Let’s talk food in Dubai!

Food in Dubai

As we have entered July, many of us have been fasting for the past many weeks. There are numerous potential health benefits of fasting, including weight loss, lowered cholesterol, and lower blood pressure, but let’s face it, people are looking forward to getting back to their normal eating schedules. Are the residents of Dubai choosing healthy options, though? How are the foods that we most commonly enjoy in the Emirates affecting people here? Here, UAE Medical Insurance’s partner Pacific Prime attempts to answer these questions by examining available information about health and food in Dubai.

Dubai’s health situation

As with many other countries in the developed world, the UAE, and thereby Dubai, has been seeing increased incidence of so-called ‘lifestyle diseases’. In fact, some of the statistics related to the health of Dubai are quite striking. For instance, 66% of men and 60% of women in the Emirate are considered to be obese or overweight, and these kinds of figures can be seen across all age groups. This can be seen easily in children in the UAE in general, where a larger portion of children are obese than is seen in the United States, and, furthermore, UAE children have been found to have cholesterol levels consistent with those commonly seen in 60-year-old men. Here are some more points about the current level of health in the UAE:

  • 1 out of every 5 people in the UAE is diabetic.
  • The average age of heart attack patients at Dubai’s Rashid Hospital is 20 years younger than the worldwide average.
  • More than 40 percent of adults in the UAE between 35 and 70 years of age suffer from hypertension (high blood pressure).
  • The most common health complaint in the UAE is cardiovascular disease, both in expats and locals alike.
  • Non-communicable diseases are now responsible for over 60 percent of all mortalities in GCC countries, which includes the UAE.

As you can tell from these facts and figures, diseases of affluence have unsurprisingly become a major issue in Dubai, as well as the rest of the UAE. To counter these trends, it would be prudent to focus on a few main points: weight gain, heart disease and diabetes. Here are some of the popular local dishes you can find around Dubai, and some you might want to avoid over indulging in.

Food in Dubai

What are the dishes that Dubai is known for?

On the relatively healthy side of things, there are many great vegetarian dishes enjoyed widely in Dubai. These include staples like Falafel, Hummus, Kousa Mahshi and Tabbouleh. These foods mostly contain heart-healthy fats, dietary fiber and a smattering of vitamins that will provide good fuel for your body while not causing you to gain weight when eaten in moderation.

One of the main ingredients in the foods we eat leading to weight gain, and, thereby, other health problems, is sugar. If not burned immediately for energy, this sweet substance will be stored as fat in our bodies. This is why some of our favorite delectable Dubai dishes should be eaten very sparingly. These include desserts like Luqaimat, Khanfaroosh, Knafeh, Esh Asarya and Mehalabiya, or breakfast dishes like Khabees. Even something seemingly healthy and natural like Dates can have a serious amount of sugar hidden within.

Moving from simple to complex carbohydrates, the array of delicious bread to be found in Dubai will tantalize even the most veteran of savory food lovers. While often good sources of fiber, the carbs in bread often spike insulin, which promotes converting energy into glucose within your body, which will then be stored as fat. This includes the bread and wheat found in dishes like Shawarma, Al Harees, Manousheh, Fatteh, Kellaj, Lahem Bl Ajin and Tabbon Bread.

Finally, we have meat-focused dishes like Ghuzi, Al Machbous, Mixed Grill, Chelo Kebab, Stuffed Camel and more. While lean protein is generally good for you (and great for those who work out regularly), it’s still important to look at what else is on the plate. Watch out for sugary sauces and starchy side dishes that often go overlooked when placing your order.

Keeping healthy

Clearly, the flavors of Dubai are both rich and varied, and now you hopefully have an idea of which dishes you can enjoy on special occasions, and which you can regularly to maintain a healthy diet. In addition, it’s not always about what you are eating as it is how much of it you eat. Keeping track of your daily calories and managing your portions will go a long way to ensuring that your waistband isn’t expanding in perpetuity.

Coincidentally, the end of Ramadan this year also signals the beginning of the Dubai Health Authorities healthcare reform that now requires every single individual in the Emirate to be covered by a private health insurance plan, and for good reason. While preventive care and healthy living should be the focus for all of us in the UAE, there inevitably comes a time in the life of some when diseases like those mentioned previously in this article will catch up. This is when it will be imperative to have a high-quality healthcare plan that can address the potential costs of chronic diseases like diabetes and heart disease.

Those who have yet to purchase private medical insurance for themselves or their families following the June 30th deadline should fear not, there’s still time. The DHA has stated that it will be giving a 6 month grace period during which no fines will be levied against the uninsured. That means people can still use the services of insurance brokers like UAE Medical Insurance to compare health insurance plans from major insurers in Dubai and receive free price quotations.  Whether you will be eating healthy now or not, it’s certainly in your best interest to prepare for any future health problems that could develop.

Insurance tax in the UK increased: Does this affect you?

Graph indicating rise in health insurance tax

On March 16 the British government released their budget for the 2016 financial year, and as with many other years, there were a number of increases announced around the various taxes levied including insurance tax in the UK. While there are a number of important increases all citizens in Britain should be aware of, it is the Insurance Premium Tax (IPT) that has the potential to impact expats as well as those living in the country. 

About the IPT

The Insurance Premium Tax, or IPT, was first introduced in 1994 with the idea of increasing government revenue raised from the insurance sector, which was deemed to be undertaxed. Since it’s conception, the IPT has been split into three different rates with different types of insurance falling into each:

  • Standard rate – Includes most common types of insurance like private health insurance, motor insurance, home insurance, etc.
  • Higher rate – Includes some common and uncommon types of insurance, the most notable being travel insurance.
  • Exempt – Insurance that has legally been exempted by the government. This includes life and long-term insurance, and less-common types of insurance like some types of plane insurance, and reinsurance.

