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Areas of health insurance cover explained for expats

With an expat health insurance, you have access to private healthcare in multiple countries. But what does ‘international’ really mean? In this guide, we take a closer look at the different international areas of health insurance cover for expats.

Areas of health insurance cover explained for expats

With a international health insurance policy, you have access to private healthcare in multiple countries. That is why it is an excellent choice for people who live and work abroad, or who spend much of the year travelling for business or pleasure. But what does ‘international’ really mean? How can you be confident that you’ll be covered when and where you need it? In this guide, we take a closer look at the different international coverage options you can choose with William Russell. We call these options ‘areas of cover’.

 

What does ‘area of cover’ for expats mean?

The area of cover is a feature of international health plans that you do not typically find in domestic plans. In short, it is the geographic or territorial limits of your plan, specifying in which countries you’re covered and which countries you’re not.

Every health plan from William Russell has an area of cover. There are five zones, and you can choose any zone with any of our health plans (though Zone 3 is only available to residents of Indonesia).

As a rule of thumb, a more restrictive zone means a greater saving on your premium.

Do all your expat health insurance plans give me international cover?

Yes. Our international health insurance plans are designed for expats, a demographic of people with travel in their DNA. For this reason, all our health plans come with international cover as standard.

For example, with a fully worldwide insurance cover, it is entirely possible that two customers in Canada and Vietnam could travel to each other’s country for medical treatment.
Yet, it’s far more likely that the Canadian resident will stay in Canada for their treatment (where costs are higher) while the Vietnam resident will stay in Vietnam for their treatment (where costs are lower).

So, while both of these customers have the same area of health insurance cover (worldwide), the expected costs are likely to be very different. How can we at William Russell calculate insurance premiums that are fair for both customers living in countries where private healthcare is expensive and customers living in countries where it is cheaper?

We deal with this challenge in two ways:

  • We calculate premiums according to the country where you live, so you don’t pay over the odds for the private healthcare available in your country
  • We have different areas of cover so you can minimise the impact of expensive private healthcare in countries (that perhaps you’re not planning to visit) on your premiums.

Take a look at this handy table with the areas of international health insurance cover for expats explained:

Zone 1

Zone 2

Zone 3

Zone 4

Zone 5

Worldwide cover, with restricted cover in the USA
Full cover in most countries, with restricted cover where private healthcare is expensive but no cover in the USA
Special area of cover for residents in Indonesia, with restricted cover where private healthcare is expensive but no cover in the USA
Full cover in Africa & Indian Subcontinent, with restricted cover elsewhere but no cover in the USA
Full cover in Africa (except South Africa) & Indian Subcontinent, with restricted cover elsewhere but no cover in the USA

 

Areas of health insurance cover: Zone 1 (worldwide cover, with restricted cover in the United States of America)

Zone 1 means full cover for private healthcare in all countries in the world, with restricted cover in the USA. ‘Restricted cover’ means you only have cover up to US$50,000 for accident & emergency treatment during temporary trips you make to the USA.

And what’s more, you have the freedom to choose any hospital, clinic or doctor for your medical treatment.

Freedom to choose any hospital, anywhere in the world

By any, we mean any. We’re quite different from other insurance providers because we don’t have a restrictive network of preferred hospitals and clinics in each country. You’re free to choose the best hospitals where you live. Or, if you wish to have treatment at home, you can travel home.

Plus, if you suffer an illness or injury where the urgent hospital treatment you need is not available locally, we evacuate you to the nearest suitable hospital.*

So, why does Zone 1 not have full cover in the USA? It’s no secret that private healthcare costs in the USA are astronomical. And only a fraction of our members need cover there. So, rather than make all members pay for something they don’t need, we limit cover in the USA as standard. Members can choose to add further cover in the USA.

Zone 1 is available to everyone, no matter where they live.

*It’s important to note that we don’t cover evacuations from, within or to the USA.

Areas of health insurance cover: Zone 2 (full cover in most countries, limited cover where private healthcare is expensive)

As a rule of thumb, the cost of private healthcare drives the cost of health insurance premiums. So, if you have a truly worldwide health insurance cover, it’s likely that expensive private healthcare in cities like Vancouver, Hong Kong and Singapore is putting pressure on your insurance premiums. But if you live in a country where private healthcare is less expensive (e.g., Kenya, Vietnam), why pay for cover in more expensive countries that you may never even visit?

Zone 2 can help by limiting your cover in countries where private healthcare is expensive to accident & emergency treatment only. In return, you can save up to 20% on your insurance premium.

So, what does international cover look like with Zone 2?

Most countries around the worldCountries where private healthcare is expensive
  • Full cover
  • Freedom to choose hospitals & doctors for your treatment
  • Cover for emergency medical evacuation
  • Cover for accident & emergency treatment only (up to US$100,000)
  • Cover for emergency medical evacuation
  • No cover in the USA

*Here’s the definitive list of where your cover is limited to accident & emergency treatment with Zone 2: United Kingdom, all countries in the European Economic Area, Andorra, the Channel Islands, Gibraltar, Greenland, Monaco, San Marino, Switzerland, the UAE, Singapore, Thailand, China, Hong Kong, Macau, Taiwan, Japan, Australia, New Zealand, Canada, and the Caribbean countries and islands.

