Expatriate
medical insurance is coverage that you purchase when
you work or travel outside of your province/country of residence
for an
extended period of time. Usually 6 months or more..
While most provincial or health plans can be used
when you are traveling domestically.
There
are usually limitations or restrictions to treatments
received out of country. There would be a maximum dollar
limit paid for hospital or
a Doctor’s care, severely
restricted dollar payouts etc...
I
have Travel Insurance coverage through work/retirement plan or credit cards -
Do I still need it?
In many cases. Employer and card plans can have
fairly strict definitions and that limited payment options. Employee plans can apply the
travel
insurance claim against lifetime deductibles. Most
cards won’t cover those aged 65 and older. In fact, even if
you are covered under your card
or employer plan. In many
cases they won’t allow you to extend coverage beyond the
contractual time limits out of province/country with other
coverage.
Why
are direct payment services so important?
There are two types of plans when it comes to payment-
Direct and Reimbursement. Reimbursement plans are a poor
choice, not just because
they require you to pay upfront,
but because in essence it is like writing a blank cheque to
the health care provider. Billing errors (double billing,
incorrectly bundled billing and over charges etc.) are very
common.
Resolving these errors after you have returned home can be,
very confusing and stressful.
A direct payment plan will a) take care of the payments and b) deal with hassles associated with complex
medical
billing.
Why are specialized emergency assistance services important?
They refer you to the appropriate health care provider for
your condition. They will monitor your condition, arrange for air
ambulance services,
communicate with family and friends back
home. In short they specialize in logistics issues that are
unique to dealing with a medical emergency that
spans two
countries. (Your home country and where the medical
emergency occurred.)
What
are deductibles and co-payments?
If your plan has a deductible, then that
means you are responsible for paying the dollar amount of
the deductible first. The insurer will pay the rest.
This does not invalidate the direct payment of bills, it
just means that, when the dust settles you are responsible
for the deductible.
Co-Payment is a formula for working out "who owes what" A
70/30 co-payment usually means that 70% of the bill is the
responsibility of the insurer,
30% of the bill is the
responsibility of the individual.
(as a general rule, the first number relates to what the
insurer will pay, though not always)
Sometimes the two concepts are combined to control costs.
You should bear in mind that the order in which these two
concepts are applied will affect
the ultimate pay out.
Using a $10,000 claim with $1,000 deductible and 70/30
co-pay.
1. Deductible first, Co-pay second.
$10,000 - $1,000 = $9,000
Insurer pays 70% = $6,300
Individual pays 30% + Deductible = $3,700
2. Co-Pay first, deductible second.
$10,000 X 70% = $7,000
Minus deductible of $1,000
Insurer pays $6,000
Individual pays $4,000
Different plans have different rules, so check with
your insurer to see how they handle it.
