Personal Insurance FAQs
– Worldwide Excluding the United States
– Greater China (China, Macau, Hong Kong, Taiwan)
– Mainland China Only
Health Insurance premiums are influenced by the geographic area of coverage desired, with coverage inclusive of the United States being among the more expensive options. This is due to high healthcare costs in the region.
We search among the world’s leading health insurance companies to provide you with coverage that will allow you to undergo treatment with any doctor, in any hospital, anywhere in the world.
Our consultants will be always be there to help you find the ideal coverage and insurance plan for you and your family.
1. For scheduled in-patient treatment the insurer commonly requires the insured to complete a ‘treatment guarantee form’ prior to treatment. This allows the insurer to contact the hospital and confirm payment direct to the hospital. In the case of emergency in-patient treatment the majority of insurers will settle medical expenses directly with the hospital. In this instance it is advisable for the insured to contact the insurer as soon as possible to arrange settlement.
2. It is common practice in some countries for foreign medical insurance companies to establish direct out-patient networks, whereby the insured can attend an out-patient clinic and have the bill settled directly with the insurer without the insured having to pay the initial fee.
3. The standard procedure for out-patient treatment requires the insured individual to initially pay the medical bill and then submit a claim form and original receipt to the insurance provider. The policy holder will then be reimbursed by the foreign medical insurance company through the agreed method of payment.
Complaints regarding Claims
Occasionally problems can arise when claims are submitted. The most commonly occurring reason is incomplete paperwork. Completing the paperwork correctly is the direct responsibility of the individual and will ensure prompt settlement. Pre-existing Conditions can also cause problems, as they are generally excluded. The client should ensure that the pre-existing condition has been accepted and is included in the foreign medical insurance policy otherwise the claim will not be settled.
For each medical condition that requires treatment the insured will be required to pay a percentage or fixed sum of the treatment costs. For example if a $50 deductible is in force the insured will have to pay the first $50 of treatment per condition. If the treatment costs total $150, the insured would pay $50 and the insurance company would pay $100. Once the $50 has been paid by the insured all further treatment for the condition will be paid by the insurance company. If however the insured at a later date requires treatment for a different condition he/she will again pay the first $50 of the costs.
An annual limit is the most common form of deductible present in health insurance packages. In this instance an annual limit is agreed upon by the insurance company and the policy holder. The insured will be required to pay for their treatment up to the agreed annual limit. Once the limit has been reached the insurance company will be responsible for all further costs. If a $100 deductible is in force the insured will be required to pay for the first $100 of treatment they receive. The insurance company will then be responsible for all further costs.
Co-insurance is most commonly found for dental and maternity benefits. Co-insurance is the amount that the policy holder is required to pay by the insurance company as a fixed percentage. If a 20% co-insurance exists and the cost of treatment is $100, the insured will be required to pay $20 (20%).
Insurance Companies normally have a waiting period before they will accept any claims for treatments. This period can vary between insurance companies and it is important to check the terms and conditions of dental the insurance coverage.
Almost all Insurance Companies accept pre-existing dental problems. The majority of individuals are likely to have undergone treatments such as simple fillings, tooth cleaning and root treatment. It is therefore extremely rare for the individual not to have any pre-existing conditions. As a result, health insurance providers will cover most dental conditions and treatment after a period of time has elapsed.
Insurance companies normally offer two levels of dental cover to enable the client to select the most suitable plan.
Routine Dental Treatment
Dental cover under this option includes:
• Consultations& Examinations
• Tooth Cleaning
• Local anesthesia
• Simple Fillings
• Root Canal Treatment
• Emergency Treatment
• Occlusion bar
Emergency Dental Treatment
Almost all major and emergency dental problems are covered under this option, including but not limited to, the following treatments:
• Tooth Adjustment
• Periondontitis Treatment
• Gingivitis Treatment
• Bridgework and Repairs
• Temporary Crowns, Porcelain Crowns and Gold Jackets
• Membrane Treatment
• Root Scaling
Selecting the right Emergency Evacuation Plan is very important for expatriates and their families. Many countries have limited medical facilities and capabilities to deliver the preferred level and in some cases necessary level of treatment needed by expatriates. Health insurance packages will often include a provision whereby expats can be transported safely to the nearest acceptable country for emergency treatment or back to their respective home country. This ensures that insured expats receive the appropriate level of care and the best facilities when needed the most.
