How to Find the Best Expat Health Care Services Worldwide
Health care isn’t an exciting part of moving, but it’s essential to make sure you’re prepared.
Wherever you’re planning to reside, you will be faced with the choice of private or public coverage, expat coverage, and global coverage.
Here’s a brief overview of your options, plus some practical advice from those in the industry and fellow expats who have been where you are. And if you need to quickly estimate a currency conversion at any time, try our new currency calculator.
Healthcare Options and Practical Advice for Expats
1. Know What You’re Getting Into at Your New Home
The Expat Info Desk has a growing list of countries that offer the best health care in the world. It’s not complete, but it does provide a useful overview of what to expect in various destinations around the world, including:
- Its World Health Organization ranking
- What kind of coverage is offered for citizens
- Whether public health services are available to expats
- The general cost of insurance coverage
While expats relocating for business don’t necessarily have a say in where they’re traveling, it’s important to evaluate your health insurance costs and options before you pack your bags.
2. Start Your Health Care Transition Months Before You Arrive
As you consider accepting a foreign job offer or following your dream to another location, start checking into what is required by the government and what options you prefer.
The UAE has incredibly strict guidelines for expats migrating to the area. According to Stephen Maclaren at The National, “It will be the responsibility of the employee or sponsor to arrange insurance coverage for their own spouse, dependents and domestic workers and to pay the premiums directly to the insurer.”
This means your employer-provided insurance might not cover your children and spouse, which increases the cost of living in the area and puts them at risk if something happens.
3. Insurance Coverage Varies Among Companies
Every country has different standards for company-provided support, and many businesses tailor their offers to save money or improve recruiting. In China, the Global Times put together a guide called One-Stop for expats moving to the country. The guide offers a breakdown of different policies and an explanation for employer-provided health care.
“All employers are legally required to provide health insurance,” One-Stop writes. “But using these policies can be tricky, because they offer complete coverage for some types of treatment, partial coverage for others, and, for still others, no coverage at all.”
You might also be limited to Chinese hospitals, depending on the company. In some cases, you might be able to opt for commercial health insurance if your employer’s policy can’t adequately meet your needs.
4. Make Sure Your Insurance Is Commonly Accepted
When researching your insurance options, there are two main levels to consider:
- What kind of coverage will you receive for the price?
- Who will accept this insurance provider?
In a worst case scenario, only a handful of doctors in the country will actually accept your insurance. You might spend hours on the phone trying to find someone who will take you, at which point the state insurance plan will start to seem more appealing.
This is why many European and UK citizen think the United States is a challenging place to move to. Mark McSherry at the Guardian profiled expats who made the transition when they left the UK, and America’s health care report card didn’t make top marks. “Some prefer to fly back to the UK for visits to the doctor or dentist because even after paying for flights it is sometimes still cheaper — and a lot less hassle — than getting treatment in the United States.”
Try to find recommendations from expats in the area before choosing your insurance provider, or you could end up traveling for hours (or flying home) just to get a cavity filled.
5. Global Health Insurance Helps If You Move Around Often
Berry Treffers is an expatriate health insurance management broker who works with people traveling all over the world. While he recommends local health insurance if you’re in a country that offers top-notch coverage, it’s not the best solution for nomads looking to move from place to place.
“A global insurance plan, however, provides you with coverage wherever you go; in your country of residence, your home country and abroad,” he writes. “It may also offer additional services in the country you live in … that may not be included in certain local packages.”
Treffers explains that local coverage might last for up to three months after you leave a country, but this varies by provider and location.
6. Expat Insurance Can Make Your Transition to a Poorer Country Easier
Many expat health care plans work to provide the best coverage when their customers fall ill abroad — regardless of the expense and bureaucracy within the country. Expat Focus has an incredibly helpful guide, written by Leslie Smith of Medibroker International, to make sure you ask the right questions about what’s covered, from outpatient costs to pre-existing conditions.
“Private Medical Insurance when abroad is like a parachute when flying,” Smith writes. “You may not need one but it better be there, as you and your family would may not survive without one.” Even if the majority of the country uses state care, you might opt for a private option to guarantee shorter wait times and better facilities.
Chuck Bolotin, founder of Best Places In The World To Retire, explains at The Street that Central and South American countries are catching up quickly to their North American counterparts when it comes to providing health services. Furthermore, private plans are still relatively inexpensive while providing top-rate care.
“A high percentage of payments for health care services are in cash,” he says. “There is generally little involvement from insurance companies and even less involvement from government.” Opting for private insurance can also protect you in case of unemployment, if the company your work for covered half of your state-sponsored insurance.
7. Private vs. State Treatment Can Vary
Opting for private insurance can result in better treatment in many countries. Private insurance can grant you access to better hospitals, shorter wait times, and private rooms — which can make a huge difference when living in a less-wealthy country.
In wealthier countries, however, the large state systems that are supported by most of the population means service is fairly equal across the board. According to the German Healthcare Guide by Just Landed, 85% of German residents use the state’s health insurance coverage, for example. Most employees are legally required to have health insurance, and a private policy is only granted in certain cases.