Generally speaking, all insurance sold in the UK, barring that which is exempt, is supposed to have an IPT applied to premiums. Some insurers will include this in the premium automatically, while others will apply it separately, meaning you will see the tax applied separately after your premium is quoted.  

The change in the 2016 budget

Historically the rate changes made to the IPT scheme have been minimal, with a tax of 4% being applied to the standard rate from 1997-1999. This was increased to 5% from 1999 to 2011, and again to 6% from 2011-2015. Last year, the government raised the standard IPT tax rate to 9.5%, a considerable jump from the previous years. This rate was announced with the 2015 budget and came into effect for all policies sold or renewed after November 1, 2015.

Now, with the recent announcement of the 2016 budget, the standard IPT rate will again increase. Luckily, this increase will be a minimal .5%, but it will bring the tax rate on insurance plans sold in the UK to 10%.

According to This Is Money, the .5% increase will be applied to policies sold after October 1, 2016. The article also reported that “The tax applies to most areas of general insurance including; motor, home, pet, car, and health insurance. But travel insurance, which is excluded from the hike because it has its own tax at 20 per cent, will not change.”

Will this impact expats?

For expats, there is a chance that you will be obligated to pay this tax, it really comes down to the wording supporting this tax policy, more importantly, the exclusions. According to the HM Revenue and Customs website, insurance plans with risk deemed to be outside of the UK are exempt from paying the IPT tax.

For example, if you currently live in Hong Kong and are not from the UK, but will be moving to the UK to work for your company for a year and secure a health insurance policy in Hong Kong before you leave for the UK, you will not be required to pay the tax as the “risk” (in this case the health insurance plan) is outside of the UK.

However, as the HM Revenue and Customs website notes this tax can be applied when you are “an individual habitually residing in the UK at the date when the contract is entered into.” In other words, if you are deemed to be a “habitual” resident in the UK when you purchase the insurance, you will be required to pay the tax.

Defining habitual residence can be tough for expats, especially because tax laws in the UK are quite complex. Generally speaking, it is safe to assume that if you are deemed to be a non-resident of the UK, then you will not have to pay the IPT. According to this article on Experts for Expats, you do have to deem yourself a non-resident of the UK, but will also be counted as one if you reside outside of the UK for more than 319 days a year.

That being said, if you are a non-resident UK expat and do purchase health insurance in the UK, you will likely have to prove that you are indeed not a resident. As the HM Revenue and Customs site notes, “If the insured gives an overseas address or otherwise indicates on the proposal form that he is not currently habitually residing in the UK, then the insurer should make the necessary enquiries and obtain and retain supporting information if the premium is considered to be exempt from UK IPT.”

So, in short, plans sold outside of the UK will not be subject to this tax, but plans sold within the UK likely will be unless you can prove you are not a resident. Of course, if you are looking to secure health insurance coverage outside of the UK, it would be a much better idea to do so in the country you currently reside in.  

One more thing British expats should be aware of

The increase of the IPT rate may cause some British expats to wonder whether they actually need to secure private health insurance or not, largely due to the fact that they do still have access to the NHS when they go home for a visit. This is a dangerous assumption to make, as last year it was announced that expats from the UK living outside of the EU will have to pay 150% of the cost at NHS hospitals if they don’t have adequate insurance.

As the Telegraph explained, “The charges only apply to hospitals – appointments with GPs and accident and emergency treatment remain free. Patients should expect to be asked questions about their residence status in the UK. The changes, which came into effect on April 6, 2015, affect British expats differently, depending on where they now live.”

While for now, this only applies to hospitals, you can rest assured that as the NHS struggles to maintain costs, extending this payment scheme to GPs and clinics will likely be one of the first things looked at.

To avoid this, it would be beneficial to secure a robust international health insurance plan. As experts in expat health insurance, we can help British expats determine whether they will be required to pay the insurance premium tax and suggest plans that may be more beneficial, especially if you are not currently residing in the UK. Talk to us today for a free quote.   

Lifesavers: Acknowledging women throughout history that have had major impacts on health and medicine

International Women's Day

It’s International Women’s Day! A day where we not only show appreciation for the women we know that make our lives better each day, but also a moment to educate ourselves on the important contributions made to the world. And there are perhaps no areas that have a broader effect on the lives of people worldwide than those of healthcare and medical science. With this in mind, Pacific Prime would like to take this opportunity to highlight some of the most profound contributions to health and wellbeing worldwide that we have only seen due to the direct contribution of some of the most dedicated and thoughtful women ever to have lived. This list is by no means exhaustive, and great work is being done by women in health and medical science still, but most will agree that the following women deserve to be recognized and remembered for their tireless work.

Mary Ellen Avery

A pioneer in pediatrics, despite contracting Tuberculosis shortly after graduating from medical school, Dr. Avery persevered through the illness and learned more about lung function. This turned into a passion for respiration that she applied to her work with prematurely born infants.  Having single handedly discover the cause behind respiratory distress syndrome in these children, a treatment was devised for the ailment that is estimated to have saved the lives of over 840,000 people thus far.

Francoise Barre-Sinoussi

At the pinnacle of the AIDS epidemic in America during the 1980s, the medical community was still at a loss for what exactly was causing the disease. Dr. Francoise Barre-Sinoussi was the first of many scientists researching the disease to identify the elusive HIV retrovirus. This excellent work has lead to Barre-Sinoussi being credited with saving over 2 million lives. She was awarded with the Nobel Prize for Medicine in 2008.

Clara Barton

Forced into service by the Civil War, Clara Barton was a patent clerk-turned-nurse that was known as America’s “angel of the battlefield” by the time all was said and done. This is because, after recognizing shortages of medical supplies on the battlefield and organizing to have this remedied, she also led the initiative to treat the sick and wounded soldiers there. To put a fine point on how prolific her work was, Clara Barton was also the founder of the American Red Cross in 1881, and the group’s leader until 1904.

