Lisa Expat Assure, Author at Expat Assure

An immigration health surcharge for long stays in the UK

Lisa Expat Assure — Tue, 16 Feb 2021 09:30:00 +0000

Post edited on 16/02/2021: with Brexit, Europeans planning a temporary stay of more than six months in the UK must now also pay the immigration health surcharge.

If you are planning a temporary stay in the UK of more than six months, you now have to pay a health tax, the immigration health surcharge, in order to access the UK’s National Health Service (NHS). Subscribing to a private medical insurance won’t exempt you from paying the health surcharge that costs £624 per person and per year (£470 for children and students). Find out in this article if you too may have to pay the immigration health surcharge, in order to be granted the right to enter the UK.

First of all, what is the Immigration Health Surcharge?

In recent years, the British Government has put into place a series of measures aiming to discourage ‘medical tourism’. The most notable one was to create a financial contribution, as part of the visa requirements, to access the NHS, called the immigration health surcharge (IHS), in 2015.

This health tax was originally intended for temporary residents from countries outside the European Economic Area (EEA) who stay in the UK for more than six months. But with Brexit, EU citizens are now also expected to pay the IHS, with the exception of a few categories of people.

The IHS gives visitors the same access to the UK healthcare system as for UK residents.

The fee is £624 per year and per person. It is reduced to £470 per year for children, students and people applying for the Youth Mobility Scheme visa.

The health surcharge must be paid for at the same time as when applying for your visa, and before entering the UK.

Visitors who are already in the UK and who are applying for a visa extension will also have to add the health surcharge on top of their visa fees.

The UK is one of the countries in the world with highest visa costs. The immigration health surcharge therefore pushes the visa bill even more. For instance, a family of two parents with a child staying in the UK two years, will have to pay £3436 in health surcharge fees alone, not including the visa fees.

The Immigration Health Surcharge is calculated based on the length of your stay in the UK. Here is an online tool to help you accurately calculate the amount of your medical surcharge.

Am I exempt from paying the immigration health surcharge if I choose to sign up for private medical insurance?

If you decide to take out international health insurance, and even if you are planning on not using the National Health Service, you are not exempt from paying the surcharge, as it is mandatory. However, for several reasons, it can still remain a good choice to take out an international health insurance for the UK.

Who needs to pay the Immigration Health Surcharge?

The British government’s website explains that “you usually need to pay the healthcare surcharge if you’re applying for a visa or immigration application”:

for more than 6 months, if you’re applying outside the UK
for any length of time, if you’re applying inside the UK

Who doesn’t need to pay the Immigration Health Surcharge?

You do not need to pay the health surcharge if you’re visiting the UK, applying for a visitor visa or if you are remaining in the UK permanently.

If you are coming to the UK as a visitor for a short stay, you will still be able to use your European Health Insurance Card (or equivalent) to access public healthcare in the UK. However, the EHIC is only valid for medically necessary and unplanned healthcare. It is not a replacement for full access to public healthcare or for private health insurance.

Australians and New Zealanders are also exempt from paying the health surcharge as their countries have special agreements with the UK.

Other categories of people are exempt from paying the IHS, such as members of armed forces, eligible healthcare workers, people applying for indefinite leave to enter or remain, asylum seekers, victims of slavery or human trafficking etc. See the full list of people who do not need to pay the IHS.

A brief history of the Immigration Health Surcharge

This financial contribution to access the NHS came into effect on 6th April 2015. It was originally intended for people coming from countries outside the European Economic Area (EEA), who plan on staying in the UK for more than 6 months: employees, students, or visitors.

Previously, some NHS care was offered to non-EEA nationals for free, whilst other treatments were payable. But it seems that the NHS was having difficulty being paid retrospectively for the services provided. This represented an administrative cost for the NHS. “The new charge will raise around £200 million a year and help offset the estimated £2 billion cost of providing free healthcare to overseas visitors, temporary non-EU workers and foreign students, the Home Office said at that time.

Then, with Brexit, the UK officially left the EU on 1st January 2021. The immigration rules applying to EU citizens aligned with the UK’s immigration rules for non-Europeans. Now, Europeans planning to stay temporarily in the UK for more than 6 months, must also pay the immigration health surcharge.

The payment of the immigration health surcharge initially amounted to £200 per year for temporary migrants and £150 per year for students and those on the Youth Mobility Scheme. This payment was doubled in January 2019, passing to £400/£300 a year. In October 2020, the fee rose again to £624/£470.

If you are a tourist from a non-European country, you will be subject to another rule

If you come from a country outside of the European Economic Area (EEA), and you visit the UK on a tourist visa, you are not affected by the mandatory NHS health surcharge, but a different rule applies to you: since April 2015, non-EEA tourists will be charged 150% of the cost of the health care they receive, 50% more than what it was previously. “This reflects the additional cost burden that the NHS carries when managing the administration for visitors to the UK”, explains the British government on its website, while stressing that “for this group, possession of adequate travel and health insurance is highly recommended”.

“The intended effect of the surcharge is that a person’s access to healthcare should be in line with their immigration status in the UK”, states the UK’s Home Office. “Temporary migrants have not built up the long-term contribution to the UK that a British Citizen will have built up and will build up over the course of their lifetime.”

As a reminder, European residents travelling to the UK for a short stay are not subject to this “right to access” surcharge and can benefit from the NHS using their European Health Insurance Card (or equivalent), thanks to the EU–UK Trade and Cooperation Agreement, that states reciprocal healthcare provision between the EU and the UK continues after Brexit.

However, British expatriates who have been outside of the European Economic Area for more than six months relinquish their residential right of access to the NHS and will also be asked to pay the 150% tariff if they are travelling in a touristic capacity.

People settling in the UK permanently are neither affected by the immigration health surcharge nor by the 150% contribution to their potential health treatments in the UK, as access to the NHS is, by definition, granted to all residents of the UK, regardless of their nationality.

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Brexit: UK residents can still access healthcare in Europe with the GHIC

Lisa Expat Assure — Mon, 01 Feb 2021 14:51:25 +0000

Now that the UK is no longer part of Europe, what has changed regarding access to healthcare in the EU? Can you still use your European Health Insurance Card (EHIC)? What is the new GHIC? Do you need international private medical insurance? What are the rules for Britons applying for social security in countries in Europe? This article answers common questions you may ask yourself regarding access to healthcare in Europe after Brexit.

Can I still access healthcare in Europe as a visitor after Brexit?

Traditionally, EU citizens planning a holiday or a short stay in any of the 27 EU countries of the European Union, as well as Switzerland, Norway, Iceland, and Liechtenstein, can access the state healthcare of the country they are visiting, using their European health insurance card (EHIC).

Now that the UK is no longer a member of the EU, the EHIC will no longer be issued to British residents (except a few categories of people – see below).

People who were issued an EHIC before the 1st January 2021 will be able to use their EHIC until its expiry date.

The new Global Health Insurance Card (GHIC)

The EHIC may no longer be available to UK residents but the good news is that they will still be able to access healthcare in European countries with a different card.

Under the terms of the EU–UK Trade and Cooperation Agreement, the UK and EU agreed that reciprocal healthcare provision would continue. This means that the EHIC will be replaced by a UK Global Health Insurance Card, that gives you access to healthcare if you are travelling to an EU country, within the same conditions as the EHIC.

