What expats need to know about the Affordable Care Act

'Murica flag to represent Affordable Care Act insurance

In our latest report on the cost of health insurance, we found that the US is the single most expensive location on earth for health insurance. One of the main reasons why the US is so costly is the fact that healthcare is so expensive, meaning that people essentially need health insurance if they plan on visiting a doctor in the US. It is primarly because of this fact that the US government took steps to drastically overhaul the healthcare system in the US. The major outcome of this overhaul is the Affordable Care Act (ACA). If you are an expat considering moving to the US or will be moving there shortly, there are a number of things you need to be aware of regarding the ACA.

What exactly is the ACA?

The Affordable Care Act, officially called the Patient Protection and Affordable Care Act (PPACA), commonly referred to as ‘Obamacare‘, was enacted in 2010 with the goal of lowering the uninsured rate, increasing insurance quality and affordability, and generally decreasing the burden of healthcare costs for people in the USA.

In order to achieve this, the US government set out a number of mandates, two of the most important being aimed at insurers and individuals. For insurers, the ACA states that they must accept all applicants, cover a set list of conditions (including many pre-existing conditions), and charge the same premiums for all applicants.

For individuals, the ACA mandates that you are required to secure compliant insurance plans should you not have one provided by either your employer or a public insurance plan. Interestingly, the fact that you ACA compliant plan is proven via one’s tax returns, and should you not have the required level of coverage, you could be slapped with hefty fines.   

Who needs to secure ACA plans?

When it comes to the ACA there are two major groups who are required to secure ACA compliant plans: Individuals and companies. Where there can be some confusion around the ACA is inbound and outbound expats, and whether you are expected to secure a compliant plan or not.

The ACA mandate for companies

According to the IRS, if your company employs more than 50 people, you are required to provide ACA compliant health insurance to at least 95% of full-time employees and their dependants under the age of 26.

Should you have fewer than 50 employees, you are not actually required to provide health insurance coverage to them. Rather, it is encouraged that you do. In order to help cover the costs of health insurance for these smaller groups, the IRS does offer tax rebates and options for offsetting the cost of providing health insurance.

For more information on the ACA for employers, check out the IRS website here.

The ACA mandate for individuals and their families

Generally speaking, all individuals who pay tax in the US are required to also secure an ACA compliant plan either through their employer or through insurance marketplaces should their employer not provide health insurance coverage. This mandate also extends to spouses and dependents under the age of 26.

In other words, if you are required to submit a tax return with the IRS, then you are more than likely required to also have secured ACA compliant health insurance, or you will have to pay a fine. Of course, there are a number of exemptions, which are explained in great detail in this PDF from the Congressional Research Service. You can also visit the IRS’s ACA for individuals website, which has an interview that helps determine whether you are exempt from this mandate or not.

The ACA individual mandate and expats

Being an expat who is either going to the US or will be leaving the US for work overseas, it can be confusing as to whether or not you are required to secure an ACA compliant plan, especially due to the fact that the US has historically strict tax laws.

As an outbound expat (someone who is a US citizen, but will be leaving for work overseas), you are still legally required to have an ACA compliant plan if you live abroad for 330 days a year or less. Should you go for, say, six months and then return, you will still need a compliant plan. For those who do spend the majority of the year outside of the US (more than 330 days), you are deemed to have an ACA compliant plan, and can tick the relevant box when you file your tax return.

As an inbound expat, if you are paying taxes in the US and spend more than 35 days a year in the US, you will be required to secure a compliant plan. The key thing to stress here is that this mandate applies to US citizens, legal US residents, resident aliens and non-resident aliens required to file tax forms. Some students and diplomats are exempt from the mandate, but the vast majority of inbound expats will need a compliant plan.

What happens if I don’t secure a compliant plan?

The US government officially follows what they refer to as a “play or pay” policy when it comes to the ACA and the securing of plans. If you do not secure a plan that meets the requirements set out by the government, you will be fined. Of course, in the US nothing is ever fully ‘mandatory’. You will not be arrested or deported should you not have a compliant plan, you will just have to pay the fine.

