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Healthcare: 9 questions expats should ask

We all know living abroad brings lots of adventure and excitement, but also raises lots of questions. And when it comes you and your family's health, we often don’t know what questions to ask until an unforeseen event prompts us to look for answers.

Healthcare: 9 questions expats should ask
File photo: Bupa Gobal

Knowing whether you and your family have adequate and appropriate medical coverage isn’t always easy. So, together with our friends at Bupa Global, a respected provider of international private medical insurance, we’ve compiled a few basic questions worth asking about your own medical coverage, whether you’re planning your next move or already living abroad.

The first question is simple: Do you have coverage abroad?

Most domestic health plans are just that – domestic. So when it comes to global healthcare coverage, what do you need to know and what should you consider in a health plan?

For one thing, not all plans are created equal, and even some domestic health insurance might place limits on coverage of chronic or pre-existing conditions. And in today’s highly connected and mobile world, international health insurance isn't just for the traditional expat moving abroad; it’s also for people who want or need coverage regardless of whether they’re in their adopted country or visiting family back in the country they used to call home.

And figuring out the differences between the health system where you grew up and the one where you live now can be a tricky task for even the most seasoned globe trotter.

Of course, finding the right information starts with asking the right questions. So no matter what you’re looking for, here are some questions everyone should think about when considering their healthcare coverage abroad.

How hard is it to get access to a doctor that speaks English?

In many parts of Europe, it’s not too hard to find doctors who have some grasp of English. Embassy websites of English-speaking countries may even keep lists of hospitals with English-speaking staff. Local expat networks or online discussion forums can also provide clues, but it’s hard to know the information is accurate and up to date.

And in an emergency situation, you can never be sure who you might get, and when it comes to complex medical terminology, it is possible that something vital gets lost in translation. But a global health plan from a private provider like Bupa Global gives you access to a team of advisers, doctors and nurses based around the world, who can provide a multilingual service 24/7 – giving you the benefit of their international experience. They can also help you find health facilities nearby with English-speaking medical professionals.

File photo: Antoine Fleury-Gobert/Wikimedia Commons

Do I qualify for a European Health Insurance Card (EHIC)?

The answer to this question may not be as obvious as you might think. According to the EHIC website, the card is available to anyone who is “insured by or covered by a state social security system” in any EU members states as well as Iceland, Liechtenstein, Norway and Switzerland. But even if you’re not a citizen of one of those countries, you may still qualify for a card if you are a legal permanent resident in one of them. Americans living in Aarhus; Brazilians living in Barcelona; and Canadians living in Cannes can all qualify for an EHIC.

FIND OUT MORE: Get a free quote from Bupa Global

An EHIC from one country allows you to access the public health system in any other participating EHIC country. Of course, you might not get reimbursed for everything even if care is authorized. In France you will still pay 20 percent of most hospital treatment. But hey, it’s better than nothing. In Denmark all treatment should be covered IF you obtain a receipt and apply for a refund with the local council before leaving Denmark. Refund rates vary, however, from year to year.

It's also important to remember that the EHIC is not an alternative to travel insurance or global health insurance, as it does not cover any private healthcare or repatriation costs, a return flight to your home country, or anything if you travel for the express purpose of obtaining medical treatment.

In short, having an EHIC does help – a lot – but it’s complicated and has limitations. For example, new rules in the UK mean that Brits living abroad can no longer access medical treatment under normal NHS rules and that their UK-issued EHICs can’t be used to access healthcare abroad either. So make sure to check the rules in advance, both in your home country and your adopted country. Of course, having your own private health insurance plan like one on offer from Bupa Global can make life even easier by giving you worldwide coverage no matter how long you've lived abroad. Click here to find out more and get a quote.

Are there private clinics available that operate outside the tax-payer financed system?

Public healthcare may be free (or highly subsidized) once you’re in the system, but that doesn't mean it’s always the best option, depending on your particular needs. Wait times can be longer than you might expect, the quality of care can vary, as can your ability to choose your own doctor or clinic.

In Spain, for example, you must ask first and ensure they accept the EHIC because some health centres offer both private and state-provided health care. If you don't know the difference and incur private healthcare costs, they are non-refundable.

The situation can be much simpler, however, with an international health plan from a provider like Bupa Global which lets you choose from more than 800,000 medical providers worldwide.

File photo: kristja/www.freeimages.com

Does my employment or legal status affect my access to the public health system?

Generally, yes. Your access to free or subsidized public healthcare depends heavily on your legal status. In Italy expats can pay social security but still not receive benefits until they receive their residency permits – and thus not receive a health card with a local authority. In Sweden, foreign students, tourists, and business people from outside the EU/EEA may not be eligible either, as you only receive free healthcare if you have a permanent personal identity number (personnummer).

