thrombosis, and Phlebitis etc. The potential cost of someone having to pay their own medical bills following a heart attack is astronomical. In more costly countries even the ambulance alone can be much as $1,000.00, with a heart bypass being as much as $140,000.00.

How do the different types of underwriting work?

If you have a pre-existing condition then you should be aware of the implications of the different types of underwriting;

·         Full Medical Underwriting – This is where you declare your medical history to the insurer and depending on the provider and the condition they will either accept the condition, accept the condition with a premium loading, exclude the condition or decline the application altogether.

·         Moratorium Underwriting – No medical declarations are made at the time of application but any pre-existing conditions suffered in the past 2 years, five years or ever (depending on the insurer) will automatically be excluded from cover for at least the first two years of your plan. Once you have been completely free from the condition for, usually, two years then this can be included in your cover – by completely free from the condition this means no treatment, medication, symptoms or doctor’s advice or visits.

Which type of underwriting is best for me?

This will depend on your medical history. If you have a medical condition that you want included in cover then you will need to look at a plan that offers Full Medical Underwriting. Please note however that not all providers carry out Full Medical Underwriting in the same way, most underwrite to exclude existing conditions whereas a small number do underwrite to try and include your pre-existing conditions where ever possible, albeit with a premium increase for doing so.

Moratorium works well if you have a clean medical history, certainly for the last couple of years. Alternatively you may have been treated for a condition that is not anticipated to reoccur and so you are happy for this to be excluded.

One thing we do know is that this is a very complex area and our expert advisors will be able to provide the best advice to you.

For free advice and information on covering your pre-existing medical condition on an International Medical Insurance Plan visit us at Medibroker.com

International Medical Insurance when you are in a War Zone

As relocation around the world becomes more commonplace, so a greater number of factors need to be taken into account by those leaving the safety of their safe home country. Currently, the Middle East and Asia remain important destinations for UK, US and other nationalities, with increasing numbers now heading towards reconstruction zones such as Iraq and active conflict areas including Afghanistan. After yesterday, we must also sadly include Palestine, parts of Israel and not forgetting of course the flashpoints of emerging African states.

 

War zones are occupied not only by traditional armies, but also by huge numbers of businesses involved in post war reconstruction and aid work. As a member of these groups, it is vital that expatriates carefully choose a policy which is tailored to suit their needs and which takes into account the particular dangers of working in a country such as Iraq or Afghanistan. Finding the right policy is not always straightforward, as many insurers have special clauses relating to war and terrorist threats. 

Policies which include limited cover against terrorist attacks are available, but with conflicts not solely confined to war zones nowadays, effective cover which reflects this new global reality is now ever more important. . Medibroker have available policies that have a ‘stand out’ benefit that really makes a difference to those expatriates living and working in world hot spots. For these individuals, Medibroker can  provide policies with ‘passive war’ cover including war and terrorist attack, in contrast to other insurers whose policies may often have a full war risk exclusion. 

Passive war cover is likely to be of particular interest staff in aid agencies and rebuilding contractors working elsewhere in the Gulf area, especially in Lebanon, Kuwait or indeed Africa. Policyholders would benefit from the full range of International services, including hospital benefits and evacuation, in the event of injury by terrorists or as part of a broader war conflict. Evacuation is likely to be particularly relevant in conflict zones, where local medical facilities may be damaged or supplies of medication and blood for transfusions may be an issue.
With over 14 years experience of supporting the international business community worldwide, and clients from 86 nationalities in 114 countries, Medibroker are used to facing the challenges of covering individuals in some of the most inhospitable parts of the world.

For free impartial, independent advice and quotations on plans offering this service, please contact Medibroker and one of our expert advisors will be in touch.

Expats in the UAE prefer medical care overseas.

Ineffective communication, a lack of specialist services and the length of time it takes to consult with a doctor are among the reasons residents are seeking medical treatment abroad. the National www.thenational.ae write.

"The Dubai Health Authority (DHA) and the Dubai Statistics Centre questioned expats who had treatment outside of the UAE.Eight per cent of respondents said they did not even seek medical advice in the UAE before opting for treatment overseas. More than half of this group (56 per cent) cited the lack of medical skill and equipment as the reason. Almost a fifth of respondents blamed long waiting times, a lack of medical skills and a lack of equipment. The cost of care was also listed as a factor in their refusal to consider treatment here.The three most popular treatments sought overseas were for cancer (19.7 per cent), bone and joint diseases (14.1 per cent) and cardiovascular diseases (12.5 per cent).More than half of those who travelled abroad cited a lack of specialist treatment as their reason for doing so, while 15 per cent did not know. Just under a third said they were aware the necessary treatment was available here.Of those, long waiting times, privacy concerns, the anticipation of unwanted outcomes and improper behaviour of service providers pushed them towards going abroad.The top places to travel for all types of treatment were Germany - favoured by 43.1 per cent of respondents - Thailand, Singapore, India, the UK and the US."