For businesses these fines are referred to by the IRS as “Employer Shared Responsibility Provisions,” and the fine will vary depending on the situation. For example, if you have over 50 full-time employees and do not offer health insurance to at least 95% of your employees you will be fined at least USD 2,000 per employee with the first 30 employees not being counted. More information on the fines can be found here.

Individuals who do not report adequate coverage will be similarly fined, or as the IRS puts it, you will be required to “Make a Shared Responsibility Payment”. The exact amount will vary based on a number of conditions, including your annual salary, dependants, etc. You can learn more about this payment here.

Can I secure a plan before I leave for the US?

As an expat heading to or leaving the US, there is a good chance you will be returning to your home country for a vacation at least once a year. Historically, if you wanted to have coverage in your home country and in the US, you would be required to have both an ACA compliant plan and an international health insurance plan primarily because many insurers who offer international health insurance plans do not meet requirements set by the ACA.

As of November 1, 2016 however, Pacific Prime is pleased to announce that we will have an international health insurance solution that offers not only worldwide coverage, but also will be ACA compliant. This plan, offered by Cigna Global, can be a great option for any expat moving to the US, as well as expats leaving the US for a position abroad.

Visit our Cigna International Health Insurance page on this exciting new plan to learn more today.

A story about pneumonia

Pneumonia virus

Did you know that according to the WHO “Pneumonia accounts for 15% of all deaths of children under 5 years old, killing 920,136 children in 2015.”? But it’s not just children who are affected, as you have probably read in the past few weeks a certain American presidential nominee was said to be suffering from a form of pneumonia, once again bringing this serious condition to prominence. While it has largely been shaken off by the aforementioned candidate, pneumonia is a condition that should be taken seriously, as one of our colleagues found out a few years ago. In this article we take a look at pneumonia, share our colleague’s experience with the infection, and the condition’s link with health insurance.


What exactly is pneumonia?

Pneumonia is a term used to describe an acute infection of the lungs, most commonly caused by either a virus, bacteria, fungi, or aspiration of material into the lungs. This infection results in the alveoli (sacks in our lungs that allow the transfer of oxygen and carbon dioxide into and out of the lungs) filling with fluid, which in turn makes it hard for us to breathe.

Because there are a number of different causes of pneumonia, doctors will typically try to differentiate the infection into a number of different types, which will then dictate treatment. The most common types of pneumonia include:

  • Community-acquired pneumonia (CAP) – This term is used to describe pneumonia caught in public spaces i.e., not the hospital or care center. An infection developed during a cold or flu is also usually labeled as community-acquired pneumonia.  
  • Hospital-acquired pneumonia – Pneumonia contracted while you are in the hospital. The vast majority of cases of hospital-acquired pneumonia develop while you are in the hospital for another health issue e.g., surgery or long-term care.
  • Viral pneumonia – Pneumonia caused by a viral infection that can be contracted either at the hospital or in the community. One of the most common causes of viral pneumonia is the respiratory syncytial virus. Like other viral infections, antibiotics won’t usually help patients recover.
  • Bacterial pneumonia – Like viral pneumonia, this can be contracted both in the community and in healthcare centers, but this type of pneumonia is caused by bacteria. According to Everyday Health, “60 percent of all CAP cases are caused by bacteria called Streptococcus pneumonia, also known as pneumococcal pneumonia.”  
  • Fungal pneumonia – A type of pneumonia caused by a fungal infection or the inhalation of fungi, and is most commonly seen in patients with other underlying health issues such as those with an immunocompromised/immunosuppressed system.  
  • Aspirated pneumonia – Pneumonia that is caused by inhaling a foreign object into the lungs such as food, liquid, or even gastric material such as stomach acid. This is commonly treated like viral pneumonia, with antibiotics.    
  • Walking pneumonia – Also commonly referred to as atypical pneumonia, this is essentially any form of pneumonia that doctors deem not serious enough for hospitalization. In other words, it is a milder form of pneumonia.  


What are the common symptoms?

