Living In France - Overseas Medical Insurance

One of the primary considerations when thinking of international or overseas retirement is healthcare and medical insurance cover. Many USA citizens already are very familiar with medical and health insurance at home but have little knowledge of how such plans work overseas, or even of the standard of medical facilities, hospitals, doctors and so on, in the location they are considering for retirement. This location may be France or Florida, the medical insurance considerations and healthcare insurance planning needs are similar.

Consequently, some major considerations are

• The cost and benefit level of any international medical plan together with ease of use, assistance, and claims handling;
• The quality of local facilities, hospitals, nursing care, doctor skills and knowledge of English in the area you are considering to make a permanent overseas home;
• Whether or not you may be evacuated back to your home country and have elective treatment in your home country, if you so wish.

There are currently some 30-40 million expatriates abroad, with millions of others retiring for long periods to a country which has never before been their long-term home. The growth of modern digital communications, Internet access and video conferencing has now transformed the level of financial and insurance services available to the individual, family or company anywhere in the World on a location, non-specific basis.

International medical insurance companies, medical assistance groups, underwriters and brokers are now all moving into what is a huge and growing market for new healthcare insurance services. The expatriate and those retiring abroad now have far more available quality healthcare insurance products available than ever before. Help lines from these companies for clients are multilingual and available worldwide 24 hours a day.

You may be in Belize, Berlin, Baku or the Bahamas, you can still be well serviced for your medical and healthcare insurance needs by international internet broker advisors and a wide range of insurance companies who specialise in this field. However, for the older clients going abroad, cost and level of cover must be prime considerations. Therefore, a check out first of local OUTPATIENT services is also a useful first move. Many developing countries or overseas retirement communities have good local Doctors and drugs and dressings. However, for serious hospital issues and treatment most would prefer the best care possible, probably "back home".

We now address the issues of proper medical insurance advice and budget planning to take you over the longer-term not short term. If you are retiring at say 55 years old, your costs of premiums will rise year on year with both medical inflation and often with "age banding" where the insurer raises premiums each five year band.

If you have been covered in USA for example for comprehensive cover at say age 54 years, this cost could rise beyond your means whilst retired overseas at say, 70 years old. What is one to do? There are several solutions, one of course taking an increasing level of voluntary deductible against premium rises, thus keeping your budget costs stable. We also suggest that you do not take out fully comprehensive cover after aged 60 years, unless you can really afford to keep up premiums for life. It is much better to locate services for outpatient care in your local community but have a catastrophic full cover hospital plan with elective cover for 30 days a YEAR BACK home.

This budget strategy will save you thousands of dollars over the long term whilst ensuring that your emergency/hospital insurance is always there for you. Many insurers call these plans "Standard Plans" giving full cover for in-patient and day-care, but no cover for out-patient. Thus, if you are placed in a hospital bed, they pay, if you are walking wounded, you pay. Remember, a phone call to the insurer help line takes care of everything when you need to be admitted to a hospital bed, even for a day. The insurer can settle directly, place a bond on your behalf and talk to local Doctors and consultants on the ground, in their own language too, if you have trouble in this respect.

This budget strategy will save you thousands of dollars over the long term whilst ensuring that your emergency/hospital insurance is always there for you. Many insurers call these plans "Standard Plans" giving full cover for in-patient and day-care, but no cover for out-patient. Thus, if you are placed in a hospital bed, they pay, if you are walking wounded, you pay. Remember, a phone call to the insurer help line takes care of everything when you need to be admitted to a hospital bed, even for a day. The insurer can settle directly, place a bond on your behalf and talk to local Doctors and consultants on the ground, in their own language too, if you have trouble in this respect.

Let me now show you a few interesting examples of this budget strategy for health insurance retiring abroad.

Couple aged 54 yrs and 54 yrs, USA passport holders, retiring to Belize or somewhere in South America. (all premiums in sterling pounds)

If this couple stayed on Global Area 3 cover with comprehensive care anywhere in the world, they could expect to pay premiums such as those illustrated below.

Clearly our example couple are going to pay a great deal more at age 64 years and at 74 years, more than double the above premiums in most cases. We therefore need a cost effective health insurance strategy, which works over time whilst giving essential peace of mind to this couple, that some cover is in place and they have protection in their elder years.

The answers are three-fold.

