Shopping for International Medical Insurance in 2018? Tips to Consider
Shopping for International Medical Insurance and Air Ambulance?
Important Issues to Consider and Questions to Ask – March 2018

Reinsurance – make sure the proposed international insurance products are underwritten by a strong re-insurer, this is very important. Reinsurers often audit corresponding companies who sell their products. Also, a strong re-insurer should have strict guidelines in place related to Underwriting, Claim Reimbursement, Customer Service, Annual Renewals, Pre-existing Conditions and Product Design. Just because the company has the logo “Lloyd’s of London”

Annual Renewals – make sure the international insurance plan that you are considering guarantees an annual renewal each year. Also, make sure that you are not penalized too harshly for poor claim experience. A strong insurance company pools its members by using “age-banded” rating and does not base the annual renewal rate solely on one’s claim experience for the year. This is one of the most important issues related to annual renewals. Many international carriers weigh in a member’s annual claims experience over many other factors. Also, make sure that the international carrier’s international pool of members does not include people who live in the USA for more than 6 months out of any year (may vary). This drives up the rates big time.
Non USA Addresses should be required. (This is our requirement)

Claims Reimbursement – make sure that a reimbursement check can be cut and mailed out within 2-8 weeks after a claim filing, and that the member is not penalized with miscalculated exchange rates. DHL or UPS are the preferred carriers for international mailing. On many occasions, monies can be wired to a foreign bank account or directly to a hospital.

Direct Payment & Wire Transfers – make sure that the international carrier can pay via “direct wire” or “guarantee of payment” for costly or expensive procedures. A few carriers require the member to pay for large medical expenses upfront; this is not good, especially for care in the USA. A quality international broker and carrier can get on the phone and make things happen and help you with a direct pay to a hospital or provider. You need to deal organizations who will talk over the telephone or in person, as opposed to relying on faxes or e-mails with no or limited follow-up. Please note that there are hospitals, clinics and providers abroad which simply do not accept insurance and will require payment ahead of time by a patient. It is good to have a credit card when you travel in case of an emergency.

Brokers – make sure your international broker or consultant has an insurance license. Many brokers outside of the USA do not have licenses and many international carriers do not require it. Also, make sure that your broker or consultant has experience in international benefits. International insurance companies often market to domestic brokers who mainly sell in the USA, and dabble in international, as prospects pop-up on their radar screens. My company, Offshore Health Benefits LTD, has been thriving for 11 years, adding new clients each year. Also, we pride ourselves with a very high annual client retention rate. Experience in international benefit planning is everything, especially in a time of crises. Approximately, 50% of our business comes from client referrals.

Broker/Agent Fees – make sure your broker or agent is not embedding extra commissions into your rates or charging processing fees. Some brokers add hidden fees and do not mention this to prospective customers. The international carriers pay out commission percentages based on the carrier’s advertised book and annual renewal rates and volume. You should never pay more than a published book rate during your first year of coverage. Many book rates are available on the internet. Beware of “application” fees; it is not necessary to pay these.

Medical Air Evacuation and Assistance – make sure that your prospective international carrier has a strong relationship with their Medical Air Evacuation and Assistance partner. Many carriers contract this service out and do not have a solid communication system in place, this is very important. Handling a crises situation correctly and in a timely manner can mean the difference between life and death in some serious situations.

Broker Communication – make sure your international broker or consultant can be reached either by telephone or email. All of our clients have our company cellular telephone number and we welcome calls 24-7, and 365 days a year. Our company Skype name is “Offshore Heath Benefits” and we welcome calls seven days a week. Many brokers take days to respond, and some cases, unfortunately, simply do not respond after a sale or claims has been made. This is unacceptable.