Having access to private healthcare like an international plan from Bupa Global means you don’t have to worry about the public health system and local rules.

What if I have a pre-existing condition or need a planned (non-emergency) operation?

Treatment that is necessary abroad due to a pre-existing illness or chronic disease is covered by the EHIC, though you will frequently need to make arrangements in advance. And the EHIC does not cover care that is the sole purpose of a visit – including standard maternity care and giving birth, which may be an issue for expats who want their child to be born in a certain country (although expenses related to premature or unexpected births are covered).

FIND OUT MORE: Get a free quote from Bupa Global

However, Bupa Global has private health insurance plans that can cover the treatment of dozens of pre-existing conditions (subject to certain underwriting conditions), meaning you have one less thing to worry about while living abroad.

Are the rest of my family members (spouse, kids) covered? Will they have access to medical care?

If you are in the EEA zone children will be covered under the same rules for EHIC, but they need to have their own card. You have to apply for your partner and children up to the age of 16 – after age 16 they can apply as a main applicant.

File photo: Alexander Kalina/www.freeimages.com

How much will I have to pay to fill my prescriptions?

The amount that you pay for filling prescriptions varies by country, even with an EHIC (and especially without one). In Italy most prescription medicines are free with an EHIC, while in France you have to pay upfront for prescriptions and only certain prescribed medicines are reimbursable.
Without an EHIC, you are on even more questionable turf. Even as a permanent resident of Sweden you are accountable for the first €235 or so of prescription costs before the state steps in.

These are just some of the questions to consider when living abroad. It’s a lot to think about, and every family needs to think carefully about what circumstances and solutions fit best for them. Luckily, Bupa Global offers a range of international medical insurance options designed to meet the unique needs that come with living life in another country.

Getting a free quote is easy, just click here and fill in the form.

This article was produced by The Local and sponsored by Bupa Global.
 

HEALTH

‘Possible link’ between AstraZeneca vaccine and rare blood clots, EMA concludes

The European Medicines Agency has come to the conclusion that the unusual blood clots suffered by numerous people around Europe should be considered as rare side effects of AstraZeneca's Covid-19 vaccine, but that overall the benefits of the jab outweigh the risk.

'Possible link' between AstraZeneca vaccine and rare blood clots, EMA concludes
Photo by Tiziana FABI / AFP

A statement published online read: “The EMA’s safety committee has concluded today that unusual blood clots with low blood platelets should be listed as very rare side effects of the COVID-19 AstraZeneca vaccine.”

The EMA added however that the benefits of the vaccine outweigh the risks.

While millions of doses of the vaccine developed with Oxford University have been administered, small numbers of people have developed deadly blood clots, which prompted countries including the European Union’s three largest nations – Germany, France and Italy – to temporarily suspend injections pending the EMA investigation.

In March the EMA said the vaccine was “safe and effective” in protecting people against Covid-19 but that it couldn’t rule out a link to blood clots, and that more investigations were needed.

On Wednesday the EMA said the AstraZeneca vaccine should continue to be used for all age groups but that people should be told of the possible rare side effects. The announcement came as the UK’s own drugs regulator said the AZ vaccine should now only be given to over 30s.

The EMA said it was “reminding healthcare professionals and people receiving the vaccine to remain aware of the possibility of very rare cases of blood clots combined with low levels of blood platelets occurring within two weeks of vaccination.”

One plausible explanation for the combination of blood clots and low blood platelets is an immune response, the EMA said but that it had not identified any clear risk factors for causing the clots including age or gender.

So far, most of the cases reported have occurred in women under 60 years of age within two weeks of vaccination. 

The EMA advised that people who have received the vaccine should seek medical assistance immediately if they develop symptoms of this combination of blood clots and low blood platelets.

Symptoms include shortness of breath, chest pain, swelling in legs, abdominal pain, severe headaches, blurred vision and tiny blood spots under the skin at the sight of the injection.

The EMA committee carried out an in-depth review of 62 cases of cerebral venous sinus thrombosis and 24 cases of splanchnic vein thrombosis reported in the EU drug safety database (EudraVigilance) as of 22 March 2021, 18 of which were fatal

The agency concluded: “COVID-19 is associated with a risk of hospitalisation and death. The reported combination of blood clots and low blood platelets is very rare, and the overall benefits of the vaccine in preventing COVID-19 outweigh the risks of side effects.”

Germany, France and Italy have all restarted AstraZeneca vaccines, but in the case of France and Germany with extra guidelines on the age of patients it should be used for. France is currently not administering the AstraZeneca vaccine to under 55s or over 75s.

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