How Insurance Coverage Choices Affect Your Premiums

Understanding the Factors That Shape Your Expat Health Insurance Cost

Choosing the right international medical plan is crucial for expats, but with so many options available, it’s easy to end up with a plan that’s either more expensive than necessary or one that doesn’t offer enough protection when you need it most.

In this article, we’ll explain how different plan features, coverage levels, and other important factors influence your insurance premiums. By understanding these elements, you’ll be able to make an informed decision that balances both cost and coverage.

 

What Affects Your International Medical Insurance Premiums?

International health insurance premiums vary based on several factors, including the insurer you choose, your age, and where you will primarily use the plan.

For example, the cost of a health insurance plan in the UK will differ from that of a similar health insurance plan in Japan, even with comparable coverage and benefits.

This is because premiums are calculated based on the overall cost of healthcare in the country where you receive coverage. Other factors affecting premiums include your country of citizenship, the countries where you choose coverage, deductibles, cost-sharing, and age.

Different Plan Levels Come with Varying Benefits and Costs

Most plans offer a basic level of coverage, a mid-tier plan, and a premium package. These are often labeled as Silver, Gold, and Platinum or Basic, Enhanced, and Premier.

Each level has different annual policy maximums and schedules of benefits with specific limits. As you might expect, Platinum plans usually offer higher overall limits and higher limits within individual benefits, but they also come with a higher cost.

Annual or Lifetime Policy Maximums

Plans usually set an overall coverage limit, either per year or over the policy’s lifetime. For example, a plan may offer $1 million, $3 million, or $8 million in coverage annually (or sometimes per policy).

This amount represents the maximum the policy will cover during that period. You’ll be responsible for any medical costs beyond that limit.

Schedule Benefit Limits

Plans also set limits on individual benefits. This lets you know how much they will pay for each type of treatment (e.g., dental care, hospital room costs, and prescriptions). Even if you are below your overall policy maximum, you might still reach the limits for certain types of care.

Inpatient Only vs Comprehensive International Coverage

The coverage options for international health policies vary widely. They range from basic inpatient-only plans covering hospitalization to more comprehensive plans that include outpatient care and add-ons like dental, wellness, or maternity coverage.

As a rule, the more extensive your medical coverage, the higher your insurance premiums will be.

While inpatient coverage forms the base of every international health plan, you can often adjust premiums by adding or removing other options such as:

• Outpatient coverage
• Mental health care
• Maternity insurance
• Repatriation benefits
• Medical evacuation
• Outpatient medicine or pharmacy services
• Optical/vision insurance
• Dental insurance
• Complementary and alternative medicine
• And more

More expensive plans typically include most or all of these benefits. Less expensive plans may exclude some of the above benefits or limit the amounts they will pay for each.

It’s important to remember that many, but not all, expatriate medical plans can be tailored to your specific needs. If you’re unsure, it’s best to compare global health insurance plans online or consult an international insurance broker.

 

Private vs Public Healthcare

International medical plans usually include access to both private and public healthcare. How you use these options is up to you, but it’s important to keep your benefit limits in mind.

Private healthcare providers are usually more expensive than public facilities. Depending on where you live, combining private and public care can help you manage your benefit limits.

For instance, you might choose private clinics for outpatient visits to save time, while using public hospitals for elective surgery to lower costs and avoid exceeding your annual coverage.

From our experience, most expatriates seeking quality medical care abroad choose private healthcare. In most cases, it will come with a better quality of service and other benefits, such as:

• Direct billing
• Medical staff who speak English and often other major languages
• Ability to choose your doctor
• Shorter waiting times for a consultation or operation
• Access to more comfortable beds and private hospital suites
• Better overall customer service

Given that private healthcare will increase your insurance premiums, it’s advisable to compare the cost of public and private care in your primary destination based on your needs and budget.

Do this beforehand to determine how high you should set your benefit limits. You can research this yourself or ask professional advisers to help you review and compare coverage and costs.

Plans Covering Pre-existing Conditions Will Cost More

One major challenge many people face when signing up for a new international health plan is getting coverage for pre-existing medical conditions – health issues that existed before joining a new policy.

International insurers often consider these conditions ineligible for coverage and may exclude related treatment costs from the plan. As a result, policyholders could be left with significant out-of-pocket expenses.

Some insurers are willing to provide coverage for pre-existing conditions, but with certain modifications to the plan. This might include a waiting period before coverage begins, higher premiums (also known as a Rate-up), or added deductibles specific to those conditions.

In some cases, it’s advisable to have specific conditions covered, especially if they could lead to more serious health issues. However, if your doctor determines that a new illness is connected to a pre-existing condition, the insurer may deny coverage for treatment.

What to Consider Beyond Insurance Premiums

While coverage options significantly affect the premiums you’ll pay, other factors are equally important when choosing international medical insurance.

The International Insurance Company

The provider you choose also affects the price of your premium. It’s generally wise to be covered by one of the top international health insurance companies.

While these insurers may charge higher premiums, they tend to pay claims faster, offer a better network of doctors and hospitals, and provide more comprehensive coverage when needed.

Additionally, larger insurers are less likely to face profit issues that could lead to sudden premium increases during policy renewal.

Another important factor to consider is the insurer’s overall customer service. While it can’t be measured in dollars, good customer service can save you time and stress when problems arise. Ask your advisor about this or read reviews of the company.

Consider Deductibles or Coinsurance

Deductibles, coinsurance, and out-of-pocket costs are ways to share medical expenses with your insurer, which can help lower your upfront premium costs.

Sometimes it makes sense to choose a plan from a well-established insurer and select a higher deductible or coinsurance. This way, you can still enjoy comprehensive coverage with lower premiums.

While your out-of-pocket costs will be higher for routine care, you’ll benefit from better service and more extensive coverage if you become seriously ill.

Network Providers List

Where you receive medical care is essential. This refers to the clinics and hospitals covered by your international medical plan. The network provider list can vary depending on your plan and insurer.

As a rule of thumb, it’s advisable to research nearby clinics and hospitals or those with a strong reputation in your area. Check if they are included in your plan’s provider list – and even better, if they are direct billing partners.

Having a more extensive network provider list means more convenient options for you, though it may also lead to higher insurance premiums.

Compare Your Options

Choosing a new health plan as an expat is a crucial decision. Take the time to compare different plans, coverage options, and benefit limits to find the best fit for your needs and budget.

To make this process easier, consider consulting one of our impartial health insurance experts who will explain your options clearly and informally.

Get a quote for international health insurance today!

 

 

Read More

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• IMG Global Medical Insurance Premiums and Cost Estimates

Author / Editor: Joe Cronin, Founder and President of International Citizens Insurance. Mr. Cronin, a former expat, is an authority in the areas of international travel, and global health, life, and travel insurance, with expertise in advising individuals and groups on benefits for today's global workforce. Follow him on LinkedIn or Twitter.