Coverage in the USA – make sure that the international carrier’s PPO (preferred provider organization) partner in the USA honors the member’s insurance card at the time of admission or appointment, and has a direct billing relationship. Also, make sure that carrier has provider internet search capabilities that are updated monthly for the members. Members should be free to go to any “western trained” provider of your liking outside of the USA. Many PPO networks offered by international insurance companies in the USA are limited, so check online lists. Check to see if your current domestic doctor or hospital is in the network prior to joining. Many international carriers allow the members to “opt out of coverage” and save 30-50% off annual visits; this is a good situation for expatriates who have national coverage in their home country or Medicare in the USA or who just do not require coverage in the States.

Not every member needs access to medical care in the USA. Don’t waste your annual premium on unnecessary benefits. If you are not from the USA, you may want to “opt” of coverage in the USA.

Annual Deductible and Co-payments – make sure that the international carrier is not imposing a higher deductible for care in the USA. (Coinsurance levels are usually higher for care in the USA). Many international insurance companies out of Latin America and Europe increase deductibles for care in the USA and offer sub par networks (BUPA Latin America). This is not the industry standard. Your overall benefit may be lower in the USA (standard), but your deductible should not change once you return the USA or your home country.

Plan Limitations – always read the plan Exclusions & Limitation Section and ask questions. Please understand that each international carrier has various limitations, especially for pregnancy, organ transplant, mental health, pre-existing conditions, preventive care, RX, air ambulance, and the first 180 days of coverage. There is no such thing as a 100% perfect plan.

Internet Purchase – do not purchase an international insurance plan off the internet without speaking to knowledgeable licensed representative first. You may not be buying what you think you are! Some countries are off-limits to certain insurers and many agents are eager to sell even without a guaranteed annual review.

Coverage & Benefits – review the various plan offered by each carrier, a few plans out there do not reimburse on a “Reasonable & Customary” model. Be aware of this. Also, Outpatient RX Reimbursement, Preventive Care, Organ Transplants, and Pregnancy coverage may not be included with all plans. Remember, if the rate is too low, you may not be covered for basic major medical procedures.

Lifetime Coverage Limits – make sure that you review plans that at least offer $500,000 of major medical coverage per lifetime (for long-term 12 month renewable plans). The standard is $500,000 – $5,000,000 per policy, per lifetime.

Choosing Annual Deductibles – check to see if there are limits with annual deductible options. Many carriers do not allow the members to lower their annual deductibles at time of annual renewal or during the contracted year. You may increase it in most cases.

Our consulting team would be glad to assist you, your family, or your business group. Remember, domestic health insurance and international health insurance is very different. Many “domestic brokers” or “domestic agents” and so-called “international brokers” offering international plans, simply do not have the international experience that is required to handle emergencies, assist with claim management, wire transfers, translate with foreign providers, negotiate renewals, evaluate plans, and assist with air & ground evacuations. A reputable international insurance company should have these systems in place.

Our team only works with expatriates & third country nationals (country by country). We work directly with our clients and do not work through middle man brokers. You do not need to pay “override” fees or commissions to a “middle-man” broker or consultant. Counting on a domestic plan to cover you, your family, or business group abroad is not a smart approach. Coverage outside the USA or other countries can be expensive and domestic insurance only covers a member living or traveling outside of their home country in case of an emergency or “life threatening emergency” if you are lucky.

Most cases, domestic coverage abroad is limited to only vacations, etc. (no more than 30-60 days, check your policy writing and do not rely solely on what a domestic agent tells you, they do not want to lose commissions). Many expatriates often move out of their home countries and maintain their home country health insurance plan (with a US address of a relative, etc) for an extended period of time or simply try to “beat the system.” This could result in a denial of claims and could cost you hundreds, if not thousands of dollars while jeopardizing your health. Many domestic plans only cover for “life threatening emergencies” when abroad as defined by corporate lawyers.

Thank you for taking the time to read these tips.
We look forward to your questions and thoughts. Safe travels to you!

Robert Tillotson
Offshore Health Benefits, LTD
cell: 512.296.4976 ( USA google)
http://www.offshorehealthbenefits.com

*this information is solely the property is Offshore Health Benefits, LTD , the reproduction, editing, copying, or redistribution is strictly prohibited without the expressed and written approval of Offshore Health Benefits, LTD.