Expatriate (Expat) insurance . . . start with two key facts:

1. International health insurance tends to look alike . . . until you have a claim!

2. Often, the most significant differences in international health insurance are not in the benefits or rates, but rather in the terms and definitions, the contract wording by which your insurance claims are actually paid . . . or not paid!

Here you will find consumer tips for both long-term and temporary international health insurance plans. Our goal is to help you buy more wisely in about 5 minutes.

6 Tips... Long-Term International Health Insurance

1.  The Wording of "Pre-Existing Condition"  (Why we avoid this "Gotcha!")

This is one of the most important definitions in a long-term health insurance policy.

Virtually all international health insurance plans exclude coverage for "pre-existing conditions." A small difference in the wording of this definition can make a big difference in whether or not your medical insurance claim is actually paid . . . or not paid!

Here are 2 examples for illustration purposes:

Definition #1. Pre-Existing Condition: "Any condition which existed at or prior to the date the policy went into effect."

Definition#2. Pre-Existing Condition: "Any condition which was diagnosed, treated, or manifested itself in such a way as to exhibit recognizable symptoms, prior to the date that the policy went into effect."

Note that in example #1, the wording is broad and ambiguous. In this example, you could have a "pre-existing condition" and not even be aware of it. An example might include any type of heart disease, which often goes undetected for years.

If you happened to have a health insurance policy with the wording in example #1 and came down with a major illness, you could be in trouble. If doctors determined that your illness existed in any form at the time your policy went into effect, even if you didn't have any noticeable symptoms, your claim could be denied.

Note: All long-term international health insurance plans found here contain a more consumer-friendly definition of "pre-existing condition," as per example #2 above (Global Citizen, Global Citizen EXP, Reside PRIME, Reside).

Some popular, widely-offered international health insurance plans are not seen here. These plans contain an ambiguous definition as in example #1. We recommend that you avoid such wording in long-term or "primary" international health insurance.

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2.  Who Regulates Your International Insurance Company? (Very Important)

In the USA, health insurance is primarily regulated by the individual states. If you are a U.S. resident traveling abroad, we strongly recommend that you seek out insurance from companies that are registered (either "admitted" or "approved") to conduct business in your home state.

Here is a brief look at two ways an insurance company might be registered to legally conduct business in your state. (The exact terminology may differ from state to state.)

"Admitted" - The insurance company is fully regulated under your State's insurance laws.

Plans with fully "admitted" insurance companies: Global Citizen, Global Citizen EXP, (plans available in most states, but not all).

"Approved" - The insurance company operates under "surplus lines" insurance laws and is not fully regulated. However, if the state obtains credible evidence of unsatisfactory claims practices or unsatisfactory financial condition, then the state may revoke the "certificate of authority" under which the insurance company legally operates in that state. Such action could influence or encourage similar action in other U.S. states and even in other countries.

Plans with "approved" insurance company: Reside PRIME & Reside (Lloyd's, London, plans available in all states, and worldwide).

Avoid insurance plans with insurers who not legally registered in your State.

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3.  A Recent Routine Physical Is Desirable (Especially for Ages 40+)

The following is not a requirement, but a suggestion based on years of experience.

Having your good health documented prior to becoming insured (or soon thereafter) could be of great value in the event of a significant medical claim later.

This documentation could be in the form of a recent routine physical exam (within one year of your insurance application). Or, it might be the records of one or more visits to a family doctor (for a cold or flu for example), where your doctor would have documented medical information such as height, weight, blood pressure, etc.

Recent documentation of good health is usually not a requirement when you apply for most insurance plans. We make this recommendation because we work for you (see Guarantees). In our experience, claims disputes are not uncommon. In the event of a dispute, having recent documentation of good health can help you greatly.

We strongly recommend this for people age 40+, but having recent documentation of good health (within one year of application) is a good idea for everyone.

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4.  When Comparing Health Insurance Plans, Check The "Exclusions."

One of the first things that experienced insurance agents look for in a health insurance brochure is the summary or list of "exclusions." Often found in smaller print, "exclusions" are not covered under the plan. Sometimes, what's NOT covered can be just as important as what IS covered.

Many exclusions are typical (i.e. acts of war, self-inflicted injuries, custodial care, etc.), while others are not and should be carefully considered when comparing health plans.

All comprehensive international insurance plans contain an exclusion for "pre-existing" medical conditions. You should carefully read and understand this exclusion.

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5.  Lower Your Premium By Electing A Higher Deductible.

The "deductible" is the amount you pay in eligible expenses before your insurance begins to pay. Most plans offer a choice of deductibles, such as $250, $500, $1000, etc. Today, most plan deductibles are cumulative, i.e. one deductible per policy period (up to one year), rather than a separate deductible "per incident."

There are 2 reasons why we normally recommend that you elect a higher deductible.

Reason #1. A higher deducible lowers your premium. For long-term plans on average, the savings often exceed 10% on the next higher deductible option.

