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Local VS international health insurance
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When the question comes to what kind of medical coverage you want for yourself, your family, or even your company, one of the decisions you’ll need to make is whether you want to take out a local private health plan or an international health insurance plan.

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Your decision on what kind of insurance plan is best for you will be heavily based on your personal situation; how healthy you are, the quality and accessibility of the local healthcare system and hospitals, whether you’re settled in your country of residence or move frequently, and whether you travel frequently among other factors. Here are some of the things you may want to consider when comparing local and international health insurance plans.

How much your medical insurance plan costs

In general, expats living abroad may not have access to the full range of benefits a public healthcare system offer, so you will have to take out some kind of private medical insurance policy to cover the costs of healthcare. The biggest concern is the overall price of your plan, and whether or not the benefits it offers makes it worthwhile. One thing you’ll want to be aware of in Singapore is that your premium, deductible or co-insurance may change depending on whether you’re a Singaporean citizen, a permanent resident or a foreigner. As expats aren’t eligible for the government MediShield Life cover, local integrated shield plans will be more expensive for you.

How does your health insurance premium change at renewal?

shutterstock_495720634%203000px.jpgOne of the biggest advantages of local private health insurance policies is the price. In many countries outside of Singapore, premiums for private health plans are typically based on your medical history and claims experience with that insurer, so if you’re a healthy individual or family with no serious medical issues, premiums can be very cheap. These are called experience-based plans.

However, experience-based premiums can have their drawbacks. If you have a serious injury or illness that requires expensive treatment, then your next year’s premium will rise accordingly. So while a local plan may start out cheap, it can quickly become unaffordable with a few years of expensive claims.

On the other hand, international plans and integrated shield plans in Singapore, tend to have pool rated premiums. This means that premiums are calculated based on the treatment everyone in your age bracket received during the year and medical inflation, instead of your premium increases being tied to whether or not you or your family got sick or injured.

Benefit limits on your health plan

Another reason local health plans are less expensive is due to the fact that they tend to include stricter limits on covered benefits than international health insurance plans. Your plan may have a limit on coverage for specific treatments, such as chemotherapy for cancer or kidney dialysis, or cover a percentage of your inpatient costs depending on what ward you are in.

In Singapore, integrated shield plans will have both a deductible and co-insurance (usually 10%), however you can buy an additional rider to help cover the base plan's deductibles and co-insurance. A rider is an additional coverage module that provides additional benefits, although as of April 2019, integrated shield plans can no longer offer full coverage riders, which means each plan has a co-payment/co-insurance of at least 5% on top of the yearly deductible.

In the end, this can leave you paying a fair amount of money out-of-pocket once all is said and done. International health plans tend to have more comprehensive benefits, and generally cover treatments in their entirety up to the annual limit. Deductibles and co-insurance are typically used as an additional way to manage your premium.

How long can you keep renewing your health plan?

In many places, one of the large differences between local and international health insurance policies is the age you can continue renewing your policy up until. Outside of Singapore, some local private plans will have a cap on the age you can continue to renew your policy, usually around the age of 70-80. Considering that people tend to develop more health conditions as they grow older, not being able to renew your insurance can be a serious problem when you’re going to be needing it most.

This is less of a concern in Singapore as integrated shield plans, like International health insurance plans, are lifetime guaranteed renewable, so you will always be able to renew your plan for as long as you need it.

Cover outside of where you live

shutterstock_543204871%203000px.jpgOne of the things you’ll have to ask yourself is whether or not you need coverage outside of where you’re living, which could be important for expatriates, or those who travel frequently for business or vacations. Most local plans will only provide you coverage in that country, while an international plan will typically offer coverage either worldwide, or worldwide excluding the USA (although these plans will usually provide 30 days of cover for emergencies even outside your area of cover).

In Singapore, you can get some cover for international treatment with an integrated shield plan, however these additional benefits are generally only available by adding a rider to your plan. This will usually cover emergency medical treatment overseas pegged to reasonable and customary charges of Singaporean hospitals, however the coverage may not include emergency assistance services or emergency repatriation that could bring you back to Singapore.

In most other countries, if you are on a local medical plan, you can always take out travel insurance to cover any emergencies, or a short-term international health insurance plan for longer travels abroad such as sabbaticals or an extended trip. However, it is important to note that in some cases where serious medical treatment is needed, a travel plan may focus on transporting you back to your country of residence, after which the travel insurance company will no longer have to cover your treatment in your home country.

International health insurance plans, whether long- or short-term, will generally come with complementary coverage for emergency medical evacuation and assistance, which includes evacuating you to a place where you can receive quality medical care, medical referrals and second opinions, tele-medicine consultations and more.

Direct billing for medical expenses

One of the benefits of a local health insurance is that they often have extensive cashless billing networks in the country they cover. This can cover both hospitals as well as doctors and clinics and can make your life much easier as you don’t have to pay for treatment - which could be quite expensive - and claim for reimbursement.

While some international health insurance plans, like APRIL International’s MyHEALTH plans in Singapore and elsewhere in Asia, do have outpatient direct billing networks for your added convenience, all of them allow you the freedom to choose your own doctors and hospitals at will.

In some cases, visiting a doctor or specialist outside of your local health insurance provider’s network can result in a higher out of pocket cost for you.

Do you need to take your health insurance with you when moving?

shutterstock_669633394%203000px.jpgIf you’re someone who has a high chance of moving due to your job, or an expat who may leave Singapore or return home in a few years, you will want to consider how you will be covered when you move. If you’re on a local plan, then you will have to take out a new plan once you’ve moved. This can be an issue if you’ve developed a medical condition or suffered a serious illness during your time in Singapore, as the insurer in your new home will probably treat it as a pre-existing condition and exclude it from coverage.

The majority of international health insurance plans are globally portable, so you can take them with you when you move with no breaks in coverage, and no need to go through the underwriting process again which means you’re not in danger of being refused coverage for pre-existing conditions.

Finding the right international health insurance policy for you

Whether you’re preparing to expatriate to another country, already living abroad in Singapore or simply looking for comprehensive international medical coverage, our expert advisors are always ready to help you find the right international health insurance plan. You can browse our range of plans or contact us today to see how we can help.

Our MyHEALTH plans are registered onshore in Singapore, making them available for Singaporean citizens and permanent residents as well as expats.

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