Changes to health systems could leave expats with fewer options

by Ray Clancy on June 4, 2013

Changes to health systems could leave expats with fewer options

Changes to health systems could leave expats with fewer options

People moving abroad to work and live are being urged to check their health insurance as changes to the system in some countries may mean that they are not eligible for free health care. There have been changes in France and Spain, two countries that are popular with expats, and in other countries private health insurance is compulsory and you won’t be admitted without it. The French government has been concerned for some time about the number of expats taking advantage of France’s healthcare system who do not or have not made any contribution to it.

As a result new legislation means that European Union nationals under the state retirement age of 60 will no longer be eligible for free healthcare in France if they are not registered to work. There are a few exceptions, for example where someone that has only recently retired and that had been paying UK national insurance. They could be able to get free healthcare, but only for two years.

The French health system is regarded as being very good but expats also need to understand that it only covers around 70% of costs and the majority of people take out top up insurance to cover the remainder. The changes mean that expats under the age of 60 may want to consider further private health insurance to cover the further shortfall left by the changes.

Quote from ExpatForum.com : “Hi, I’m looking for some information on moving my family abroad. We have 2 young kids, and myself and the wife. My wife is a rather highly placed healthcare executive in the USA, running a medicaid/medicare health plan. She’s an RN and has a Masters in Public Health. We were thinking about looking into Australia or NZ maybe — we’ve moved around quite a bit in the US, and think broadening the scope for our kids might be in order in the near future.”

David Retikin, director of operations at Pryce Warner International Group, said that people moving overseas should review the state healthcare options available to them. ‘Many countries have fantastic healthcare systems but do not offer as easy access to expats as to nationals. This means that expats often need medical insurance to top up what is offered by the local system,’ he explained. ‘In France this top up will now need to be fully comprehensive cover for expats to have complete peace of mind,’ he added.

According to Matthew Aston, head of marketing at AXA PPP International, many people don’t realise that comprehensive medical insurance is a necessity, not a luxury. Countries such as Germany, Switzerland and the Netherlands require residents to have cover through a locally registered and approved provider. In Australia and the United Arab Emirates, expats are required to provide evidence that they have appropriate medical cover in order to satisfy very strict visa requirements. Otherwise, they could face being turned away on arrival.

‘By having insurance before you go, you minimise any health issues, during what can be a very stressful moving process. It also gives you peace of mind, not just for the first year, but longer term,’ said Aston. ‘People may opt for local state care after the first year, but it may not be as good or as efficient as the NHS, not to mention the added uncertainty of language and cultural differences,’ he added.

He also pointed out that although cover through a local provider can be cheaper, it often comes at a cost. ‘State or local medical cover may not cover maternity, evacuation and repatriation, health screens and dental treatment, all of which are covered by most international health insurers,’ he explained. ‘In state care, a good knowledge of the local language is needed whereas an international private insurer will help you, usually offering interpretation services, and guide you to a hospital or clinic where the staff speak English,’ he added.

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