Growing demands lead to top notch international health insurance being available for the first time. You barely have to turn the page in a newspaper or magazine these days to see that globalization is at the epicenter of the new world order. As global lifestyles emerge, the demand for comprehensive international health insurance has grown rapidly.
In response to this demand, a new generation of superior health plans is now available to serve expatriates and their families. This is a positive development for American expatriates who have historically had limited choice when it comes to coverage. Existing insurance options have often missed the mark because of limited benefits, long waiting periods, harsh exclusions, pre-certification penalties, lack of portability and other hidden gotchas.
What does this mean to me?
Insurance regulators have historically encountered international health plans primarily in the form of surplus lines products. These plans are technically not health insurance policies. Nevertheless, surplus lines plans have been the only renewable health option available to American expatriates up until now.
More than 40 U.S. states have recently stepped up to approve the sale of a new health insurance plan geared to serve people with global health insurance needs. Benefits are available inside and outside of the United States with no limitation on time spent in any one location. The new generation of plans responds whether you spend the majority of the year in London or Los Angeles.
Admitted Health Insurance vs. Non-Admitted, Surplus Coverage
Comparing surplus lines coverage to true health insurance is a little like comparing apples and oranges. They are built very differently with far reaching consequences. Your personal health and financial security could hang in the balance.
Admitted health insurance advantages
1. Critical Protection You are protected under U.S. insurance laws and oversight. U.S insurance laws are strict and have long favored the health care consumer. This means that policy language must meet the plain English definition. Policy wording, plan definitions, exclusions, state mandates for coverage, claims process, claims turnaround times, formal appeals process all must meet regulatory muster. 2. Ongoing Coverage Rights An admitted plan can be kept even after your employment ends or your overseas assignment ceases. U.S. insurance laws have stepped up to ensure portability and renew ability of coverage. This is designed so that people do not suddenly find themselves out of a job, back home and uninsurable. 3. Medical Provider Networks Larger networks tend to be available in the United States with fewer billing issues for members. In addition, contracted doctors and hospitals are available in most locations. These providers are set up in many instances to bill the insurance company directly. Providers are profiled and contracted and members can review their biographical information.
4. Better Benefits Admitted benefits tend to be broader and deeper with few waiting periods or low limits on medical conditions. The table below illustrates some of the major differences between an admitted health plan and a non admitted surplus plan.
Coverage Consideration
Admitted Health Insurance
Non-Admitted Surplus Insurance
Must conform to U.S. health insurance laws
Unlimited time can be spent in or out of the U.S.
Pre-existing conditions coverage available*
Covers appendicitis, kidney stones, gall stones, breast disorders in the initial 6 month period and beyond
Substance abuse benefits included
Transplants covered to policy maximum
Terrorism covered with no excluded countries
Preventive services covered with no waiting period
Pre-certification is not required for hospitalization
Alcohol related injuries and illnesses are covered
Deductible waived for physician office visits
Wellness benefits covered with no waiting period
Cashless access to physicians outside U.S.
Access to 700,000 contracted providers in the U.S.
* References individual products and is subject to prior credible health insurance. Chart is meant as a general guideline of individual products offered. Some benefits and services may vary by insurer.
International living just got a little easier Navigating health insurance just got a lot smoother. Expatriates often have an appetite for “best in class” and can now enjoy superior health insurance. As always, it is a good idea to do your home work. Always ensure that you read the fine print rather than just scanning a benefit schedule. Ask your broker or insurance company to send you a sample policy so you can get the complete picture.
Given the choice, would you rather buy a health plan that is subject to state regulators’ standards, or one that is not?
When it comes to international health plans, consumers often encounter products from “non-admitted” insurers that operate beyond the reach of U.S. state insurance regulations. These offshore plans – also referred to as surplus lines policies – are cheap but should be purchased only after very careful consideration.
What is a non-admitted health plan? Any plan that has not been approved by the state insurance department as health insurance is considered non-admitted even if the administrator or marketing company is located in the U.S. By law, buyers typically must acknowledge in writing that they are aware that they are buying a plan that does not conform to health insurance regulations. This is a kind of “buyer beware” warning.
Non-admitted insurers are not bound by state financial solvency requirements. To draw an analogy, buying a non-admitted plan can be likened to opening a bank account that is not FDIC protected.
The “rock bottom price” on a non-admitted plan can be a warning of troubles ahead. The cheapest health plan at the time of purchase often turns out to be the most expensive in the long run.
When plans from Admitted carriers, such as those offered by HTH Worldwide, are an option, consumers are fully protected under the law
If a consumer files a complaint with the Department of Insurance, the state has direct recourse to the Admitted insurer to demand fair claims payment.
State regulations are designed to protect consumers, making it is less likely that buyers will have to confront hidden gotcha’s on waiting periods, harsh exclusions, inside limits, penalties or unusual claims payment procedures.
Policy definitions must be stated in plain English. For example, admitted plans define a pre-existing condition as one that was treated or diagnosed prior to the effective date of the policy. In contrast, non-admitted plans often define it as a condition that was treated, diagnosed, or “could have manifested itself (whether symptoms existed or not)” prior to the effective date. This broad, ambiguous wording often backfires at time of claim.
Those returning from a stint abroad in need of a new health plan have peace of mind knowing that U.S. health insurers will recognize an admitted plan as creditable coverage. Additionally, members returning home are entitled to keep coverage in place for the long haul on certain HTH products such as the Global Citizen plan.
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