Many people are becoming expatriates these days who are currently taking prescription drugs for short-term or chronic medical conditions. Others may need medicine for new ailments or injuries that occur during a short- or long-term work assignment overseas, while travelling, or when retiring abroad. While most countries have much lower prescription costs than the United States, there are many that have drug costs that can be very expensive, especially if the drug is being used to treat a major illness, is a brand name or is a new drug.
Why Expats Should Get Prescription Drug Coverage
If you are moving abroad, choosing an international health insurance plan that includes prescription drug coverage can be especially important, particularly in countries where you must pay for medications privately. We have found that even relatively common prescriptions can become a significant ongoing expense. If you develop a chronic medical condition, you may require specialty, biologic, and cancer medications that can cost tens or even hundreds of thousands of dollars per year. Drug coverage can also be valuable if an expat unexpectedly develops a chronic condition that requires long-term medication after their policy begins. Note that if you have an existing medical condition and you are applying for a plan on an individual or family basis, that medication may not be covered. If you are lucky enough to be on a global benefit plan, it is highly likely that medication will be covered.
Comparing Prescription Medication Coverage for Expats
When comparing plans, expats should look beyond the overall medical maximum and check the prescription drug limit, deductible or coinsurance, formulary restrictions, prior authorization requirements, and whether both generic and specialty medications are covered. We generally recommend purchasing adequate prescription coverage at the outset rather than assuming you can simply add significant drug costs to the plan later.
When comparing international health insurance plans, global citizens should look beyond whether prescription drugs are simply listed as covered. Compare the annual drug maximum, deductibles, coinsurance, formulary restrictions, prior authorization requirements, and coverage for specialty or biologic medications.
Also check whether prescription expenses fall under the overall policy maximum or have a separate limit. Expats taking regular medications should confirm that their prescriptions are eligible and available in their destination country before selecting a plan. If your existing global healthcare policy is covering your existing medications, you should think twice before switching to a new policy, as it probably won’t cover those ongoing costs.
Expensive Medications for Expats
For example, the new biologic medicines are essentially genetically engineered to treat conditions such as rheumatoid arthritis. Some of the drugs can cost as much as $1000 to $3000 USD per month. Another expensive drug is Sovaldi, which was approved in 2013 to treat Hepatitis C, which is quite common in some developing and developed countries. This new drug is quite effective, but can reach almost $80,000 over a 12-week treatment period. Check out our article on Biologic Medications for Expats.
Medications and Expat Country Destination
Prescription drug availability can vary significantly between countries. A medication that is commonly prescribed in Canada, the United States or Europe may not be readily available in an expatriate’s country of assignment, or it may be marketed under a different brand name. Expats who regularly take prescription medication should therefore consider their medication requirements before relocating overseas. This is particularly important for employees managing chronic or complex medical conditions.
If you are going to a country where medication costs are high, you should definitely consider obtaining a global policy that includes prescription medications and take a higher-limit policy as well. The higher the limit, the higher the drug coverage limit. Some expats we work with going to low-cost medical countries will forgo outpatient coverage, which often includes medication insurance.
Also, if you are travelling with your medications, make sure the pills are in the prescriber’s bottle and properly labelled, along with your doctor’s prescription. This is especially important for some medications, such as pain relief pills and even some non-prescription allergy pills. In some countries, bringing medications into the country can land you in serious legal jeopardy, so do your research and talk to your doctor.
Drug Formularies and Prior Authorization for Expats
International insurers may use drug formularies and prior authorization requirements to help manage prescription costs. Your plan may also have a deductible or coinsurance option for medications that you purchase. Most plans require you to pay up front for the medication and then submit to the insurer for reimbursement unless the pharmacy is in-network.
A formulary generally identifies medications that the insurer will cover and may encourage the use of generic or other clinically appropriate alternatives where available. More expensive specialty medications may require prior authorization before the insurer will approve the prescription.
The insurer may request medical information from the treating physician to confirm that the drug is medically necessary or that other appropriate treatments have previously been considered. No global medical plan will cover all medications, especially experimental or nonmedically necessary ones.
What are the Best Steps for Global Citizens who Require Prescription Coverage?
So, what can expatriates do? The simplest and best answer is to obtain a global medical insurance plan that will cover your global prescription costs while living overseas. Most group plans have high drug-cost limits, but you should check with your HR manager. Some group plans employers offer will not cover prescriptions or will exclude pre-existing conditions. For individual expat health coverage, most policies will provide some prescription drug coverage or allow you to add it as an option. However, if you are already taking a medication for a pre-existing medical condition, the individual plan provider may exclude that condition and the drug costs associated with it. That’s why it makes sense to obtain your global medical coverage as soon as you are about to move overseas, before you get sick or injured.
Securing Global Healthcare with Medication Coverage
Expat Financial offers several global insurance plans that can provide excellent drug coverage for expatriates living abroad. Some of the global medical plans we offer can even cover local nationals in select countries. The international health plans from providers such as Cigna and Allianz can provide prescription drug coverage for most expatriates. Base coverage for these plans provides prescription drug coverage if you’re admitted to a hospital, but you will need the outpatient module for drug coverage outside a hospital setting. You can get a quote and even apply for the individual expat health plans we offer. Note that Expat Financial is a division of TFG Global Insurance Solutions Ltd.
The Importance of Advisor Advocacy
Our role does not end when a global medical insurance policy is placed. We regularly assist multinational employers and their expatriate employees with benefit questions, claims issues and communication with international insurers.
When a medically necessary prescription is delayed, declined or requires additional authorization, having an experienced global benefits broker advocating with the insurer can be extremely valuable.
We also offer group plans that can provide very comprehensive drug coverage for expatriate employees. To learn more, contact Expat Financial today.
