Whether some form of Brexit occurs or not, Canadian business travellers and expatriates heading abroad will need to monitor changes to visa rules and health insurance requirements when planning trips to the UK or the remaining countries of the European Union.
Unlike Canada’s single-payer healthcare system, by which provincial governments mandate the services to be provided, set the fees for those services, pay the providers, and forbid private entities from competing, most European systems allow—even encourage—a variable blending of public and privately funded health insurance.
The UK, for example, offers access to its highly respected National Health Service to expatriates who meet certain residency requirements, but many prefer to “upgrade” to private plans that fill in coverage gaps, shorten wait times for referrals and certain services, and allow access to private hospitals and specialist networks. (As members of the EU, UK residents have access to the European Health Insurance Card [EHIC] that allows reciprocal coverage for health services provided in other EU countries, but the range of these services is limited and many non-EU expats choose to go private for more comprehensive and quicker coverage.)
In many other countries, among them Germany, France, and the Netherlands, foreign nationals from non-EU countries are required to either join their state-sponsored public health systems as a condition of receiving visas to work and live in the country, or they must sign up with private insurers (some drawn from a list of approved insurance companies). Though these state-sponsored plans are highly rated for their quality of service, private insurance plans offer an additional layer of benefits and more flexibility for expat lifestyles and needs.
Whether the expat’s host country specifically requires health insurance as a condition of residency or just strongly “advises it” is academic, as Canadian provincial insurance expires several months after the expat leaves his or her province—and even if it didn’t, its benefits are virtually valueless abroad as they cover only a minuscule share of any foreign hospital charges.
B.C., for example, pays foreign hospitals only up to CAD$75 per day for services provided to its residents abroad (OHIP pays up to $400), while foreign visitors to Toronto, Calgary, or Winnipeg may well be charged up to $5,000 a day for their emergency hospital care—more in intensive care. And make no mistake, healthcare in the EU, especially in its major cities, is expensive. It has to be, to pay for the high quality of services.
Consequently, Canadian expats posted abroad have several key priorities when seeking health coverage in their new location, the first of which is to seek out a Canadian broker or insurer with experience and access to a broad range of plan options, provider networks, and the flexibility to coordinate these into an affordable benefits package while still conforming to the specific and varying requirements of the host country’s healthcare service.
Brokers need to help clients satisfy their key concerns:
- Will enrollment in a publicly funded state plan meet the expat’s needs, or would a higher-grade private plan which may provide quicker referrals and a broader range of providers and benefits be the better choice?
- Will the plan allow coverage for travel to other countries, or occasional trips “home” where the expat’s eligibility for benefits may have expired?
- Will the benefits cover preventive care, maternity services, dental care, air ambulance repatriations, sports-related mishaps, medications, services of ancillary providers, or co-payments required by hospitals or specialists?
- Will the benefits be compatible with and acceptable to the host country’s residency requirements?
- Will the expat be able to reintegrate with his or her provincial health plan immediately on returning home after the foreign assignment is completed, or will a mandatory waiting period require further supplementary coverage from their expatriate insurance plan? (Some, but not all provinces impose a three-month waiting period before coverage can be reinstated.)
- And what about the cost?
With some nine per cent of the Canadian population living and/or working abroad at any given time (according to the Canadian Expat Association), and with foreign governments frequently recalibrating their healthcare systems and residency requirements, selecting the most appropriate healthcare insurance coverage at an acceptable cost is a job best left to professionals who know the territory.
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