David is a 56-year-old widower who is moving to Italy to retire, following the death of his wife earlier this year. Having witnessed his wife's suffering, he now sees the value of private medical insurance (PMI), and is looking to obtain international PMI for when he moves to the continent. David is in reasonably good health but recently learned from the doctor that he has arthritis in his left ankle. However, he is on sufficient medication to curb the pain. He is also not restricted in terms of budget. What would you recommend for him?
Andrew Wilson, MedibrokerTwo key areas should be considered. Due to David's experience prior to the death of his wife, a plan providing high levels of benefits for managing chronic medical conditions should be considered.
As David has recently been diagnosed with localised arthritis, a solution that has the potential to cover pre-existing conditions (possibly with premium loading) should be discussed in the eventuality of the arthritis spreading or getting worse.
Bearing this in mind, one idea could be the IHI Danmark International Health and Hospital Plan - giving quality benefits, including for new chronic conditions, and is a full medically underwritten plan whereby pre-existing conditions may be covered.
Assuming David is not only looking for hospitalisation and inpatient cover but also outpatient and drugs and appliance cover, first-year premiums could range from £1,420 with a £5,500 annual deductible to £4,542 utilising a nil deductible. Nil deductible means one provider would pay all eligible medical expenses without further contribution from the policyholder. Although this may seem expensive, there is the added benefit that after the age of 60, David would not incur further age-related premium increases - presenting him with potential savings in premium over other plans where premiums would continue to increase with age.
As such, I would also recommend further plan options including chronic coverage, such as Vanbreda International Expatplus Orbit (£2,346 with a nil deductible), GoodHealth Lifestyle (£3,020 with a £65 excess) and ExpaCare ExecutiveCare (£3,243 with a nil excess).
Michelle Ewens, William Russell As David is not restricted on budget, we would recommend that he joins our Global Health Elite Platinum plan, which is a new edition to our plan range this year and has been designed for those who require top-level international cover. Being covered under the Platinum plan would provide David with complete peace of mind wherever he lives or travels.
Should he need medical treatment, he can call our 24-hour emergency helpline and, if necessary, we will arrange an emergency evacuation and settle all bills directly with the hospital concerned. He can select to return to the UK for treatment.
In addition, the Platinum plan provides a wellbeing benefit, which pays towards the cost of regular annual medical check-ups, including a prostate cancer test. At David's time of life, this benefit offers reassurance that any medical problems will be identified and treated early.
Unfortunately, Global Health Plans do not cover David's arthritis in his left ankle, as it is a pre-existing condition. However, the Platinum plan will provide a full refund for consultations, tests and prescribed medication to maintain the stability of any other chronic condition that David may be diagnosed with after joining the plan.
For worldwide cover excluding the US, the Platinum plan would cost David £324 a month with a standard excess of £30. If he preferred a nil excess, this would cost £389 a month, which would mean that he would be fully refunded for any claims that he made. Once he has joined the Global Health Plan, he can continue to renew his plan.
Sarah Jewell, à la carte healthcareInternational private medical insurance (PMI) is a vast and complicated market, and it is important that David takes the time to find the right coverage for him as everybody's circumstances are different.
All products on the market would aim to provide cover for in, day and outpatient treatment but David needs to be sure that he is not paying for elements of cover that he does not need, such as pregnancy, childbirth and cover outside of Europe. Some products within the market are 'off the shelf' and do not allow policyholders to tailor the cover to suit their needs, which is why a modular policy would work well in this situation.
Another important point is that PMI is designed, as is all insurance, to cover unforeseen eventualities and not to pay expenses for conditions that are likely or certain to occur in the future. Although some pre-existing conditions can become covered after a symptom and treatment-free qualifying period, there are others that cannot. Such conditions are classed as chronic, and David has been unfortunate to discover that he has developed a condition of this nature by way of arthritis in his left ankle. A chronic condition is generally defined as something that continues indefinitely and has no known cure, so in this situation he would be excluded for arthritis of the left ankle and conditions directly relating to it.
Cover for David with in, day and outpatient cover starts at around £150 and can include dental cover, routine health checks and a great deal more.