However, there’s a difference between the EHIC and the GHIC: The GHIC is not valid in as many countries as the EHIC. British residents won’t be able to use their GHIC in Norway, Iceland, Liechtenstein or Switzerland, as was possible with the EHIC.

For Norway, you can use your UK passport to get medically necessary healthcare during your temporary stay (for example emergency treatment, or to treat a pre-existing condition).

You can apply for a GHIC on the NHS website.

Some categories of people can still get a new UK-issued EHIC

Some categories of people can get a new UK-issued EHIC which is valid for visits to the European Union, Norway, Iceland, Liechtenstein and Switzerland. People who can apply for the new card include:

EU, Norwegian, Icelandic, Liechtenstein or Swiss national, that have been living in the UK since before 1 January 2021
Some British State Pensioners who live in the EU and their families
Frontier workers and their families
UK students studying in the EU

What does the GHIC cover?

The GHIC, like the EHIC, only covers emergency or necessary medical care during your temporary stay in one of the 27 countries of the European Union.

“Necessary healthcare means healthcare which becomes medically necessary during your stay, and you cannot reasonably wait until you’re back in the UK to get it”, explains the NHS website.

This includes things like:

emergency treatment and visits to A&E
treatment for a long-term or pre-existing medical condition
routine medical care for pre-existing conditions that need monitoring
routine maternity care, as long as you’re not going abroad to give birth
oxygen and kidney dialysis

You can only access public healthcare and with the same level of cover as a resident in the country you’re visiting. This means that you can get healthcare at a reduced cost or for free.

What doesn’t the GHIC cover?

Like the EHIC, the GHIC might not be sufficient to cover all costs related to the medical problems that you may encounter abroad. For example, the GHIC doesn’t cover repatriation to your home country.

The GHIC only covers you for unforeseen treatment: if the purpose of your trip is to seek treatment, this would count as planned treatment and the card would not be valid.

The GHIC doesn’t guarantee free health services. You are only guaranteed the same level of access to treatment as the nationals of your host country.

In summary, the GHIC is not an alternative to travel insurance and the NHS website advises that you should also buy travel insurance which includes health cover as “the GHIC does not cover any private medical healthcare such as mountain rescue in ski resorts or being flown back to the UK”.

“If you’re travelling to Switzerland, Norway, Iceland or Liechtenstein, you should get appropriate travel insurance with healthcare cover before you travel. Make sure it covers any pre-existing conditions that were previously covered by your European Health Insurance Card (EHIC)”, explains the UK government website.

Can British expatriates still access healthcare in their country of residence after Brexit?

The EHIC and GHIC are for UK residents travelling to Europe for a short stay. If you are permanently moving to a European country, these cards are not valid and other rules apply regarding access to healthcare in your new country of residence.

If you became a resident in an EU country before Brexit

If, as a British national, you were legally resident in an EU country before 1 January 2021, your rights will be protected by the Withdrawal Agreement.

You will continue to have the same rights to work, study and access public services, including healthcare, and benefits as before the UK left the EU.

If you became a resident in an EU country after 1 January 2021

The automatic right to live and work in the EU has now ceased. If you are looking to move and work in an EU country, you will need to apply in accordance with that country’s existing immigration rules.

Regarding healthcare, in general, if you become a permanent resident in a European country, you will benefit from the same healthcare rights as the local nationals. Check our European country guides for more information on accessing each country’s healthcare system. For those wanting coverage of their private health costs, a private health insurance will be the way forward.

Expat Assure can help you to find the international medical cover best suited to your needs. Feel free to contact us directly or fill in a form online to request your insurance comparison.

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Australia Old

Lisa Expat Assure — Thu, 13 Aug 2020 12:25:57 +0000

Australia

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An expat guide to healthcare and health insurance in Australia

Are you researching an expat health insurance for Australia? It is important to find out about the local healthcare system first.

Whether you are moving to Australia or you are already living there as an expat, read our guide on the Australian healthcare system and your different options of medical insurance for Australia.

Health Statistics

Total Population (2016) : 24,126,000
Gross national income per capita (PPP international $, 2013) : 42,540
Life expectancy at birth m/f (years, /2016): 81/85
Probability of dying between 15 and 60 years m/f (per 1 000 population, 2016): 77/45
Total expenditure on health per capita (Intl $, 2014): 4,357
Total expenditure on health as % of GDP (2014): 9.4

*Data from the WHO

Healthcare in Australia for expats

The Australian healthcare system is of high quality, as is evident from the long life expectancy in this country. The quality of care is good in the private sector as well as in the public sector. There are numerous and easily accessible medical facilities throughout the country. Each city has walk-in clinics where it’s possible to receive treatment without prior appointment.

Medicare

The Australian healthcare system is called Medicare. Australian citizens and permanent residents can enrol in Medicare. Medicare gives free or highly subsidised access to health care facilities. The Australian health system is partly funded by Australian tax payers who pay a “Medicare levy” of 2% of their income.

If you are on a temporary visa, you may be eligible for Medicare too. Click here to find out more.

As an incentive for the population to sign up for a Medicare approved insurance, people can claim a tax rebate every year matching the type of insurance they have.

People who don’t have an appropriate level of cover for hospital care and earn above a certain income (90,000 Australian dollars for single people and $180,000 for couples and families), must pay a Medicare levy surcharge, which equates 1 to 1.5% of their taxable income.

The Medicare levy surcharge is designed to encourage Australians and residents to apply for private health insurance, and reduce the pressure on the Australian public healthcare system.

All info on Medicare and tax can be found here: https://www.ato.gov.au/Individuals/Medicare-levy/Completing-Medicare-and-private-health-insurance-on-your-tax-return/

Medicare does not cover:

– Ambulance services,
– Private patient hospital cost,
– Medical and hospital costs outside Australia,
– Medical and hospital services deemed not necessary, which includes most dental services, glasses, contact lenses and hearing aids and cosmetic surgery,
– Consultations with the doctor of one’s choice.

Around 30% of the Australian population has signed up for a private medical insurance in order to have a wider coverage than that offered by Medicare.

I’m a foreigner: should I sign up for health insurance in Australia?

Your type of visa determines whether you must register or not for compulsory health insurance before entering the Australian territory. You need to check the conditions of your visa. However, even in the situation where you are not obliged to take out insurance, it is still strongly recommended because of the high medical costs in this country.

There are two typical cases:

– If you are a permanent resident, you must register for Medicare. Signing up for a private medical insurance on top is optional.
– If you haven’t been a permanent resident in Australia for the past two years (tourist, student, on a working holiday visa…), you are not eligible for Medicare and you will have to sign up for private medical insurance.

Healthcare agreement between Australia and 11 countries:

People from 11 countries that have a reciprocal healthcare agreement with Australia are entitled to limited subsidised health services in Australia with Medicare. The countries are: New Zealand, the United Kingdom, Ireland, Sweden, the Netherlands, Finland, Italy, Belgium, Malta, Slovenia and Norway. Students from Norway, Finland, Malta and Ireland can’t access Medicare. The access to Medicare is only for medically necessary treatment while visiting Australia and the agreement won’t cover pre-existing conditions or non-urgent treatment.

It’s therefore important to sign up for a private health insurance in order to cover the medical costs that Medicare won’t cover.
On certain types of visa (for example 457 for temporary workers and 485 for students lengthening their stay in Australia), you are obliged to subscribe to a private medical insurance with a certain level of cover decided by the Australian authorities. This health insurance policy can be local or international, but regardless of the type of insurance that you choose, you must make sure it complies with local requirements.

