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Aetna Refreshes the International Healthcare Plan

The “International Healthcare Plan for individuals and families” from Aetna International will be seeing several benefit enhancements – effective 1 October 2013.

Posted on Sep 27, 2013 by Eamonn Singleton ()

The "International Healthcare Plan for individuals and families" from Aetna International will be seeing several benefit enhancements – effective 1 October 2013. Benefits will be improved for inpatient, daypatient, emergency care and diagnostic, and disease and chronic condition management. Some benefits and exclusions will also change for mother and child cover. The premium will increase 10.71%, sitting slightly above the global benchmark of 10%.

About the International Healthcare Plan

The International Healthcare Plan (IHP) is a comprehensive health benefits solution to help people overseas meet their changing medical needs. IHP offers four base plans: Major Medical, Foundation, Lifestyle and Lifestyle Plus. The most basic level is Major Medical with a comprehensive range of benefits such as inpatient and day patient treatment, evacuation and transportation, emergency treatment, outpatient care and alternative treatment. After that, each plan is an improvement over the last with the Lifestyle Plus as the most comprehensive option, which includes routine pregnancy, routine dental treatment and major restorative dental treatment.

Clients can also choose some optional benefits, such as extended emergency evacuation, outpatient direct settlement network and room restrictions in China and Hong Kong

Changes to the Plan

Starting in October 2013, the IHP will be showing some changes.

Exclusions

One such change is the removal of "hereditary medical conditions" from the congenital anomalies' exclusion list.

However, the weight loss or weight problems exclusion will now include bariatric procedures, diet pills or supplements, health club memberships, diet programs and treatment in a residential treatment facility for eating disorders.

Another addition to the exclusion list is infant formula given orally that can be purchased without prescription.

Benefits

Several benefits are increasing to match the rising cost of medical treatment worldwide and to ensure that clients are receiving coverage that matches the global needs.

In Inpatient Care, diagnostic procedures for reconstructive Surgery and Rehabilitation are expanding to include (but not limited to) pathology tests, ultrasound scans and X-rays. The rehabilitation now must be recommended and under the direct control of a Medical Practitioner, whereas before, a specialist was required.

The treatment received in an accident and emergency ward of a hospital or dental clinic will extend from 7 to 10 days of incurring accidental damage to sound natural teeth.

The routine pregnancy benefit, however, will no longer include costs incurred for the care of the baby for the first 24 hours following birth. This benefit will now only include costs for routine neo natal care and new born packages. The newborn must also be enrolled as a member of Aetna within 30 days after birth in order to be eligible for any benefits after the first 24 hours.

Premium increase of 10.71%

Aetna IHP has four different levels of premium that change according to the country of residence of the insured member. The clients will be covered worldwide, except USA. This means that members are covered only for accident and emergency treatment in USA for new medical conditions. If anybody wishes to include elective treatment in the USA, there is a 5th area available with an extra premium. These Areas allow to companies a better way to estimate the insurance premiums, according to medical inflation in each region.

According to the 2013 Globalsurance International Insurance Review, "Aetna Global maintained an average of 10.6% across all regions between 2009 and 2013". However, the premium rates increase for 2012 was only 8.2%. Globalsurance's analysis is that Aetna's upward trend on the 2013 inflation adjustment "can most likely be attributed to the blanket increase placed across all regions this year". According to the report, Aetna would be "able to boast a yearly adjustment under the global benchmark" of 10%, which is a good sign for companies thinking about a long-term investment in health insurance for their employees.

Aetna offers additional options for clients to help manage their premium rates such as restrictions on hospital accommodation in Hong Kong and China, though they also offer extended coverage such as USA Elective and Extended Evacuation.

It should be noted that all quoted premiums are for monthly payments; however, if clients pay their premiums annually instead of monthly, they will enjoy a 6% discount.

IHP also offers standard excesses applicable to each new medical condition. This excess could be nil until US $5,000, according to the base plan.

All premiums are quoted in US dollars, but Aetna International also accepts alternative currencies for payment. Sterling is available to policyholders registered in the UK and Euro is available to policyholders registered in Europe.

New definitions in the "Member handbook"

According to Aetna, the company is always enhancing their product portfolio in order to deliver the best coverage possible to customers. Usually Aetna also updates the terms of the policy, like definitions and general conditions to better outline and explains the policy's details. Clients can check these updates in the Member handbook.

Clients will see in the member handbook new definitions, like "Sound Natural Teeth" for teeth without any problem at the time of the accident. Aetna also updated some general conditions, among which is the phrase: "The period of cover is annually renewable thereafter, at the discretion of Aetna". Usually an international health insurance is guaranteed renewable for life, however, Aetna has put in writing something most companies already put into practice.

In the rights of termination, Aetna specified that the policy is subject to suspension or termination if the policyholder stops paying premium during period of cover. In that case, the policyholder will still be responsible for the full premium.

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Aetna International is the international business segment of Aetna and one of the world's top international health providers. Aetna operates in more than 10 countries, has more than 160 years of experience, and covers more than 500,000 members worldwide.

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