Of course you can only do this if you have international medical insurance that covers you on a worldwide basis with or without USA cover and not just in the UAE
Medibroker is an independent broker specialising in international medical insurance solutions for expatriates. One of the major advantages of using a broker based in the UK is the assurance that they are regulated by the Financial Services Authority (FSA). The FSA is noted the world over for its overseeing of the global markets operating from the city of London.

As our customer, you can be confident in the quality and value of advice being offered by our expert advisors in any and all circumstances. For free impartial information, advice and quotations from thirty+ international insurers visit Medibroker

Health insurance brokers are on your side

Steve Nelson of Medibroker Speaks to Privatehealth UK

Seasoned expatriates understand the importance of international medical insurance when working abroad, so for many employees, ensuring an appropriate international healthcare package is in place before any posting is a high priority. For the employer, sending people overseas represents both a cost and a risk. Ensuring they have access to treatment if they fall ill is a vital part of business as well as human resources planning. Private medical insurance is available for both self-employed individuals and employees working abroad. Policies can be designed to offer cover for major events such as evacuation and hospital treatment, but cover levels can also be varied depending upon the territory. Choosing a provider can uncover a range of difficulties. Few expatriates fit into any convenient one size fits all category, with some having complex medical protection needs that could include, for example, a medical condition such as hypertension. With individuals, this can give rise to a need to negotiate bespoke policies, whilst for groups, depending on the number of lives to be covered, a skilled broker can arrange medical history disregarded terms and of course discounted premium rates. Another fact often overlooked when selecting a provider is that where a pre-existing condition is declared, it is not only that condition but related ones too which some insurers can choose to exclude from the cover, unless this has been specifically negotiated at the outset. So if hypertension is declared, heart attacks and strokes may be omitted from cover. Specialist international insurance brokers Medibroker play an important role ensuring the most appropriate cover levels are in place across all international territories, with cover being varied according to individual need and local regulations. Steve Nelson at www.medibroker.com explains, "Companies sending employees overseas understand that a significant investment in time and money is being undertaken so any placement has to be carefully planned. Their health is essential."

For free impartial information, advice and quotations on working and living overseas come to www.medibroker.com

Why Expats in the Far East are facing large premium increases in the cost of International Health Insuranceinsurance

Health insurers take a new look at world

The Daily Telegraph writes:

Gone are the days when international medical insurers divided the world into two blocs.

Radical changes in global trade triggered by the growth of emerging economies have caused international medical insurance companies to “slice up” the world in different patterns.

Until the 2000's, most insurers simply regarded the world as two blocs. One was the world, less the USA. The other was the entire world (which included the USA). Sometimes Europe would be taken as a separate entity.

China has changed that. Set to rival the USA as the leading economy, it is also set to rival it in terms of medical costs – at least for hospitals used by the expatriate community.

Medical bills faced by the international community in China far outstrip the other BRIC countries – Brazil, Russia and India.

The swing to the Far East has been pronounced and rapid, according to Kevin Melton, sales and marketing director of AXA PPP International. “I can see it in the sort of service that expatriates are expecting now in China and the Far East,” he said.

“In the UAE it was absolutely the norm that customers expected direct settlement of their bills – the policyholder would not have to produce his cheque book or credit card. The insurer would pay direct. In East Asia, the customer paid the bill and was reimbursed.

“That changed with the exodus from Dubai in 2008/9. Some of the reports of cars abandoned at the airport have been exaggerated, but you can see the fall-off in numbers – there’s much less traffic on the road. The expats have moved East and taken their expectations with them.”

So insurers are adapting. They are making direct-payment arrangements with hospitals and clinics. At the same time they have priced up premiums for people in Beijing and some other Far East locations.

Moves to selective premium setting are inevitable, according to one broker consultant.

He said: “As we see health care costs increasing in emerging markets where more and more expats are moving, so we are going to a more selective approach to pricing. It’s not just China, Singapore prices are also a worry.”

Bupa International has gone furthest down the road of splitting the globe so that premiums more exactly reflect risk and medical fees. In July 2009 the company made its first policy revision in 21 years. It split the world seven ways. Until then, no international insurer of individuals, and probably of groups, had divided the globe into more than three parts.