Of course, Zone 2 is only available if you live in a country where private healthcare is less expensive. It’s designed for expats living in Latin America, Africa, the Indian Subcontinent, and Southeast Asia who don’t really need cover in countries and regions where private healthcare is expensive (e.g., Europe, East Asia).

Zone 2 wouldn’t work well for residents of Hong Kong or France, because they’d only have cover for accident & emergency treatment where they live and work.

Okay then, so what kind of saving can you expect on your premium with Zone 2?

  • 20% on personal health plans with Zone 2 (compared to Zone 1)
  • 20% on health plans for businesses with Zone 2 (compared to Zone 1)

Areas of health insurance cover: Zone 3 (special area of cover for people living in Indonesia)

The ideas behind Zone 3 and Zone 2 are similar: we help you to reduce your premium by limiting your cover in countries where private healthcare is expensive. But there are a few crucial differences:

  • Zone 3 is only available if you live in Indonesia
  • The countries where you have limited cover under your health plan are different
  • The cover limitations in those countries are different

So, what kind of saving can you expect if you choose Zone 3?

  1. 15% on personal health plans with Zone 3 (compared to Zone 1)
  2. 15% on health plans for businesses with Zone 3 (compared to Zone 1)

But why is there a special health insurance cover area for people living in Indonesia?

Indonesia is one of the largest countries in Southeast Asia by population and its popular with expats and tourists alike. It might surprise you to know that there are hundreds of companies in Bali operating in the health insurance industry.

But Indonesia poses a unique challenge for health insurance companies. It’s an archipelago of islands like Bali, some of which are incredibly remote and many of which have limited healthcare systems. As a result, island residents must often travel to Jakarta for medical treatment.

Sometimes, expats prefer to travel to foreign cities like Singapore and Hong Kong for their medical treatment. While there is nothing wrong with this practice (if international travel is medically safe), it does cause a problem for insurance providers.

Private healthcare in cities like Singapore is considerably more expensive than in Jakarta. So, we need a way to calculate premiums that are fair for expats who are happy to stay in Indonesia for most (if not all) of their medical treatment.

That’s where Zone 3 comes in. It’s perfect for expats in Indonesia who are happy to receive their medical treatment in Indonesia (or other countries in Southeast Asia where private healthcare is less expensive). In return for a 20% premium discount, Zone 3 limits the cover you receive in China, Hong Kong, Macau, Taiwan, Japan, Singapore, Switzerland and the London area.

Where is my health insurance cover limited with Zone 3?

Here’s the definitive list of where your cover is limited with Zone 3: China, Hong Kong, Macau, Taiwan, Japan, Singapore, Switzerland and the London area. There is no cover at all in the USA.

How is my health insurance cover limited in those countries?

There are two different limitations. In the countries listed above, you have:

  • 80% cover for elective treatment costs
  • 100% cover for accident & emergency treatment (up to US$100,000)

Areas of health insurance cover: Zone 4 (full cover in Africa & the Indian Subcontinent, with restricted cover elsewhere)

If you live in a country in Africa or the Indian Subcontinent, and you’re not too worried about cover while you’re travelling through countries outside these regions, you might want to consider Zone 4 as a way to reduce your premium. Zone 4 restricts your cover in countries outside Africa and the Indian Subcontinent, where private healthcare is usually more expensive, to accident & emergency treatment only.

So, what does your cover look like with Zone 4?

Africa & Indian SubcontinentElsewhereUSA
  • Full cover
  • Freedom to choose hospitals & doctors for your treatment
  • Cover for emergency medical evacuation
  • Cover for accident & emergency treatment only (up to US$100,000)
  • Cover for emergency medical evacuation
  • No cover

Of course, Zone 4 is only available if you live in a country in Africa or the Indian Subcontinent. It wouldn’t work well if you lived in France, for example, because you’d only have cover accident & emergency treatment in France and neighbouring countries.

Areas of health insurance cover: Zone 5 (full cover in Africa & the Indian Subcontinent except South Africa, with restricted cover elsewhere)

Zone 5 is very similar to Zone 4. The only difference is that, for Zone 5, we don’t count ‘South Africa‘ as belonging to Africa and the Indian Subcontinent. South Africa is the most expensive country for medical treatment in Africa, so restricting your cover there means we can give you a better discount.

So, what does your cover look like with Zone 5?

Africa & Indian Subcontinent (excl. South Africa)Elsewhere (incl. South Africa)USA
  • Full cover
  • Freedom to choose hospitals & doctors for your treatment
  • Cover for emergency medical evacuation
  • Cover for accident & emergency treatment only (up to US$100,000)
  • Cover for emergency medical evacuation
  • No cover

Like Zone 4, of course, Zone 5 is only available if you live in a country in Africa or the Indian Subcontinent. It wouldn’t work well if you lived in Germany, for example, because you’d only have cover accident & emergency treatment in Germany and neighbouring countries. The same goes for South Africa: Zone 5 is not available if you live in South Africa. Zone 4 is a better choice for you.

