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Expatriate Health Plan FAQs
- Who is eligible to buy a premier long-term expatriate plan?
You must meet only one of the requirements below:
All U.S. citizens and U.S. permanent residents living abroad who are 74 or younger at the time of application are eligible to apply for coverage or;
All legal residents of the U.S.(citizens and foreign nationals) who are age 74 or younger at the time of application are eligible if they apply from a state listed below or;
An employee of a U.S. company, whereby the company is domiciled in a state listed below and the company pays the insurance premium.Alabama, Arizona, Arkansas, California, Delaware, District of Columbia, Florida, Hawaii, Illinois, Indiana, Iowa, Kentucky, Michigan, Mississippi, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, West Virginia, Wisconsin, WyomingColorado, Connecticut, Georgia, Idaho, Kansas, Louisiana, Maine, Nevada, Utah, Virginia
If you live in any other U.S state, please contact your agent directly or HTH Worldwide.
- Why would I want this insurance if the country I am going to offers me National Health Insurance?
National or Public Health Insurance can be very different to what most Americans are used to and can be of limited service for mobile citizens. Many public plans offer less in terms of medical services than what is covered under a private plan. In particular, public plans generally only cover you in your host country or region. For an expatriate that travels for business or returns home throughout the year, benefits stop at the border. When covered under a national plan you may not have access to the leading private facilities or specialists. You may experience different treatment protocols or long waiting periods for elective surgeries. It is unlikely you will be covered for medical evacuation benefits under a public health plan. With us you are covered all around the world with comprehensive coverage and access to the best treatment options. If you select one of our plans with the US coverage area, you are free to return home for treatment and to convalesce. You can also keep the coverage for up to 9 months upon repatriation, guaranteeing future insurability. Purchasing plans that are U.S. Admitted, like our Expat policies, offers better benefits, unrivaled networks and a high degree of consumer protection.
- Am I guaranteed to be issued an expatriate policy if I apply?
No, this plan is not a guaranteed issue plan. Each application is medically underwritten. Your application may be 1) accepted, 2) accepted with a rate increase due to your health status, or 3) denied.
- Is the quote I receive binding?
No, the quote you receive is not binding. The quote you receive may not apply if 1) you provided us with an inaccurate zip code, 2) you misstated a material fact on your application, or 3) we increase the rate due to your health status.
- When determining a rate while overseas, what zip code should I use?
Policies for U.S. citizens residing overseas are issued through the Global Citizens Association office in Washington D.C. The zip code that applies is 20036. Please enter "20036" or "0" in the quoting tool if applying online while living overseas.
- How long will the medical underwriting process take?
The underwriting time frame depends on the medical history listed on the application. Turnaround can be as quick as one day or as long as one month. Our commitment is to respond to a submission in writing within 3 - 5 business days. This may mean that we send a request for additional information to the applicant, such as a specific medical questionnaire, or notify the applicant that they erroneously missed a question on the application form. Occasionally we have to obtain medical records from hospitals or providers. Our turnaround time in these situations will depend on how quickly the provider responds to our request.
If we receive the application before the requested effective date, we can honor the effective date even if the approval comes through thereafter.
- Once I'm approved for coverage do I have to go through medical underwriting again?
You do not need to go through medical underwriting when you re-enroll into your current plan design without changes. You may be medically underwritten again if you decide to select different benefits (see below). Plan changes can only be requested at time of re-enrollment.
If a member would like to increase benefits (by lowering the deductible or adding pharmacy coverage) they must complete a new underwriting application. If a member would like to reduce their benefits, they do not need to complete a new underwriting application.
- How do I calculate out of pocket expenses and the annual limit?
Out-of-pocket expenses are defined as the expenses a member incurs when satisfying the plan’s deductible and coinsurance requirements. The deductible and coinsurance level varies based on where treatment is delivered as shown in the illustration below. The total annual out-of-pocket expense limit is calculated by adding the deductible and coinsurance maximum together.
Deductibles must be satisfied before any benefit is paid by the insurer. Note, the plan deductible is waived for office visits with physicians.
Coinsurance is applied as a percentage of the payable medical charges, after the deductible is satisfied. No coinsurance charge applies to care delivered outside the U.S. and covered benefits are insured up to 100%. Coinsurance charges do apply to care delivered in the U.S. at a rate of 20% for in network services and 40% for out of network services. Stated another way, the plan insurer covers services at 80% in network and at 60% out of network in the U.S. Members are protected by the coinsurance maximum shown below, should they incur large medical expenses. The coinsurance maximum is designed to limit a members out of pocket expenses.
