“They never told me that”
Five words. That’s the inspiration for this week’s article on buying health insurance in Vietnam from a Vietnamese provider. Time & time again we hear these five words when speaking to clients.
When buying direct, there’s an overwhelming chance you’re getting a salesperson, not a health insurance adviser. This person will know approximately 3-5 products out of the hundreds of plans that are available.
Narrow plan offerings coupled with the pressure of hitting sales targets, lead to bias & improper recommendations. As the sale comes first, many important facts are often not disclosed.
To prevent yourself from getting in this situation, here are 6 questions to ask when buying health insurance from a Vietnamese provider.
1) How do you handle pre-existing conditions?
When getting quotes for health insurance in Vietnam, all premiums initially given to you are indicative in nature. They are based on the standard rates. They do not factor in extra fees for pre-existing conditions, high BMI, smoker loadings, etc.
Some providers can charge a premium loading to have a pre-existing condition covered. In general, chronic conditions will almost always be excluded, e.g. high blood pressure, diabetes, heart conditions, back problems, etc.
Ask the rep how their company handles pre-existing conditions. Most budget Vietnamese providers will automatically exclude pre-existing conditions.
Providers like Pacific Cross, Liberty & InterGlobal will at least consider covering them with a premium loading, but it’s all done on a case-by-case basis. If you want official offers from various providers, you will need to apply to each individually.
2) Are there any co-pays, deductibles or waiting periods?
Most Vietnamese providers have some set waiting periods for:
- Waiting period before regular coverage begins
- Special Diseases
Many Vietnamese insurers have a fixed 30-day waiting period before people are eligible to make claims for any illness, disease or condition. It’s also very common for Vietnamese insurers to having a 1-year waiting period for special diseases, which could include:
- Heart diseases
- Liver diseases
- Kidney diseases
What’s considered a “special disease” will vary by provider.
3) Do you have direct billing outside of Vietnam?
While your coverage area may be SE Asia, that doesn’t mean that your provider will actually do direct billing outside of Vietnam. That may not be an issue for low value claims, but you’ll probably want direct billing if you have a planned surgery with a $5,000 bill.
If they do offer direct billing, it’s usually only for pre-approved hospitalizations, such as an elective surgery. Usually it will take a few working days to coordinate direct billing as the provider will thoroughly check to make sure the claim is eligible.
4) What happens at renewal period following major claims?
If you have low claims relative to your premium paid, then your renewal premium should remain relatively unchanged, barring any age related changes or an annual premium increase from the provider.
But what about your policy if you have very high claims, chronic conditions, cancer or special disease?
That’s a subject that no Vietnamese provider will ever voluntarily bring up.
Most potential buyers & novice insurance salespeople, are probably unaware that Vietnamese providers can do with your renewal what they wish following high claims, chronic conditions, special diseases. If you have cost them money & you will continue to be a liability on their books, they will take action at your renewal. This can include:
- Large premium increases – premium increases can be from 20% -500%+. Really budget providers will just offer your renewal premium at how much money you cost them in the previous year.
- Limit your benefits – Will your fully covered benefit be fully covered at renewal? Yes, some providers can change people’s benefits.
- Co-insurance – you’re now responsible for X% of all your bills.
- Not renewing your insurance – some providers offer guaranteed renewability, meaning they won’t ever kick you off your plan at the renewal period. Some providers do not guarantee your insurance will be renewed.
Cue in: “They never told me that”
Simply put if you cost them money, then they’ll make it back up at renewal. If you have an ongoing condition, then that’s where you really see unfavorable renewals.
“I’ll just change providers if that happens”
If you have a serious enough condition to warrant that, then you’ll never get a new insurer to cover it as a pre-existing condition. The only current insurer with an office in Vietnam that does not operate like this is InterGlobal/Aetna.
See our article how Vietnamese providers differ from International providers
5) What claims support do you provide?
You should try to figure out if your salesperson is just that, a salesperson or if they’ll be there to support you throughout the year too. More than likely, after you buy your plan, you won’t hear from the salesperson again until your renewal date, that is if they’re still working there.
When you are direct with a provider, 100% of the onus is on you to make claims. No one will ever go out of their way to help you with claims & make it more convenient for you. You will need to spend your time, effort & energy for all things claims.
6) Is there Anything I should be careful about with this plan?
While you could get a full spectrum of answers here, try to figure out any specific weaknesses of the provider you’re going with. It could be direct billing, customer service, nitpicky claims, maternity plans, sports coverage, etc.
See if you can pinpoint some weaknesses to at least have your expectations set from the onset rather than be over promised and under delivered.