Reason #2. In the event of a medical claim, insurance companies often request copies of prior medical records. This is to show that your claim is not the result of, nor related in any way to a "pre-existing" medical condition. In the event of one or two small dollar-amount claims, the need to provide prior medical records may not be worth your time and effort.

Remember, health insurance is primarily for the big expenses. Consider saving money by electing the highest deductible with which you feel comfortable.

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6.  Insurance Application Health Questionnaire . . .

Long-Term medical plans are intended as "primary" medical coverage and are issued based on "medical underwriting" through the use of a detailed health questionnaire.

Personal medical history could be a determining factor when selecting a company to apply for insurance. Based on personal medical history, some people could be declined for insurance by one company, but accepted by a different company.

Note: For the plans found here, if your health questionnaire is answered truthfully and accurately, and you are accepted for coverage, you cannot be cancelled or singled-out for future rate increases due to medical claims.

-- Activate Your Best Memory When Completing The Health Questionnaire.

It is important to remember that by nature, the human mind tends to forget or minimize past or present illness. A positive mental attitude can beneficial in the healing process, but failing to properly disclose a material health condition on your insurance application could jeopardize your coverage entirely.

A "medical audit" (obtaining prior medical records, researching medical information bureaus, etc.) is often done when there is a major claim. The insurance company can revoke coverage and return all premium if it can be shown that the policyholder failed to disclose a material condition on the application.

-- For Any "Yes" Answer on Your Health Questionnaire, Note The Positives!

Your completed health questionnaire becomes a part of your insurance contract, so it is important to be complete and truthful when answering all questions. When applicable, be sure to state the positives when giving an explanation to any "yes" answer.

For every "yes" answer on your health questionnaire, be sure to give a clear and complete explanation.

If you have a condition that is well controlled by medication, give complete details. For example: high blood pressure, take 10mg (medication) daily, well controlled, take own BP readings, last reading 120/80 (and date). If a previous medical outcome was good, say so in writing. For example, when accurate, add descriptive terms such as "full recovery," "no further symptoms," and "no further treatment or consultation."

Your questions are encouraged. Quality health insurance is never cheap. You owe it to yourself to be sure you are getting what you expect. Email.

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International Health Insurance for virtually all Expatriate Insurance Needs.

6 Tips... Temporary International Health Insurance

1.  Coverage Period

This is a seemingly obvious definition, but we start with this term as it is used in other definitions here.

If a medical condition is first diagnosed or treated during the "Coverage Period," then eligible insurance benefits will be paid (subject to policy limits).

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2.  Benefit Period (very important)

The "Benefit Period" is not the same as the "Coverage Period." The "Benefit Period" is the maximum period of time during which an insurance policy will pay benefits for a covered medical condition that was first diagnosed or treated during the "Coverage Period."

The "Benefit Period" may extend beyond the end of the "Coverage Period" (and often does). In many cases, a longer insurance Benefit Period is desirable.

Most Temporary health plans have a "benefit period" of "up to 6 months." The Diplomat Plans have a Benefit Period of "52 weeks" (to our knowledge, the best in the industry). If temporary insurance will be your "primary" health insurance, then an extended Benefit Period becomes a key feature to consider.

Note: There are many temporary health insurance plans sold today where the Benefit Period ends when the Coverage Period ends. This is OK if you have coverage upon return to your Home Country. Otherwise, if your plan has no extended Benefit Period, then the last few days or weeks of your coverage could prove to be of limited value.

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3.  Coverage for "Pre-Existing Conditions"

All private health insurance plans contain "exclusions," which are conditions, circumstances, or treatments which are expressly not covered. One common exclusion is for "pre-existing conditions. "The definition of "pre-existing condition" varies by plan.

The wording of the definition of "pre-existing condition" and possible coverage (if any) are important factors to consider in temporary international health insurance plans.

A Comparison of Coverage for Pre-Existing Conditions:

Diplomat Plans - No coverage for medical "pre-existing conditions." However, emergency medical evacuation (up to $300,000) is a separate benefit and is not subject to the "pre-existing" exclusion for medical benefits.

Liaison Majestic - For U.S. citizens traveling outside the USA or Canada, this plan will pay up to $20,000 for the sudden and unexpected reoccurrence of a "pre-existing condition," (to $2500 for persons age 65 or over). Also, emergency medical evacuation (up to $300,000) is a separate benefit and is not subject to the "pre-existing" exclusion for medical benefits (see plan literature for details).

**New for Liaison Majestic (only) - For U.S. citizens under age 65, traveling outside the USA or Canada, pre-existing conditions are covered to the policy limit if you have a "primary" health plan in place in the USA.

Liaison International - For U.S. citizens traveling outside the USA or Canada, this plan will pay up to $20,000 for the sudden and unexpected reoccurrence of a "pre-existing condition," (to $2500 for persons age 65 or over).