The World Health Options plan, which followed a £250,000 market research exercise by Bupa, also introduced pick-and-mix, allowing policyholders to choose what they wanted covered.

To see how precision pricing of premiums can pay off, take the cost of a routine appendix removal within Asia. In Beijing, it is US$12,000-15,000, in Thailand US$4,500. In Malaysia, an appendectomy costs US$6,000.

Insurers other than Bupa might well have pioneered the move to precision pricing earlier than 2009. But they lacked the data and the number-crunching facilities available to the market leader.

Bupa International then had 850,000 customers in 190 countries – figures that have subsequently increased.  “If you look at premium increases year on year in those seven different pricing zones, you’ll see the difference in pricing dependent on cost.”

The size of an insurance company’s database largely determines the extent to which it can set premiums in line with risk. Also, the greater an insurer’s customer base, the easier it is to set up good settlement terms. Hospitals need regular customer flow, just like hotels. They reward insurers accordingly. So the trend to selective premiums will mean that smaller insurers will have to depend on their traditional strengths of personal service and niche benefits.

“Bupa International is still the global name. Cigna say they are the largest in terms of number of people covered, but people still look to Bupa as market leader.”

Cigna, a US company, has traditionally concentrated on group cover, largely corporate business. But it recently entered the expat market for individually bought insurance. “Their plan is modular and very similar to the Bupa Worldwide Health Option,” 

To have such a big insurer as Cigna focusing on the market for individual buyers can only be good for customers

Ends.

Medibroker provide independently sourced, International Health Insurance for expatriates working, living or regularly travelling abroad. For free impartial quotations, information and advice visit www.medibroker.com

Check before you click when buying online insurance

Take care when buying an insurance plan online

Providers of medical insurance report an increasing proportion of sales online. Insurers like it. It saves back-office time. For customers, there’s the attraction of instant and easy cover. Insurance kicks in now. Job done.

However, buying insurance of any type is trickier than buying, say, a washing machine. And international medical insurance is more complex than domestic insurance. You can fall into the trap of buying cover from a respectable company only to find, as you arrive at immigration in Abu Dhabi, that your plan is not recognised. You are on the next flight home.

As countries across the globe find their health budgets rocketing, so compulsory insurance for expats becomes a legal necessity.

It gets worse. Governments tend to demand insurance from a local provider, or at least an international insurer with local connections – effectively a brokerage with a local businessman on the board.

Germany, for instance, is particularly reluctant to recognise some top-rated insurance plans from UK providers who are dominant in the international market. Some claim that the German position breaks EU competition rules. But it’s not quite that simple, because under German law insurers have to provide all-embracing cover, such as aspects of elderly and long-term care cover. That is beyond the scope of most international companies. Switzerland is particularly awkward, with each canton setting its own rules, the francophone cantons being somewhat more flexible than the German-speaking sector.

Japan, Germany, Holland, France and Spain are among those who have made insurance compulsory, or who are changing their regulations.

One broker candidly admitted to me that he could not keep abreast of the ever-changing regulations as to which insurance plans had the stamp of approval of a specific country and which were likely contenders. “I always say to customers it’s down to them, in the last resort, to check that their plan is recognised wherever they may be going,” he said.

All brokers agree that it is essential to read your plan carefully. You might assume that insurance with a company such as Bupa International automatically includes emergency evacuation. Not so.

Problems are usually averted because most people buying online have the sense to ring their prospective provider before clicking on Pay. As well as underlining the growth of online sales – up to 50 per cent with some providers – industry figures show that most buyers like to hear a human voice before completing an expensive transaction.

But it’s still a hassle. The alternative is to use a broker. Here the absolute rule is to check the broker is just that and not a tied agent of one or two companies. It’s also worth asking what commission your friendly broker is on. Commissions up to 40 per cent of the first year’s premium are far from unknown. That simply encourages “churning” – moving your client from one provider to another to maximise the rake-off.

One reputable broker says there are two ways of buying international medical insurance: “You can either do it the hard way and flog through all the documents yourself – and that presupposes a certain familiarity with insurance – or you scan it to a broker and say: is this what I want, and if not, can you suggest an alternative? I always recommend that people do have in-patient and day-patient cover, and that CAT scans and MRIs are covered.”

It’s been said that the only people who shouldn’t buy medical cover are the very poor and the very rich. There’s some truth in that for the indigenous citizen, but not for those who live overseas, where services are either inadequate or denied to expats.

From the Daily Telegraph 2nd Nov. 2012

Do not take the decision to buy medical insurance lightly, for true impartial advice contact an expert advisor at www.medibroker.com