International health insurance for expats in Australia

If you are a permanent resident in Australia you can either register with Medicare or a private health insurance registered with Medicare.

If your private health insurance provider is an overseas provider that is not registered in Australia, you will not be eligible for any tax rebate on your policy, and you may need to pay the Medicare levy surcharge (if you are earning over a certain income and if you don’t have a suitable level of private hospital cover).

However it’s possible to take an international private health insurance on top of your Medicare cover, which allows you to be treated abroad.

An international health insurance for Australian allows you to be treated in the hospital of your choice or with the doctors of your choice, in Australia or abroad. This is often the best option for people preferring to seek treatment in the private sector, whether in Australia, their country of origin or another country.

Expat Assure helps you decide the most appropriate expat health insurance for Australia depending on your situation and needs. Don’t hesitate to contact us for your personalised health insurance comparison.

What is the best health insurance for expats in Australia?

The best health insurance in Australia for one expat might not be the best for you as everyone has different needs and expectations.

In order to find which one is the best health insurance in Australia for you, it is important to consider several aspects such as your medical history, your age, your specific needs in terms of medical cover, your situation in Australia, alongside other parameters.

Expat Assure helps you to find the international medical insurance for Australia that best suits your profile and requirements. Contact us today to request your free and non-obligatory health insurance comparison.

How much does healthcare cost in Australia

If you are not registered with Medicare, you will generally pay:

Consultation with a general practitioner: 40 – 50 Australian dollars

Consultation with a specialist doctor: around 150 Australian dollars

Dental care: oral examination: 40-100 dollars, check-up: 200 – 250 dollars, crown: 1000 – 1900 dollars.

Emergency admission to hospital varies between 230 and 900 dollars. Costs of stay in public hospital rooms can be more than 1000 dollars per day, which doesn’t include treatment.

Practical information

Vaccinations
It is recommended to have an up-to-date vaccination schedule. Vaccinations against Japanese encephalitis may be advised, depending on the conditions of your stay.

Health examination before entering the Australian territory

Before entering the Australian territory, some visitors are required a health examination such as an Aids, Hepatitis B and C screening, and/or a chest X-ray. More information on the Australian immigration website: http://www.border.gov.au/Trav/Visa/Heal/meeting-the-health-requirement/health-examinations

Emergency number

000

Useful links

Medicare: http://www.humanservices.gov.au/customer/dhs/medicare

Healthcare agreement between the UK and 11 other countries: https://www.servicesaustralia.gov.au/individuals/services/medicare/reciprocal-health-care-agreements/when-you-visit-australia

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Coronavirus: Does international private medical insurance cover Covid-19?

Lisa Expat Assure — Mon, 01 Jun 2020 14:19:17 +0000

In the past few weeks, we have had a lot of enquiries from clients and prospective clients asking us if international health insurance would cover them in the event that they contract the coronavirus Covid-19. In a nutshell, the answer is yes. But the situation is a bit more complex. What happens, for example, with the travel restrictions currently in place? Living abroad as an expat in these exceptional times raises a lot of questions around medical cover. We will try to cover them in this post.

Will my international health insurance cover me if I’m diagnosed with coronavirus?

All international health insurance companies Expat Assure has a partnership with cover the costs of treatment for Covid-19 in the same way as they would any other viral infection.

The conditions vary from insurer to insurer and you should read your policy for more details. For example, if you need out-patient care, you’ll need to have out-patient cover included on your policy.

It’s also important to note that you might not be covered depending on your medical history and any exclusions in place on your policy.

Other insurers may have exclusions in place for pandemics which would exclude Covid-19. Whichever health insurance contract you have, it’s important to read their general conditions to see if your plan will cover you for this pandemic and any future ones.

I have Covid-19, but I’m not insured. Can I get health insurance to cover my treatment?

If you are presently infected with Covid-19 and you don’t have any health insurance in place, then you will not be able to purchase a plan that covers your current condition. If you had Covid-19 and are now clear of the virus, the likeliness to be covered for it or have an exclusion will depend on each insurer’s terms and conditions but also on how severely you have suffered from Covid-19. Like with other medical conditions, insurers don’t have a blanket approach and your application will be studied on a case-by-case basis.

Do health insurance plans cover for COVID-19 testing?

First of all, if your expat health insurance policy includes cover for routine screenings, the cost of a Covid-19 test you’ve had may be eligible for reimbursement from this benefit. However, some insurance plans don’t include this benefit. If your policy does not cover routine health screenings, then a Covid-19 test will only be covered by your international health insurance plan if you have symptoms.

Are masks and protective equipment covered by private health insurance plans?

No, private medical insurance plans do not cover costs for items such as gloves, masks and sanitiser.

Can I have a video doctor’s appointment with my international health insurance policy?

As face-to-face consultations are currently not recommended due to the risk of propagating the virus, many international health insurance companies are now reimbursing tele-consultations. However, it is important to note that certain insurers are only covering tele-consultations via an approved mobile app service, so it is important to check your cover in advance.

I live abroad. Am I able to use the evacuation and repatriation benefit if I become ill with coronavirus?

In theory, if you are covered for medical evacuations, this would be arranged if suitable treatment is not available locally. Regarding COVID-19, it could be, for example, a real difficulty in breathing, in a country without well-equipped intensive care units. In practice however, the benefits for evacuation and repatriation might be affected by the international measures put in place to contain the pandemic, such as closure of borders and travel restrictions. Some local governments may also insist on local treatment, within their quarantine framework.

To support their customers during this difficult time, some insurance companies have exceptionally extended their emergency medical cover for their members who are in in a country outside their area of cover and can’t travel due to the pandemic.

Please note that if you’ve travelled to a country against the advice of the Foreign and Commonwealth Office (FCO), you will not be covered for any treatment of Covid-19.

International health insurance companies also don’t cover non-medical evacuations and repatriations for expats who want to go back to their home countries during the pandemic.

Useful links

Here is a list of useful websites for information on the coronavirus outbreak, and information from international expatriate health insurance companies and UK private medical insurance companies.

Lockdown policies map showing the disruptions on global mobility

International Air Transport Association’s information on air traffic restrictions

Coronavirus information from the World Health organisation

Coronavirus guidelines and information from the British government

Specific Covid-19 information from international health insurance companies:

IMG Global

Aetna International COVID-19 extra support for members

Allianz Care

April International Care

UK Private Medical Insurance companies Coronavirus information:

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Work with us

Lisa Expat Assure — Mon, 10 Jun 2019 09:56:20 +0000

There are currently no vacancies available

However, we are always keen to meet enthusiastic and talented professionals who would like to join our team. If you wish to be considered for any future positions, please send your CV and covering letter to contact@expatassure.com or fill in the form below.

About Expat Assure

Expat Assure is an expert in international health insurance, income protection and life insurance.

We are an independent insurance broker based in North London. We work with different insurance companies from around the world in order to offer a wide range of solutions. We are a small family-owned business, with great ambitions and strong ethical values, and always put our clients first.

To learn more about Expat Assure please click here.

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Scotland Old

Lisa Expat Assure — Mon, 27 May 2019 08:21:01 +0000

Scotland

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An expat guide to healthcare and health insurance in Scotland

Are you looking for expat health insurance in Scotland? It is important to learn about the local health system first.

This guide is for people who are moving to Scotland or are already living there as an expat. It explains how the Scottish health system works, your options of expat health insurance in Scotland and gives an overview of average costs of local healthcare.

Health statistics

Total population (2016): 5,4 millions
Gross national income per capita: £ 27,900
Life expectancy at birth m/f (years): 81,2/ 77,1
Total expenditure on health per capita and per year: £2,160

The Scottish healthcare system

The state healthcare system in Scotland is NHS Scotland (National Health Service), the same as in the rest of the UK. The NHS works on the principle of universal medical coverage and permanent residents in the UK are entitled to it. Find out how the NHS works and how to join.

Despite the NHS operating in all four countries of the UK (England, Scotland, Wales and Northern Ireland), it is managed differently in each, and therefore NHS Scotland has some different rules. For example, prescription drugs are completely free, and eye tests and dental check-ups are also free for the entire population. Scotland is the only one out of the four countries to offer domestic personal care and nursing services for over 65s.

The NHS in Scotland has the reputation of being the most efficient compared to its neighbours, and Scotland has been used as an example to be followed by other NHS organisations.

What does NHS Scotland cover?

As in the rest of the UK, access to free healthcare is a fundamental principle of the NHS in Scotland. Free services for all categories of the population via NHS Scotland are:

Appointments with general practitioners and specialists
Stays and care received in hospitals and clinics
Accident and emergency services
Prescription drugs
Eye tests and dental examinations

Services that may require a fee are:

Dental treatments up to £384
Glasses and contact lenses

The paid NHS services are free for certain categories of the population – these include pregnant women, children, full-time students, people over 60, people with low resources or with specific medical conditions. They may also receive vouchers towards optical costs. Travel costs for hospital appointments are subsidised for people with low resources.

The limitations of Scotland’s NHS

Although the NHS in Scotland is seen as an example to follow for the rest of the UK, it is under great financial pressure, as with everywhere in the UK, which can affect the quality and performance of the public health service. One of the most common problems for patients is long waiting times to see a specialist or to receive certain treatments.

More generally, the functioning of the NHS is not always suitable for the expat population. With NHS Scotland:

Patients have the choice of which doctors’ surgery to register with (within the geographical/catchment area it covers), but not necessarily their choice of general practitioner.
The consultation time with the general practitioner is considered too short (the average duration is ten minutes) and in general only one medical problem is treated per consultation.
It is necessary to go through a general practitioner to get referrals to specialists, including gynaecologists or paediatricians. You cannot choose the specialist/consultant. You will usually be treated by the doctor on-duty at the time of your appointment.
Shared wards in public hospitals lack privacy.

For these reasons, many expats in Scotland prefer to top up their NHS coverage with UK or international private health insurance.

Local private health insurance in Scotland

It is possible to take out private medical insurance (PMI) in Scotland to overcome the main disadvantages of the NHS. A PMI is a complementary insurance that often works in conjunction with the NHS, and it is a classic private health insurance which is valid throughout the UK. Some insurance companies may include the Channel Islands and the Isle of Man.

Having a PMI makes it possible to consult a private medical specialist and to access tests or treatment very quickly in the private sector, therefore avoiding the long waiting periods in the public sector (although you still need to be referred by a GP first). A PMI also allows you to be hospitalised in private facilities where the stay will be more comfortable.

This type of insurance, which is often cheaper than expat health insurance, may be suitable for those who are generally satisfied with the NHS but wish to avoid its more major inconveniences, while agreeing to receive treatment only in the United Kingdom.

Many UK companies provide PMI-type health insurance to their employees. However for many expats in Scotland, local health insurance does not always meet their needs:

This type of health insurance does not cover consultations of private GPs, maternity, dental and optical.
In order to consult a private medical specialist (including a paediatrician or a gynaecologist), you must first go through a GP.
Dental and optical costs are not covered. These options can be added separately but reimbursement limits are low.
The monitoring of chronic conditions is not covered (an exception is often made for cancer).
This type of insurance only covers you in the UK.
You may only consult specialist physicians who are members of your insurance company’s network. Therefore, as an expat, if you wish to consult a doctor of your nationality practicing in Scotland, it may be that they are not approved by your insurer and therefore not covered by your policy.

Expat Assure helps you decide the most appropriate expat health insurance for Scotland, depending on your situation and requirements. Don’t hesitate to contact us for your personalised health insurance comparison.

International health insurance for expats in Scotland

Although more expensive than local private health insurance, international health insurance in Scotland is generally the most suitable option for an expat lifestyle. It is not geographically restricted to the UK and you can choose to be covered anywhere in the world (within the coverage area of your insurance policy), unlike local health insurance.

Consultations with private GPs are supported.
Maternity, dental care and optical costs may be included.
You can consult a specialist (paediatrician or gynaecologist etc.) without having to be referred by your NHS or private general practitioner.
Chronic conditions or potentially recurring illnesses are much better covered than with UK PMI policies, and can even be completely covered.

Please note that although IPMI policies offer maternity cover, there are not private maternity facilities in Scotland. Therefore, if you wish to give birth in a private hospital you would need to travel to a different part of the UK, or abroad.

Expat Assure helps you to find the international health insurance for Scotland that best suits your situation and needs. Contact us today to request your free and personalised expat health insurance comparison.

What is the best health insurance for expats in Scotland?

The best health insurance in Scotland for one expat might not be the best for you, as everyone has different needs and expectations.

In order to find which is the best health insurance in Scotland for you, it is important to consider several aspects such as your medical history, age, specific needs in terms of medical cover, situation in Scotland, alongside other parameters.

Expat Assure helps you to find the international medical insurance or UK Private Medical Insurance for Scotland that best suits your situation and requirements. Contact us today to request your free and non-obligatory health insurance comparison.

Overview of medical costs in Scotland

NHS care is free, but below is an overview of the private sector’s medical costs.

Consultation with a general practitioner: prices range depending on the duration, from £100 for a 15-minute consultation, up to £300 for a one-hour consultation.

Consultation with a specialist: cost can range from £100 to £250.

What is the cost of private health insurance in Scotland?

Such as with any type of health insurance, the price of a medical insurance for expats in Scotland varies greatly depending on the personal situation, age and medical history of each individual as well as other parameters.

If you would like an idea of the cost of private health insurance in Scotland, we can prepare a personalised comparison of different international health insurance plans for you. Contact us today for your free expat health insurance comparison.

Useful information

Vaccinations

No specific vaccination is required to enter Scotland, but it is recommended to have an up-to-date vaccination schedule.

Emergency numbers

999 – Medical emergencies (ambulance, police, fire brigade and coastguard)

111 – Medical emergencies less urgent than 999 (24-hour service, call if your situation is not an emergency but you need medical help)

101 – Police (non-emergency)

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8 reasons why you need expat insurance

Lisa Expat Assure — Tue, 12 Mar 2019 10:23:09 +0000

If you become ill or are involved in an accident, what quality of healthcare would you receive in your expat country? Or worse, what if you can’t work due to a disabling illness? And what if you lose your life? Who would provide for your family? Many expats find out about the healthcare system of their expat country only once they experience it… And often wish they had known more about it earlier and subscribed to private expat insurance.

Beyond the convenience, having an expatriate insurance in place is not a luxury; it’s often a necessity for people living abroad.

Here are 8 reasons why private international insurance is so important for expats.

