Although expatriate plans are likely to address most health insurance needs of Americans traveling abroad for extended periods, there may be some drawbacks to buying them, especially if you aren't careful about the company from which you buy.
One potential problem, for instance, is that the plan might not fall under the jurisdiction of your state's insurance regulators. Don't care? You might, if the sight of tulips in Holland causes you to plunge from your bike into a canal and your health plan refuses to pay your medical bills. If the insurer isn't specifically licensed in your home state — many are filed as a group trust in Washington, D.C. — your state insurance regulators won't be able to order it to pay your bills.
In addition, if your expatriate health plan has been issued by an insurer based in the United Kingdom or on other foreign soil, you'll probably have to rely on the insurer's own complaint process to settle your gripe. Some companies, like Lloyd's of London, require you to contact an offshore law office.
In addition to potential claims disputes, you should understand the possible consequences for your federal HIPAA rights before you buy an expatriate plan. HIPAA, the Health Insurance Portability and Accountability Act, grants you certain rights when you switch health insurance plans so that you aren't penalized if you have pre-existing medical conditions.
This could become a concern if you return to the U.S. and join a new group health plan. If your expatriate plan is not considered "creditable coverage" per federal law, you could lose your HIPAA protection and wind up without coverage for your pre-existing medical problems for as long as a year, according to the Centers for Medicare and Medicaid Services, which administers HIPAA.
These are your HIPAA rights under several scenarios:
- If you purchase an expatriate plan from a domestic health insurer, that coverage is considered creditable, and thus you'll preserve your HIPAA rights when you join a new U.S. group health plan.
- If you've purchased your expatriate plan from a foreign insurer, your coverage will not be considered creditable in the U.S. and you'll lose your HIPAA eligibility.
- If you're an American working overseas for a foreign company, and your employer provides group health coverage through a private health insurer, that coverage is considered creditable, even if the insurer isn't domestic.
As with any insurance policy, buying an expatriate health insurance plan requires careful comparison shopping. Make sure you understand which benefits you are getting and which services are excluded. Lying ill or injured on a stretcher in a foreign country is not the time to find out how well your expatriate health insurance plan works.
Back to page 1.
British Citizens:
Canadian Citizens:
