When you go overseas, one of the biggest decisions you will need to make is making sure you have the correct health insurance. It may seem like an easy task, but once you start to look at things like PPO and HMO and the fine print associated with these items, things get a little complicated. More and more, these systems integrate into the less familiar parts of the U.S. healthcare system, and if you pick the wrong one, they can and will charge you very high costs for little care abroad. More and more recently, these systems integrate into the less familiar parts of the U.S. healthcare system, and if you pick the wrong one, you will end up being charged incredibly high costs for little care abroad.
We here at ExpatGlobalMedical in Winston-Salem, NC, assist individuals, families, remote workers, globe-traveling employees, and worldwide travelers in attaining dependable, inexpensive worldwide medical insurance, travel medical insurance, and air transportation medical insurance. Also, we have a contract with top-rated life providers such as Transamerica Life, John Hancock, Ole’, and American Fidelity.
This brief will relate the differences between the vast PPO and HMO networks overseas and explain which one fits best for a majority of expats.
What is an HMO? Why Doesn’t It Work Well Abroad?
If you know how an HMO works in the U.S., you know how constrictive and locked in it is. You have to select one primary care physician, and you have to stay in a network and receive referrals for almost everything. This setup works for people that stay in one location and use health care services in a predictable and repeated system.
The problem with HMOs is that they do not do well with people traveling internationally. Most HMOs do not have many partnerships with hospitals around the world. This means you might be limited to only emergency treatments, and even then you might have to pay out of pocket and file for reimbursement later, and even that is with complicated instructions.
For expats that live abroad full time or travel a lot, an HMO becomes more of a liability than a benefit. The network restrictions alone make it almost impossible to get sustained and consistent care. And if you are in a country with limited English-speaking doctors or if you are in need of a specialist and you are in a country with few doctors, then the referral requirements can cause delays that are not needed.
Overall, HMOs work best if you are within the borders of the U.S. The moment you step outside, the benefits are that much less.
Read More: US vs. Canada Medical Insurance: What Expats Need to Know
Why PPO-Style Plans Are Best for Living Overseas
Flexibility is at the core of PPO plans. It is this very need for flexibility that expats need the most. When living abroad (or in several different countries for the year) you can’t be stuck in a narrow network or be waiting for referrals.
In contrast to the PPOs, which are based in the United States, international PPO plans are designed for a different set of needs. They are created for individuals living or traveling abroad, which means you can see virtually any doctor or go to any hospital you want. Rather than be tied to one country’s healthcare, you get access to the globe.
A unique feature of many countries is direct billing. For hospitals that partner with international insurers, you can walk in, get the care you need, and walk out without any payment being made at the time of service. It is the hospital that gets billed. In emergencies, this is a huge relief.
Also, many countries don’t have decent advanced care at all. If you were to have a serious injury, you would likely need to be transported (air or otherwise) to another country or back home, so international PPO plans providing coverage for this are essential. HMOs don’t include this.
You will never have to walk to get a referral. Unlike in countries such as the U.S., where access to a specialist is more regulated, you can get a specialist appointment right away. This is a great perk.
What Happens When You Need Care Outside Your Host Country?
This is the circumstance where the difference becomes more significant. Life abroad is not always predictable, such as, for example, a siesta in Spain or a cross-border business trip. Additionally, you might just want to get medical care in a country with better medical care.
With a PPO-style international policy, this freedom is built into the plan. You are not tied to one country. Many expats seek medical care in countries with world-class healthcare, such as Singapore, Germany, Thailand, or Costa Rica.
With an HMO-style plan, leaving your host country usually means your coverage goes with you. With such plans, you would be vulnerable to high out-of-pocket medical expenses as well as high costs for emergency-only treatment.
Cost Differences: PPO vs HMO for Expats
One should know that most people think that PPO plans are almost always more expensive than other plans. This may very well be true in the United States. However, internationally the situation is different since healthcare costs are different everywhere. Plans that are International PPO-style, Medicare Advantage, or HMO offer premiums that are surprisingly affordable in comparison to U.S. domestic insurance. This is because international PPO-style plans are more prevalent because of the variety of healthcare costs in different countries.
Your costs will greatly be dependent on the following factors:
- Your age
- Where you live
- Your plan includes U.S. coverage
- Your deductible and annual benefit options
Most of the time expatriates are more satisfied with international PPO plans because of their greater service, higher benefit limits, more global service, and most importantly the freedom that they offer and the significantly lower price than domestic U.S. plans.
Which of the options should you choose as an expat?
If you do not plan to stay in the US exclusively, the obvious option for expats, global nomads, remote workers, international students, and global students is a PPO-style international plan because it will be the most beneficial in the long run and will cater to most of the healthcare.
An HMO-style plan is not suitable for people of International Living because it cannot offer the worldwide coverage and broad network, or even the emergency evacuations that are really crucial when you live abroad.
Why ExpatGlobalMedical Is the Best Partner for Your Global Coverage Needs.
Just as important as selecting the right network is selecting the proper insurance provider. ExpatGlobalMedical understands the challenges of living abroad, as we handle expats on a daily basis.
- Based in North Carolina we provide
- Reasonably priced, quality international PPO medical plans
- Medical travel insurance for short visits
- Shelter and reclaim protection
- Group protection for remote staff and international businesses
- Access to top life insurance companies such as Transamerica, John Hancock, Ole’, and American Fidelity
For you to live abroad with safety and peace, we wish to make the complex world of international healthcare easier.
Read More: Expat Life Insurance: Why It Matters and How to Choose the Right Plan
Conclusions
Comparing PPO vs HMO abroad is more than a line-for-line comparison. It is an important step to ensuring that you live overseas with as little headache as possible. A PPO-style international medical plan is the only option for those living abroad in the USA. It allows you to pick your providers and comes with direct billing and emergency evacuation protection. Things that an HMO will never give you once you are abroad.
Working overseas, retiring to a new country, or living life on the road as a digital nomad, the right insurance is a must! With ExpatGlobalMedical, we guarantee your insurance will follow you wherever you go.
