International Health Plans

Get Beyond the Spin and Choose the Policy You Need

By Carla Valentine

The main reason to buy an international health insurance policy is peace of mind. But sometimes you may have to buy insurance—for visa purposes or because your present company or HMO won’t cover you abroad. How do you can find the policy that offers you the right coverage to fit your budget and level of risk?

When I began my search in July 2002 for international health insurance for a 34-year-old single female I found that prices ranged from $274 for plans without U.S. coverage to $1,500 per year for comprehensive, worldwide plans.

The quote you receive will depend on your age, gender, health, length of stay, overall amount of coverage and deductible chosen, and whether you want "home country" coverage. To be eligible for most international health plans you must already be living outside the U.S. or plan to leave the U.S. within 30 days of your policy start date.

While the insurance company is checking you out, make sure you check who the underwriter of your policy is and if he or she has a good rating for payment of claims. Ratings are given by independent evaluators: A.M. Best or Standard & Poor’s.

Comprehensive Coverage

Examples of established plans that offer more comprehensive coverage at about the same price:

IHI, International Health Insurance (www.ihi.dk). Based in Denmark, IHI has offered international medical insurance for more than 25 years. Unlike U.S.-based plans, IHI imposes no 6-month home country limit; you can receive treatment in the U.S. for as long as you like and even retain your policy once you return home.

Like other international policies, you must be living abroad or in the process of moving overseas and give a foreign residential address at the time of enrollment. But once enrolled you are guaranteed lifetime renewability, regardless of where you live. This is truly portable healthcare.

The company's Premier 1 Diamond plan, its most comprehensive, offers $1.5 million in coverage per year (note: not lifetime, as in other plans); its Premier 1 Gold plan provides $1 million in coverage per year.

Both plans offer free choice of doctors and hospitals worldwide and no need for precertification (except in the case of air ambulance and other benefits, such as rehabilitation and hospice care). Both policies are covered for air ambulance service, but only the Diamond plan offers repatriation of mortal remains. Also, co-insurance applies for coverage in the U.S. and Canada. Cost: $1,290, Diamond; $1,114 Gold for a person age 30-39 with a $5,000 deductible. (Both plans provide free health insurance for up to two children under age 10 and children born into the policy.)

Global Medical Insurance, offered by International Medical Group (IMG, www.imglobal.com) of Indianapolis, Indiana, offers $5 million in lifetime benefits. It also offers free coverage for the first two children age 14 days to 9 years if both parents are insured under the plan. Air ambulance (but no repatriation) is included. It is renewable annually. Cost: $1,135 for women, $670 for men, age 35-39, with a $5,000 deductible. Underwritten by Sirius International, rated A, "excellent" by A.M. Best.

Travel Policies with Medical Benefits

Less comprehensive but very economical, these travel/health policies offer medical benefits in the case of accident or sickness, air ambulance service, emergency reunion, and repatriation. However, home country coverage is limited and there is no coverage for pre-existing conditions. As such, they are considered "guaranteed issue" policies, open to anyone.

You can choose from a $500,000 or $1 million limit, with deductibles from $100 to $2,500. Besides the medical benefits, the plans include trip cancellation and lost luggage insurance and accidental death and dismemberment coverage.

Ex-Patriot Plus, offered by IMG, is available for a minimum of six months and renewable for up to two years. It offers "end-of-trip home country coverage," which allows you to buy one month of additional coverage upon your return home. Cost: $684 ($500,000 limit) or $756 ($1million limit) for a person age 30-39 with a $250 deductible. The cost decreases at higher deductibles. If you are traveling for six months or more you get a 10 percent discount. An alternative plan is available for those traveling 15 days to one year.

Atlas Extra, offered by Multinational Underwriters, provides up to 30 days of home-country coverage. Coverage is open to anyone traveling six months or more. For shorter terms, ask about the Atlas International plan. Cost: $504 ($500,000 limit) or $540 ($1 million limit) for a person age 30-39 with a $2,500 deductible.

It takes a lot of time and deciphering of fine print to compare health plans and get beyond the spin of marketing brochures. But by researching your options thoroughly, you can find the right plan for you.

CARLA VALENTINE is a Massachusetts native and former newspaper editor. She is currently living and teaching English in Venice, Italy.