Medical evacuation will only be covered by an insurance company when it is requested by a recognized medical practitioner and agreed by the insurer. It is not possible for the patient to simply demand to be evacuated. Any decision on medical evacuation must be taken by a medical practitioner and not just the request of the patient.
Expatriates seeking health insurance should always consider the inclusion of emergency evacuation coverage into an insurance package necessary. Costs for such an evacuation, wherever you are, are likely to be high.
We would always advise an Expatriate to have a level of coverage for Emergency Evacuation included in an insurance package, regardless of where they are located in the world.
The most important exclusions are pre-existing chronic conditions which the client has suffered or had treatment for prior to taking out the policy.
Below is a list of treatments which most commonly appear in the exclusion section in a typical medical insurance scheme. Cover will not usually be provided for the following conditions unless agreed with the insurance company.
• Conditions developed due to misuse of drugs or alcohol
• Experimental or unproven Care
• Fertility treatment or testing
• Plastic and cosmetic surgery
• Treatment of psychological conditions
• Termination of pregnancy unless medically prescribed
• AIDS or HIV related diseases.
• Contraception, including sterilization
• Epidemics that are under the direction of the authorities
• Obesity treatments
• Sexual dysfunction
• Injuries inflicted whilst committing a terrorist act
The health insurance plans are designed for families traveling abroad regularly and expatriate families. We will approach the world’s largest insurance companies on your behalf to ensure that you get the most appropriate and cost effective overseas health insurance cover. For a health insurance quote for your family you should contact our advisors at BlueStar AMG.
We can include a deductible (excess) to help keep your premium costs low and minimize the policy administration. Policies can be designed to include chronic conditions, maternity, dental, medical evacuation, personal accident cover and numerous other benefits. If you are suffering from a pre-existing medical condition our medical consultant will negotiate on your behalf to get you the very best care available from the world’s leading health insurance companies.
The group health insurance plans can include deductibles/excess to keep your premiums low and minimize the plan administration. Our advisors can tailor your group plan to allow employees of different levels to receive appropriate benefits and coverage.
We can provide expatriates worldwide with a bespoke insurance quote. To receive your quote, simply fill in the group enquiry form and we will contact you within 24 hours to discuss your requirements and give you a free quotation.
If an individual leaves the group policy, many insurers will allow the individual to change to an individual plan and allow all pre-existing conditions coverage to remain the same. This is a significant advantage for the policy holder. Group health insurance policies are not country specific so if a member was to relocate to another country, they will still be covered.
Group plans generally provide better coverage than individual plans. This is because your group policy can include coverage for pre-existing conditions whereas individual policies generally exclude pre-existing conditions.
The costs related to hospitalization and surgery can be high. Whilst most people only undergo an operation two or three times during their lifetime, the costs involved in one small operation can be more than all the insurance premiums they will ever pay.
Health Insurance providers offer optional benefits such as out-patient, dental and maternity care which can be added to inpatient cover. An inpatient only plan is available from most international health insurance providers.
Typical benefits of inpatient cover include:
• Semi-private/private hospital room
• In-patient medicine
• Organ transplant
• Out-patient surgery
• Surgery, Anesthetist and Operating theatre charges
• Surgical appliances and prostheses
• Intensive care room
• Ambulance costs
• In-patient Lab tests, X-rays, Diagnostic tests, MRI etc.
Our advisors can provide detailed quotes for expatriates worldwide. In order to receive a comprehensive individual health insurance quote, please contact our consultants.
We can advise you on health insurance policies that are tailored to your needs. The policies can be customized to allow for inpatient only cover for all your emergency needs and to ensure a low premium. We can also provide additional benefits to a plan ranging from outpatient care to dental plans. A special feature of our packages is that the plans are guaranteed renewal. Meaning that your medical costs will be covered by the insurer for your whole life. Your premiums will typically change as your age increases but will only rise with the average. Regardless of how many claims or large claims being made in the previous year your premium will stay the same.
