Dr Ulrike Sucher looks at the growing problem of chronic conditions and explains how international health insurers are providing clients with more options.
International vs domestic insurance
The line between chronic and acute conditions is not the only one that is being blurred. It also applies to the traditional division between domestic and international health insurance.
Currently, most domestic health insurance only provides cover in the country where the insured member is living, with potentially some element of cover for emergency treatment abroad. However this traditional framework is becoming increasingly at odds with the market it serves. People travel, often regularly and extensively on business and/or for leisure.
In addition, medical tourism, whereby people choose to go abroad for certain treatments, or feel like they have to go abroad due to a strained healthcare system at home, continues to grow. With technology and communications systems, it is also much easier than ever before to work remotely. Plus, in the past 20 years, there has been an increase in medical specialisation.
Today, if patients need to see a specialist, they will have to travel to them, as each hospital cannot afford to employ a full roster of sub-specialists. With patients’ increased mobility and treatment progressively being sourced internationally, the lines between local and international health insurance are increasingly becoming blurred.
In the short to medium term, it is likely that health insurance will continue to evolve towards more geographically flexible cover, plus the demand for cover for chronic conditions will also increase, in line with the changing demographics of the world’s population.
So what’s changing when it comes to cover for chronic conditions? In the past, many insurers, particularly domestic providers, excluded chronic conditions from cover due to the associated high medical costs. Hence domestic health insurance primarily provides cover for acute conditions or injuries that can be treated and cured in relatively short order, leaving chronic conditions to be treated and maintained by the public health system (if available) or self-funded.
In contrast, international health insurance has traditionally focused on providing a more comprehensive level of cover for its clients as many expats will not have access to a domestic healthcare system. For corporate groups, who are assessed on a medical history disregarded (MHD) basis, all chronic and pre-existing conditions are generally covered.
Private cover
Until recently, it was a different story when it came to individuals/families and smaller corporate groups. For these clients, who are underwritten based on the details of their medical history, international health insurers, like their domestic counterparts, were also more likely to exclude cover for chronic conditions.
