Expatriate Healthcare Insurance: International Private Medical Insurance (iPMI) Vs Local Healthcare Insurance Plans

In this iPMI Global Insights article, iPMI Global CEO Christopher Knight, speaks with leaders from the international private medical insurance (iPMI) market, and asks, why would an expatriate choose an international private medical insurance plan over a local health insurance plan and vice versa.

Ross Walker, Cigna Healthcare: There are a wide variety of reasons someone needs an IPMI product, but most often it’s because they value high quality coverage which moves with them wherever they are in the world.

We are increasingly finding that some customers, which previously might have been more comfortable with a local plan, are choosing IPMI because they value high quality service and portability.

Jeroen Van de Velde, Foyer Global Health: The decision to opt for International Private Medical Insurance (IPMI) over local health insurance solutions is often dictated by the unique circumstances and requirements of the client. While the choice can hinge on various factors, a common thread is the presence of a temporary component and the act of crossing international borders, which introduces specific healthcare needs that local solutions may not adequately address.

Clients typically signal their need for IPMI coverage due to several compelling reasons. For those temporarily relocating to another country, the lack of access to local insurance coverage necessitates an alternative that can provide comprehensive healthcare support internationally. Even when local insurance is available, it may restrict treatments to within the country, prompting individuals who wish to receive medical care in their home country or another preferred location to seek IPMI. This preference can be driven by various factors, such as language barriers, extended waiting times, or perceived differences in the quality of healthcare services.

Moreover, some clients opt for IPMI because it offers service in English or their native language, which local insurance providers may not support. This linguistic alignment ensures ease of communication and understanding, which is critical during health-related discussions and decisions. Others may find that while they have access to local insurance, the scope of coverage does not meet their needs for comprehensive care, leading them to seek the broader protections afforded by IPMI plans.

Apart from individuals crossing borders, there are those who, despite not leaving their main country of residence, find IPMI solutions more aligned with their needs. This includes individuals with residences in multiple locations, those who spend significant time abroad, or even globetrotters who do not fit into a conventional “local” health insurance framework. Their reasons mirror those of cross-border travellers, such as limitations in the quality of local healthcare, long waiting lists, and the desire for more extensive coverage.

For corporate clients, the motivation behind choosing IPMI over local solutions often revolves around the desire to provide a consistent, comprehensive healthcare coverage umbrella for their globally mobile workforce. This uniformity ensures that employees have reliable access to quality healthcare services, irrespective of their location, fostering a sense of security and well-being that supports their professional mobility and productivity.

In summary, the choice of IPMI is largely informed by the clients’ individual situations and preferences. Whether driven by limitations of local healthcare systems, the need for language-specific services, the desire for care in preferred locations, or the requirement for a consistent coverage framework for a global workforce, IPMI offers a tailored, flexible solution that addresses the diverse needs of an international clientele.

Kevin Melton, International Medical Group (IMG): IPMI plans allow portability of cover to various countries, unlike a local health insurance plan. If an expatriate is a digital nomad, global citizen, could be moving to another country on a work assignment, or has family members in other countries, they need an IPMI plan—otherwise they would have to apply for new cover with each move.

IPMI plans tend to have more comprehensive benefits than a domestic provider and typically offer more customization options than local coverage. For example, IMG’s Global Prima plans allow expatriates to choose from five plan options, areas of coverage, multiple excess and currency options and even different underwriting methods to help build the appropriate cover.

Additionally, IPMI providers can better understand the needs of their expatriate clients and provide multilingual support or assistance with navigating the health system of a new country, whereas local providers may not.

A local health insurance plan could be more suitable for an expatriate who plans to stay in one country for an extended period and would prefer a plan specifically tailored to the health care landscape of that country.

Iara Vilches, PassportCard: IPMI plans usually offer expats comprehensive level coverage. Not all local providers would enable comprehensive plans. Therefore, potential clients who relocate from countries with solid medical infrastructure, may find the medical coverage in their target country to be more limited than at home. The international private providers offer a stable level of care no matter where you go. In addition, local providers may enable you with coverage in your target country only. By choosing international private insurance, the worldwide coverage enables you to maintain insurability (insurance continuity) no matter where you travel or relocate to.

In addition, one should take into account that the rules of renewal and pricing can differ between EU-regulated providers and certain local providers. As an example, EU law prohibits price differentiation between men and women, while women in the UAE are likely to pay as high as double the price of men due to potential pregnancy costs. In addition, renewal price increase regulations in the EU are based on “clusters” of clients while the underwriting in the UAE can be as granular as 1 person’s cluster. This imposes a higher risk on the individual’s price stability there.

With that said, one should take into consideration the regulatory requirements and visa requirements of their target countries and review if the international product supports them with that regards as well.

Dr Christopher Percival, iPMI Expert: Richer benefits within specifically designed policies for the expatriate community. Portable requirement for the global business communities with access to mature networks with medical excellence.  

Claire Hargreaves, Trawick International: There are material differences between the two. IPMI products are never designed to replace local mandatory coverage requirements; they are instead there to complement them and ensure a third-country national (TCN) and/or expatriate has access to a portable policy that goes beyond the non-native country within which they reside/work. Interestingly, some +60% of expatriates & TCNs will choose to return to their home country to receive planned elective surgeries. It is important to this customer base they have cover when and they need to access it both locally and at home.

Dan Tuman, Tuman Global Solutions: The definition of an expatriate means you are from another country of which, ostensibly, one day you will permanently return or at the very least, periodically visit. As part of the global workforce, expatriates need to have insurance protection no matter where they are residing at any given time. Local in-country health plans are geared towards local nationals that typically do not travel extensively outside of their home country. Local plan benefits can be limited in both scope and area of coverage, which consequently are inconsistent with expatriate lifestyles. Expatriates require access to private medical facilities with western certified medical physicians. They should have the freedom to choose to be treated anywhere in the world. This includes both voluntary treatment and in the case of emergency, medical evacuation to a suitable overseas facility. If you are an American, your plan should provide coverage in the United States using a preferred provider network like a typical domestic plan. In summary, expatriate plans should be much more comprehensive, have greater access to private clinics, and be managed by a financially strong international insurance company.

Lourdes F. Peters, World of America: An expatriate might purchase an international private health insurance plan instead of a local one for several reasons. First, international plans typically offer broader coverage that can extend to multiple countries, which is especially useful for expats who travel frequently or live in different locations for varying periods of time. Additionally, international plans can provide access to a broader network of healthcare providers, including receiving high-quality healthcare at recognized facilities worldwide.

On the other hand, expatriates who reside in a specific country permanently and want to benefit from a well-established local healthcare system could opt for a local health insurance plan.

Regional health plans may be tailored to the needs and regulations of the country of residence, which could result in lower costs and a better understanding of local healthcare.

In summary, the choice between an international and a local health insurance plan depends on factors such as the expatriate’s mobility, personal preferences, desired level of coverage, and the health system in the country of residence. The possibility of attaining a local plan also depends on the individual’s residency status and short-term vs. long-term status to achieve residency or work-related visa status. Therefore, an international plan is a convenient form of coverage at an affordable price, giving access to benefits locally and internationally.