Elizabeth Blackwell

Elizabeth Blackwell is known as a trailblazer simply by virtue of being the first ever female medical doctor in the United States in 1849 (which, assuredly, was actually not a simple thing to achieve). Today in the United States, half of medical school grads are women; A figure that can be appreciated thanks in part to the work of Dr. Blackwell. The funny thing is, Blackwell did not even want to be a doctor for most of her life. Working as a teacher, she turned to medicine only after a dying friend confided in Elizabeth that her suffering would have been greatly diminished if only her doctor was a woman.

Marie Curie

A Polish chemist, Marie Curie, along with her husband, invented a way to harness the power of X-rays, and apply them to healthcare. She was the first woman to receive a Nobel Prize, and remains the only woman to have won two Nobel prizes. She is also one of only 4 people to win the Nobel Prize in two separate categories (chemistry and physics). The awards are well deserved seeing as countless lives have been improved thanks to the medical technology the Curies developed together.

Dorothea Dix

As much as we feel that mentally ill patients slip through the cracks today, in Dorothea Dix’s day there was absolutely no help for them in the US. However, thanks to her work, the first wave of American mental health facilities was established. In addition to the mentally ill, her career also focused on helping and promoting the rights of others who were often forgotten by society, namely prisoners and the disabled.

Grace Eldering  and Pearl Kendrick

Both of these ladies were stricken with whooping cough by the age of five. Due to this fact, you could perhaps say that it was revenge that allowed the pair to change the world. At the height of the disease, it was responsible for over 6,000 mortalities a year inside of Eldering and Kendrick’s home country of the United States. However, using their backgrounds in science and medicine, the pair were able to develop a vaccine that sent incidences of whooping cough tumbling rapidly by the 1960s. As a result, these women have been credited with saving over 13 million lives today.

Gertrude Belle Elion

Even though she never earned a PhD thanks to attitudes about women in academia around the time of the Great Depression, Gertrude Belle Elion did not let that stop her from learning all she could about cancer after seeing her grandfather pass away as a result of the disease. Undaunted by society’s unspoken rules, Elion went on to create the first major drug used to fight leukemia, and developed 45 treatments to aid in battling cancer. Also, she, along with Dr. George Hitchings, developed Rational Drug Design, which was a process for researching and inventing new pharmaceuticals. This methodology was later used to develop drugs such as the popular AIDS medicine AZT. Elion capped her career by winning a Nobel Prize in 1988.

Alice Catherine Evans

Thanks to her hard work as the first permanent female scientist to be hired by the US Department of Agriculture, Evans found that infections carried by cows could cause illness in humans. This research lead to milk pasteurization laws being put in place that are still keeping populations around the world healthy today.

Rosalind Elsie Franklin

Franklin’s work led to the discovery of the double-helix model of our DNA as we know it today. Following her death, her colleagues James Watson, Francis Crick and Maurice Wilkins later went on to win the Nobel Prize thanks in large part to her efforts. Rosalind Franklin was also well known for her trailblazing work on X-ray diffraction.

Alice Hamilton

In academia, Alice Hamilton holds the distinction of being the first woman appointed to Harvard University’s faculty. Beyond this, Hamilton’s impact has been long lasting, as she was a pioneer in identifying environmentally hazardous materials as also having a negative effect on human health. Thanks to her, workers around the world today are (or at least should be) working in safe and regulated conditions.

Ann Holloway and Anna Mitus

Perhaps the women in medical history who have helped save more lives than any others. Their work as part of the team that developed a vaccine for measles has led to the prevention of over 118 million deaths. Working closely with John Enders on the project, Holloway also previously assisted him in developing a vaccine for polio, for which Enders won the Nobel Prize.

Mary-Claire King

Geneticist Mary-Claire King discovered the genetic marker for breast cancer when the popular thought was that the disease was caused by a random series of environmental and genetic factors. Her research led to the discovery of the exact chromosome (chromosome 17) and gene (BRCA-1) responsible for breast cancer.

Florence Nightingale

Despite belonging to a wealthy family, Florence Nightingale felt an attraction to helping others through nursing early on in her life. Once educated, she was flung into the Crimean War and put on a path towards her now legendary status. Noting dreadful hygienic conditions in medical treatment areas, Nightingale was able to reorganize operations in a way that drastically improved medical outcomes. After the war ended, she proliferated the same ideas by founding her own nursing school that then paved the way for modern nursing techniques.

Eleanor Roosevelt

It is expected of the First Lady today to spearhead sweeping health initiatives in the United States. However, this trend began with Eleanor Roosevelt. As the head of the UN Human Rights Commission in 1948 and one of the authors of the Universal Declaration of Human Rights, Roosevelt ensured that access to health care was considered a fundamental human right.

Margaret Sanger

Margaret Sanger is the original champion of reproductive rights. In addition to being a nurse, she spent her career as an advocate for birth control (even popularizing the term), as well as a sex educator. Mind you, this was in the 19th century, when the public’s tolerance for such ideas was low to say the least. Nevertheless, Sanger went on to open the United States’ first birth control clinic. Other organizations she founded later became what is known today as the Planned Parenthood Federation of America.

Rachel Schneerson

In partnership with John Robbins, Schneerson developed a vaccine for Haemophilus Influenzae type b, also known as Hib. While many people may not be familiar with this type of bacteria, they no doubt will be more familiar with the bacterial meningitis that it causes. Since the development of the vaccine Hib disease has been practically eliminated throughout developed nations, which is believed to have saved the lives of 660,000+ lives.

Rosalyn Sussman Yalow

Rosalyn Sussman Yalow developed the procedures that have allowed for screening out infectious diseases from blood donations, thereby preventing the spread of many illnesses through blood transfusions. Although she was a physicist, she won the Nobel Prize for Physiology or Medicine in 1977.

