The Ultimate Guide to International Health Insurance

You are probably well aware of the need for “regular” health insurance, which helps cover expensive healthcare bills such as hospitalisation and surgery costs. However, if you travel a lot, or if you are an expat, you may not be adequately covered by your health insurance policy when outside of your home country.

That’s where international health insurance comes in. An international health insurance plan provides medical coverage to anyone working and living outside of their home country. It works in pretty much the same way as health insurance, except it covers you in multiple countries, even globally. This guide will explain all you need to know about international health insurance.

Generally, there are a few groups of people who may want to consider international health insurance: expats (whether those living in Singapore, or Singaporeans planning to relocate), overseas students, and frequent travellers.

That’s mainly because the cost of healthcare varies hugely from country to country, even city to city. Furthermore, when you are overseas, you may not qualify for subsidised healthcare rates meant to benefit locals.

So if you plan to spend any meaningful amount of time outside of your home country, international health insurance would be an important part of your portfolio.

Of course, if you are relocating for a job or as a dependent of someone with a job overseas, you might already enjoy some coverage under the employer’s group health insurance policy. This is a good starting point, but you should understand the policy benefit limits and evaluate if they are sufficient to meet your needs.

A personal international health insurance plan can be tailored to meet your own needs and bridge any coverage gaps. As a bonus, it would serve as a safety net in the event of job loss or employee transfers, ensuring there is no disruption to your health coverage.

This article was first published on GoBear’s guide to international health insurance

The main benefit of an international health insurance plan is hospitalisation coverage. So if you are hospitalised overseas, your plan covers the hospital bill, which can include costly procedures like surgery and chemotherapy on top of ward fees.

Most international health insurance plans also cover pre- and post-hospitalisation costs, such as diagnosis, consultation and treatment. However, the extent of coverage differs; it may be anything from 90 to 180 days pre- and post-hospitalisation.

Another important area of coverage is emergency evacuation or repatriation. If you have bought travel insurance before, you might be familiar with this benefit: it refers to evacuating you, possibly by air ambulance, back to your home country for emergency treatment.

All these benefits are subject to an annual cap, sometimes referred to as the maximum payout per policy year. In order to provide adequate financial protection, make sure that this annual payout limit makes sense given the cost of healthcare in your destination or new country of residence.

When shopping for an international health insurance plan, you’ll most likely notice that the base plan mainly covers hospitalisation, pre- and post hospitalisation, and emergency medical treatment costs.

These may be sufficient if you will only be in your destination for a short while. However, if you are planning to relocate and put down roots overseas, it may be worthwhile to consider the following riders (add-ons) to your base plan:

1. Outpatient treatment: This refers to medical treatment without requiring hospitalisation. Although not as severe as hospitalisation, outpatient treatment illnesses and injuries (especially chronic ones) can be expensive overseas. Adding on an outpatient treatment rider would help cover those costs.
2. Maternity: For the most part, international health insurance plans do not cover maternity-related costs including childbirth. If you are planning to start a family abroad, consider adding on a maternity rider to make sure your pre- and post-natal costs are well-covered.
3. Dental & optical: Basic international health plans tend to cover the essentials and do not include dental care and optical care coverage. However, if these are important to you personally, some plans allow you to add on a rider for extra coverage.

Note that the riders will be at additional cost to you, so you’ll have to weigh the benefits and select those that are important.

Just about every international health insurance plan comes in several coverage tiers (e.g. “Basic”, “Premium” and “Luxury”). Similar to travel insurance and health insurance, the tiered system allows you to choose the level of coverage you want.

While the types of covered expenses are typically consistent throughout the tiers, the coverage limits would differ, with the lowest limits on the basic plans and upper limits on the top-tier plans.

For example, a low-tier international health insurance plan may have an annual claim limit of $500,000, while the top-tier one would cap it at $2 million.

Of course, the lower the coverage limit, the cheaper the premium. However, that’s not the best way to choose an international health insurance plan, as being under-insured means you might need to pay high upfront costs should you get hospitalised overseas.

To choose the right amount of coverage, you would need to know the cost of healthcare in your destination. If you are going to live in multiple countries, do the research and peg your coverage level to the most expensive one.

Generally, the topmost tier should be sufficient to cover healthcare worldwide, including in the US, where healthcare is regarded as the most expensive in the world.

If you are going to live in a much cheaper country like Thailand or India, then you can choose a lower coverage limit and save on your premiums.

If you are hospitalised while covered by an international health insurance plan, there are a few possible procedures.

If it is a medical emergency, you should call the insurer’s global hotline to make arrangements — either you get directed to a local hospital, or, if there are no nearby medical facilities, to arrange an emergency evacuation.

When hospitalised overseas, you can pay the hospital and surgical bills out-of-pocket first, then submit a claim to your insurer for reimbursement. Be sure to submit all relevant records such as your receipt, discharge documents and medical certificate.

Some insurers also offer a pre-authorisation service so you can seek treatment with greater peace of mind. If the situation permits, you can do this by calling your insurer to arrange a planned hospital visit, along with a Letter of Guarantee.

For outpatient treatment (if your plan covers it), you would typically pay upfront and claim later. But you may want to check if your insurer has a panel of clinics in your destination country where you can enjoy cashless medical treatment.

International health insurance is highly customisable, and therefore suitable for just about any kind of overseas living/working arrangement. However, that also means that there are more choices compared to, say, travel insurance.

Here are some considerations to think about to help you select the most ideal policy.

• Who to cover: Unlike local health insurance which is tied to the individual, with international health insurance, you can choose to cover yourself and your spouse, yourself and your kids, or the entire family. Who you cover would depend on whether your family might move over or live with you overseas for a significant amount of time. Your family arrangements would also impact whether you opt for maternity cover or not.
• Geographic region: You do not have to be too granular about which countries to get covered in, as insurers usually offer just a few geographic tiers to choose from. For example: Asia, Worldwide excluding USA, and Worldwide. Apart from making sure that the destination country is covered, you should also anticipate the countries you’ll be travelling to for business or leisure, and make sure those are covered in the geographic region you select.
• Living/working arrangements: Is there a chance that you’ll have to relocate somewhere else or perhaps become a permanent resident of another country? Sometimes it’s hard to know where life/work will take you and your family. If so, look for a “portable” international health insurance plan which would follow you as you move across the globe.
• Existing coverage: If you are relocating for work or school, you are probably covered by some form of group insurance already. This can vary a lot from organisation to organisation, so do check the policy documents and find out what your existing coverage is. Take into consideration as well your spouse’s existing coverage, if any, to avoid duplicate coverage.
• Personal health concerns: Those with pre-existing health conditions especially would want to customise their international health insurance plans to cover specific areas of concern. Note that some international health insurance plans do cover pre-existing conditions (often subject to a waiting period), but you may need to pay higher premiums.
• Premium cost: Finally, the cost of premiums is a factor — the more coverage and add-ons you have on your plan, the more expensive it will be. Still, given that you are unlikely to enjoy citizen healthcare subsidies abroad, your international health insurance premium could be well worth every penny.

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