Do I need expat insurance when reciprocal health care agreements are in place?

The Living Abroad Series

Some helpful information for Australians who are planning to live and work overseas.

Part 1: Do I need international health insurance (expat insurance) when reciprocal health care agreements are in place?

Australia has reciprocal health care agreements with 11 countries; these agreements are in place to allow Australians visiting these countries to get publicly funded medical care.

Each agreement is slightly different and is generally limited to emergency care or treatment for an illness or injury that can’t wait until you return home. There are also certain conditions that must be met in order to access services under the agreements.

Australia has a reciprocal health care agreement with the United Kingdom, however, to have your medical cost covered the treatment must occur within 6 months of your arrival in the country. Therefore if you are planning on living in the UK, you may not be able to access these services under the agreement and may have to pay for your treatment.

What services are not included under the agreements?

The services not accessible under the agreements are different for each of the 11 countries, therefore you should familiarise yourself with the agreements with the country to which you are travelling:

For example:

The agreement with Norway does not cover students, Sweden does not cover the daily fees for staying in hospital and Finland does not cover fees for out-patient care.

The current 11 countries and their agreements are listed below with a summary of the extra cost possibly not covered by each agreement.

So do I need expat insurance when agreements are in place?

Yes, most agreements will only include treatment within the first 6 months of arrival as they are designed for travellers, not for those living abroad for an extended period. Also the agreements are designed to provide emergency treatment, so if your condition is deemed not urgent enough to be treated you may be denied treatment under the agreement and need to pay the cost of the care provided.

CountryCriteria for treatmentPossible Extra CostsCosts not covered
BelgiumMust be essential care that can’t wait until you get home.Hospital stay - admission fee and a small daily fee.

Hospital services - partially reimbursed.

GP or specialist doctor, dental and allied services - pay 25% to 40% of the cost.

Ambulance travel - 50% of the cost.
Certain pharmaceutical medicines.
FinlandMust be essential care that can’t wait until you get home.Daily accommodation fees to stay in hospital.
Fees for specialist care or out-patient care.
ItalyMust be essential care that can’t wait until you get home.

Through the national health service.

Within 6 months from the day you arrive.
May need to pay for medicines and tests.
MaltaMust be essential care that can’t wait until you get home.

Within 6 months from the day you arrive.
May need to pay for medicines and tests.
The NetherlandsMust be essential care that can’t wait until you get home.

Within 12 months from the day you arrive.
Prescription medicine - a full or part refund.

Transport - a part refund for ambulance or taxi travel to get urgent care.
Staying in a comfortable or single room in hospital unless it’s essential.

Non-specialist dental care if you’re 18 or older.

Psychiatric care if you’re under 18.

Repatriation costs - costs associated with sending you back to your home country.
New ZealandNecessary medical care that can’t wait until you get home.

Within 2 years from the day you arrive.
Care from a GP or other primary care.

The full cost of medicines a GP prescribes - you’ll pay part of the cost of these.

Ambulance travel.
NorwayMedically necessary care that can’t wait until you get home.

Within 12 months from the day you arrive.
Full price until you spend about $347 in 1 year.The agreement doesn’t cover students and diplomats.
The Republic of IrelandMedically necessary care that can’t wait until you get home.

Within 12 months from the day you arrive.
You will need to pay a fee for each service.Accommodation as a private patient in a private or public hospital.

Care as a private patient - this includes as a private patient in a public hospital.

Prescription medicines below a set amount in 1 month.

Anything you arranged before you got to Ireland.

Visits to a GP.
SloveniaMust be essential care that can’t wait until you get home.You will need to pay part of the cost for some services.

Part of the cost for medical treatment in the public health system, GP, specialist, dentist and pharmacies.

30% of the cost of prescription medicines.
Care from a GP, specialist or dentist who doesn’t have a contract with the HIIS.

Medicines on the negative list.

90% of the cost of medicines on the interim list.

90% of the cost of any other ambulance travel.
SwedenIt must be medically necessary care that can’t wait until you get home.Adults will need to pay a small fee for each service.Cover daily fees for staying in a hospital.
United KingdomMedically necessary care that can’t wait until you get home.

In the National Health Service (NHS) system.

Within 6 months after you arrive.
Most NHS services are free. You’ll still pay fees for some things, such as medicine.

If you get private care you’ll pay the full cost.
Non-subsidised medicine from pharmacies.

Prescription medicines if you’re not an NHS patient.

Any dental services.

This information is provided as a guide only.  Please visit the Department of Human Services website for additional and updated information. This information is current as of September 2018.

The information contained in this blog is for general information purposes only.  In some instances, it may contain general advice; i.e. the advice has been prepared without taking account of your objectives, financial situation or needs.  Because of this, you should, before acting on the general advice, consider the appropriateness of the advice, having regard to your objectives, financial situation and needs.  You should obtain a product disclosure statement ("PDS") relating to the relevant insurance policy and consider the PDS before making any decision about whether to acquire the insurance policy.

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