Their Bottom line; or Your Lifeline?

Whether you’re looking for a comprehensive international health insurance plan for your family or you just want to cover the essentials for yourself, or if you’re a growing business with employees travelling regularly to new markets, or you have expats working around the globe, you are out for quality easy-to-manage health insurance at a clear price.

Even if you’re a small business with all your employees needing medical insurance there are many flexible international health insurance options to choose from.

Health insurance is important in maintaining your health; it isn’t just an issue when you or a family member gets ill. It is also important to your financial situation. You want to make sure that you have the right amount of coverage- not too little or too much.

Consequently the reasons for choosing private healthcare are clear cut, and the benefits obvious. The first reason is getting treatment when you need it, without having to wait in queues or on waiting lists for government supplied treatment. The next benefit is the ability to choose your preferred consultant, possibly someone recommended by your GP or a specialist in the field of treatment required. Along with choosing the location and hospital that suits you best, this provides substantial benefits and peace of mind. Another reason is the simple option of having greater comfort and convenience during your treatment, which can contribute to your health and recovery.

Overall, the security of having private medical insurance is an added bonus. If you believe that these factors are worth paying premiums for, it makes your decision that much easier.

The fact is that private health treatment comes at a price. And that’s precisely the risk you want to mitigate by buying insurance. For you, your family, your people to have the necessary capital available in the event of accident or illness. For that reason you pay a premium in order that usually large sum of money to be there for you if and when you ever need it.

The problem is that premiums often increase at a rate that raises some troubling questions about the practices of certain health insurance providers.

Is it Profits Before People?

Some health care experts claim the real reason why we’ve seen health insurance premiums increase so much is simply due to increasing costs in health care. In the past several years, there have been amazing breakthroughs in the medical and prescription drug fields. Of course, these breakthroughs cost money to develop and implement, now that cost is being spread to insurance premiums. In a way, it’s created a catch-22 in the health industry – we all want the best medical services available, but not everyone can afford to pay the rising cost of health insurance that medical advances require.

However some other experts, those who are good with numbers and spend time digging deeper into the matter come up with some rather alarming findings.

Some leading insurance providers made heavy investment losses during the recession. Similarly, profits are down because many people/companies have given up health insurance due to financial circumstances. It seems that their answer to boosting profits is now to provide more inferior cover to their remaining policy holders.

Still underlying revenues the likes of international insurance go up by over 40%

Some call themselves a not-for-profit business while at the same time boasting “… phenomenal growth. We have grown profits by 30% each year…” as per their own CEOs, whose executive compensation ranges in the $Millions, including bonuses and pension contribution.

Obviously as people grow older their health declines, so premiums generally go up higher than inflation but many people see premium rises which seem to excessive.

One day you are 60 years old and the next day being 61, the annual fee for your healthcare policy goes up by 38%!

Is it their Bottom line Against Your Lifeline?

Recent changes to the referral process have been badly received by some. Instead of doctors making specific referrals they now have to make generic open referrals where the insurer gives a short list of doctors who they will pay for you to see. This often means that the most expensive doctors, usually those who are in demand due to their expertise, are not available to you.

Of course what is covered really depends on your package, and if you want the peace of mind knowing that you’ll be covered for almost anything it’s best to go for the higher package and be willing to accept the premiums that come with this. However should you decide to go for the high premiums which might be worth paying to ensure you’ll actually get the best treatment covered, you deserve top quality, service, value for money. You don’t want to find yourself with some insurer they will try to avoid paying out if they can, or be sent to some of their hospitals which aren’t up to the standards many expect when paying top rates.

That means to say that you, your family and friends, may have to travel further to alternative hospitals, and may not be able to continue your care with your own consultant.

Some alternative hospitals have fewer specialties and facilities and you may not receive an equivalent service with them. Many of these alternative facilities are not close to the patient’s home. Patient choice is the bedrock of private healthcare, but cost-cutting leads to de-listing some top-class hospitals eroding choice and convenience for patients.

Whose health is to be cared for; Yours? or their Balance Sheet’s?

There used to be thousands of the older generation who were so driven into thinking that if they chose a household name insurer they would always be there for them. Not true. Despite the high and ever increasing premiums.

Today people have choices. There are health insurance providers who are customer-centered rather than seeing their customers as profit centers.

There are two main reasons why people in light of recent developments break the decades old “habit” and switch to alternative providers.

  1. Their health insurance premiums rise each year by an amount that massively outstrips inflation. Although they realize that as we age, we become a greater health risk to insure, they feel that the increases go way beyond this.
  2. Their health insurance provider claim that the cost of providing cover is increasing and they need to curb costs.