 

Health insurance cover for expats in the United States of America

Most of our members will never need cover for private healthcare in the USA. Zone 1 comes with some restricted cover in the USA, but if you need more cover we have two options.

These options might be useful if you make regular business trips or holidays into the USA. Alternatively, if you’re a US citizen and you’re lapsing your domestic insurance, you might want some cover for trips home.

It’s important to note that the options only give you cover on temporary trips to the USA. However, there is no limit to the number of trips you can make in a single year. Final detail: the USA options are also only available if you choose Zone 1 as your area of cover.

USA-45

This option gives you cover for private healthcare in the USA while you’re making a temporary trip of up to 45 days. The overall amount we pay towards your treatment is US$250,000 each year, but there are two important caveats:

  1. We only pay for medically-necessary treatment you receive in the USA up to US$100,000
  2. We pay up to US$250,000 for accident & emergency treatment that you receive in the USA as long as you’ve never suffered from that condition before starting your trip

Even with the USA-45 option, we don’t cover you for emergency medical evacuations to, from or within the USA.

USA-90

This option gives you cover for private healthcare in the USA while you’re making a temporary trip of up to 90 days. The overall amount we pay towards your treatment is US$250,000 each year, and that includes both medically-necessary treatment and accident & emergency treatment.

Even with the USA-90 option, we don’t cover you for emergency medical evacuations to, from or within the USA.

 

So, what international health insurance cover should you choose?

It all depends on your location! Check the below:

If you live in a Southeast Asian country like Malaysia or Vietnam (where private healthcare is less expensive), Zone 2 might be a good place to start. You have full health insurance cover in most Southeast Asian countries and cover for accident & emergencies when travelling in Europe and East Asia. Plus, you save up to 20% on your premium.

If you live in Singapore and Thailand, your only option is Zone 1. This is because private healthcare in Singapore and Thailand is expensive (almost as much as Hong Kong, Europe and Canada for certain treatments).

If you live in Indonesia, you can choose any of the three area of cover options. The right option for you depends on your preferences:

  1. If you want to keep things simple and you have the budget, Zone 1 gives you worldwide cover except the USA. This means you have full cover if you wish to travel to Singapore or Thailand for treatment.
  2. If you want to save money on your premium, you can consider Zones 2 and 3. These give you full cover in Indonesia and most Southeast Asian countries, but limited cover in places like Hong Kong and Singapore.

East Asia (also known as the Far East) typically includes the following countries: China, Hong Kong, Macau, Taiwan, South Korea, Mongolia and Japan.

Suppose you live in South Korea or Mongolia. In that case, you could consider Zone 2, which gives you full health insurance cover in those two countries and accident & emergency cover elsewhere in the region and when you travel to regions where private healthcare is expensive (e.g., Europe, Australia).

If you live in another East Asian country (e.g., China, Japan), Zone 1 is the only available option, which gives you full cover worldwide except the USA.

The Indian Subcontinent typically includes the following countries: India, Sri Lanka, Pakistan, Bhutan, Bangladesh, Nepal and the Maldives.

If you’re looking for cover while you’re living, working and traveling in the Indian Subcontinent, then Zone 2 might be a good option for you. You have full cover across the Subcontinent, Africa and Southeast Asia, and limited cover for treatment when you’re travelling in countries where private healthcare is expensive.

If you require full cover in Europe and the more expensive locations in Southeast Asia and East Asia, then Zone 1 might be best for you.

If you’re only looking for cover while you’re living, working and travelling in the African continent, then Zone 2 might be a good option for you. You have full cover in all African countries, full cover if you travel to India for treatment, and cover for accident & emergency treatment when travelling in countries where private healthcare is expensive.

If you require full cover in Europe and the more expensive locations in Southeast Asia and East Asia, then Zone 1 might be best for you.

If you’re only looking for cover while you’re living, working and travelling in Latin America continent, then Zone 2 might be a good option for you. You’ll have full cover in all Central and South American countries (including Mexico). You also have cover for accident and emergency treatment in Canada and the Caribbean.

Suppose you’re looking for cover in the USA. In that case, you can consider Zone 1 with one of the options for temporary cover in the USA.

If you live in Europe or the UK, Zone 1 is the only available option, which gives you full cover worldwide except the USA.

Wherever you move, we can help you safeguard your health

At William Russell, we have nearly 30 years of helping expatriates move abroad and settle into their new lives overseas by providing world-class international health insurance. Plus, we produce lots of expert material to help you and your family adapt to life abroad.

Making the move to another country can be challenging. But no matter where you go, you can take one thing off your mind. William Russell offers global health insurance that can cover you for everything from minor injuries to long hospital stays, and we even offer medical evacuations to patients who require treatment in other countries.

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Notes on the areas of cover
You won’t find complete information for our plans on this webpage, nor the full T&Cs, limitations, and exclusions that would apply if you purchase one. You can find complete information in the plan agreement, which we suggest you read together with this webpage. All the benefits on this webpage are per member per period of cover, unless we state otherwise. We show the benefit limits in US dollars, but we can also denominate your plan in pounds sterling or euros.