Retire In The Sun With International Medical Insurance

One important consideration when thinking of international retirement abroad is your healthcare and medical insurance cover. Many North American/European women are 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 locations they are considering for living in retirement. The location may be France or Florida, but the medical insurance considerations and healthcare insurance planning needs are essentially similar.

Some major considerations are:

• The cost and benefits levels offered by any international healthcare medical plan together with ease of use, speed and quality assistance, and claims handling by the insurer;
• The quality of local facilities, hospitals, nursing care, doctor skills and knowledge of English in the country which you are considering making a permanent overseas home;
• Whether or not you may be evacuated back to USA/Canada/Europe/UK or elsewhere, then have elective treatment in your home country too, if you so wish.
• What happens when you or your partner dies?

There are currently some 30-40 million expatriates abroad, with millions of others retiring to a foreign 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 these retiring individuals or families 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 growing market for new healthcare insurance services globally. Those retiring abroad, now have 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. (On a free call basis)

You may be in Belize, Berlin, Baku or the Bahamas, yet still be well serviced for your medical and healthcare insurance needs by international internet, electronically based broker advisors. However, for the more mature, retiring or elderly clients going abroad, cost and level of cover may be primary considerations. A check out first of locally based OUTPATIENT services, in your new home country, is a useful first move. Many developing countries or overseas retirement communities have good local English speaking Doctors with drugs, dressings, and outpatient costs being cheap compared with the USA/Canada or Europe. But, for serious hospital surgery and treatments most clients would prefer the best care possible, probably "back home".

If you are retiring at say 54 years old, your costs of premiums will rise year on year with both medical inflation and "age banding" where the insurer raises premiums each five year band. (Often plans can rise in premium 10% annually)

If you have been covered in USA/Canada for example for comprehensive cover at age 54 years, this cost could rise beyond your means whilst retired overseas at say, 74 years old, some 20 years later. What is one to do? There are several solutions. One option is to take an increasing level of voluntary deductible payment against premium rises, thus keeping your budget premium 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 the rest of your life. (At the rate of medical inflation) It is much better to locate services for outpatient care in your local country community but have a catastrophic full cover hospital plan, (basic or standard) with elective cover for 30 days back in the USA/Canada/Europe or at home, elsewhere.

This budget strategy may 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 or Basic Plans" which give full cover for inpatient and daycare, but no cover for outpatient care. Thus, if you are placed in a hospital bed, the insurance company pays. If you are walking wounded, (Outpatient) you pay the bills. 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 local consultants, in their own language, if you have trouble in this respect.

Let me now show you a few examples of this budget strategy for those wishing private health insurance when retiring abroad to live in a new country.

Couple aged 54 yrs and 54 yrs, USA passport holders, retiring to St Tropez or somewhere in France. (All premiums in US$ Dollars Comprehensive Cover)

If this couple stayed on Global Area 3 worldwide cover with comprehensive care, based in France but covered anywhere in the world, they could expect to pay premiums as these illustrated below.

Clearly our imaginary couples are going to pay a great deal more at age 64 yrs and again at 74 years old. Possibly more than double the original 54yrs old premiums in many 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 still have protection through their old age. Retirement income does not often rise at ten percent a year (10%), as do medical insurance charges and premiums worldwide to expatriates.

The answers are three fold.

Firstly, our American/Canadian 54 year old couple living in St Tropez, should no longer need USA/Canada based cover all year around, so can go to a lower based Area 2 cover, with possibly 30 days a year back in USA or Canada for elective care. At a minimum, they should have cover for emergency care in North America, up to 30 days annually.

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

Finally, as they age further, they could decide to increase the level of " co insurance" they will pay against each hospital bill, or voluntary deductible amount on claims, to reduce their premiums further. (Useful after 65 yrs old)

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 USA/Canadian passport 54 year old couple in France (W/wide excluding USA/Canada).

Clearly, our couple needs to examine the Area of cover, type of plan and benefits they feel are essential to them and then decide their ten-year health insurance needs, at least. The premiums above present a major saving on those mentioned earlier, yet from a serious illness viewpoint, where hospitalisation is essential, they can still give our couple peace of mind in their retirement location.

If we move them on now to 64 years old still in Europe but traveling around the world occasionally. They have decided to co-pay higher deductibles or voluntary excess so as to reduce their premiums against age increases.

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

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 69 years living in the South of France with three months a year in Germany, rates are as below for the examples of InterGlobal and William Russell as before. They no longer travel worldwide.

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 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 to the poorly informed, as that will increase their own sales commission income. If the sales person is a tied agent or sales person of the product carrier, the client is not being given a full range of medical insurance company choices. Tied Agents by definition are "tied" to one insurer in the vast majority of cases. Direct sales people are in the same position of often only promoting one Brand name.

Only a truly independent specialist advisor or broker can offer healthcare insurance advice to you on a Best Value comparative basis, showing all major insurers against each other on "an apples to apples" benefits/premium matrix

Medical inflation is running at some 8-10% annually and premiums increase again 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 fully comprehensive global plan. It would be just too expensive. The techniques of strategic healthcare 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 over insure or have cover for an Area of the World you do not need. If local facilities for outpatient care are reasonable, at your new country location then why not use them? Simply learn the language, if not English and use local outpatient services.

If our 54 year old imaginary couple start their medical insurance budget with perhaps US$4000 dollars per year, they can still have a good level of "basic cover" when aged 70 years old, with proper planning and impartial advice, 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. Outpatient cover is not of course included. It is important that clients read the product brochures and conditions carefully. Medical insurance can be a minefield for the unwary, but can also be a godsend, if you have the right cover, just when you most need to use it.

Financially, your health insurance premiums will be far lower by staying out of the USA or Canada as much as you can. By paying yourself for any needed local outpatient services and using deductibles on your health insurance, you can control your exposure to higher and higher premiums. Peace of mind as one ages, living in a foreign country, can be an invaluable pre requisite of good health.

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