Health Insurance Answers

I raised the question of health insurance in my last post. I have had quite a number of emails and a post from Americans who are either in transition to moving to Ecuador, planning a move to Ecuador, or are investigating a possible move to Ecuador and expressed to me their concern about health insurance. Now, I will share with you what I learned:

First, there was absolutely no response from expats to my post for advice on health insurance, so I will share with you what I learned through my own exploration. The lack of response from expats may have been due to the following reasons: To reiterate from my previous post, I spoke to at least a dozen expat couples and singles while I was in Cuenca last summer about health insurance. I do not recall one of them saying that they carried health insurance. The rationale given was that health care is of a high quality in Cuenca and so inexpensive compared to the states that there is no real need for health care insurance.

My concern for carrying health insurance is primarily to cover for catastrophic casualties, which even can become expensive in the Ecuadorian system. Imagine the cost from a serious accident or from a debilitating stroke, plus the cost involved with rehabilitation as well. The costs soon outweigh the $9,000.00 to $12,000.00 cost of Cobra for single and family plans that are saved by a pay-as-you-go for incurred expenses. No doubt much can be saved from year to year, if one is willing to take the risk. My biggest concern, since I am not eligible yet for Medicare, is being sure that I am covered while I am visiting in the United States.

Each of us have to decide how much risk with which we are willing to live, and whether our retirement income determines whether or not we can also afford to carry a health insurance policy. People living with minimal pensions and social security may have little choice but to pay-as-you-go, and if faced with a major medical catastrophe, may choose to simply file for bankruptcy. For people who have additional assets at risk, if hit with major medicals expenses, they may have greater concern for protecting their assets.

Keep in mind also that even those who qualify for Medicare and are paying into the system, will not be covered outside the United States, unless they are volunteers. You would probably have to delve into the small print to discover what constitutes volunteers. I would assume a volunteer would be someone like a Peace Corp volunteer, not someone like me who is voluntarily relocating to Cuenca. (Sorry, no smiley faces available.) However, Medicare will cover those eligible while they are traveling and visiting in the United States. I mention this because I had one email where the spouse thought he was covered by Medicare once they relocate to Ecuador, and only his younger wife would need health care coverage.

I also mentioned in my previous post that I had read that Ecuadorian health insurance companies may not be reliable in paying on big claims. I had hoped possibly some expats who have Ecuadorian policies might offer their insights on such policies. However, it may be that they have not invested in Ecuadorian insurance policies. Also all the expats I have met or have a nodding acquaintance with from reading their blogs have also been in Cuenca three years or less. I assume the expat community in Cuenca is a relatively new phenomenon, and may still be feeling their way around about insurance. Or if they have international or Ecuadorian policies have not had time to use them to verify their effectiveness and integrity.

Now, to get to what I have learned. I explored two international insurance companies, Bupa and Health Care International Global. Both are large international insurance companies that have been in existence for thirty or more years, and both deal with tens of millions of insured clients world-wide. Both companies are located in Great Britain. Bupa is the older company. Health Care International Global is not publicly-traded, which they claim leads to their profits being reinvested into the company.

Below you will find a comparison of a single policy between the two companies. If I go with either, I will choose Health Care International Global. It provides better coverage at less cost with a much lower deductible. My cost quote is based upon my age and a single cover policy. The company allowed for only a $2,000.00 deduction, and I chose for premium quote purposes a 10% co-pay. Both policies provide me with coverage when I am visiting in the United States. The premium with Health Care International can be canceled in writing fourteen days before it goes into effect. After that, it can’t be canceled or modified until the end of its first year.

Bupa offers more deduction choices without a co-pay, and is about $300.00 cheaper than Health Care International, but that is at a deduction rate of $8,500.00. Also Bupa appears to be more physician and hospital restricted. Health Care will cover any physician, hospital, or clinic that is licensed or accredited by the country in which you are residing or traveling at the time of medical attention. Bupa also disappointed me, because it failed to call me in a follow-up when I responded to an email, and also when I set up a time for appointment on their web page. (Keep in mine, that Great Britain is five hours ahead of us.) Also, when I found the page that was to list the providers in Ecuador, the page was blank except for the Bupa name and company logo. (The International site also directs you to Bupa, Latin America web page, but that site did not provide me with a medical providers list either.) I tried on three different occasions over two days, and always got the same result--no hospitals, clinics, or physicians listed.

Once I am eligible for Medicare, I can drop the international coverage. I can then procure catastrophic coverage for $900.00 to $1,200.00 that covers me regionally or just while I am in Ecuador. There are also short-term inexpensive traveling insurances, which requires greater investigation.

