What Are The Key Differences Between An iPMI And A Local Insurance Plan?
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In a recent International Private Medical Insurance Magazine executive round table business forum, we spoke with leading C-Level executives about the major differences between international private medical insurance plans and local insurance plans.
As expatriate hot spots around the world continue to mandate insurance cover for expatriate employees, under various visa and employment laws, questions from the business community continue to be raised. Issues focus around how new laws will help and assist expatriates and what levels of cover they may expect from local insurance plans.
GREGOR SCHULTE Globality Health: At their heart, international health insurance plans are designed to cover all costs of high quality medical care regardless of the location of the insured person and the standard of local health services. Whereas a local plan is designed to provide cover primarily in a single country, taking into account the insurance practice and requirements of that country, access to state healthcare provisions and treatment costs in local hospitals only.
Of course international plans offer cover that transcends borders and generally include benefits specifically applicable to expatriates, such as repatriation and evacuation cover, assistance services and benefits, portability and freedom to choose the healthcare provider. The result is that iPMI usually provides far higher levels of benefits than those available from ‘local’ schemes, although this is dependent on which country is considered.
ANDREW APPS ALC Health*: Superficially there are many similarities between a local and international private medical (iPMI) plan. The fundamental difference is the target audience for each of these two very different products.
An iPMI plan is designed to cover a policyholder, usually an expatriate, for practically any health-related matter they may encounter, a local scheme does not have the same mandate, being designed with the local population in mind and most often acting as a support to local, often staterun facilities. This means that the features of each of these plans are markedly different.
The most noticeable difference is that an international plan usually offers a wider, more comprehensive range of benefits and with much higher benefit limits. For example, with an iPMI plan there can be generous cover for items such as GP visits, full chronic conditions cover, routine pregnancy and childbirth cover, evacuation and repatriation cover, and usually overall sum insured amounts that can be ten or twenty times higher than those of a local scheme.
Typically, an iPMI plan will also be portable, and not restricted to their country of residence, allowing the geographically mobile policyholder full access to all of their benefits wherever they are, in their chosen area of cover. Some iPMI plans also do not require their insured members to seek treatment within a network. The policyholder has the freedom to choose where they wish to receive treatment.
Naturally local schemes are usually less expensive than international plans, but correspondingly, the benefits are far less comprehensive, with low benefit limits (sometimes the benefits are blatantly only a contribution towards the total cost of treatment), out-of-network penalties, co-pay benefits, none or very limited out-of-country coverage. Most local schemes also do not offer 24 hour support.
Similarly by their very nature, local schemes are very much tailored to the local population with policy documentation available only in the local language and the benefits tailored to the audience the plan is designed for. The unwary expatriate with local cover may well find that he either has to make do with low levels of cover, or more likely will have to self-pay at least part of his treatment.
PHIL AUSTIN Cigna: International Health Insurance plans by their nature are better suited to expatriate life than local plans. They usually provide cover worldwide, meaning that wherever the individual happens to be in the world, they will be able to receive treatment.
Local plans on the other hand will normally only provide cover in a single country. This means that when the expatriate is making a trip back home, or is spending time in another country, they are potentially ineligible for treatment.
Moving to a new country often brings about basic challenges like language barriers and cultural adjustments. An international health insurance plan helps the expatriate remove a lot of this uncertainty as they will be dealing with a provider with experience in working with expats and experience in global healthcare. This means that often a language barrier can be removed by speaking to the insurer who can communicate directly with the hospital, and the expat can seek advice about local customs and peculiarities.
Finally and perhaps most importantly, expatriates who are not permanent residents or citizens of the country they are moving to may be ineligible for a local plan.
SHIRLEY PUCCINO GeoBlue: Local plans are designed to deliver coverage and services inside the host county and tend to incorporate underlying government health programs, networks, and delivery systems reflecting local languages, customs, business practices and provider relationships. International health insurance plans strive to provide more comprehensive global cover and an optimal experience globally, while to the extent possible, allow for local nuances in plan administration, delivery and practices.
READ THE COMPLETE ROUND TABLE, CLICK HERE.
*At the time of round table publication Andrew was working at ALC Health.