For many expats the choice is made simple. The employer decides the healthcare options as part of a total relocation package.
 
"For us, it totally depends on employers. They come to us and we present them with the options from about five health insurance providers we work with. The client decides what options to make available to the expat employee," says Jacqueline Biersma of RMS Relocation Management Services in the Netherlands.
 
Fortunately or unfortunately, depending how you look at it, many other expats going to work in Europe have to do the leg work themselves—and there are a lot of health insurance providers focusing on the expat market.

Making the decision

Finding providers may be easy, but with little difference between the options of the various providers, how do you make the final choice?

"Many of our clients are aware from their own research, that there are more insurers than ever competing against each other. Therefore they come to us for advice and guidance," says Andrew Wilson, CEO of April Medibroker (www.medibroker.com), an independent specialist broker advising expatriates on international medical or healthcare insurance.

There are many things to consider when choosing a provider, and perhaps the most revolutionary aspect of medical insurance in the last 10 years is pre-existing medical conditions. In the past, pre-existing medical conditions have been excluded from cover, along with all related conditions.

For instance, says Wilson, “Someone suffering from high blood pressure would find they were also not covered for such conditions as heart attacks, strokes. The costs incurred could run into hundreds of thousands of pounds. “We now have access to a number of insurers who seek to cover pre-existing conditions and everything related to them.”

Choosing the right area of cover is another important task. Generally with international plans there are three areas of cover – Europe, Worldwide (exc USA and Canada) and Worldwide. It is not just the country they are going to be living in that the expatriate needs to think about. What if they were to get a condition such as cancer?

Would they want to stay in unfamiliar territory, or would they want to return home to be treated, with loved ones and friends. Also what if the medical facilities in their new country leave a lot to be desired? They would need to make sure evacuation was included within a plan to get them to the nearest centre of excellence.

Many expats are now considering local plans in today’s economic climate. However, a local plan means exactly that. Local care, in a local language and usually restricted to a handful of hospitals where medical facilities may not be adequate. Again, the expat needs to think about where they would like treatment for the more serious conditions.

Some expats are bound by local visa restrictions to take a locally compliant plan, such as Abu Dhabi. This cover is relatively cheap and may be supplemented with an international plan, so they can seek more specialist care in other hospitals and countries if need be.

Not always according to Wilson who observes that smaller companies can be much better in their administration, and customer service. They also have the ability to treat each customer as an individual rather than a number. As they are smaller, they can be quicker to pro-actively respond to the changing needs within the market place.

That said, larger companies can be more widely recognised by medical institutes in some remote places. Other companies will allow claims by email, when others need claim forms.

“There really is a lot to consider,” adds Wilson.  “In the 12 years experience we have gained, things are changing more than ever, and more quickly than ever before in the insurance market. That’s when the expert advice and guidance of an experienced broker becomes vital.”

Cormac Mac Ruairi / Expatica