We have put together an exhaustive list of important insurance-related terms and definitions for expatriates who are shopping for the best international health insurance for themselves and their family members. Global health insurance is often confusing and complex, so we have tried to put together explanations of key insurance terms that most expatriates will require in order to understand and purchase expat coverage.
Helping Expats Understand International Health Insurance Terms
We sincerely hope that the explanations below will help you navigate our website and allow you to fully understand your requirements and coverage. Please note that you should read and understand your expat plan terms and conditions as they differ from plan to plan and insurer to insurer and the explanations are only a rough guide and vary depending on your coverage and policy. You should also consider downloading our free international health insurance guide or obtain a quote online today
Glossary of expat insurance terms used by insurance companies in global health insurance brochures.
Affordable Care Act
The Affordable Care Act is a comprehensive health care reform law passed by the US government in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”). Expat health plans are offshore policies that do not have to comply with the PPACA laws.
With respect to benefits, this often refers to insurance coverage or the amount of risk or liability that is covered for an individual or entity by way of insurance services
The beneficiary in expat insurance terms should usually refer to who is to receive the benefits in the event of a claim.
All international health plans will have some benefit limits for certain types or treatment or medical procedures. This can be seen as the maximum payout in a year or lifetime for a treatment or condition.
Chronic conditions can be referred to broadly as medical conditions that last one year or more and require ongoing medical attention or limit activities of daily living. Well-known chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability for expatriates and global citizens. Most international health plans will cover chronic conditions IF you are covered and healthy before these conditions occur and you are covered. Some expat health plans will cover some chronic conditions declared when applying depending on the severity of the condition.
This could be referred to how the claims are paid to the expatriate living abroad under a global health plan or how to make a claim.
For most global health plans, coinsurance is the amount, generally expressed as a fixed percentage, an expat insured must pay against a claim after the deductible is paid. The higher the coinsurance amount that the insured person pays, the lower the risk to the insurer and the lower the premium that the insured expat will pay. We find that most global nomads purchase plans with little or no coinsurance, but there may be coinsurance for medical treatment in the USA depending on the policy.
This refers to the areas that expats are covered in for medical treatment. Most international health insurance plans will provide two coverage areas – global excluding the USA OR including the USA. However, some expat insurers such as Allianz, have an option to limit care to Africa if you are an expat there.
The deductible is what you pay in the event of an expat health claim during the policy year. The larger the deductible, the lower the premium as you are taking on more financial risk instead of the global health provider.
Dental treatment refers to the treatment of your teeth. Expat dental plans are a means to help you to pay for your dental treatment when living abroad. Some global health plans include or have an option dental benefits for a variety of reasons, including the promotion of good health. International dental coverage can lead to good oral health and can often cover basic, restorative and orthodontic treatment. Generally, most global health plans will cover dental checkups every 6 or 12 months.
Emergency Medical Evacuation
Medical evacuation for global health plans is often included or can be purchased as a rider. Evacuation insurance is where someone is not able to be adequately treated in the country or area that they are sick or injured in and need to be evacuated to another region or country for medical treatment. If you live in a country where medical treatment is lacking or sub-standard, you should definitely get medical evacuation coverage. Note that medical evacs need to be approved and coordinated with the international health insurance or their assistance provider.
Insurance expenses for expatriates are often referred to as the amount that an insurer pays to get an insurance contract and any additional premium payments. It could also refer to the claims that are submitted.
Exclusions can generally be viewed as cases where the insurance company does not provide coverage. All insurance plans have some exclusions for their insurance policies. For expat health plans, these might be things such as cosmetic treatment or pre-existing conditions. Sometimes the expat insurer adds an exclusion for specific medical conditions that they will not cover if it occurs during the life of your policy. Many people are ok with some exclusions and you can often ask the insurer to remove the exclusion and the worst they can say is no.
Other exclusions exist to prevent insurance fraud, to prevent claims that go against the underwriting of a line of coverage.
Hazardous Sports Coverage
This often refers to sports that are hazardous in nature that the global insurer may or may not cover because they are likely to result in a claim. Some expat health plans will exclude hazardous sports such as bungee jumping, paragliding, scuba and off-piste skiing. You should declare if you participate in hazardous sports and read the fine print to see if it will be covered.
In expat terms, this would be the person who is covered by the expat life, disability or global health plan. The insured could be yourself, partner and children.
In-patient coverage is a treatment that is received in a hospital.
International or Local
This usually refers to whether a global health insurance policy can cover locals or just expatriates. Most international health plans are designed and solely for expatriates, otherwise referred to global nomads. This can also pertain to whether an international citizen will purchase a local or international health plan.
Maternity benefits refers to the childbirth expenses that are available to be paid by the expat health insurance provider for normal or cesarean deliveries. Individual expat health plans all have 9, 12 or 24 month waiting periods for pregnancy assuming the policy you have purchased has maternity coverage. Expat group insurance plans that have a large number of expat employees can often cover maternity from day one.
Maximum Policy Coverage
Most international health insurance policies will have an overall maximum that they will cover in a given year or lifetime. The higher the maximum, the larger the premium.
Out-patient coverage refers to the medical services an expatriate receives outside a hospital. Some global health plans will allow you to add out-patient care to your global health policy for an extra charge.
This refers to the plan terms and conditions for your global health plan. You should read these carefully before you apply or pay your premium.
The expatriate health insurance premium is what you as a global citizen pays each year. Note that all international health insurance premiums are based fundamentally on your age and as you grow older, the premiums increase. Note that some global health policies can cover expats up to any age at the time of application as long as they are in good health. We recommend global medical plans that can cover expats for life, especially if they are retiring abroad.
Note that other things impact your premiums, such as citizenship, where you live and health history.
A pre-existing condition is a medical illness or injury that existed prior to applying for international medical coverage. Make sure you declare your pre-existing conditions when applying for an international health plan as some can be covered, excluded or you may be denied coverage.
Primary coverage is insurance coverage that pays out regardless of whether there are other existing insurance polices covering the same risk/expat. The primary coverage will generally be the first payor in the event of a claim. That primary coverage may be the local healthcare you receive in your expat destination.
Repatriation insurance is often part of an expat health insurance plan that includes medical evacuation coverage. It often involves repatriating you back to your home country in the event of death, but can also include getting you back to your expat destination country where you were covered after you were evacuated.
Secondary insurance coverage refers to the priority of payment when you file a claim whereby the policy you have may be secondary to any primary coverage in place.
The standard exclusions are the conditions that are generally not covered by all international health policies. This could include medical conditions that are the result of crime.
Travel assistance is sometimes included in some global health plans and refers to the assistance you may receive in the event of an injury when living or traveling abroad. It can also include legal assistance, crisis care and much more.
The waiting period for global medical policies refers to the time period an expat client must wait before a medical condition is covered. For example, there may be a 9 month waiting period for pregnancy or 12 months waiting period for orthodontics.