Individual health insurance premiums are not dependant on nationality or occupation and are instead based on your country of residence and your age.
If you return to your home country or relocate to another country you can normally take your plan with you and the coverage will stay the same.
Reasons for choosing international coverage include:
1. Local medical insurance plans provide cover only in the specified country. This is is important to consider given the fact that healthcare in the country you are working in may be of a poorer quality than you would enjoy back home. If the need arises for you and your loved ones to go to another country with better medical facilities, you should ensure that your coverage provides for this.
2. International coverage allows you and your family the flexibility to move around the globe while keeping your health insurance plan. Your desire and ability to relocate and enjoy life will not be constrained by your insurance needs.
3. International health insurance plans allow for a wider range of facilities and hospitals to be at your disposal. Selecting a country specific coverage plan will in contrast, limit the number of facilities available to you and reduce the direct billing network.
4. International medical plans are normally renewable for life. Country specific plans often terminate coverage over a specific age threshold. For example a country specific policy may not allow renewals for persons over the age of 65 due to country specific financial constraints and lack of facilities suitable to persons above that age threshold.
5. Whilst it is true that all insurers have exclusions and exemptions to coverage, the likelihood of exclusion on various conditions is smaller with packages that offer international coverage as they have a wider range of facilities at their disposal for treatment. The financial limit of coverage is also often much higher, usually over $1 million USD.
6. Renewal premiums for country specific health insurance plans are generally based on the previous year’s claims. Whereas an international health insurance package is generally an aggregate figure. This means that your renewal premium is based on policy holders worldwide and does not penalize you for having made claims the previous year.
7. Most expatriates choose international coverage because of the peace of mind it gives them, knowing that they and their loved ones will be secure wherever work or life takes them.
8. Local coverage can at first appear cost effective, but when the unfortunate does occur, you may be liable to costs you had not considered at the time or may incur these costs somewhere outside of your coverage. It is always better to be safe and take action to protect you and your family’s well-being.
Out-patient care usually covers consultations and treatments provided by a specialist or medical practitioner when an overnight stay in hospital is not necessary.
The combination of inpatient and outpatient care will result in a higher premium but must be compared to how much outpatient care a person is willing to pay for themselves.
Like all health insurance packages provision of outpatient care also includes exemptions.
Typical benefits that would be included in an out-patient plan include:
• Medical practitioner and specialist fees
• Prescription medicines
• Alternative treatments
• Diagnostic tests, including X-rays
• Home nursing
Who is covered?
The Insurance Policy will specify who is covered. This id the defined policy holder whose name will eb incorporated into all documentation.
Where are you covered?
The area of coverage will be specified in the policy conditions. This could be international coverage or country specific.
What is covered?
Your policy will define and outline the terms of coverage. These will include what specific treatments, tests and facilities you will receive at inpatient and outpatient level as well as any optional benefits such as dental care. Exclusions and pre-existing conditions will also be defiend.
When is the coverage?
The commencement date and expiration date can be found within the policy documentation.
Most likely, such conditions will be found in older people and this is one of the factors that causes a slight increase in premiums for people who take a health insurance package at a later stage in life. For young people who are unfortunate enough to contract such a condition it can be difficult to gain insurance once diagnosed. This is another important reason to make sure you are insured as early as possible.
Overseas medical insurance plans with full coverage, including chronic conditions, are more expensive for the obvious reason that the insurer will be incurring more cost. However it is still beneficial for someone with such a condition to be insured as it will reduce the cost of treatment in the long term and ensure a satisfactory standard of care.
Typically the general limitations are:
Acute Phases only.
This is when a condition ‘flares up’ or requires special treatment over a short period of time. It is important that if this is likely to occur that you have negotiated coverage for this with the insurer.
The insurer will agree to a lifetime limit on chronic conditions. If this period reaches an expiration date, the treatment for such conditions will cease. It is important that you have this clearly defined in your policy agreement with the insurer.
The insurer will apply a limit to expenses during the year. This is by far the most common limitation insurers apply. You will have a fixed allowance for the treatment of chronic conditions that cannot be exceeded.
Health Insurance packages with an international level of coverage are more likely to offer vaccinations as part of their insurance policy due to the likelihood that these will be needed while staying abroad.