Care can look different from one side of the border to the other. What works like a charm one place is suddenly obsolete the moment you cross some imaginary line, and most people only find this out when it is far too late and they are in the midst of an emergency out in the world.
People make many mistakes when they move abroad, but one of the biggest is thinking that their health coverage moves with them. Domestic protections apply to domestic systems, but the moment you change your residence, they no longer apply the way you think they should.
The Coverage Cutoff
What actually happens when someone moves abroad is that their health coverage becomes nearly useless for everyday life. What was once a comprehensive policy will not cover a doctor’s visit when you cross an international border. Some domestic policies have provisions for using your policy in case of emergencies abroad, but not when you make another country your new home.
Emergency provisions are usually heavily capped and conditioned. They are only intended to cover short trips and not those who live abroad full time. The insurer expects you to return home to access healthcare, which is impossible if you live abroad. Even policies that nominally cover you for international emergencies expect you to pay for health services upfront and reclaim them later. This leaves you dealing with foreign currencies and a strange medical billing system when you have already battled to recover after an emergency.
The lack of coverage has implications for different life scenarios. Retired couples who have experienced employer-sponsored protection for years have to find it in a different market. Remote workers need coverage that keeps up with them as they regularly relocate. Families need to figure out pediatric care in an alien health care system. Each requires thinking about coverage in a new way.
Healthcare Systems Around the World
People are often shocked at how different the delivery of health care is across the globe. Some countries have free universal public healthcare systems. Others have private systems that require insurance to cover all costs. Yet others have hybrid systems with a public one and a private one that runs parallel. Knowing what your new home has in store for you allows you to know what you need to look for to be covered.
Publicly funded health care systems across the world do not automatically allow for people who reside in their system, but who are not citizens. Just because you reside legally in the country does not guarantee you access. Most systems have a window where they will not cover or allow you to use the system after you become a resident. Sometimes this window is only a couple of weeks, but it can stretch on for as long as two years. They still need protection before they can access the public system, and if you want protection that covers use outside your domestic system, expat medical insurance fits the bill for people who reside outside of their country of origin.
Private systems in other countries operate at price points that are often significantly lower than people are used to seeing. What might be an expensive procedure in your home country costs peanuts in another country. This does not mean that you do not need protection living abroad. Without it, even inexpensive services become costly if you need to use them.
What Actually Travels with You
Very little travels with you abroad. Your prescriptions and pharmacy relationships do not follow you. Your medical history regarding the drugs you take does not come. Your medical records need to be formatted and translated, and your trusted specialists must be replaced by strangers who do not know your medical history. Getting a prescription filled for a chronic medication needs you to navigate another system with names you are used to hearing one way but have very different names in another country. Pharmacists are not trained to help you with this, and you may have to spend more time than you bargained to get the assistance you need.
Chronic conditions are unique when moving abroad. Many people have to be continuously catered for and cannot experience a lapse in treatment and access to the drugs they need to survive. Making sure that they get the proper treatment at the right time becomes imperative. The wrong coverage can lead to missing this timeline.
You might find yourself asking what happens with mental health services, and thankfully they vary a lot less than physical health services do. Different approaches to therapy and different attitudes in different cultures regarding treatment impact what people will find abroad.
The Paperwork Problem
Moving abroad means dealing with three different sets of paperwork simultaneously. One set is related to your new home’s healthcare system. The second set is also paperwork related to the country you just relocated from, and the last set relates to the coverage you currently enjoy or need to inquire into.
Medical tourism complicates this. Many people who live abroad yet still travel home for major procedures believe that they will still be covered by their old system and that the system will care for them as it has always done. In some instances, it does, but it does not always work this way. Insurers might look at where someone resides rather than where they were born and treat someone who has lived outside of their country for a while one way and someone who moved last week another.
Pre-existing conditions come with their own challenges when someone moves abroad. How different programs handle this varies far and wide. Some allow you to be covered without question, while others impose waiting periods even on private international insurance. Your timing regarding when you buy insurance relative to when you move also makes a difference.
Planning For the Unexpected
Medical emergencies put your coverage to the test in ways that everyday scenarios do not. When you are sick or have an accident abroad, there are many situations where the use of emergency services like ambulances is needed, getting treated in an emergency department, being admitted for treatment in an emergency or even urgent procedures being authorized well before every minute matters.
Getting coverage for some sort of evacuation might not even cross people’s minds until it is too late. If something happens in an area where there are no adequate facilities, getting help might become a matter of life and death. In some instances, medical evacuations to other countries are required, and although emergency insurance often covers this, it is not usually covered by domestic healthcare coverage schemes, and the costs can run up to tens of thousands of dollars for a single flight.
Family configurations pose their own challenges when moving abroad. Coverage for spouses and dependents, partners who might be pregnant, pediatric coverage, and even fathers wanting to move all need consideration.
Making It Work
The only way to manage your health across international borders is to plan ahead of time, before you need to use anything. Familiarizing yourself with the medical system in your new home, exploring options that will protect you and ensuring that you receive adequate protection before setting foot on foreign soil ensures that people will not find themselves in the perilous interim position where they live abroad but have not secured domestic or foreign coverage in time.
Timing is everything when protecting yourself across domestic and foreign borders. Some protections require you to wait to be covered after you make your request, while others can require examinations before you are adequately covered. Some only offer temporary cover, though costly.
Using your medical coverage properly requires familiarizing yourself with what you paid for and not just having something to protect you. Knowing how the exclusion list looks, the policy limits, how deductibles work, and how to claim all prepare you for what to expect before you must face a claim.
Healthcare can be confusing, but getting this right when preparing to live anywhere should be easy. Coverage that adequately protects people should be attainable without it being one more thing on their plate to fumble with after relocating abroad and needing to adjust to a new environment. The coverage people need exists; knowing what one actually needs from coverage before purchasing or researching potential coverage options becomes one less thing to worry about after relocating internationally.