There are actually two common sets of symptoms with most types of pneumonia: bacterial pneumonia and non-bacterial pneumonia. Should you develop the symptoms below, it is advisable to consult with a doctor or go to the hospital if they are serious enough. Doctors will usually do a blood test and an x-ray to see if there is fluid in your lungs. Tests will then be run to confirm what type of pneumonia you have. From there you may be admitted to the hospital or given antibiotics.  


Symptoms of bacterial pneumonia

While these symptoms may be different for each patient, most people will notice:

  • A productive cough with phlegm that is green or rusty in color. There may also be blood in the phlegm.
  • Fever.
  • Strong chills that lead to teeth chattering.
  • Shortness of breath with fast shallow breaths.
  • Pain in their chest, especially whey they breathe in.
  • Feeling tired and drained of energy.
  • Nausea.
  • Night sweats or excessive sweating at night.  

For many people who contract bacterial pneumonia, the symptoms will usually come on seemingly all at once and will commonly start during or just after a cold, flu, or upper respiratory tract infection.


Symptoms of nonbacterial pneumonia

For most cases, the symptoms of nonbacterial pneumonia will actually feel quite similar to a cold or flu and will commonly include:

  • Light fever.
  • Dry cough with little to no phlegm.
  • Shortness of breath.
  • Headache.
  • Muscle pain or weakness.

The main difference here is that, while cold and flu symptoms will tend to lessen after a couple of days, these symptoms stay or even get worse as time goes on. For example, you may find it harder and harder to breathe, your cough gets worse, and fever increases. Other times, you may not even know you’ve had pneumonia, this is what doctors refer to as walking pneumonia.


Is pneumonia contagious?

No, and Yes. The vast majority of common pneumonia are not actually contagious. If someone you know is diagnosed with it, it does not mean that you too will catch it. Instead, it is the viruses or bacteria that cause pneumonia that are contagious. If you are exposed to the virus or bacteria, then you could get sick and could see pneumonia develop if your body can’t fight the illness.


Our colleague’s experience with pneumonia

When discussing this article and the situation that sparked the idea to cover it, we found that one of our colleagues on the marketing team actually had an interesting bout of pneumonia a few years ago. Here is his story:

“In April 2012, a few months after I had moved to Bangkok from Hong Kong for a new job. I had settled into Bangkok nicely and was enjoying the city, but had to return to Hong Kong for a visa run. About a week before my trip back to Hong Kong I caught a pretty nasty cold and spent a few days in bed recovering. It was one day before my flight and I felt better, so I decided not to postpone my trip. This, I believe, turned out to be a major mistake!

On my flight to Hong Kong, I was sat beside a guy who sounded like he had a miserable cold. A nasty, near constant cough, the continuous blowing of his nose, etc. More than once he sneezed without covering his mouth and I am fairly certain I was exposed to his germs. That night I felt ok and went out to catch up with old friends from Hong Kong. By the end of the night, however, I was feeling like another cold was coming on and decided to get some extra sleep.

Throughout the weekend, the symptoms digressed and I really felt like the cold was in my chest. By Sunday night I remember feeling extremely tired, it was hard to breathe, I felt nauseous, and I certainly had a fever. I took some Panadol cold medication to try and break the fever and went to bed at 6:00 pm, thinking a good night’s sleep would do the trick, as I had to fly back to Bangkok the next day.  

I vividly remember waking up at around midnight with the sheets soaking wet from head to toe. I thought to myself that this was great, the fever had broken and I was just ‘sweating it out’ as I changed the sheets and went back to sleep. The next morning, Monday, I woke up feeling worse but decided that I felt well enough to fly back to Bangkok where I could take a few days off at home and rest.  

That flight back to Bangkok was one of the worst flights I have ever taken. My breathing had somehow gotten worse with a dull pain whenever I took a breath and my fever was back. By the time I got back to my condo in Bangkok I was exhausted and was now coughing up phlegm, but I decided to just go to bed instead of going to the hospital.

The next morning, I woke up and coughed up some phlegm. As I spit it out into the sink, I noticed that there was a blood in the phlegm. My exact thought being “Hmm, that shouldn’t be there. I think I should go to the hospital.” My next thought was “Which hospital do I go to? I can’t speak Thai.”  