In the table illustration below, the most a member would pay out of pocket, assuming all care is delivered out of network in the U.S. is $6,000 ($2,000 deductible and $4,000 coinsurance). The most a member would have to pay out of pocket, assuming all care is delivered in network in the U.S., is $5,000 ($1,000 deductible and $4,000 coinsurance).
Deductible Coinsurance Maximum Outside U.S. U.S.in Network U.S.out of Network 1,000 $500 $1,000 $2,000 $4,000
Out of Pocket Expense Example
An expatriate member is covered under the 1,000 plan and receives services from an in-network hospital in the U.S.
Incurred hospital charges are $80,000. The $1,000 deductible must be satisfied by the member. After the deductible is paid, a 20% coinsurance charge applies to the $79,000 balance. The Member pays the 20% coinsurance amount OR the coinsurance maximum level, whichever is less. In this example, 20% of $79,000 equates to $15,800. The coinsurance maximum of $4,000 is less than $15,800 and would apply in this instance.
Member is responsible for $5,000 in out-of-pocket expenses ($1,000 deductible + $4,000 coinsurance).
- How are the deductible and coinsurance calculated for families?
Deductibles reflected in the plan grid above are per person deductibles. For a family, the maximum deductible and coinsurance are increased by a factor of 2.5., regardless of the size of the family. For example, a family covered under the 500 plan pays a maximum deductible of $1,250, calculated by multiplying $500 (per person) by 2.5. The coinsurance maximum is $7,500, calculated by multiplying the coinsurance maximum of $3,000 (per person) by 2.5. The family's annual out-of-pocket expenses limit is $8,750 ($1,250 + $7,500).
- Will my policy automatically renew? At what rate?
You can enroll in this policy up to age 84. The policy does not automatically renew upon your request. You will be notified of your new plan rate at least 30 days prior to your policy expiration date. You must confirm your new policy rate in writing or by accepting the rate when logged in to our secure website. Plan rates are based on age at time of enrollment and are impacted by medical inflation. You will not be asked any medical questions and your personal health history will not determine your new rate. Long-term expatriate plan rates are standard rates for all re-enrolling members.
- When does my coverage end?
We may terminate your policy if:
- You no longer meet the eligibility requirements
- You fail to pay your premium
- We discover that you committed fraud or misrepresented a material fact
- We terminate the plan in your state or geographic service area
- Will my pre-existing condition be covered under a this plan?
If you were previously covered by a group or individual U.S. health plan that issues you a Certificate of Creditable Coverage, underwriting will apply this prior coverage to the pre-existing conditions waiting period, provided you meet the medical underwriting criteria. We will also consider private health insurance issued in other countries as creditable coverage. There are several reasons why coverage would not be considered creditable: 1) The medical benefits are too low 2) We do not consider surplus lines insurance sold in the U.S. as creditable coverage 3) We do not consider National or Public Health Insurance as creditable coverage 4) There is a time lapse where there was no coverage up until your effective date of your new plan.
The number of months of coverage shown on the Certificate will reduce or eliminate the six month pre-existing condition waiting period. If you have six or more months of creditable coverage, your waiting period will be eliminated. If you have less than six months creditable coverage, your waiting period will be reduced by the number of months you had creditable coverage. For example, if you have two months of creditable coverage, your waiting period will be reduced from six months to four months.
- How do I access participating medical providers outside the U.S. and avoid claim forms?
Our Global Health and Safety services help members identify, access, and pay for quality healthcare all over the world. This includes a contracted community of elite providers in 180 countries. Members can access these carefully selected providers and arrange for the bills to be sent directly to us for payment as follows: go to www.hthtravelinsurance.com and click on "Member Login" then click on "Register Here". After registering, you are able to create a Well Prepared profile and use the related web tool to request an appointment with the participating provider. We will automatically arrange for direct settlement of the bill for this visit. Please note, direct billing may not be available everywhere.
Direct billing can also be requested by calling the assistance telephone number listed on your member ID card, or by emailing email@example.com. Please note that in the U.S. a member can simply show their ID card at time of service and participating providers will only bill the member for any required deductible or co-payment.
A claims instruction page is available online and can be accessed by visiting www.hthtravelinsurance.com and selecting "Contact Us" from the top right navigation bar. Claim forms are downloadable from this section of the site as well.
- I am based in the U.S. Can you help me find participating doctors in my hometown?
The U.S. Network you should use depends upon the state in which you currently reside. Please email firstname.lastname@example.org or call 888-243-2358 for further assistance.
- I am trying to find a doctor in the U.S. in your network, but there is no one listed within 25 miles of where I am searching. What should I do?
