Q: What advice on health insurance can you give to people planning to retire in India? Can we purchase an international health insurance policy for medical services there?
A: The best options for retiree coverage vary greatly depending on the country where you plan to live, the type of coverage you need, whether you are eligible for Medicare and whether you will be a citizen or simply classified as a medical tourist.
India and Malaysia are considered bargain destinations for patients seeking certain procedures, so, depending on your health needs, you may be better off paying out of pocket for health care than paying for a full health insurance policy, said Josef Woodman, author of “Patients Beyond Borders,” a medical tourism guide that is printing an updated edition due out in January.
If you are or will be eligible for Medicare, experts recommend signing up and paying into the system on time to ensure you’ll have coverage if you return. Some people retiring abroad participate in Medicare, pay out of pocket for routine care in their retirement city and carry limited evacuation insurance that can get them back to the U.S. if they have an emergency.
“Most expat insurance is really just for emergency care, so it can be a false sense of security to think you are covered,” Woodman said. “First, think about health care in general in the country you’re choosing, before thinking about insurance. Especially for older folks, having strong diagnostics is really important” and often not available in certain countries or covered in basic policies, he said.
Original Medicare itself generally doesn’t cover non-U.S. care, and even supplemental plans are extremely limited, said Jim Krampen, co-founder of Seven Corners, Inc., in Carmel, Indiana. The company offers health insurance plans predominantly for people who need coverage in multiple countries. Costs vary by age and health status, but a 59-year-old might expect to pay about $3,000 a year for coverage, Krampen said. Costs jump substantially for people in their 60s and 70s, he said.
The average annual premium for international coverage through insurer Cigna Corp. is $4,000, but there is a huge range — from $500 to $20,000 — depending on the type of policy, said Phil Austin, Cigna’s global head of individual private medical insurance.
“Every country is different, so we built a modular approach, and consumers can decide what they need,” Austin said. Beyond a core hospitalization plan, the company offers four modules of coverage that add outpatient services, pharmacy, evacuation and other services, he said.
For expats who only need coverage in one foreign country, such as India, the company has joint ventures in place with local insurers that offer plans there, he said.
“This is definitely one of those areas where one size doesn’t fit all,” Austin said.
As you shop for carriers, look closely at what’s covered, the breadth of the provider network where you’ll potentially need care and whether the country itself has a health care system that’s worth insuring for or whether you should plan to travel home for more routine care and elective procedures.