International Health Insurance

How can employers support staff in health terms while they are outside the UK? For an employer, the first decision will be whether the cover should be a travel insurance policy which includes a health benefit, or a private medical insurance plan tailored to the employee’s needs.

Image of a globe and stethoscope illustrating an article about international health insurance
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Rod Jones, Head of Partnerships at ActiveQuote, says international PMI policies are designed to provide comprehensive treatment and care should something happen when you are abroad.“They will be more expensive than a standard travel insurance policy, but depending on your length of stay, may be the better option,” he says.“For individuals working abroad, it’s essential to have both travel insurance and private medical insurance in place. This means that, in the event of something happening while you’re working away, you have some form of protection in place.“In terms of cover available, this will depend on the amount of time that’s spent abroad and where you are working – for example, some medical insurers won’t offer cover if you are working in the US.“There will usually be a limit on how long you can be abroad with a travel insurance policy. Therefore if you are working away for a long period of time it maybe that you are no longer covered by your travel policy.”

Emergency medical procedures

Do employees know which number to dial in an emergency, and what to expect from the emergency services? If you dial the equivalent of 999 when you are abroad, what if the operator does not speak English? Do they know what treatment they will be entitled to, where the local hospital is, and what facilities are there?Do they know who to inform at the company if they or a colleague are taken ill or have an accident? Who is their next of kin? If they call an emergency number will there be a problem with a language barrier or explaining where they need to send help? They may not be familiar with the area, and may not know where to go or which hospital is closest or most suitable.All these procedures should be agreed with the member of staff before they go abroad, so that there is no confusion at a time of real emergency.

How to find the right health cover?

Juan Peña Núñez, Business Development Director at Healix, a global leader in international medical, security and travel assistance services, says finding the right cover depends on the location and the length of the assignment.“We provide international security, assistance and risk mitigation to insurance companies, working directly with governments and multi-national companies, FTSE 100 companies, Fortune 500 companies, and any company that has an international footprint,” he says. “All of these employees have reason to be overseas, but they will have a different footprint. David Attenborough on location filming a nature programme is going to have different profile from someone who is in Ecuador on business travel.”

Corporate travel policies

When a member of staff is posted abroad, up to one year, on a work placement, employers have the responsibility for ensuring that the cover is suitable for each posting. The organisation needs to be clear about who is responsible for employee welfare – it could be HR, the risk manager or security manager, or someone who is in charge of employee benefits.“The product will be based on geographical footprint, the budget available, and the coverage that is required,” says Juan Peña Núñez. Healix provides 24/7 medical and security assistance and pre-trip medical and security advice, in-patient and out-patient cover, dental cover, repatriation or evacuation. “The latter might be necessary if the medical care in the local area is limited, or it is an emergency condition which needs specialist treatment. In this case we would transfer the person to a centre of excellence where they can be stabilised or continue treatment.”Under corporate travel policy the vast majority of calls – around 98% – are medically related and include falls, accidents, acute conditions or infectious diseases, for example malaria. They might involve people with an out-patient problem like diarrhoea and vomiting, an infected insect bite, or a fracture. Those requiring in-patient treatment might be suffering from a heart attack, high blood pressure, stroke, appendicitis, all of which are acute conditions and which could be very serious.“Where you fall ill can have a direct effect on your likely outcome,” explains. “If you have a heart attack in Addis Ababa in Ethiopia rather than Montreal in Canada, the quality of treatment will be different.”In extreme cases, policyholders ring if they need support for evacuation, which might mean organising an escorted transfer from their hotel, chartering a private aircraft if passenger flights are grounded or the airport closed, or following advice to stay put while the situation develops, making sure they are safe and have sufficient food and water.Corporate travel policies are quite permissive; they are there to facilitate travel. So there is a duty on the employee to use it wisely. Exclusions might include some psychiatric conditions, alcohol or drug abuse.

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Private medical insurance for expatriates working and living abroad

Expatriate employees living and working abroad will need international private medical insurance and their cover will need to be more robust. While the business traveller may be away anything from a few days to a few months, the expatriate will be living abroad over a longer period of time, and their needs will be different.They could be travelling with their family and they will want to know about the security situation, whether the medical care available locally is going to be appropriate, or perhaps whether there will be the equivalent of the NHS vaccination programme for children available.Expatriate cover tends to be more generous in terms of benefits. For example, someone who was living in the Lebanon for work could choose where they had their medical treatment – and that might include returning to the UK to have surgery.“Cover will be personal and unique to each company depending on their needs,” says Juan Peña Núñez. “It helps if the company can prepare employees in advance about how to deal with an incident.”In the majority of countries, most capital cities will have a public emergency service, but the definition of what an ambulance is, for example, will be very different from the kind of high-tech vehicle we are used to in the UK.The main reasons for calls are acute conditions, acute trauma – car accident or sporting injuries.

Healthcare in the United States

In the US, healthcare is very expensive and complicated and the policy should have adequate and preferably unlimited benefits.“If you are admitted to a US hospital with chest pain, you will have thorough checks done and that will result in scans and diagnosis, which could push up a case of indigestion into a $20,000 bill,” he says. “In one recent case we dealt with, a lady was hit by a car crossing the road and she was in hospital for a month, which resulted in a medical bill of $1 million. We negotiated a reduction of $300 off the invoice.”

Corporate and social responsibility for employee wellbeing

“Companies have a responsibility for the wellbeing of an employee who is taking on an overseas assignment, and healthcare is a big part of that obligation,” says Kevin Melton, Global Head of Sales and Marketing at AXA – Global Healthcare.Plans can include cover for both emergency and everyday medical treatment and consultations, as well as services such as a dedicated cancer care team, virtual doctor consultations via phone and video conference and a second medical opinion.“This kind of cover not only removes the risk of having to cover significant medical bills, but should an expat become ill, they may also have access to translation services, online access to their policy wherever they are and consistent service from a multilingual team, all of which can make things easier when they’re away from home,” he says.

The impact of new technologies on health cover

Thanks to advances in technology, features like AXA-Global’s virtual doctor service are also becoming more popular. It provides access to experienced, internationally qualified, multilingual doctors over the phone 24 hours a day, or via a video consultation, and helps customers to fit healthcare into their busy schedules.“Many expats learn enough of the local language to at least get by with the basics, but it can be hugely reassuring to be able to discuss medical terminology in their mother tongue, especially when trying to navigate an unfamiliar healthcare system,” he says.AXA-Global Healthcare’s World of Work report showed that as well as international health insurance, the benefits most valued by expats on assignment include housing support, flights home and education support for their children.“For employees to be motivated, they need to be engaged, and offering a comprehensive benefits package, alongside regular contact and support, can really help to achieve this. It makes them feel valued as well as offering peace of mind that everything is taken care of for them and their families.” 
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