Firstly, our 54 year old couple living in Belize, no longer need USA cover all year around so can go to a lower Area 2 cover, with possibly 30 days a year back in USA or Canada for elective care, or a minimum, have cover for emergency care there in USA.

Secondly, they have found a good local doctor and small outpatient clinic so no longer need to pay fully comprehensive premiums. They go for a standard hospital plan only, but for worldwide, giving cover back in USA too.

Finally, as they age, they have decided to increase the level of "co insurance" or voluntary deductible amount on claims to reduce their premiums further.

The differences in premiums now become quite dramatic. Plans below are now "hospital and emergency cover only" not including outpatient Premiums below are however, still applicable to our 54 year old couple in Belize.

Clearly, our couple need to examine Area of cover, type of plan and benefits they really feel are essential to them and then decide their ten-year plan. The premiums above present a dramatic saving on those mentioned earlier, yet from a serious illness viewpoint, where hospitalisation is essential, they give our couple peace of mind.

If we move them on now to 64 years old still in South America. They have now decided to co-pay some deductible or voluntary excess so as to reduce their premiums against age increases. Couple both aged 64 years old

Now to illustrate our couple staying another few years and being joint 69 years old in Belize. They now take the maximum co insurance or voluntary deductible possible as shown.

I have just given two examples here, the William Russell Group Global Health Plan called Selectcare with a 40% discount for a £1000 pound deductible per claim and InterGlobal with their Standard Plan and £1000 deductible for a 20% discount in this case. Couple both aged now 69 years old.

Other plans from such as IMG based in the US, offer clients the possibility of very large deductibles to reduce premiums. Their Global Medical Insurance Plan for a 69 year old falls to just US$ 3,700 dollars annually with a US$5000 deductible added.

Some of these companies also offer European cover Area 1 only, without the higher worldwide cost cover or the USA medical costs, which can often be added for either emergency periods or limited periods of cover in the premium years.

Taking our couple now aged 64 years living in the South of France with three months a year in Germany, rates are as below for the examples of InterGlobal, William Russell and PPP.

Clearly on selecting plans, one needs to compare company benefits on an "apples and apples" basis but these figures above give some idea of a European budget for our couple of 64 years old for medical insurance.

We are thus able to demonstrate that healthcare insurance premiums may be kept flat, or be controlled on slow rises over many years, if clients are willing to change the type of plan, limit their cover, Area of cover and also take on voluntary excesses or deductibles as they age. Medical Insurance sales people working on commission, may often try to sell an "all bells and whistles" policy, as that will increase their income. If the sales person is a tied agent or sales person of the product carrier, the client is not given a full range of choices. Only a truly independent specialist broker can offer such advice.

Medical inflation is running at some 8-10% annually and premiums increase again also by age banding every five years or so. It is often financially impossible for a 50 year old to have the same level of cover at age 70 years old, particularly a full comprehensive global plan, it would be just too expensive. The techniques of strategic planning outlined in this report, can give comfort to those retiring. If your income is more or less fixed on retirement, then your healthcare insurance budget should be the same and you can manage this by the simple methods shown above. Do not overinsure or have cover for an Area you do not need. If local facilities for outpatient care are reasonable, then why not use them?

If our 54 year old imaginary couple start their medical insurance budget with say US$4000 dollars per year, they can still have a reasonable level of "catastrophic cover" aged 70 years old, with proper planning and impartial advice from a Broker in this field, for a similar budget. A good standard plan includes full cover for accidents and emergencies, intensive care, theatre costs, hospital accomodation, surgeons, anesthetists, and physician's fees. Standardcare also covers in most cases, prescribed medicines and drugs, pathology, diagnostic tests, oncology tests drugs and consultant fees, X rays MRI and CT scans. Radiography, radiology, radiotherapy, and chemotherapy. Physiotherapy may be included also parent accomodation with some plans and post hospital treatment. Other benefits sometimes offered as Standard are organ transplants, nursing at home, hospital cash benefit, legal expenses, personal legal liability, emergency evacuation and repatriation, repatriation of mortal remains or costs of cremation, burial. It is vital that clients read the product brochures and conditions carefully, as medical insurance can be a minefield to the unwary. However, it can also be a godsend, if you have the right cover just when you most need to use it.

J Leslie Smith
Founder
Medibroker Limited

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