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Expats and international health insurance

Everything is different in another county, and that includes health care and the necessary insurances. Expats and their accompanying family are tied to both their home and destination countries with respect to local regulations on health insurance.

To choose the right insurance, both the employee and employer should keep the following in mind:

  • Is this a short-term assignment?
  • Are family members joining?
  • Is there a social security treaty between the host and home countries?
  • What are the relevant provisions in the treaty for the employee and their family?
  • Group or individual insurance?

The answers to these questions will vary per individual, but ultimately offer support in order to choose the most adequate health insurance for the situation.

Short-term or long term

If the expat goes abroad for a short period and doesn’t live in the host country for an extended period of time, they may need different insurance than someone who is staying in the host country for a longer period. In certain situations, such as when the expat stays for a short time in the host country, business travel insurance may be the solution.

Family members

Whenever family accompanies the expat on an assignment and the international post lasts longer than a few months, the employer usually has a policy in place for the reimbursement of healthcare costs. Based on the policy, the company might have a dedicated insurer that provides the advantage of accepting all employees without medical testing. Before each assignment, it is important to evaluate if the standard insurance provides the right care and coverage. If not, then additional insurance policies can cover any gaps.

Social Security treaty

A social security treaty between counties determines which coverage is valid for each other’s residents and how the costs are settled between the different coverage and care systems. If there is no treaty, then the expat can obtain an international health insurance, possibly combined with the basic insurance of the home country.

Within the European Union, there are social security treaties in place in member states. However, these are not all the same, so the advice of an expert is necessary to ensure the right measures are taken. The Netherlands and Belgium also have treaties with various countries outside the EU.

When assigned to a country with a social security treaty with the home country, it could be decided to register the expat with a local health insurance in the host country. Nevertheless, several social security treaties require that the expat and family members maintain healthcare insurance in their home county. Coverage in the host county is usually different than the home country. It is crucial to have this information before the assignment begins.

Quality and coverage

International health insurance policies generally come down to two choices: Coverage including or excluding the United States. The price difference is substantial, related to the high cost of healthcare in the US. It is only advisable to take US insurance, if the US the host or home country.

Specific points that determine the health insurance choices for expats include:

  • Is repatriation for medical reasons covered?
  • Can the insured person choose an English-speaking doctor?
  • Can the insured choose for medical care in their home country?
  • Are costs paid at time of care or is the insurance company billed directly?
  • Does the insured have a point of contact from the insurer for questions about care?

Group or individual?

Companies with a large number of expats usually have international group health insurance, that helps keep costs lower and makes the acceptance of insured persons easier. It is also important to review the medical coverage for an employee or family member that may have a pre-existing medical condition. Additional insurance may be required.

A company with less international staff may not be eligible for a group insurance.

And finally…

Should the expat need to go on an international business trip.  Business travel  insurance may be an option as international health insurance policies do not cover all situations. Experts can help you put together the best package for your employees.

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