In the UK when we are sick or injured and in need of medical treatment we have a choice whether to ...
In the UK when we are sick or injured and in need of medical treatment we have
a choice whether to go private or wait for free NHS treatment.
Yet for many British expatriates living overseas, this choice, which we all take for granted is often removed, and where insurance is not in place the cost of accidents and illness can be exorbitant.
In Norway it would cost nearly £2,000
for a prostate examination as would a hysterectomy in Spain, while a hip replacement in France would cost well over £8,000, according to
PPP healthcare's claims experience. With medical costs as high as
this and with no NHS equivalent to fall back on, international
private medical insurance has a different role to play than its domestic counterpart.
Fundamentally different
As a result, international PMI plans have a fundamentally different benefit design to domestic plans to ensure policyholders have sufficient cover in a country where there is no NHS or equivalent. GP cover and accident and emergency cover have, as a result, become integral parts of the plans.
Further cover requirements will be dependent on the individual and on the country being lived in; for example, in areas such as South East Asia or Africa where the level of healthcare provision may not be adequate, emergency evacuation or repatriation is essential. This ensures that in the event of medical emergency the insured will be flown to the nearest suitable facility for treatment.
Most insurers include this as standard in these plans. Exeter Friendly Sociey, however, offers it as an optional buy-in as does BUPA, which states that it is not mandatory on its plans since inhabitants of many well developed countries where healthcare provision is of a particularly high standard would not need this facility.
Beyond this, benefits are pretty much in line with domestic
plans. The only other significant difference is areas covered. If
and when overseas cover is provided on a domestic plan, it usually
only applies on a short-term basis - for example, to provide cover when on
holiday.
However, on international plans the cover tends to be worldwide, and in the majority of cases, broken down into three global areas. These are usually Europe, worldwide and worldwide excluding Canada and the US. However, some of the smaller domestic insurers operate in more confined areas. Exeter Friendly Society, for example, only extends cover to France, Spain, Portugal and Gibraltar - areas that tend to be popular with retired British expatriates.
Costs
Like domestic PMI, plans are not cheap, and with medical inflation reaching 10% a year costs are not likely to fall either. However, besides taking a budget plan which means taking fewer and lower benefits there are number of ways in which this cost can be reduced.
Around half the providers offer voluntary excesses, with WPA charging a compulsory £100 excess and Norwich Union charging
a mandatory £25 fee per claim. Further discounts of around 5%
can also be sought from many providers if premiums are paid by
direct debit.
More commonly found on car insurance, a handful of providers have started to offer 'no claims bonuses' to reward the healthy policyholder. WPA's clients for example receive their sixth year of membership free if the plan remains claim free for five years, while Interglobal does not apply age-related subscription increases for as long as the plan remains free of claims. Exeter Friendly Society goes one step further and never applies age-related subscription increases irrespective of the number of claims incurred.
Europe-only plans do tend to be the cheapest, and as the premium tables indicate, premiums rocket when cover in the US is required, owing to particularly high medical costs.
Rachel Williams is a staff writer
