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Medical Insurance for Couples, Families and Children |
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Why do I need Medical Insurance? |
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I'm sure it will never happen to me or my family and if anything does happen I will worry about it then. Anyway, there are always the Government hospitals, right?
This is what I hear all the time when I talk to people. Most prefer not to think about unexpected catastrophes or illness; they are seen as something that happens only to others. But what if something does happen, who will pay the medical bills? Well, you can always go to your local GP or to the Government hospitals but if you need to visit the doctors frequently or for more serious complaints the bills start to add up. How much will it all end up costing? Do you really want to spend several days or maybe even weeks in a Government hospital in a crowded public ward where most of the staff will not be able to speak English very well? Do you want your children to go through the same thing?
Public hospitals can be very cheap and very good; there is no doubt about that. The quality of medical and surgical care is excellent but the other services offered may not be up to the standard that you expect. They have large public wards; long waiting lists for non-emergency treatment; few English speaking nurses or care staff and then you will have to put up with the food. If you want to have a private room (or semi-private), want to choose your own doctor or surgeon or do not want to wait what may be several months for a routine operation then you must go private - and that will be expensive. If you are living in or traveling to other countries the quality of medical care and hospitals may not be any where near as good and your travel insurance (you do take out travel insurance, don't you?) may not be adequate.
If you are planning on having children you need to decide on whether you will go private or semi-private the delivery. Private rooms in the top hospitals can be very expensive. At the other end of the scale there are public hospitals that are justly famous for their maternity facilities. Whilst you can easily go all the way through the public system for the pre-natal tests and checkups for almost next to nothing, most mothers-to-be opt to go semi-private for the actual birth and then suddenly the costs can start adding up, especially if there are any complications.
Because of the uncertainty associated with illness and hospital stays, it is impossible to predict what your final medical bills may cost. If you are healthy then in any one year the costs may be low or nothing but if you do become ill, your bills could be very high indeed. If you do not have suitable insurance cover then you will have no choice but to make do with what you can afford. If you have comprehensive medical insurance, most or all of your costs will be covered for you. You can choose where you want to be treated, choose your own doctor or surgeon and have full control of when you will receive treatment.
You may be covered by your company and do not give much thought to doctors or hospital bills, after all the company will take care of everything, right? But you should ask a few questions of your HR manager regarding your existing plan:
- How much does your company plan cover you for? Many plans have limits on treatment or low annual plan limits.
- Does it offer full cover for hospitalization or just daily cash back payments? Cash back options rarely cover private treatment.
- Will this be adequate?
- Does it cover all of your family? Often cover does not extend to the whole family or may just cover the spouse and not the children.
- If it does cover you family, is the cover the same or at a lower level?
- Does it cover you only in locally or worldwide? Most company plans will only cover local medical.
- Is maternity cover included? Usually this is not covered in company plans.
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What is Medical Insurance? |
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So, what is private medical insurance and what can it offer me? Quite simply, medical insurance will pay for you to have private treatment at the hospital or doctors of your choice for accident and emergency treatment and most acute conditions and illnesses. It can also cover maternity, including cover of the newborn child and may offer annual preventive health checks including a medical examination, such as cervical smear test and mammogram for women and a prostate cancer tests for men. It will usually cover you worldwide (with some restrictions on USA and Canada ) include emergency ambulance coat, evacuation if you cannot receive suitable treatment where you are or evacuation to your home country if applicable. It will also be fully portable if you need to relocate. It may also offer additional benefits such travel and accident insurance.
Most insurance companies offer several levels of cover to suit all pockets; from Basic plans offering only accident and emergency treatment to Premium plans covering everything including routine GP visits, long-term care and routine dentistry. Maternity is usually offered either as part of the Premiums plans or as an optional add-on.
Medical insurance will not usually pay for the ongoing treatment of chronic conditions or pre-existing conditions (some companies are now starting to offer this with a life-time limit) although several companies will cover pre-existing conditions after a 2-year monatorium (i.e. no reoccurrence or treatment sought for the condition).
Most locally based schemes allow you to receive adequate treatment on a semi-private basis, provided you do not need too many expensive tests or scans. They will almost certainly not be able to cover the real cost of private medical treatment and will not be portable or cover you in other countries if you travel or relocate. Whilst travel insurance will usually cover basic accident and emergency treatment you may be limited in the choice and level of treatment on offer. Other countries hospitals may not be up to the standard that you are used to or expect and it is almost certain that your company or local scheme will not cover you overseas. In contrast, most expatriate medical insurance schemes cover you worldwide (with some restrictions on USA/Canada) and are fully portable.
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Maternity Cover |
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The cost of having a baby can be pretty high (OK, that is an understatement). A quick search around will show you the costs in the various hospitals. A normal pregnancy will cost between USD10,000 for general ward, USD15,000 for private. These figures go up considerably for Caesarean. Of course these are just rough costs and depending upon the hospital you choose or if there are any complications then the final costs could be much much higher.