However, private policies still have their benefits. “At the doctor, you will often be treated preferentially compared to state insured patients, as you are generally more profitable,” the Just Landed guide notes. “Some doctors even restrict their practices only to private patients.”
Wherever you live, money will have its benefits.
8. Health Care Changes Can Happen Overnight
Last year, the UK’s National Health Service adjusted its coverage for expats who return home for medical treatment. As the German version of The Local recently explained, “The UK Department of Health confirmed that there is no ‘grace period’ following a move during which they can use the NHS — the moment they have left the country they lose their right to NHS treatment.”
However, health care changes aren’t necessarily bad. David Morrill and Greg Medeiros recently reported on changes to the Ecuadorian health care system, and the dramatic improvements it’s been making overall.
“Various surveys have shown that the country has moved from the middle of the pack of Latin American countries in health care quality, to being one of the top five,” they write. “Annual funding has more than doubled for public health care from previous levels.”
By following a country’s health care trends, you can get a better picture of what life will be like then looking at a snapshot.
9. Visit Hospitals and Specialists Before You Move (If Possible)
Viva Tropical, run by two American expats who live in Costa Rica and Panama, recently explained what their fellow expats can expect when they arrive. While there are plenty of wonderful public hospitals in those countries, they write, others are run down, poorly staffed, and under-prepared to meet the needs of the community.
“Something that’s important for expats to understand about Panama’s health care system is the disparity between the well-trained, well-meaning physicians and their ability to meet wide-ranging needs with the limited resources available to them.”
They recommend finding a specialist you like before you move instead of choosing a city and then researching pediatricians or oncologists.
Italy is another country where the hospitals vary by region. Expat Arrivals created an Italian health care guide that reviews the drastic difference: “Although the SSN is a socialised system, regional governments are in charge of managing it on a provincial level. … Public hospitals in Italy’s northern and central regions are known to offer higher standards of care than those in the south.”
10. Finding Affordable Health Care Can Make or Break Your Move
Charlotte Beugge and Elizabeth Roberts at The Telegraph recently interviewed a retired British couple that moved to Australia. The couple said their health insurance premiums have risen 123% since they arrived in 2006, but their British state pension rate froze as soon as they left the UK. They’re planning to move back the UK or Singapore, because they can’t afford 2016-level health care costs on a 2006-level pension.
“Unlike permanent residents, temporary residents in Australia do not get access to Medicare, the publicly funded national health care scheme, which covers many costs,” Beugge and Roberts write. This means if you’re only expatriating for a few years for a project, or staying on a visa, you could pay more than you planned on health care — even in traditionally accommodating countries.
11. Research Expat Groups Offering Health Care Solutions
While healthy young people tend to take larger risks with their health care, older expats hoping to retire abroad have to be more careful where they settle down. Like the British couple above, the New York Times has the story of an American couple wanted to retire in Paris, but struggled to find health care coverage.
“They acquired coverage by joining the Association of Americans Resident Overseas, a Paris-based group that represents United States expatriates,” reports the NYT’s Tim Gray. “Members can buy into a group plan insured by Swiss Life in Zurich.”
Before you move, research organisations run by fellow expats that can provide coverage, or help people in your situation choose the best option.
12. Consider Medical Evacuation and Repatriation Coverage
This isn’t something anyone wants to think about, as many expats think of medical coverage for helping treat mild flu symptoms and the occasional rash, but you may want to consider adding coverage for medical evacuation and repatriation if you’re going somewhere with limited medical options.
Medical evacuation is used when the needed treatment is unavailable. As Dr. Ulrike Sucher of Allianz Worldwide Care explains in Health Insurance Daily, the countries from which the company most frequently evacuates clients include Mozambique, Libya and China, “where specialist medical care is limited.” Patients are often flown to South Africa or Germany, where top-notch care is available.
Meanwhile, medical repatriation covers sending patients back to their home countries for treatment. Expats might opt for this to receive better treatment, or to receive care in a familiar environment, where they speak the language and can understand what the doctors ask them.
13. Don’t Judge a Country’s Hospitals Until You See Them
Despite the reputation that your new host country has, don’t immediately book tickets home every time you need a check-up. In an article for Transitions Abroad, Heather Van Deest explained why she loves living in Thailand — and the quality health care makes the list.
“Both of my sons were born in Bangkok, at a state-of-the-art hospital rivaling Western facilities,” she writes. “The waiting rooms here are filled with people from across the world, particularly the Middle East and Europe, who travel to the country as ‘medical tourists’ seeking affordable, quality health care.” It’s worth noting that Van Deest’s insurance was provided by her husband’s job as a teacher.
The best way to get a feel for a country’s health services is to visit the facilities for yourself. Talk to expats in the region and get their opinions for what health insurance options are best, and try to leave windows for change. This way you won’t get stuck with an expensive or useless health plan that you can’t get out of.