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Accessing Healthcare Being an Expat isn't Easy

01/10/2014 10:09 BST | Updated 29/11/2014 10:59 GMT

The world has quite a rosy picture about expats. Inflated salaries, extra benefits and perks, children getting international exposure and different cultures - this could be the life of an expat, right? Not completely.

Though some of it may be true, the actual life of an expat is beyond this. There are grey areas that only expats understand. While one of it may be changing life circumstances, and thus some kind of inconsistency in lifestyle; what worries the expats most these days is the changing health scenario.

Life isn't as predictable and easy as it used to be a few years ago, thanks to some of the changes National Health Service (NHS) has been incorporating into company policies. Add to this the pressure of job assignments they hold overseas, and health surely takes centre stage.

Though expat insurances are designed to cover the financial and other losses incurred by expats when they are living in a country that's not their own, they are often subject to change from time to time, depending on the changes brought into policies by their country of origin. Most common types of insurances purchased by expats include health, automobile, personal liability and short-term travel insurance among many others.

Alison Massey, Marketing and E-commerce Director of Now Health International says "Most expats from the UK travel to three main destinations: Spain for the retiree market, Australia for the long-term move and the UAE for a short-term assignment."

Other than Australia where the public health system rivals that of the UK, there is little to no government assistance for outbound UK expats. Though NHS does recommend using its own agencies for any health cover, expats are often advised to do their own homework on buying policies to cover their individual and families' health concerns during their stay in a foreign country.

In a nutshell, today an expat has many more issues to consider than he/she did previously.

Earlier, the 'expat contract' that would include rent, school fees, extended holidays and a comprehensive life, critical illness and international medical insurance package. But, now it is history. When expats take up assignments overseas these days, the local contracts come with limited holidays, no rent or school fees and very likely reduced insurance coverage.

In the recent times, expat health coverage in the first year of stay in a foreign location is limited to emergency situations and basic walk-in situations into a hospital. Only after a year, even by NHS standards, does a comprehensive health plan kick in covering checkups and follow ups. Most of the times, health is an expat's own lookout.

Though some agencies do help the expat curate a health plan for self and family, the choice is never easy and complete.

Because, very often employers will provide their international employees with a budget to buy health insurance, and it's here that the main issue arises. Massey elaborates on the situation. "Majority of expats buying international health insurance are doing so for the first (and probably only) time. This means that they need additional assistance from their company on the right product to buy. Invariably however, internal company resources rarely stretch to provide this level of information which is why expats need to find reliable sources of independent information to help them make a good decision."

With a limited access to doctors, and complications arising out of keeping separate health plans timed differently, all add to the existing issues an expat and his/her family faces while on a high-stress job.

Agencies like Healthcare International. Cigna Expatplus, Expacare, Clements Worlwide, BUPA, AXA, Allianz Worldwide care, Aetna International - all cater to the growing health needs of expats. They also calculate the premiums according to the countries' ranking as per the medical costs.

An international health insurance plan is drawn based on the age and health condition of an expat. What's tricky here is, if an expat suffers a medical emergency while on a holiday in his own country, the policy works differently. In most cases, the situation even gets more complicated since the reimbursement and meeting of medical expenses in one's own homeland needs a different policy that applies in his country.

For instance, in the recent times, NHS decided it would not bear the cost of an expat's health care that enabled them to access free treatment in neighbouring countries, when they do not qualify through employment. Till late, expats passed on this cost to their homeland treasury in Britain. However, time margin was provided to some policy holders who held special category permission such as Social Security Residual Form S1. But, once it lapses, those living in other EU countries would require to buy a private medical insurance.

The changes that are made to their policies in their nation of birth, may even be out of the purview of an expat, making the health tracking a difficult issue.