Tu Youyou

This Chinese teacher and chemist was awarded the Nobel Prize in Physiology or Medicine in 2015 for her work in discovering dihydroartemisinin and atemisinin. For the layman, these are pharmaceuticals used to treat Malaria all around the world. Her work has already saved millions of people from dying of the disease.

This informative article is brought to you by Pacific Prime Insurance Brokers; providers of international health insurance plans that provide high quality medical insurance coverage virtually anywhere in the world. Contact one of our sales agents today to find out more about the plans we can provide through some of the world’s best insurance companies, and get a free plan quote.

Mental health and insurance

Doctor talking about mental health

According to the National Alliance for Mental Illness (NAMI), “One in four adults experiences mental illness in a given year. One in 17 − about 13.6 million − live with a serious mental illness such as schizophrenia, major depression or bipolar disorder.” With revealing numbers like this, it is clear to see that mental health has become one of the most important health concerns of the past decade. Long considered to be a somewhat taboo subject in much of the world, Asia included, mental health has started to see an emergence as a true concern that needs to be addressed, studied, and treated much like any other illness would. This exact issue was recently raised in an intriguing article published in the International Travel & Health Insurance Journal (ITIJ), which features insight from Pacific Prime’s Darren Counsell. 

Stigma still surrounds mental health

The problem is, many countries simply are not giving mental health the support required. For example, here in Hong Kong, the SCMP reported last September that, “There are under 200,000 such [patients receiving psychiatric help for a mental illness like depression] in the Hospital Authority (HA) system. According to an official assessment, the average queuing time for a first appointment with a psychiatrist jumped from three to seven weeks between 2000 and 2012.” The article went on to note that there are only around 300 psychiatrists working in the public system, which is far short of the recommended number set by the WHO.

Singapore does not fare much better, with resources and statistics from the government being relatively hard to find when compared with other diseases, and a somewhat low number of professionals working in Mental Health with 2.81 healthcare professionals employed per 100,000 people in 2011, according to the WHO (compared to 4.39 per 100,000 in Hong Kong).

The cost of mental health

The SCMP article linked above highlighted a common issue many countries and cities around the world are facing: The public health sector can not fully cope with the demand for mental health care. To receive the care people need, many are turning to the private health sector. While this sector will usually have much lower wait times, it does come at an increased cost. For example:

  • The Hong Kong Society of Psychiatrists notes that, “Fee charges range from about HKD 500 (USD 54) to HKD 2,000 (USD 257) per consultation.”
  • The Australian Psychological Society states that for a 45-60 minute consultation with a psychologist you will be charged AUD 238 (USD 172).
  • The Noble Psychological Wellness Center charges SGD 90 (USD 64) for a 15-minute session.

Add the cost of psychological care and medicine on top of that, and it is clear that mental health care is not cheap. In order to afford the mental health care many need, many will turn to private health insurance. While plans like international health insurance plans will offer strong coverage elements with high limits, there is a caveat you need to be aware of: Some insurers may not cover specific mental illnesses.

Pacific Prime discusses mental health and health insurance

In a recent article which addressed mental health published by the International Travel & Health Insurance Journal (ITIJ), Darren Counsell, Director at Pacific Prime, discussed mental health from an insurance standpoint, as well as what you need to know about when it comes to whether your health insurance covers mental health care.

Some of the important information shared by Counsell included the most valuable piece of information anyone receiving care for mental health needs to know: “While the best insurers offer cover for diagnosed psychiatric conditions, many exclude self-harm, along with alcohol and drug misuse, even if they can be attributed to mental health issues.” He also explained that, “In short, many popular international insurance companies do actually cover psychiatric conditions, but often insurers impose low limits and caps for coverage related to treatment of these conditions.”

The article itself provides an in-depth look into mental health and health insurance, and is well worth the read – especially if you are looking to learn more about how the two topics are intertwined. The full article can be found on the ITIJ website.  

In order to learn more about whether your health insurance plan covers mental health care, please contact us today.

Mosquito-Borne Diseases and Insurance

Moaquito representing mosquito-borne diseases

Recently, numerous diseases have been in the news in Asia. Of these, the most reported on all have one thing in common: They are transmitted by mosquitoes. From the scary new Zika virus that seems to be spreading to Asia rapidly from South America to the ever present Dengue fever, which appears to be on the rise in South East Asia, there are a number of diseases you could be exposed to while in the region.

Due to the seriousness of many of these diseases, according to publications including the Smithsonian, “The diseases that mosquitoes carry and transmit to people they bite kill 725,000.” This makes the mosquito the single most deadly animal in the world. Over the past few months, Pacific Prime’s offices in Shanghai, Hong Kong, Singapore and even the UAE have fielded a number of questions about mosquito-borne illnesses. To help we have created this short overview of the top five mosquito-borne diseases and insurance. 

Zika

Zika virus is arguably the most talked about disease in recent months; receiving press all around the globe and evidence that transmission is spreading in different countries. This virus, commonly referred to as Zika fever, was actually first discovered in 1947 in Africa, with the first major outbreak not happening until 2007. Despite the spread of the disease, it did not receive much coverage in the news until last year when an outbreak in Brazil was linked to microcephaly. While this has not been fully proven, the WHO notes that “Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly.”

To top it off, countries with a recorded Zika fever outbreak have also recorded a potential link between the fever and Guillain-Barré Syndrome (GBS) – a rare sickness where the body’s immune system attacks the nerve cells, causing weakness and sometime paralysis. As the CDC reports, “The Brazil Ministry of Health has reported an increased number of people who have been infected with Zika virus who also have GBS.”

