Different insurers have varying policies that may have standard exclusions for expat health plans, usually for pre-existing & chronic conditions.
List of Standard Exclusions for Expat Health Plans
Here is a list of claims that may not be covered by insurers unless previously agreed upon by the insurance company:
- Epidemics
- Birth control
- Maternity under 12 months or entirely
- Fertility care
- Cosmetic care
- Mental care
- Sexual dysfunction
- Obesity care
- Untested care
- Claims as a result of alcohol or drug abuse
- HIV
- Pre-existing medical conditions
It is important that you understand what your offshore health plan will cover and what it won’t. All health insurance plans have exclusions and it is a good idea to read the fine print before you obtain your expat health insurance plan.
Why do Health Plans have Exclusions?
As noted above, and it kind of goes without saying, all insurance plans have some exclusions. Exclusions are required to keep the policies affordable and for insurers to make a profit. If the insurers don’t profit, they can’t cover expats. Here’s a short list of reasons why global health providers have exclusions on their policies:
Cost Control: Global medical plan exclusions help insurers manage costs by limiting coverage to certain essential services. They can then offer more affordable premiums to expatriates. The fewer the exclusions, the higher the premiums. Note that group expat benefit plan insurers can provide much fewer exclusions because the risk can be spread amongst many more people in a group.
Risk Control: Certain medical conditions or treatments that some expat may want can pose higher risks or be more costly to cover. International insurers exclude these to mitigate their financial exposure and maintain the plan’s sustainability.
Specific Treatments or Services: Some plans may exclude coverage for elective or cosmetic procedures, alternative therapies, or experimental treatments that are not considered medically necessary. This is entirely understandable.
Legal and Regulatory Compliance: This is less common, but health insurance regulations vary between countries. Some global providers may have exclusions that may be necessary to comply with local laws or regulations governing insurance coverage.
Pre-existing Conditions: Insurers can often exclude coverage for pre-existing medical conditions to prevent adverse selection, where individuals only purchase insurance when they anticipate needing expensive treatment. Sometimes, certain conditions can be covered by some insurers, but it really depends on the condition and insurer.
Geographical Limitations: Most global health plans may have exclusions for treatments or services not available in certain regions or countries where the insured individuals are residing or traveling. Most plans will cover expats globally excluding the USA, but can offer it for an extra fee. Note that expat insurers will also exclude cover in some countries, such as Iran, because of sanctions laws.
Contact an advisor at Expat Financial today to review your international health insurance needs and make sure you read the fine print. You can also obtain a quote online via our website.