1. Get quality healthcare wherever you live

It can be stressful to experience an unexpected illness or even receive routine medical care, in a country where you are not familiar with the local social security system, and where you do not necessarily speak the language. There are in fact several factors that can make the process of going through treatment difficult for an expat such as the difference in culture, the language barrier or the low quality of healthcare in the expat country. An international medical insurance gives you the guarantee that you will get quality private health care regardless of which country you move to and whatever local healthcare system is in place.

2. An expat insurance is often better than a local health cover

Besides an international medical insurance, you may also consider an expat income protection plan or an expat life insurance. An expat income protection insurance provides you with a replacement income in case of accident or disabling illness that prevents you from working, while an expat life insurance will pay a fixed amount to your dependents should you pass away.

3. An expat insurance is more suited to the expat lifestyle

Depending on the country you are going to live in, there is sometimes the possibility of signing for local insurance plans for health, life insurance and income protection. However local insurance often comes with restrictions, such as a limited network of doctors or healthcare providers you can have access to, or a limited geographic area where you can claim your insurance. Be it with a medical insurance, an income protection plan or a life insurance, the international cover will often be a better option than the local one as it gives you the freedom to be covered worldwide (as long as it’s included in your zone of cover).

If you travel extensively, often move around for work or often move from one country to another, expat insurance plans are the best solution as you will generally remain insured within your zone of cover, and the insurance travels with you.

4. Be covered in your home country as well as in your country of expatriation

Thinking about their health, expats often feel the need to stay connected to their home country, where their family doctor knows their medical history, where they are familiar with the health system and procedures, where they know which consultant they would like to see. However, when moving to a different country you lose your access to the social security system of your home country, as you are no longer a resident or tax payer. Access to healthcare in your home country becomes limited to emergency care and becomes a service you may have to pay for. With an expat medical insurance, you can be covered for medical care in your home country (as long as it’s included in your zone of cover).

5. Keep control of your health costs

Not having an international health insurance cover in place puts you at risk of paying your medical bills out of your own pocket. These costs can quickly become very high.

This is often the case in countries with a two tier health care system: a public health care system which is free but of mediocre quality and a private health care system which is excellent but extremely expensive. For example, in some countries, the cost of one night in a private hospital room can easily be around £800. In case of emergency, an international health insurance policy allows you to be treated in the private sector without having to worry about the financial implications.

6. Get treated faster

In countries where public health care is free, the public institutions are oversubscribed and the waiting lists for certain treatments or specialists are extremely long. This is the case in the UK for example; there is a good quality, free public healthcare system however sometimes the long waiting lists can mean waiting weeks or even months for something as simple as an appointment with a specialist. Health insurance allows you to be treated quickly, in the private sector, and to avoid long waiting lists.

7. Freedom of choice

If your health insurance is a local insurance, your choice will often be restricted to a network of pre-approved doctors and medical centres, or sometimes limited within the city or region where you subscribed to your insurance. An international health insurance offers more flexibility in terms of allowing you your choice of doctor, hospital and the time of your appointment.

8. Be treated by a doctor in your native language

In many countries, to be treated by a doctor speaking your native language you will need to turn towards the international medical centres. These establishments are often expensive and a private health insurance allows you to be treated within these international medical centres whilst enabling you to keep your costs in check.

Why is it important to subscribe to an international health insurance as early as possible?

In order to be sure of benefiting from a comprehensive medical cover, it is advisable to subscribe to your international health insurance before you move to your new country of residence, or to do it soon after your arrival. This is because if you develop a medical condition before you subscribe to an insurance contract it is possible that it will not be covered. Find out more in our article Expat medical insurance and pre-existing conditions.

This advice is also valid for life insurance and income protection, where signing up as early on as possible will guarantee you better yearly premiums.

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Lille in France: a top destination for UK businesses looking at a post-Brexit relocation

Lisa Expat Assure — Thu, 14 Feb 2019 13:35:37 +0000

The prospect of Brexit creates a climate of uncertainty and insecurity for many international businesses based in the UK. Many of them are considering the option of relocating somewhere else in Europe. Lille, a city in northern France, just over the other side of the English Channel appears to be a good location for UK businesses to set up, not only for its strategic geographic position but also for its quality of life.

In this interview, Jean-Baptiste Toursel, CEO of Lille’s Agency, a French government funded business development agency, gives advice to UK-based businesses who are considering a post-Brexit relocation and explains why Lille would be a good option for them.

Old Lille, ©Vincent Lecigne

Expat Assure: A lot of international businesses based in the UK are now considering to relocate elsewhere in light of Brexit. What advice would you give them for a successful relocation? What criteria should they take into account?

Jean-Baptiste Toursel: In this time of great uncertainty and insecurity, companies should focus on what matters most to them, i.e. business! Keeping business at the forefront will reassure them and their stakeholders: shareholders, clients, partners, employees.

But in order to keep business in focus, I believe that companies will have to audit a few components of their activities, and most importantly:

Employees, who and where do they come from? Where to find them tomorrow after Brexit?
Supply chain: Businesses should map and audit their suppliers and logistics partners, in order to ensure the continuity of their activity.
Customs infrastructure. 4.25M trucks cross the Channel each year, companies need to anticipate customs formalities to avoid congestion at the border.

Then, when thinking of a new location to expand their activity, companies and their management team should consider:

Business-minded cities that offer network and business opportunities.
Pool of talent. Talent is key to today’s organisations, and companies should have a close look at cities which offer education, innovation, specific talent available in numbers for their specific operations.
Cost-effective locations. The idea here is not to look for the cheapest options (low tax, low cost of work, low cost of premises, low cost of incorporation), but rather focus on finding a location that will enable your company to get the best balance between cost, fluid operations, and long-term ability to fulfil the company’s vision. Managers too often focus on short-term ROI when opening a new operation abroad. Mid and long-term issues should also be tackled. In 3 or 4 years, will that location still be giving my company new options to expand? Will that location enable me to add new building blocks to my business?

Local support. Local government teams which will take care of all aspects that enable the companies’ core activity : premises, administration processes, recruitment, funding, legal, compliance…
Finally, companies should also look for great places to situate themselves. Lille offers a vibrant cultural scene, affordable housing, nature, sports and great connectivity to enjoy city breaks not only in Brussels, Paris, London of course, but also Rotterdam, Bruges, the Ardennes, the Opale Coast and Le Touquet-Paris-Plage.

Jean-Baptiste Toursel, CEO of Lille’s agency

EA: How can Lille’s Agency help these businesses and what can Lille’s Agency offer them?

J-B T.: Lille’s agency always keeps an eye on what’s ahead. Our economic development agency operates in a 3 steps process:

Help the company understand the market (macro level) and understand its new ecosystem (micro level). We assess our client’s goals and objectives and design a project plan that will comply with them. Usually, our role at that stage is to reassure businesses on the ability of both Lille Metropolitan Area and Lille’s agency and its partners to help tackle the following issues:
- Presence of competitors, i.e. companies of the same sector, having the same value chain,
- Meetings with experts (legal, technical),
- Talent pool: available workforce for their project,
- Cost structure (tax, labour, real estate, utilities, incentives…)
- Legal: what will their presence look like? Direct presence? Joint-venture? Acquisition?
Once the company has defined its plan and schedule, Lille’s agency and its partners will be there to deliver:
- Site selection and all administrative compliance,
- Financial engineering,
- Recruitment,
- Personalised welcome and integration solutions for new employees,
- Publicity and opening events.