While GBS and microcephaly are worrying, it is important to note here that the links between Zika fever and these illnesses are not fully understood. Many disease specialists are recommending care being taken should you live in a region where Zika is known the be present. This is especially true for pregnant women, as it is known that Zika can be transmitted from mother to fetus.

It is also important to know the signs and symptoms of Zika fever which include:

  • Fever
  • Rash
  • Joint or muscle pain
  • Headache
  • Conjunctivitis (red eyes)

According to the WHO, “The incubation period (the time from exposure to symptoms) of Zika virus disease is not clear, but is likely to be a few days…These symptoms are usually mild and last for 2-7 days.” In other words, there is not a great chance that you will be hospitalized should you contract it.

Because of the fact that there is no known vaccine, it would be advisable to take precautions to prevent the disease. We cover the most common ones below, but it would also be a good idea to keep an eye on where the disease has been reported. While the outbreak is largely concentrated in South and Central America, there have been recorded outbreaks (in the past) and cases in South East Asia. Visit the CDC’s Areas with Zika page to learn more.

Dengue

While Zika virus is receiving a large amount of news coverage at the moment, there is a mosquito-born illness that many disease control experts would consider to be substantially larger: Dengue and Dengue Hemorrhagic Fever, or Severe Dengue.

Like Zika, Dengue is thought to have originated in Africa and remained mostly limited to the region until around World War II, when cases started to be recorded outside of Africa. Now, Dengue fever is considered to be endemic in over 100 countries – basically any tropical or subtropical location – which translates to about ⅓-½ of the world’s population being at risk, and it is on the rise. According to the WHO, “Cases across the Americas, South-East Asia and Western Pacific exceeded 1.2 million in 2008 and over 3 million in 2013.”

In recent months there has been news of an outbreak in Singapore (which Pacific Prime Singapore covered in a recent article), an increase in cases in Hong Kong, and even an ongoing outbreak in Hawaii that has caused the state to declare a state of emergency.

Due to the increasing number of cases, it is important to be aware of the symptoms of Dengue which include:

  • High fever
  • Headache
  • Strong pain behind the eyes
  • Joint, muscle, and bone pain
  • Rash
  • Easy bleeding of gums and cuts

Unfortunately, like Zika fever, there is no approved vaccine for Dengue, but for most people the symptoms will be mild. Doctors will usually prescribe painkillers and rest, with recovery usually happening within a week. The problem with Dengue, however, is that a small percentage of cases where Dengue is more severe – an illness referred to as Dengue Hemorrhagic Fever.

As the CDC notes, “Dengue hemorrhagic fever is characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms consistent with dengue fever. When the fever declines, symptoms including persistent vomiting, severe abdominal pain, and difficulty breathing may develop.” In some cases where care is not received in time, this can lead to circulatory failure and death. According to the WHO, “An estimated 500 000 people with severe dengue require hospitalization each year, a large proportion of who are children. About 2.5% of those affected die.”

Yellow fever

Much like the two disease above, Yellow fever is a serious mosquito-borne illness that is common in certain parts of the world. Unlike Dengue however, yellow fever is not as widely spread, only present in parts of Africa and South America. The WHO has found that, “There are an estimated 200,000 cases of yellow fever, causing 30,000 deaths worldwide each year, with 90% occurring in Africa.”

Unlike the two illnesses above, there actually is a vaccine for yellow fever which has proven to be incredibly successful. That being said, it is still a concern in some regions, so if you plan to travel to Africa or parts of South America you should be aware of the symptoms which are broken down into two stages.

Acute yellow fever symptoms which usually last 3-4 days include:

  • Fever
  • Backache
  • Headache
  • Shivers
  • Loss of appetite
  • Nausea

Toxic yellow fever symptoms which become present usually 24 hours after the end of the first stage and include:

  • Return of the high fever
  • Jaundice
  • Abdominal pain and vomiting
  • Bleeding from the mouth, nose, eyes
  • Blood in body secretions including feces or vomit

If the toxic stage is reached around half of all patients will die within 14 days. This makes it a considerably more serious illness than some others, so it is important that you receive a yellow fever vaccine before visiting endemic countries (which can be found on the CDC’s yellow fever page)

Chikungunya

Chikungunya, like the other mosquito-borne illnesses in this article, was first discovered in Africa. Unlike yellow fever, however, this illness has become much more widespread, with local transmission recorded in Europe, the Americas (North, Central, and South), Asia, Africa, and the Pacific.

While not as common as Dengue, cases are still reported in various countries in the region. For example, Singapore confirmed 42 cases in 2015. This makes it an important disease to know the symptoms of. These symptoms include:

  • High fever
  • Joint pain
  • Muscle pain
  • Headache
  • Nausea
  • Fatigue

While similar in symptoms to dengue, Chikungunya is usually accompanied by more severe joint pain that, in some cases, can last weeks. Similar to the other diseases on this list, there is no known vaccine for Chikungunya, but as the WHO explains, “Serious complications are not common, but in older people, the disease can contribute to the cause of death. Often symptoms in infected individuals are mild and the infection may go unrecognized, or be misdiagnosed in areas where dengue occurs.”  

Malaria

Finally, we have malaria. The most widespread and studied of the mosquito-borne illnesses. Caused by the plasmodium, it is estimated that nearly half of the world’s population is at risk of contracting malaria. According to the latest WHO estimates, released in December 2015, there were 214 million cases of malaria in 2015, and 438,000 deaths. While the number of cases has decreased nearly 37% between 2000 and 2015, it is still a serious disease.

Because it is present in much of Asia, Africa, and even Europe and the Americas, it could help to be aware of the symptoms of malaria which include:

  • Fever
  • Headache
  • Chills
  • Vomiting

While not dangerous at first, if left untreated it could become severe malaria with symptoms that could include:

  • Seizures, coma, loss of consciousness
  • Anemia
  • Blood in the urine
  • Respiratory distress and troubles breathing
  • Hypoglycemia
  • Kidney failure
  • Cardiovascular collapse

Any of these symptoms are considered to be an extreme medical emergency, and will be treated as such. Luckily, many strains of malaria have been well studied and doctors are generally able to use anti-malarial drugs to cure most cases.