Luckily, my uncle also lived in Bangkok at the time, so I called him and he instructed me to go to Samitivej Hospital, one of the international hospitals in the city. I checked into the hospital, filled out the paperwork and sat down where they told me to. A few minutes later a nurse came along and asked me to explain my symptoms, which I did:

  • Fever
  • Night sweats
  • Phlegm with blood
  • Chest pain when I breathe in
  • Extremely weak and tired.

She got a very, very worried look on her face and immediately called a wheelchair over. I was taken right into the doctor’s office at the pulmonary ward and given a chest x-ray along with a blood test. Reviewing the x-ray, the doctor told me that I had a fever of just under 38 degrees along with a worrying amount of fluid in my lower right lung (in other words pneumonia). I was subsequently admitted to hospital for three nights and then told to take three weeks off of work to recover. I was also diagnosed with asthma, which I still have to take an inhaler daily to keep under control.

Now, you are probably asking “Why didn’t I go see the doctor in Hong Kong? Why did I wait so long to see a doctor in Bangkok?” Well, the answer to that is that I did not actually have health insurance. Through a slip-up at my new company, my company-sponsored health insurance application was not actually submitted when it should have been, which meant I had not received coverage before I got sick.

At the time, I was not making a lot of money and knew I couldn’t afford a hospital visit, even in Thailand. Because of this, I ended up having to borrow money from my uncle to cover the costs of care, which came to THB 55,000 (almost double my monthly salary at the time). To make matters worse, when my insurance application was accepted (after I recovered) the insurer denied coverage of asthma due to the fact that it was a pre-existing condition. All of this could have been avoided if I had health insurance.

Yes, it was from this experience I learnt a valuable lesson the hard way: If you are going to move countries, ensure that you have health insurance in place before you move. The cost of securing an international health insurance plan may seem like a steep investment, but it pales in comparison with potential medical bills. I wish I had known of Pacific Prime before I left Hong Kong!”

If you would like to learn more about your health insurance options before you move countries or even jobs, contact Pacific Prime today.  

Allergies in Asia

Cleaning for allergens

It all starts with a night out with your family. Things are going well until your youngest child starts to complain that their throat itches and skin feels itchy. Then within a matter of minutes their lips and eyes have puffed up, they are having trouble breathing, and you see hives breaking out all over their skin. This can be a scary situation for any parent, especially when you need to rush to the hospital for care only to find out your child is allergic to eggs or peanuts.

Life certainly just got a lot harder, especially if you live in Asia where some common ingredients like eggs, peanuts, shellfish, and even soy are used in abundance. But, it’s not just food allergies that we have to worry about, in fact, there’s a long list of things that can cause allergies including medication, insects, the environment, and more. According to the World Allergy Organization, “The prevalence of allergic diseases worldwide is rising dramatically in both developed and developing countries.” And, it’s not just kids being affected with different organizations such as the Allergy and Asthma Foundation of America noting that 40% of adults suffer from some form of allergy.

While the vast majority of cases will inevitably be mild, leading to a quick doctor visit if a patient is worried enough, there is still a risk of serious allergic reactions that can be life-threatening. In this article, we take a look at what exactly allergic reactions are, the common causes and cures, and how your health insurance can play a key role in ensuring you receive the best care for any allergic reaction.  


What exactly is an allergic reaction?

Chances are high that you have had an allergic reaction before, you likely may not have known it or may have associated it with something else. At a high level, an allergic reaction is when your body reacts to a foreign substance commonly referred to as an “allergen”. When an allergen enters your body, either by being inhaled or ingested, or even comes in contact with your skin, your immune system will react by producing antigens in order to protect you. This reaction to usually harmless items is what doctors refer to as a hypersensitivity reaction, or an allergic reaction.