Atlas Travel Plan - If you are under age 70, you are covered for an Acute Onset of a Pre-existing Condition, up to $15,000 Maximum for Eligible Medical Expenses and up to $25,000 for Emergency Medical Evacuation (see plan literature for details).

TravelGap Excursion - Fully covered. You must have "primary" coverage in the USA to be eligible.

Note: The above exceptions for coverage of "pre-existing conditions" do not apply to known, scheduled or expected treatments, procedures, or medication. The summaries above are subject to change without notice. Verify all information in plan literature.

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4.  Do You Want The Option Of Home Country Treatment?

On occasion, someone traveling abroad suffers an injury or illness, whereby they wish to return to their home country (including to the USA) for follow-up treatment and recuperation.

If you maintain domestic health coverage during your travel abroad, then this plan feature may not be of importance to you. However, if temporary or short-term international health insurance will be your only health insurance, then how a policy treats "Home Country Treatment" can be a very important consideration.

A Comparison of Plan Options for Home Country Treatment:

Diplomat Plans - Up to $5000 in "follow me home" Home Country treatment included with optional Home Country "rider," which provides coverage for incidental short-term trips back to your Home Country. See brochure for details.

Liaison Majestic - This plan shall pay for Covered Expenses incurred in your Home Country up to $5,000 maximum, for conditions first diagnosed or treated while traveling outside of your Home Country. (This $5000 limit does not apply to Emergency Evacuation or Repatriation benefits.)

Atlas Travel Plan - Contains no exclusion for travel for treatment. Therefore, follow-up treatment for a covered condition first diagnosed or treated outside of your Home Country, will continue to be covered for the remainder of the Benefit Period, anywhere you wish, including the USA. (Your insurance policy terminates upon return to the USA for treatment, but the Benefit Period doesn't.)

TravelGap Excursion - None. You must have "primary" coverage in the USA to be eligible.

Note: "Home Country Treatment" is NOT the same as "Home Country Coverage," which is an optional or built-in benefit on many temporary international plans. "Home Country Coverage" provides limited medical coverage during one or more short-term trips back home.

In Summary:

* If you are outside the USA and you will NOT have health coverage upon return to the USA, consider Atlas Travel Plan.

* If you are traveling outside the USA and you will have health coverage upon return to the USA, consider Liaison Majestic, or TravelGap Excursion, or Diplomat Plans (without Home Country option).

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5.  Who Regulates Your International Insurance Company? (very important)

In the USA, health insurance is primarily regulated by the individual states. We recommend that you seek out insurance from companies that are registered (either "admitted" or "approved") to legally conduct business in your home state.

Here is a brief look at two ways an insurance company might be registered to conduct business in your home state. (The exact terminology may differ from state to state.)

"Admitted" - The insurance company is fully regulated under your State's "life and health" insurance laws.

"Approved" - The insurance company operates under "surplus lines" insurance laws and is not fully regulated. However, if the State obtains credible evidence of unsatisfactory claims practices or unsatisfactory financial condition, then the State may revoke the "certificate of authority" under which the insurance company legally operates in that State. Such action could influence or encourage similar action in other U.S. States and even in other countries.

All plans found here are backed by insurance companies which are either "admitted" (various US-based insurance companies) or "approved" in all states. (The insurance syndicate of Lloyds, operating as Lloyds of London, Certain Underwriters at Lloyds, etc., is "admitted" in KY and "approved" in all other states and DC.)

Diplomat Plans - insurance company is fully regulated ("admitted") in most states.

Liaison Majestic - insurance company is fully regulated ("admitted") in most states.

Atlas Travel Plan - insured by Lloyd's, London, "admitted" in KY and "approved" in all other states.

TravelGap Excursion - insurance company (varies by state) is fully regulated ("admitted") in all states where available.

For U.S. expatriates, we only recommend international health insurance backed by insurers who are registered, either "admitted" or "approved," in your home state.

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6.  Lower Your Premium By Electing A Higher Deductible.

The "deductible" is the amount you pay in eligible expenses before your insurance begins to pay. Most plans offer a choice of deductibles, such as $250, $500, $1000, etc. Today, most plan deductibles are cumulative, i.e. one deductible per policy period (up to one year), rather than a separate deductible "per incident." 

Here are 2 reasons why we normally recommend that you elect a higher deductible.

Reason #1. A higher deducible lowers your premium. For temporary plans, you save on average about 10% with the next higher deductible option.

Reason #2. In the event of a medical claim, insurance companies often request copies of prior medical records. This is to show that your claim is not the result of, nor related in any way to a "pre-existing" medical condition. In the event of a small claim, the need to provide prior medical records may not be worth your time and effort.

Remember that insurance is primarily for the big expenses, to keep you from going broke or possibly to save your life. We urge our expatriate clients to consider saving money by electing the highest deductible with which you feel comfortable.

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International Health Insurance for virtually all Expatriate Insurance Needs.