Almost all medical plans can offer some sort of cover for childbirth and complications of pregnancy. You will usually have to wait a year or so before you can claim on these benefits, so it is no use getting cover if you are already pregnant! Having said that, many will cover complications arising from childbirth after 6 months cover (but will not cover the routine cost of the delivery pregnancy) and a few offer cover for birth defects and congenital abnormalities.
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Child Cover and Families |
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After you have had the baby, the child will usually be automatically included in the mother's plan for the first 28 days or so. After that time you will then need to either add the child to your existing plan or take out another plan.
Some plans are more suited to larger families with 2, 3 or more children. They allow you to add one child at the standard children's rate and then add up to 3 more for no extra cost or at greatly discounted rates. If you have a large family this can result in significant savings.
Most expat medical plans have a plan Excess. This excess is deducted from each claim submitted for out-patient care or GP visit during each period of cover, which is usually defined as a course of treatment for a specific illness or injury. For young children who may be visiting the GP frequently for many different complaints this could turn out to be expensive. Some plans will cover all out-patient visits with no excess or have a system of direct settlement doctors that you can visit with out paying any fees or excess, but of course the initial plan premiums would certainly be more expensive in the first place and there may be an annual or monthly limit to the number of GP visits. However for young children, this may be the cheapest option in the long term.
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How and Who? |
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So, who to choose? What level of cover do you require? There are several choices available on the market and it can seem bewildering at first. It is therefore important to seek professional, independent and qualified advice.
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What to Look For in Medical Insurance |
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So what questions should you be asking of your insurance plan? Below are a few of the things you should be asking when looking at any medical insurance and a few you should be asking if you are looking for maternity cover.
- Does it offer worldwide cover? Will it cover you when you travel or return to your home country?
- Does it fully cover hospital accommodation? If cover is for a child, is parental accommodation included?
- Is maternity cover included or available as an add-on?
- Is maternity cover only included in certain plans?
- Does it cover prenatal care? What prenatal tests are covered?
- Is there a co-payment involved for maternity? If so, how much is it?
- Are complications of pregnancy covered and if so is the cover adequate?
- Does it cover routine GP visits? If so are you paying a premium for this, do you really need this level of cover if you do not visit GPs very often?
- If you are looking for GP cover for a child, is there a no-excess option available?
- What are the total levels of cover? This is the total plan cover and can range from a few hundred thousand dollars per annum up to several million US dollars.
- Are there any policy maximums? Some policies have lifetime maximum benefit limits although usually this only applies to certain conditions such as organ transplants or ongoing treatment of chronic conditions.
- Does it offer the range of cover you require?
- Are there any exclusions? For example, most do not cover for things like cosmetic surgery.
- Does it offer private rooms or semi-private?
- Does it offer full cover for specialists' fees?
- Does it cover emergency road ambulance?
- Does it offer full payment or a daily cash benefit?
- Does it offer cover that you do not require? Are you paying a premium for something that you do not need or want?
- How do you make claims? How easy is it to contact the company in an emergency?
- In what currency is the plan denominated?
- Are there restrictions on age or pre-existing conditions?
- What is the financial security of the company? What is their history and credit rating?
- Are there any restrictions on sporting activities or occupation?
- Do they offer evacuation cover if you get sick in a foreign country?
- Are organ transplants covered and if so what is the plan maximum? Is there a life-time maximum?
- Is there an excess? Many plans have an excess payable per treatment for outpatients and GP treatment.
- Are there any hidden excess'?
- And last but by no means least; do you have any personal recommendations from friends? Companies and schemes can look great on paper or when the salesman is presenting them but when something happens and you need emergency treatment it is the quality of service that is the final judgment.
These are just some of the things that you need to consider. After you have identified your needs, what next? There are several excellent private medical insurance plans available to expatriates offering something for everyone and covering all prices ranges. Some of the leading companies worldwide that are worth looking at are William Russell, Interglobal, IHI-Bupa, GoodHealth and BUPA. Each has its own unique benefits, options and add-ons and one of them will be suitable for you and your family.
All of these companies offer plans covering different areas of the world, usually worldwide excluding the USA and Canada (or maybe including USA/Canada for emergency cover for a limited period) and worldwide including USA/Canada, cover that usually comes at a premium.
They all offer full coverage for emergency and routine hospitalization and have several different plans offering increasing levels of cover which may include full outpatient care and GP visits, maternity, travel and accident cover if desired. For corporations of several people custom tailored plans can be arranged offering the utmost in flexibility and benefits.
William Russell Limited, a leading provider of expatriate protection plans.
Globalsurance is an independent Worldwide Health Insurance Advisor. We work with all the major insurance company and can give you independent advice or a range of free International Health Insurance Quotes; click for Free Advice and Quotes.
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