Finally, once the company’s site is operational, Lille’s agency will integrate its director/manager to L’ABC, Lille’s agency business club. The club’s mission is to anchor foreign business executives in their new community in the most durable way. Too often, newcomers who open a new site/facility face the sense of isolation: they need support from peers to tackle their daily challenges and make their new operation a success.

EA: What makes Lille a good city for these businesses?

J-B T.: Lille offers of course all the amenities an international city offers, but one thing no other city in Europe has: its strategic position, 35 min from Brussels, an hour from Paris and an hour and 20 min from London or even 45 minutes from beaches!

The area around Lille has a deep European spirit and, being located at the border of Belgium, Lille business ecosystem understands cross-border trade. The Lille region is also the leading French region for foreign investment outside Paris, and 85% of them would recommend their peers to set up their new operation in this area.

Rents are between 1.5 and 4 times less expensive than Brussels, Paris and London, Lille is an interesting and comfortable city to live in. According to the cost of life website numbeo.com, you would need 3,240.48€ per month to live in Lille and have the same level of life than you have in Paris for 4,300.00€. Regarding the quality of life, the offer of a great cultural life in Lille is an important point to consider when you’re moving in: 20 museums, 6 being classified as historical monuments (LaM, The Palais des Beaux-Arts museum which is the France’s second largest art collection after the Louvre, La Piscine.), Lille Opera and Lille National Orchestra for classical music lovers.

Pop, electro and rock music scenes are not to complain either! The Zenith and the Pierre Mauroy stadium host big musical events like festivals and international performers while we can find smaller artists in more intimate places like l’Aeronef or Le Grand Mix.

Regarding sports, Lille organises more than 150 sports events every year and welcomes international sports like the Davis Cup finals in 2018 or the Euro Football cup in 2016.

You can find lots of clubs and associations for every sport at every age. At Lille, we count 200 clubs for 60 sports disciplines. 100,000 practicing, 20,000 licences, and 5,000 volunteers.

Lille Metropolitan has many green spaces within which you can exercise, and makes every effort to promote green practices and a healthy environment. To do so, it provides incentives, and does not hesitate to show ambition such as an application to the 2021 European green capital and lots of urban projects aiming to create more green spaces, parks and gardens for inhabitants.

To go through the metropolis, you can take the tramway, subway or bus as many times as you want for 56€/month. Your “going out” budget won’t be too affected: with 35€ you can eat with your friends in a good restaurant, and pay between 3 and 5€ to have some good local beers in one the many bars of the city!

EA: What about the cost (including all charges) of personnel, offices, taxes and social charges? Is it interesting in Lille for UK businesses?

J-B T.: The Lille Metropolis is less expensive than most of the other French Metropolis for operating costs & premises. Operating costs are averaging 13% lower than our European competitors for all types of business meanwhile payroll is lower than in main competing regions in France. Ranked among the top 3 most attractive regions for business premises costs, prime office space up to 50% less expensive on average compared with our French and European competitors. In 2018, 280,157m² have been placed (sold or rented) in Lille!

On average, Lille is 10% less expensive than its European competitors (Londres, Brussels, Munich, Barcelona…) for operational costs. When you add to this the salaries which are 6% lower than other European cities, and 15% lower than other French regions (20% than Paris), you understand Lille is of course a good location for your business!

Additionally, foreign companies are not often familiar with: the “Fillon reduction” is reduced employer social security contributions for salaries up to 1.6 times the statutory national minimum wage (SMIC).

EA: Are there some industries/types of businesses that would benefit more from being in Lille than elsewhere?

J-B T.: The Lille Metropolis is THE place to be for doing business in retail! Lille is Europe’s Retail Valley where retail giants like La Redoute, Decathlon, Leroy Merlin, Castorama or Auchan were born.

Today with 44,000 jobs and 65€ billion of turnover, the whole value chain is represented in Lille which makes it the strategic point of entry in Continental Europe for every retail buùsiness.

A lot of British and International retailers have operations in the area, should they be returns-logistics-fulfilment centres (Asos, Made.com, Amazon, Decathlon, Vestiaire Collective), HQs and Marketing (JD Sports, Kingfisher-Castorama), Customer Care (Booking.com, AirBnB).

Pioneer for the 3rd and the 4th industrial revolution in France, the Lille Metropolis has also been able, between heritage and modernity, to highlight this historically industrial region) , for a transition from yesterday’s industries to those of tomorrow. With at least 2 competitive clusters dedicated to services industry, the Lille Metropolis is one of the most important French tech flagship cities, which makes it an ideal location for businesses in services industry.

Euratechnologies is definitively the most flourishing tech hub in France, is home to companies in all the major industries of the future: transportation, energy, banking, insurance, big data, cybersecurity, AgTech, digital e-commerce, etc. With over 80,000 m² dedicated to digital industries, “Euratech” provides solutions to start-ups, SMEs and corporates.

Great names such as Cap Gemini, IBM, Tata Communications and rising stars such as Critizr, Sencrop or Pumpkin have located themselves in Lille.

Lille is also a great place for shared services and outsourcing. Lille has all that it takes to open a shared services centre: accessibility, talent pool in core competencies (IT, HR, Procurement, Legal, Customer Care), reasonable cost of labour and premises.

To give you 2 examples of successes in Lille:

Booking.com arrived in Lille in 2011 with the ambition to open a customer care centre of 250 agents, mostly dedicated to French speaking customers. In 2019, they are now 530 people and plan a strong increase to arrive at 850 by 2020. This shared service centre concentrates 27 spoken languages and 42 different nationalities, 100% of them speaking English.
IBM opened in 2014 a client innovation centre in Euratechnologies. 600 IT talents now work in this centre which operates not only for the French market, but for overseas clients. Taking advantage of this great pool, IBM decided to locate its French SOC (Security Operations Centre) here in 2018.

EA: The “gilets jaunes” action has made the headlines in UK news. The reputation of France seems to be affected for businesses wanting to relocate. France, at the moment, does not appear to some people as a land of political and social stability. Can you comment?

J-B T.: According to an Ernst & Young study from June 2018, France remains a privileged and attractive destination to settle its business. “It is considered as a country whose attractiveness is going to increase the most in Europe over the next three years, according to 55% of the foreign business leaders questioned by the consultancy firm, ahead of Germany (45%) and the United Kingdom (30%).” Says the report.

Thanks to those results, Paris passed over London to become the most attractive European city for foreign investments.

The first summit “Choose France” held by President Macron helped raise 3.5 billion investment for France. And as foreign companies represent 2 million jobs in France, and almost 20% of French R&D, the country seems to remain a safe place for businesses.

In that broader landscape, Lille and its region has become in 2017 France’s second region for Foreign Direct Investment, with France’s largest market share for industrial projects (20% of total new jobs in France in 2017).

Reasons for this? 85% of foreign investors in the Region would advise another company to set up a subsidiary here, and over 70% of them view the Lille region labour force as productive and engaged.

No country has stability for granted (Brexit in Britain, Shutdown in the USA, Crisis in Venezuela…). Thus “old” economies like France and Lille offer long term stability.

EA: Most British businessmen do not speak French: is it easy to find bilingual executives and staff in Lille?

J-B T.: With more than 100 000 students and many of them being international, the bilingual talents potential is high. Moreover, with the increasing presence of international companies, Lille has France’s highest rate of exporting companies combined with our great connectivity, can assure you that you will find bilingual employees.