They try to introduce an “open referral” system. This means that your GP will be unable to refer you to the person he or she thinks has a particular expertise for the condition you are suffering with. Instead, they will only be able to refer in a “generic” style – e.g. to “an orthopedic surgeon”. The insurer will select the consultant or give a limited choice of who you are allowed to see. Undoubtedly, they will provide that choice based largely on economics, except perhaps where they stand to gain by providing both the insurance and the treatment.

In essence, this means that if you need a hip replacement – and the most experienced hip specialist in your area is not on their limited list, you’ll end up seeing someone else…..but who?

In order to gain consultant recognition in recent years, they have made new consultants sign up to a contract where they are unable to charge more than the insurance company tells them they can have. So economically speaking, it will be in the company’s interest to refer you on to a new and somewhat less experienced surgeon or perhaps someone who is more of a generalist rather than one who has particular expertise in hip surgery!

You might consider that this serves the more experienced consultant right for charging more…but here are the shocking facts:

Your household name insurer, like all insurers print a schedule of procedures which details what they are prepared to pay for each procedure. Those limits have not risen since 1991 – yes, that’s a 20+ year pay-freeze. During this time however, inflation has risen as well as overheads such as medical indemnity premiums. Furthermore as per their new schedule of procedures have now downgraded the amounts payable for many procedures. Some limits have been reduced by over 45%.

These reductions will either force more consultants off their books -further limiting choice for patients- or it will leave patients having to part fund their treatment because the insurer reimbursement will be less

Relentless cost-cutting is leading also to complaints by their employees, who are unhappy about working conditions and pay rates. While these perhaps should not be given too much credence – many employees are unhappy with their employers – there are clearly problems with certain health insurance providers’ working practices. With a direct reflection to the quality –or the lack of- of customer service.

Who’s by Your Side? – It all comes down to Who’s by Your Side.

When buying international healthcare insurance a competent Private Medical Insurance Consultant is the one to work with.

The PMI consultant’s role within this enterprise stems from two essential functions: reducing search costs and uncertainty

They reduce the search costs to insurance buyers looking for the right coverage and the right insurer for their risks.

They know the insurance marketplace. They know their clients’ risks; they know the insurers willing to cover those risks; and they know the best way to secure that coverage.

Individual insurance purchasers and companies do not have all the information relevant to the placement of a policy, which makes it difficult to negotiate a fair price and the proper terms and conditions of a policy. Purchasers know the risks in need of coverage, but may not know the financial health of the insurer or the prevailing conditions of the insurance market.

By knowing the insurance marketplace, they solicit and provide information on insurance purchasers and companies, and they make the information more easily understood to both parties to a transaction.

In the interest of long-term client and insurer relations, the PMI Consultant has a strong incentive to ensure that all parties have the information they need so as they are able to enter into a mutually beneficial arrangement.

Insurance purchasers and companies may come to a transaction with unequal bargaining power. A small- or medium-sized insured may come to a transaction with significantly less clout than the large insurer with whom they need to do business. It is the Consultant’s intermediation able to balance the equation by leveraging its business volume with carriers, and thereby obtain better terms and conditions for the client.

Every insurance carrier essentially offers the same promise – to compensate the insured for a loss. To make that promise meaningful, however, the carrier must have the ability to properly understand and evaluate the risk presented and the capacity and financial solvency required to pay any claims that may result from that risk, as well as a reputation that suggests a willingness to make good on that promise.

The intermediary PMI Consultant search the insurance marketplace to find and place coverage for their clients’ risks. They also assist clients in the development of alternative risk transfer mechanisms for risks that otherwise would be impossible – or prohibitively expensive –to insure, and they provide services to both insureds and insurers.

In today’s complex insurance marketplace, however, intermediaries have become more than middlemen between insurance companies and insurance buyers. They bring experience and expertise to the insurance marketplace, using their knowledge of the insurance markets, their familiarity with their clients and clients’ risk, and their access to insurers forged through long-term relationships, to sell and service insurance coverage for costly, and in many cases unique, risks.

Commercial insurance clients are generally professional risk managers. As sophisticated insurance purchasers, they realize that commercial insurance products are not commodities; rather, they are customized risk transfer tools, the price and terms of which are generally negotiated on a case-by-case basis.

Whether travelling frequently or living abroad international health insurance secures peace of mind.

Working together with a qualified PMI Consultant makes peace of mind possible and affordable.

 

 

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