When we do see an allergic reaction, most of the time it is usually minor with symptoms that can often include one or many of the below symptoms including:

  • Hives on the neck or face
  • Light to moderate itching
  • Runny or congested nose
  • Rash on the skin, especially where something you are allergic to touched you
  • Red eyes
  • Slight discomfort

With some cases, allergic reactions can be more severe and include symptoms such as:

  • Pain in the abdomen
  • Difficulty breathing, or breath coming with a wheezing sound
  • Tight chest
  • Moderate to extreme discomfort
  • Nausea or vomiting
  • Diarrhea
  • Swelling of eyes, lips, or tongue
  • Trouble swallowing
  • Heart palpitations
  • Loss of consciousness  

When it comes to the more severe symptoms of an allergic reaction, like trouble breathing and swelling of throat/eyes/mouth, this is commonly referred to as anaphylactic shock and it is essential that you seek medical care at an emergency room ASAP. Many people that have an established allergy will often carry an EpiPen with them. EpiPens are a device that inject epinephrine (pure adrenaline) directly into the body in order to help open airways and keep them open long enough for that person to get to a hospital.


What causes allergic reactions?

The list of things that can cause an allergic reaction is incredibly long, primarily because there are so many different types of allergens out there. In Asia there are a number of common allergens that cause allergic reactions in people including:

  • Insect bites and stings.
  • Foods like milk, nuts, and shellfish.
  • Medication like penicillin, aspirin, or common barbiturates used to dull pain after surgery.
  • Mold like black mold, commonly found in humid climates and buildings that are not well ventilated.  
  • Seasonal allergies to pollen in the air.
  • Animal dander.

In a recent article published by the SCMP, there were 3 potential factors uncovered by recent studies as to not only why the number of people with allergies is increasing, but also the main causes behind these allergies.

  1. Our environments are too clean – A common thought is that one of the reasons kids develop allergies is that they simply aren’t exposed to the microbes and germs in the environment as often. Think about young children these days, many parents keep them from playing in the dirt which scientists believe exposes their immune systems to potential allergens at an earlier age, giving them a chance to build up immunity.
  2. We have less exposure to vitamin D – One study found that the further people live away from the equator, the higher chance they will develop a food allergy, it also found that many children with food allergies also have low levels of vitamin D. This is, of course, a theory, but it could very well be plausible.
  3. Our diet during our early and formative years – Traditionally, some health experts have recommended delaying a child’s exposure to common food allergens at an early age (as in less than one to two years). Now, it would appear that studies have found that actually feeding your child things like milk, nuts, and eggs from an early age can help reduce the chance of developing an allergy later in life.


What cures it?

Unfortunately, for the most part, there is not a whole lot that can be done to “cure” an allergy. Some people will outgrow an allergy, but others are usually recommended to avoid the source of the allergy. This is especially true for allergies to food and environment where a reaction has been severe. Mild reactions will usually be treated with antihistamines or some lower powered corticosteroids

If an allergy is severe enough, many people will be instructed to carry an EpiPen with them in order to help ensure that should you have a reaction you will be able to get to a hospital in time. They may also be prescribed powerful corticosteroids that are meant to be taken over a period of time, or administered via an IV drip to help get the body recover from a reaction.   


How does health insurance factor into allergies?

Health insurance can play an important part in the care for and recovery from allergic reactions, primarily because if you do have a reaction, you are likely going to need to see a doctor. Unlike other health concerns, it can often take time to identify exactly what you are allergic to, which means the need for multiple visits to the doctor along with a likely visit with specialists. In cities like Hong Kong, Singapore, and indeed much of Asia, you are likely going to need to look for care from the private sector, which can be incredibly expensive, especially if you need multiple visits.

Beyond that, you may need to acquire an EpiPen or similar device. In the US it has been reported that the price of these pens has increased by nearly 600% since 2007. Other countries have seen price increases of these devices, which while you hope will never have to be used, do expire and need replacing every year or so. This makes EpiPens a considerable investment regardless of your location.  

It is largely because of these costs that it is important to secure a health insurance plan. Many plans will cover allergic reactions and the resultant care along with medication, which can help ensure that you are not left with a large medical bill should you have an allergic reaction. To learn more about our plans available, visit our website today.

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 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.


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, 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.”  


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


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?


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.