Preventing these diseases

The one key thing about the diseases included above is that they can all be prevented. While some, like yellow fever and malaria, have drugs or vaccines, others don’t, so it is best to take preventative measures which include:

  • Removing all standing water in and around your property
  • Wearing long pants and shirts and sunrise and sunset
  • Sleep under a mosquito net, or use air conditioning and closed windows
  • Use mosquito repellent on exposed skin and permethrin on clothes
  • Spray repellent around your house and windows, but never into the air conditioning or fan system, as this could blow the potentially harmful repellent into the room causing you to inhale it.
  • Follow the directions on the CDC or WHO websites for what to do if you are traveling to an area that has any of the diseases above.

Will health insurance cover these diseases?

With many of the diseases in this article, your insurance will cover it. Recovery in a short time is often possible, which means that visits to the doctor will not be overly costly and should be covered by your insurance. If there are complications, however, you may need to seek costly medical care. It would be beneficial to ensure that you have a plan with higher limits that can cover any potential care required from mosquito-borne illnesses. To learn more about your health insurance options, contact our experts.  

 

Battling high premiums

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Health insurance premiums are almost always guaranteed to increase year-on-year. Some years, the inflation may be more than others and providers will have different premium increases from their competitors. Some years, the premium increase of your international health insurance plan can be drastic, making it feel like high premiums have made the plan not worth it. While these increases usually can’t be avoided, there are a number of things you can do to reduce the premium you pay either when renewing an existing plan, or signing up for another plan.

Reducing premiums when renewing your plan

If you find that the premiums for your existing plan have increased beyond your price threshold, it may feel like you are stuck paying the increase, but there are actually a few things you can do to reduce your high premiums, or at the very least minimize the increase.

First, review your existing plan

Almost every health insurance plan has different coverage options you need to select when you sign up for the plan. It would be a good idea to review what exactly is covered by your plan as there may be some coverage elements that you may not need at this time. These extras will vary by plan, and there are some you may be able to remove, which could lower your premium.

You can also look at the dependents on your plan. It could be that your spouse got a new job in the past year with a solid benefits package, including health insurance, or your children have started at a new school which offers health insurance via the school. If this is the case, it could be worth it to remove them from your plan in order to lower your premiums.  

Another option that has become increasingly popular in the past few years is to introduce a co-pay or deductible to your plan. A co-pay is an agreed upon amount that you will pay each time you submit a claim, while a deductible is an amount you pay each year or for each claim before it can be submitted. By adding one, or both of these to your plan, you will see your premiums decrease. If you are currently healthy and have not had to see a doctor regularly in the past couple of years, this could be a viable solution.  

One thing to be aware of, however, is local regulations regarding health insurance. Take for example Dubai, which has implemented regulations that state that all expats need health insurance before a visa will be issued. This health insurance needs to meet, and cover, specific limits, and if you go below these you will likely see your visa renewal refused. If you live in a country with regulations like these, it would be beneficial to not only know the mandated requirements, but also to not reduce your plan below them.

Second, consider discounts

We don’t mean asking for a discount on your normal premium – most insurers will not normally offer any discounts – but there are other ways to receive a discount. Many insurers offer family plans that come with a form of built in discount. For example, some plans may require you to pay for your first child, while offering free coverage to your other children. Others will offer a discount of up to 25% on children.

The same can be said for group or corporate medical insurance plans. If you own or manage a business, establishing a group plan for your employees is usually a good way to reduce premiums largely because insurers can spread the risk seen with individual plans around, and will offer lower premiums to reflect this. It could be worth checking into transferring an existing plan over to a group plan.

Another option is to look if your plan has what’s called a ‘No Claims Discount’, or NCD. Plans with this type of policy will automatically apply a discount if you go a certain period of time, usually one year, without any claims. With many NCD policies there is an increase in the discount (up to a certain amount) for every year without a claim.

Reducing premiums before you purchase a new plan

If you feel that your existing plan is just not going to work, or that the premiums (even after discounting measures are taken) are too high, then looking for another plan may be a solid strategy. Here are four things to consider when looking for a plan with lower premiums:

Region of coverage

One of the key factors around the ever increasing cost of international health insurance is the fact that health care in places like the US, the UK, Hong Kong, and indeed almost every other country, keep increasing. If you are looking for a new plan, you could find lower premiums if you restrict your coverage by region. For example, if you are not from North America, then a plan that offers worldwide coverage, excluding the US and Canada will have considerably lower premiums.

The same can be said for more regional coverage – a plan with South East Asia only coverage will have lower premiums than full worldwide plans. Just be aware that if you do limit your coverage on a regional-basis, you will not receive coverage for any medical bills incurred outside of this region, so if you travel a fair amount outside of the region a more robust plan may be worth it. 

Type of coverage

Health insurance plans of all types offer numerous types of coverage with the vast majority basing their plans on three of them:

  • Inpatient – coverage for medical care that is deemed to be inpatient only. This usually requires you to be admitted to a hospital for a certain amount of time – usually 24 hours or more.
  • Inpatient and outpatient – Coverage that includes inpatient care and care that is not inpatient, but usually given at medical centers or hospitals. This includes doctors offices and normal checkups.
  • Full coverage – This includes the two types of coverage above along with additional elements including maternity, dental, and more.

Generally speaking, full coverage plans carry the highest premiums, while plans with inpatient only coverage have the lowest. Plans with inpatient and outpatient coverage will have premiums that can be quite spread out, and are usually based on what is covered by the provider.