Let me go back to the example of Booking.com and its 530 employees. This Shared Service Centre concentrates 27 spoken languages and 42 different nationalities, 100% of them speaking English.

EA: How easy is it to find English speaking main contacts in law (establishing the company and employment law regulating the company & staff), Tax, Accountancy, office brokers (best advice to find an office)…?

J-B T.: We have a 30 years’ experience of networking: it allows us to connect our clients to preferred contacts. And of course, English speaking contacts in technical and legal procedures are easy to find in Lille, and we would be pleased to introduce them.

EA: How easy is it in Lille to find qualified personnel?

J-B T.: As I said previously, this is how we have worked for 30 years now. According to the company’s needs, we browse our network and interact with our partners to fit the project requirements. Speaking about HR, we work with public and private partners to find the best candidates: we operate targeted publicity operations with them, schools and universities, temp agencies or larger recruitment firms to make sure we fulfil your needs. We helped IBM Global services to develop its activities within the Lille area. This project created more than 600 new jobs.

EA: In conclusion, would you say that Brexit, rather than being an issue, can be seen as an opportunity for these businesses for great development and great partnerships in a city like Lille?

J-B T.: Yes, Brexit must be seen as an opportunity for both parties. For this purpose, in 2017 we signed a City-2-City agreement with London&Partners (our sister organisation in London) to strengthen trade and investment links. Thanks to this relationship we are able to establish a business welcome program to help entrepreneurs to understand where to settle and develop their activity in several markets.

We are also member of the IMRG, UK’s industry association for online retail, and the Franco-British Chamber of Commerce and Industry. One of our priorities is to keep close and strong ties with our neighbour countries. Collaboration and partnership are what we believe in.

Lille and the Hauts-de-France Region work actively on every possible scenario in relation to Brexit working with Air and Borders Police, the French Customs and their UK partners to maintain the fluidity for freight and tourists. This work concerns everybody, and is a priority to protect English and French businesses.

Find out more:

Follow Lille’s new destination brand on Twitter, with the hashtag #hellolille

www.lillesagency.com

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The impact of the recent American healthcare reforms on expats

Lisa Expat Assure — Thu, 17 Jan 2019 12:05:35 +0000

The US healthcare system was vastly overhauled in 2013 with the Patient Protection and Affordable Care Act (ACA), nicknamed ‘Obamacare’ in reference to the previous US president, Barack Obama, who led the reform.

With the arrival of President Donald Trump in power, the American healthcare system has undergone further changes. This article discusses the consequences for expats of the various reforms of the American healthcare system.

What is the Affordable Care Act?

Entered into force on October 1, 2013, the Affordable Care Act is the largest health reform in the United States since the creation in 1965 of Medicare and Medicaid – government programs providing free health insurance to the elderly (Medicare) and those on a low-income (Medicaid).

The reform is based on:

The principle of universal medical coverage
Creating online health insurance marketplaces selling ACA compliant insurance plans
An extension of Medicaid to people with incomes of 138% of the US federal poverty line (FPL)
The guarantee of minimum essential health coverage

By setting up the ACA, the ambition of the former US President Barack Obama was to solve the structural problems of the American healthcare system, including inequalities in access to care and costs which were too high. The aim was to cover the 15% of the American population who had no medical insurance and reduce the cost of health per person for the state.

One of the cornerstones of ACA was the obligation for individuals and employers to take out an ACA compliant health insurance. This included expats resident in the United States (green card or work permit holders).

However, the Trump administration revoked the individual mandate from 2019 onwards. In the majority of the American states, individuals now have the choice whether to take out an ACA compliant insurance or not. Employers with more than 50 employers must still purchase an ACA compliant policy for employees working more than 30 hours a week.

What is an ACA-compliant health insurance?

The ACA more strictly regulates private insurance companies so that they are more favourable to the insured. Previously, many abuses were noted on the part of insurers to the detriment of the health of the insured.

Only insurance companies registered with federal authorities and meeting certain criteria can issue ACA-compliant health insurance policies in the United States. For example, insurance companies are prohibited from refusing to insure an individual, imposing higher fees on people with medical problems, capping expenses, not covering people with pre-existing illnesses and cancelling the policies of people with a serious illness. The ACA also eliminated lifetime limits in healthcare policies relating to essential services.

ACA-compliant insurance policies must provide at least these ten health benefits:

Ambulatory patient services (outpatient care)
Emergency services
Hospitalisation
Maternity and newborn care
Mental health and addiction treatment
Prescription drugs
Rehabilitative and habilitative services
Laboratory services
Chronic disease monitoring, wellness services and preventative medicine
Paediatric services for children, including dental and ophthalmology

As we will explain below, the obligation to hold an ACA compliant health insurance (individual mandate) has been revoked, which reopens the insurance market to insurances companies that don’t necessarily follow the guidelines of the ACA.

The Affordable Care Act under the presidency of Donald Trump

The current American president Donald Trump has always strongly opposed Obamacare. His arrival in power was accompanied by new reforms concerning the ACA.

After a failed attempt to repeal Obamacare, Donald Trump’s administration has recently managed to pass amendments that change the foundations of the system. Firstly, the administration cut promotional funds that encouraged people to subscribe for individual health insurance coverage via an internet portal and with the aid of tax credits.

In December 2017, the obligation for every individual to have health insurance (the individual mandate) was revoked on the federal level. This reform, which came into force in January 2019, only affects Americans (or expats residing in the USA) who are insured individually. If you are an employee in a company of 50 employees or more and you work more than 30 hours a week, your employer must retain an ACA compliant health insurance policy for you or they will be subject to a fine. The majority of the population in the USA is insured through their employers or through a public health scheme, and these have not been affected by this new reform.

This reform, however, was considered a big step backwards for Obamacare. At the time of its adoption, the individual mandate was considered an essential element of the financial equilibrium of the Affordable Care Act.

Universal medical coverage means that ill people are not the only ones to take out health insurance. By ensuring that healthy people are also insured, insurance risks are spread and rates for all can be kept down. Conversely, a larger proportion of insured people with a more complex medical history results in a more costly population to insure, and therefore a general increase in the rates of insurance policies.

In a report dated May 2018, the Congressional Budget Office wrote that an increase in insurance premiums of 15% per annum was expected as a result of the Obamacare reforms, as well as a total of 35 million uninsured people in 2027.

In order to continue to encourage policyholders to keep their insurance, some states have re-introduced the individual mandate in their territory, such as New Jersey, the District of Columbia and Massachusetts as of 2019. Vermont will implement it from 2020. Other states are likely to follow.

What’s changing under Donald Trump for expats?

The removal of the individual mandate also applies to non-US residents. From 2019, if you are not insured by your employer, you are not obliged to take out individual health insurance anymore; except in the states that have restored the individual mandate.

As an expat in the USA, it is therefore important to check if the ACA insurance individual mandate applies in the state where you are going to live. If it doesn’t apply you can choose the health insurance policy of your choice, be it American or international, ACA-compliant or not. If the individual mandate applies in your state where you live, you can either subscribe to an ACA-compliant health insurance policy or decide to choose a non-compliant policy and pay the penalty: this second option is sometimes cheaper than going for an ACA compliant health insurance policy. As an example, here are some prices for an international health insurance for a non-smoker 39 year old woman, not including dental an optical care: the price would be $21,100 per year with an international ACA compliant policy vs $7,600 to $10,000 a year with a non-ACA compliant policy (not including maternity).

