When expatriates need care, medical networks offer first-class support
As an expatriate, you could be living anywhere in the world. If you've taken out adequate international private medical insurance protection you can rest easy when it comes to healthcare protection. But the world is a big place. How does one medical insurer ensure they can provide access to care where you are at the moment you need it?
The answer is medical networks.
A medical network is a group of hospitals, healthcare clinics and doctors' surgeries that have been established by an insurer. All medical providers within the network will have an agreement to provide healthcare services to the insurer's policyholders. Medical networks run into the thousands of medical facilities – and for some of the larger insurers, the figure is in the hundreds of thousands.
So what benefits do medical networks bring to you, the expatriate policyholder?
The wider the net the insurer can cast with their network, the greater the chance of their policyholders being able to access the care they need quickly and easily wherever they are. Where this isn't possible the insurer will implement evacuation or repatriation procedures but the easiest solution for all is the right care, locally.
Generally speaking, if you use your insurer's network for treatment, you won't have to worry about paying for the care out of your own pocket and making a claim for reimbursement. Insurers will have a direct settlement agreement with their medical providers where payment will be taken care of without your involvement.
If you choose a facility outside of the network, however, and you'll have to pay for the treatment yourself and submit a claim for the money.
You are free to be treated within a facility outside of your insurer's network. However, you run the risk of being overcharged and your insurer refusing to meet the cost of your care in full. If you can, it's better to use a network facility. That way you won't have to pay (generally) for your treatment up front and there's no risk of being out of pocket.
Insurers will have negotiated favourable rates with in-network facilities. This won't affect you directly but there will be less pressure to increase insurance premiums if all their customers' treatment was administered by in-network facilities.
Standard of Care
Medical facilities within networks are, to a large degree, vetted by the insurer. It's not practical to fully vet all facilities, especially in the larger networks but you can be very confident that the standard of care you'll receive will be of a high standard. Use a facility out of the network and you won't have the backing of your insurer's expert vetting process.
As well as generalist facilities, insurers will have a range of hospitals and clinics that offer specialist care. That way, when you call to ask for advice on accessing care, your insurer will be able to recommend a facility that has the specific expertise and resources that your particular circumstances require. Choose the facility yourself and they may be tempted – for financial reasons - to take on your case even if another facility is better able to treat you.
If you're an expatriate, you don't want to risk your health. Being away from your home country can be a daunting experience, especially for first time expats. You'll want to ensure that you can access medical care quickly and easily. If you are covered by private medical insurance, you'll be free to choose where you access your treatment. Go outside of your insurer's network and the care you receive might be perfectly good. However, choosing an in-network facility can be a more certain process at a time when additional assurance could well be welcome.