One way people reduce premiums is by going with a plan that offers a lower level of coverage. For example, if you have a plan that offers full coverage, you could see reduced premiums if you change coverage to inpatient and outpatient only. The same can be said for people who don’t go to the doctor often, an inpatient plan that is really for serious medical conditions only could be more beneficial.

Plan network

Many health insurance providers have a preferred network of doctors and clinics that they work with. This network has agreed to accept payment from the provider directly, meaning that the facility will bill your provider first. While the larger insurers have strong networks in place, there is a chance that your preferred doctor or clinic may not be part of this network. If this is the case, you will usually be required to pay out of pocket and then submit a claim for reimbursement. Should your provider deny this claim (because it is “out of network”) or only pay part of it, you will be left with a bill on top of your premiums. Therefore, it would be a good idea to ensure that your clinic of choice is part of your provider’s network.

What’s more, it would be a good idea to also check how much your doctor charges. Higher cost doctors, such as those in niche markets or private facilities, will usually charge more which means you will need a plan with higher limits to cover care. Plans with higher limits will inevitably have higher premiums, if it is possible, finding a doctor that is cheaper could allow you to reduce your coverage limits, which means lower premiums.

Coverage you actually need

Finally, one way to find a plan with lower premiums is to look for one that offers coverage only for what you need. For example, if you are a male, the chances of you needing maternity coverage are zero, so securing a plan with this type of coverage leads to you paying premiums for claims you will not actually need to make.  

Contact our insurance experts

Finding coverage, or reducing premiums on an existing plan can be an involved process. What we recommend is working with one of the experts at Pacific Prime. We can help you identify your needs and plans that meet them, and even suggest ways you can reduce your premiums. Contact us today to see how we can help.

Should we be worried about MERS?

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In the first week of June one of the top stories carried by almost every news agency was centered on MERS. In Greater China the news centered on one man who flew from South Korea to Hong Kong after being exposed to the disease and subsequently entering mainland China, exposing people in both Hong Kong and Southern China to the disease. Beyond that, MERS seems to have caused a massive scare in South Korea, where CNN reported that on June 4 the government closed over 900 schools and as of June 5 over 1,300 people were in quarantine with 35 people actually having the disease and four dead, with all figures expected to rise – possibly exponentially.

This reaction is similar to that seen in Hong Kong during the 2009 swine flu epidemic that swept through the city, causing schools to close early and widespread near panic. The thing is, MERS is not exactly well known in this part of the world, and a number of clients have called us asking if they should be worried, as well as if their insurance will cover any MERS related illness. To help, we have come up with this brief guide that looks at what MERS is, whether it’s as serious as news agencies are making it out to be, and how insurance companies will cover it.

Define MERS

MERS (Middle East Respiratory Syndrome), according to the CDC, “Is an illness caused by a virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV).” This virus is in the same family as that of the common cold and SARS, and was first discovered in 2012 – with the first officially recorded case coming from Saudi Arabia.

To date, almost all of the cases can be traced back to the Middle East, including the latest outbreak in South Korea and subsequently China and Hong Kong. In this case, the first patient had traveled to the Middle East and became sick after he returned. His son was exposed and then visited both Hong Kong and southern China potentially exposing passengers who sat near him and maybe even others who have had contact with him while he has been quarantined in a hospital in China.

Because MERS is part of the coronavirus family, the symptoms are often similar to those of the common cold, only more severe. According to the WHO (World Health Organization), “The clinical spectrum of MERS-CoV infection ranges from no symptoms (asymptomatic) or mild respiratory symptoms to severe acute respiratory disease and death. A typical presentation of MERS-CoV disease is fever, cough and shortness of breath. Pneumonia is a common finding, but not always present. Gastrointestinal symptoms, including diarrhea, have also been reported.”

With a death rate estimated by the WHO to be around 36% of all cases, and an increase in the number of cases in the past couple of months, it has many in Asia (especially China and Hong Kong, both of which have a dense population) worried.

Is MERS as serious as it’s made out to be?

This can be a hard question to answer, largely because we aren’t trained medical professionals, and partly because it can often be tough to decipher the severity of an incident from news articles alone. In our research, we have found that this is a serious enough issue to spark cities like Hong Kong to implement warnings and increase screenings at points of entry so as to hopefully be prepared for any outbreak.

According to the WHO, “The virus appears to cause more severe disease in older people, people with weakened immune systems, and those with chronic diseases such as cancer, chronic lung disease and diabetes.” Scientists are still trying to figure out exactly how this virus is transmitted, but it appears that the vast majority of cases currently stem from people who have been exposed to it while caring for others in the hospital. From what is known about MERS, transmission is normally due to close contact with an infected person and human-to-human transmission is not sustainable as long as precautions are implemented.

These precautions, according to the CDC, include standard cold and flu prevention (washing hands frequently, covering your mouth and nose, staying home when sick, avoiding contact with sick people, and cleaning surfaces touched by sick people on a regular basis. If these steps are followed – especially the avoiding of close contact with sick people – then we should see this disease managed.

If you believe you have been in contact with someone who has recently traveled to the Middle East and start to get sick, it would be a good idea to see a doctor as soon as possible.

Will insurance cover me if I get MERS?

You should be covered with almost all plans purchased through Pacific Prime largely because there’s a good chance you are not putting yourself at risk of contracting MERS (e.g., visiting the Middle East on a regular basis). Even if you do travel to the Middle East, you should still be covered as long as you have an international plan which includes coverage in that region. It would, however, be a good idea to check the documentation that came with your plan to make sure there are no exclusions for MERS.

In fact, we recommend contacting one of the insurance experts here at Pacific Prime. We can help you go through your plan and recommend options or other plans if need be. Contact us today.

Is your doctor covered by your insurance plan?