What insurance to take out as an expat in the USA?

Generally speaking, an international health insurance is the more suitable option for the expatriate lifestyle compared to a local health insurance. With this type of insurance, if you decide to seek treatment in your country of origin or another country for a particular issue, your medical expenses will be covered. In addition, if you move to another country after the United States, your international health insurance can follow you, unlike with local insurance.

In light of recent reforms and possible future reforms of the American healthcare system, you may also be wondering if you should go for an ACA compliant or non-ACA compliant health insurance policy (regardless of whether the policy is international or local).

As explained above, some expats in the USA, or their employers, prefer to opt for a non-ACA compliant health insurance policy and pay the penalty because this can end up cheaper than taking out an ACA-compliant policy or because the insurance they chose better suits their needs.

So after 2019, will it be wiser to purchase a non-compliant ACA insurance? This will depend on the type of visa you have, the state where you live, your residency status, your needs, your medical history, and also insurance rates in force on the market. This question can only be answered on a case-by-case basis.

The consultants at Expat Assure can help you in your choice of health cover for the USA. Feel free to contact us or request your personalised international health insurance comparison to benefit from our free expert advice.

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Indonesia old

Lisa Expat Assure — Wed, 05 Dec 2018 11:05:31 +0000

Indonesia

REQUEST YOUR INSURANCE COMPARISON

An expat guide to healthcare and health insurance in Indonesia

Are you researching an expat health insurance for Indonesia? First, it is important to find out about the local healthcare system.

Despite a recent reform offering access to healthcare to the entire population, the Indonesian health system struggles with inefficiency and other issues. It is recommended to opt for the private sector, and sometimes even to go abroad for treatment.

Whether you are moving to Indonesia or are already living there as an expat, it is important to have international health insurance in Indonesia that covers your health costs locally and in other countries. Read our guide to the Indonesian healthcare system and your different options of medical insurance for Indonesia.

Health statistics

* Data from the WHO

Total Population (2017): 264 million
Gross national income per capita (PPP international $, 2017): 11,900
Life expectancy at birth m/f (years, 2016): 67/71
Probability of dying between 15 and 60 years m/f (per 1 000 population, 2016): 205/146
Total expenditure on health per capita (Intl $, 2014): 299
Total expenditure on health as % of GDP (2014): 2.9

Healthcare in Indonesia for expats

The Indonesian government undertook a major reform in 2014, with the establishment of the National Social Security Law (Jaminan Kesehatan Nasional or JKN), which provides access to social security coverage for the entire population, including for healthcare, accidents at work, old age and death.

Regarding healthcare, the goal is to cover all Indonesians by 2019, offering access to basic healthcare in public facilities. This new health insurance system in Indonesia also applies to foreigners residing in the country for more than six months.

The limitations of the Indonesian health system

Despite the reform of social security and the ambition to provide medical coverage to the entire population, the Indonesian health system remains largely underfunded, which affects the quality of care provided.

The Indonesian healthcare system is classed as one of the poorest out of the Southeast Asian countries.

There are very few healthcare workers in Indonesia. In its 2016 report, the World Health Organization stated that Indonesia has 15.9 health professionals per 10,000 inhabitants in 2015. By comparison, France has 124.9 health professionals per 10,000 inhabitants. There is also a lack of medical facilities that is mostly felt outside the main tourist centres such as Bali or Jakarta. People living in rural areas have to travel to big cities for treatment. Those who can afford it turn to private medicine (whether in Indonesia or abroad), while the poorest have difficulty accessing primary care.

It is advised by some countries’ foreign ministries that evacuation to nearby Singapore should be considered in the case of a significant health problem, but you will need to ensure that you have evacuation/repatriation insurance.

International health insurance for expats in Indonesia

Due to weaknesses in the Indonesian health system, expats in Indonesia are advised to have private health insurance that allows them to be covered privately, or even abroad if necessary. International health insurance is preferable to local health insurance.

An international health insurance gives you the opportunity to seek treatment in the medical facility of your choice or with the doctor you choose, whether in Indonesia or abroad. Choosing an international insurance with a coverage area beyond Indonesia is the best option for people preferring to seek treatment abroad or in their country of origin in case of a specific medical problem.

Moreover, if after Indonesia you decide to live in another country your expat health insurance can follow you, unlike with an Indonesian health insurance, which is only valid locally.

It is important that your expat health insurance in Indonesia includes repatriation/medical evacuation insurance. This type of assistance covers medical transport costs in the event of an emergency in an area where there is no infrastructure to treat you.

Whatever your choice of expat medical coverage, please note that your international insurance does not exempt you from paying your contributions to the Indonesian health system, if this is mandatory for you.

Expat Assure helps you decide the most appropriate expat health insurance for Indonesia depending on your situation and needs. Don’t hesitate to contact us for your personalised health insurance comparison.

What is the best health insurance for expats in Indonesia?

The best health insurance in Indonesia depends on your specific needs rather than a general criteria, so the best insurance for one expat might not be the best for you.

In order to find which one is the best health insurance in Indonesia for you, it is important to consider several aspects such as your medical history, your age, your specific needs in terms of medical cover, your situation in Indonesia, alongside other criteria.

Expat Assure helps you to find the international medical insurance for Indonesia that best suits your profile and requirements. Contact us today to request your free and non-obligatory health insurance comparison.

How much does healthcare cost in Indonesia?

Consultation with a private doctor: Rates may range from 345,000 to 825,000 Rp (Indonesian Rupiah), equal to around $24-$56 in US dollars (or £18-£44). This depends on the duration of the consultation, the establishment and whether it is a general practitioner or specialist.
Home visits vary from 2 million to 3.6 million Rp ($137-$247 or £107-£193).

Consultation with a private dentist: Rates are between 500,000 and 1.5 million Rp depending on the establishment ($34-$103 or £26-£80).

Rates in international establishments are between 1.7 and 2.8 million Rp ($116-$192 or £90-£150).

The laying of a porcelain crown costs 3.7 million Rp ($254 or £198) on average.

Hospital fees in a private room in a private hospital: Rates are between 750,000 and 1.3 million Rp ($51-$89 or £40-£70) depending on the establishment and whether the room is intensive care. Be aware, this does not include treatments, tests and nursing care. Hospital costs can be much higher depending on the medical condition being treated and the hospital chosen.

How much does health insurance cost in Indonesia?

Such as with any type of health insurance, the price of medical insurance for expats in Indonesia varies greatly depending on the age, medical history, family composition of the applicant and other factors.

If you would like to have a precise estimation of the cost of international health insurance for Indonesia, which applies to your specific situation and needs, we can prepare for you a personalised comparison of different international health insurance plans. Contact us today for your free health insurance comparison.

Practical information

Vaccinations

It is recommended to have an up-to-date vaccination schedule, Vaccinations against Japanese encephalitis, hepatitis B, rabies and typhoid may be advised, depending on the conditions of your stay.

Malaria

Indonesia is a country at risk for malaria. Before departure, consult a doctor or your nearest travel vaccination health advice service centre.
Emergency numbers

Ambulance: 118 or 119

Global Doctor: (21) 723 11 21/24

Police: 110

Firefighters: 113

Useful links

Ministry of Health of Indonesia

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