Procuring health insurance is a very personal decision; both companies offer other more expansive plans as well. I cannot sign up for Health Care International until thirty days before I want the policy to go into effect, so I have a little more than two weeks to make a final decision. There are many companies out there dealing with international insurance. Ultimately, each of us will have to do our own research, based upon our needs. I do hope, however, that today’s post provides a starting point for exploration and comparison. If you think you have found better insurance coverage for the dollar in the next two weeks; I’d appreciate it, if you would share with me whatever you have learned.

Health Care International Global
Your quotation for Individual Private Medical Insurance

Thank you for enquiring about cover under the Emergency + Worldwide Including USA, incorporating a claim deductible of US $2,000 with a 10% Co-Payment starting 14 March, 2011. We can confirm that the following premiums will apply for you and your family based on 1 adult aged between 61-65 years:

Plan Type Emergency + Worldwide Including USA Annual Premium US $2,582.51
Claim Deductible US $2,000 Semi Annual Premium N/A
Co-Payment 10% Quarterly Premium N/A
Dental Cover 1 members Monthly Premium N/A
PA Additional Cover US $50,000, 1 members at US $85 each

* The premium may differ slightly, depending on the exchange rates applicable at the time or if you are paying in a different currency to the plan's currency.
HealthCare International Medical Insurance Plans offer some of the most innovative and user friendly plan benefits currently available. By working closely with our underwriters, we have been able to include many benefits as standard that are often excluded by other international programs.

• In-Patient Hospital Treatment Accommodation
• Life-saving Organ Transplants
• Hospital Cash Benefit
• Daycare Surgery Treatment
• Road Ambulance Transportation
• Dread Chronic Diseases
• Emergency Medical Evacuation Medical Repatriation
• Repatriation of Mortal Remains
• Personal Accident Cover

Accidents do happen, so it's important to insure yourself and your family against any eventuality and with our Personal Accident programme, we will provide a cash payment which is yours to use in any way you like. You are automatically covered for US $25,000 as part of the benefits to all the medical plans (benefit not available for those under 18 years of age) with a maximum limit of up to US $125,000 per person.

With the consequences of being ill, particularly in unfamiliar surroundings, often proving to be a distressing experience, each of our plan's have been purposely designed to provide against not only for the financial worries you may often have to face but to meet those experiences associated with specialist treatments often excluded by other international plans.

http://www.healthcareinternational.com/home-international-insurance.php


Bupa Critical Care

Bupa Critical Care is specifically designed to cover major illnesses and injuries, with access to thousands of quality doctors.

Key Benefits

Bupa Critical Care only covers the following illnesses and medical needs (subject to the coverage limits detailed below):
Neurological illnesses, including cerebral vascular accidents $150,000
Cardiac surgery and angioplasty $150,000
Cancer treatment, including chemotherapy, radiotherapy and reconstructive surgery $200,000
Severe trauma (polytrauma) including rehabilitation $150,000
Chronic renal insufficiency (dialysis) $100,000
Severe burns, including reconstructive surgery $300,000
Severe infectious disorders (septicemia) $150,000

Organ Transplant (per insured, per lifetime):
Transplant procedures (per diagnosis, per lifetime) $300,000
Heart $300,000
Heart/Lung $300,000
Lung $250,000
Pancreas $250,000
Pancreas/Kidney $300,000
Kidney $200,000
Liver $200,000
Bone marrow $250,000
Air ambulance (per insured, per year) $25,000

Plans & Premiums for cover starting on 14-Mar-2011

Product name James
Worldwide Medical Insurance
(USD 8,500.00 Deductible) USD 2,231.01
Worldwide Medical Plus
(USD 170.00 Deductible) No Cover
Worldwide Medicines and Equipment
(USD 80.00 Deductible) No Cover
Worldwide Wellbeing
(USD 0.00 Deductible) No Cover
Worldwide Evacuation
(USD 0.00 Deductible) USD 289.00




Annual Total USD 2,520.01




Annual Grand Total : USD 2,520.01

Bupa Plans & Premiums for cover starting on 14-Mar-2011

Product name James
Worldwide Medical Insurance
(USD 8,500.00 Deductible) USD 2,231.01
Worldwide Medical Plus
(USD 170.00 Deductible) No Cover
Worldwide Medicines and Equipment
(USD 80.00 Deductible) No Cover
Worldwide Wellbeing
(USD 0.00 Deductible) No Cover
Worldwide Evacuation
(USD 0.00 Deductible) USD 289.00




Annual Total USD 2,520.01




Annual Grand Total : USD 2,520.01

http://www.bupa-intl.com/