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Spend even a short amount of time looking for health insurance in Hong Kong and you will quickly find that there is a mind-boggling number of plans available. While to many, this choice is a good thing – you can find a plan that fits your needs perfectly – it can also be overwhelming if you’re not familiar with health insurance. A common issue that comes up when looking for a plan without thoroughly understanding the policy is that you may find your doctor or facility of choice is not covered.

In Hong Kong, there are a large range of medical facilities available. You can find facilities that charge 100 HKD for a visit, or some that charge over 1,000 HKD for a simple consultation. As such, not every insurance plan will cover all of the facilities in your area. In fact, insurance companies usually offer coverage based on health care networks – a group of medical facilities that essentially agree to accept payment from the insurance company. These networks, and actually finding where your plan is accepted in Hong Kong, can be confusing. So, to help, we have written this article which looks at the three most common groups of networks.

Group 1: Public and low cost facilities
As the name suggests, plans that support these networks provide coverage only for low cost providers and public facilities. These plans are often designed to be very cost effective with lower premiums and, subsequently, lower limits and benefits. This means that if you purchase one of these plans you will only have access to lower cost facilities because the limits will only really cover the costs at these facilities

While some insurers do not cover treatment outside of your network, others will. This really depends on the insurer you choose. In fact, many will give you the flexibility to still visit doctors and hospitals outside of the network, but they will only provide coverage up to the average cost of facilities that are within your list.

So if you do purchase a budget plan, and they tell you that your doctor or hospital is covered, you still need to be careful and check the limit that they will cover up to. The plan won’t be very useful if it only covers a small amount of what your desired doctor actually charges.

Group 2: Mid to high cost facilities
These are plans that offer higher limits and a larger health care network, but may still impose coverage limits, copays, or deductibles on your treatment cost. Essentially, these plans have been designed to allow you greater flexibility in selecting your hospital, but the cost will be shared.

A copay or deductible is a part of the treatment cost that you will pay out of pocket. This amount will be agreed to before the start of the policy, and is a good way to help manage the cost of your plan while allowing you to better set and manage risk. In this way, you can still get care from the doctor or hospital that you want when you need it, without paying a high annual insurance premium.

The main downside with this type of network is that it may still limit access to the most expensive facilities in your area, especially those who are extremely specialized or serve only a small niche market. Other plans will allow you to access these facilities, but the coverage limits will be lower, which means you will be paying more if you visit them.

Group 3: Unlimited Network
Plans with unlimited networks are typically offered by international insurers, and will have high or no limits. Yes, the premiums for these plans are typically more expensive, but they do let you rest easy knowing that you can have access to the very best care that the world has to offer, because you’re not limited to treatment in public or lower tier private hospitals in Hong Kong. In fact, because these plans are international in nature, they will usually cover medical treatment anywhere in the world.

Because of their international nature, these plans are also most suitable for expats and High Net Worth individuals because they provide coverage in facilities and locations that will feel most comfortable to them – e.g., an expat’s home country. Another benefit for expats is that these type of plans allow for treatment immediately, without waiting months to re-enroll in the public healthcare system if they move to a new city or country.

How do I find out if my doctor/medical facility of choice is covered?

Regardless of the insurance plan you select or the provider you work with, there is a chance that your doctor or medical facility of choice may not be covered. There are three common ways this can be found out:

1. Look at the documentation included with the plan
All plans come with documents that explain not only what is covered, but also where you can receive medical attention. For example, if you buy a plan through Pacific Prime, we send you a Quick User Guide with information on your plan, including where you are covered.

Other plans, especially local ones, will also come with a booklet or a link to a website that lists all locations, clinics, and hospitals where your plan is accepted. When you sign up for a new plan, it is a good idea to store this information in a secure location so you have access to it when you need it.

2. Contact your main doctor and ask
If you have had your plan for a longer period of time, or are unsure whether your doctor or clinic of choice will accept your insurance plan, it could be a good idea to contact the office directly. They will likely be able to tell you right away if they are part of your provider’s network.

3. Talk to Pacific Prime
Living in Hong Kong, English may or may not be spoken to a level where you can communicate effectively with the receptionist at the clinic or hospital you have selected, so calling and asking may leave you with more questions than you started with in regards to coverage. What we recommend is contacting one of our knowledgeable health insurance professionals. Because we work closely with virtually every health insurance provider in Hong Kong, we can provide you with the details you need, and even recommend a solution if one is necessary.

Transgender Health Care and Insurance

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Across international news, we’ve been hearing the word ‘transgender’ a lot more. Some states in America are passing transgender bathroom bills to make public facilities more (or less) inclusive. The Amazon series Transparent picked up its first Golden Globe, and in March even Pope Francis set aside some time to meet with Diego Neria Lejárraga, a Catholic man rejected from his local church after sex reassignment surgery.

Transgender means a person’s gender expression doesn’t match their biological sex. Diego Neria Lejárraga (who, by the way, was welcomed into the Catholic church with open arms by Pope Francis) was born a woman. People who are transgender usually say that while growing up, they never identified with their sex, often experiencing a feeling of having been born into the wrong body. When the choice becomes available, many opt to take hormones or undergo sexual reassignment surgery in order to change their sex.

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Top 6 Hiking Trails in Hong Kong

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When most people think of Hong Kong their minds tend to drift towards crowded sidewalks, soaring skyscrapers, designer shopping centres and astonishing luxury stores, but there is another side to this city. A cursory glance at a map shows that great swathes of the territory are open space to explore. In fact, 40 percent of Hong Kong’s land mass is protected, which means there is a wealth of tree lined plains, woods, mountains, wetlands and beaches to explore. With the health benefits of hiking including reduced risk of heart disease, lower risk of blood pressure, lower risk of colon and breast cancer, reduced depression and better quality sleep, there’s no reason not to get out there and tackle one of Hong Kong’s many hiking trails. We count down six of the best trails. Continue Reading…