Switzerland: How International Health Insurance Plans Compare

In international private health insurance there are many different providers with even more different plans. Yet, of the large number of plans, only a few are ultimately worth considering. This article compares the key aspects of some of the best health insurance plans.

For many expats it is advisable to choose a plan that can be continued for life, regardless of their place of residence. Many plans, however, for example of Allianz Worldwide Care, have to be terminated once an expat moves back to their home country. Likewise, some insurers do not insure you if you move your residence to certain countries. ExpaCare plans for instance cease to cover you 90 days after you move to the United States. William Russell, IMG, Exeter Friendly and many other providers have similar provisions in their policy conditions. Gouda International Insurance quite frankly state that they will offer their insurance "for the first years, but not permanently."

There are other aspects which may also prevent you from being insured too long: Many plans may re-calculate your annual premium based on your claims record. Others such as Gouda have provisions to basically decide freely whether they wish to continue to insure you on a yearly basis. In other words, if you really use the insurance because you fall ill and produce high medical bills, your premiums will go up or your insurance may be quite simply terminated. William Russell on the other hand has the interesting provision that as long as you have no claims, your annual premium stays at the level of your age at your date of entry. Only the IHI danmark plans give both lifetime guarantees and also have reasonable premiums in higher age bands, which is another important point: The premiums of some health plans become extremely expensive for higher age bands and effectively price old people out of the insurance. If you are insured under the ExpaCare SpecialCare plan with worldwide cover, for example, you pay US$ 3,155 annually when you are 35 years old, but a hefty US$ 23,450 per year when you are 75 - and more likely to be needing the insurance. The same is true for the comprehensive BUPA Gold Plan where standard premiums vary from US$ 15,275 at age 65 to US$ 23,250 at 80 and above.

While most companies, in particular BUPA, William Russell and IHI danmark, provide very clear and easy to understand policy conditions and benefit guides, there are some insurers which provide general brochures but where it is difficult to find out the details and fine print. In the PPP brochure, for example, it simply says that "details of the benefits and terms of membership will be provided on enrolment".

Also when it comes to cover, not all plans are created equal. There are basically two aspects of cover: area of cover, and extent of cover. The area of cover is relatively clearly defined, and usually you can choose between worldwide cover, worldwide excluding North America, and Europe only. If you are insured with Allianz Worldwide Care, like with many other plans, the otherwise worldwide coverage does not extend to the USA and Canada, where cover is limited to emergency treatment and to temporary stays of max. 6 weeks only. Since some of the world’s best medical facilities are in the USA, it may be sensible to consider a plan that actually pays for treatment there as well. On the other hand, restricting cover can of course bring premiums down. This is a major disadvantage of IHI denmark, where there is simply no geographical choice as all plans are only offered with worldwide cover.

Less clear is the extent of cover. IHI denmark, BUPA, MediCare and HealthCare International for example offer very extensive coverage. HealthCare International is one of the few insurers that covers chronic illnesses and even AIDS. Some insurers cover pre-existing conditions after a waiting period of two years, others such as BUPA or IHI danmark clearly exclude all pre-existing conditions. There are comprehensive plans, like the Global Medical Insurance plan of IMG, and there are modular plans, like IHI danmark’s International Health and Hospital Plan, where in-patient, out-patient and other modules can be selected depending on the individual needs.

Service quality is another interesting aspect. While all queries are answered very efficiently by companies like BUPA, Allianz, IHI danmark and William Russell, others sometimes take their time to respond. The same holds true for claims handling. An interesting claims handling guarantee feature is offered by InterGlobal: they guarantee to settle all eligible out-patient claims within 21 working days and offer to pay a penalty of US$ 15 per day for delays.

Finally, it is also advisable to ask what the situation will be like in ten years' time: will the health plan – and the insurer - still be around? Viator International is one example of a provider that came on the market not so long ago and disappeared again after only two years of operation. It is not very sure how many of the companies that recently entered the international health insurance market will still be there in a few years from now.

What is the ultimate health insurance money can buy? Until this year, one could debate about this, but since IHI danmark came out with their IHI Superior Plan it is clear: it is the ultimate PMI money can buy. It covers absolutely everything, everywhere. However, with annual premiums ranging from US$ 7,400 to US$ 22,000, it is clearly at the very high end of the market also in terms of pricing.

The five best international health insurance providers, assessed against 25 criteria (including financial strength and management of the insurer, history and continuity of service, extent of cover, exclusions, pricing for different age groups, assistance services, international name recognition of the insurer, claims handling, etc.)

1. IHI danmark
2. BUPA International
3. William Russell
4. Allianz Worldwide Care
5. PPP healthcare