In the U.S., if a member does not have a participating physician in an appropriate specialty available to them within 25 miles, we will apply in-network benefits (80%) to the provider they see.
Outside the U.S., 100% coverage always applies after any applicable deductible or co-payment.
- I am a Canadian citizen planning to move to the U.S. Am I eligible for this plan?
In order to be eligible for this plan, you must be a citizen or a resident of the United States. If you are in the U.S., you must reside in an approved state. As a Canadian, once you arrive in the U.S. you can apply for coverage if you reside in an approved state (see above for a list of approved states). To ensure that you meet our medical underwriting standards prior to arrival in the U.S., you may wish to complete a pre-screening form.
- I live in Texas and therefore am not eligible to buy a premier long-term expatriate health plan. When will Texas be an approved state?
It is very difficult to predict state approvals. We are working with state insurance regulators to accelerate the process if possible.
If you are going abroad, you may wish to complete a pre-screening form prior to leaving. You can then apply for coverage using an abbreviated application when you are no longer a resident of Texas.
- I purchased a plan, but would like to cancel my insurance prior to its expiration. Is there an enrollment minimum? Will I have to pay any cancellation fees?
At the time of enrollment, HTH has a 6 month enrollment minimum. However, customers are not locked into a 6 month contract. HTH understands that life plans change, therefore we allow our members to cancel any month they choose with no cancellation fees or penalties. All cancellation requests must come from the insured subscriber and be received by HTH in writing via email, fax, or regular mail. HTH does not refund premium for a partial month. Retroactive cancellations are not permitted.
- Are acts of terrorism covered under this plan?
Yes. This plan does not exclude illnesses or injuries related to terrorism or a terrorist act. In order to be covered in countries where there are open hostilities, such as Iraq and Afghanistan, a member must not be engaged in hostile or combative activities.
- How does the optional pharmacy benefit work?
The optional pharmacy benefit provides coverage inside the U.S. and a higher benefit limit outside the U.S.
We offer members the convenience of a direct billing service inside the U.S. so that the member is only responsible for co-payment at participating pharmacies. Most major pharmacies participate in this program. Outside the U.S., members pay the pharmacy directly and then submit a claim for reimbursement. The optional pharmacy benefit is not subject to the deductible or to the co-insurance on the plan.
- How are medical evacuation decisions made?
The evacuation benefit pays for a medical evacuation to the nearest Hospital, appropriate medical facility or back to the U.S. Transportation must be by the most direct and economical route. All evacuations require written certification by the attending physician that the evacuation is medically necessary.
- How do I qualify for maternity benefits?
After 364 days of continuous coverage, long-term expatriate members are eligible to enroll in a new plan that covers maternity costs in the same way as all other conditions. Members do not need to submit a new health statement.
- What is the Global Citizens Association?
GCA is a not-for-profit association serving those who travel the world for business, study and leisure. GCA promotes health and safety around the world through online knowledge tools and email news alerts. GCA members also benefit from the Association's group purchasing programs for travel, insurance, entertainment and telecommunication services. GCA benefits are available through its Rewards Worldwide program at www.rewardsworldwide.com.
- Does this plan meet the Affordable Care Acts requirement for Minimum Essential Coverage?
This plan does not provide Minimum Essential Coverage and therefore does not meet the requirements of the Affordable Care Act (ACA). It is filed as a limited duration policy designed specifically for international living. Coverage by the insurer can be 1) accepted, 2) accepted with a rate increase, or 3) denied based on the health history of the applicants(s). A waiting period for pre-existing conditions applies unless you have 6 months of prior creditable coverage. There is no tax penalty for purchasing this policy if you are outside the U.S. for 330 days or more in a calendar year.
Visit HTH Affordable Care Act FAQ's for more information.
- Does this plan meet all Schengen Visa requirements?
Yes, HTH plans meet all of the Schengen Visa requirements. If you will be traveling to any of the countries within the Schengen area and depending on your nationality, you may be required to show proof that your insurance plan has certain benefits. HTH can provide you with a Visa letter that you can use as proof to show the consulate that your policy meets all the Schengen visa requirements. The Visa letter contains all the specific wording the consulate is looking for.
The countries within the Schengen area requiring a short-stay visa and proof of insurance include Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France and Monaco, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland. See the most current list of countries within the Schengen area and find out which nationalities require a visa and Schengen travel health insurance.
- Where can I read the fine print?
To see plan definitions, limitations or to review a sample certificate visit: hthtravelinsurance.com/gl_citizen/cert_landing.cfm