Analysis: International PMI and chronic conditions

Every insurer treats chronic conditions differently. Cigna Global Health Benefits has two corporate plans, Premier and Premier Plus, both of which cover chronic conditions, including asthma, diabetes, heart, cancer and kidney, says John Kaye, director, sales and client management.

“Premier Plus also provides more preventative treatment, such as cancer screening," he says.

This is vital cover for companies sending staff overseas.

“They have to send the right individual, regardless of their medical history," Kaye explains. "As a result, employers tend to cover chronic conditions, allowing employees to concentrate on their assignments knowing they have comprehensive cover.”

Cigna does cover pre-existing chronic conditions on its group plans, but its fully-underwritten individual plan, Cigna Global Health Options, excludes them. However, it does cover any chronic condition that arises during the period of cover, unless related to a declared pre-existing condition.

Chronic conditions can land the insurer with a hefty bill, says Debbie Purser, managing director at MediCare International, another iPMI provider.

“Treatment has no obvious end in sight," Purser says. "With asthma or multiple sclerosis, costs could run into tens of thousands of pounds, but we will cover the cost of treatment and ongoing medication.”

MediCare International has picked up some major bills for chronic care in the last 12 months.

“We have refunded more than £23,000 for a case of Crohn’s disease in Germany, £15,000 for rheumatoid arthritis in Hong Kong, and £90,000 for a case of multiple sclerosis in the US," she explains.

Cancer can be an even bigger challenge.

“Cancer blurs the boundaries between chronic and treatable illnesses, now that many cancers are curable, albeit after lengthy treatment," Purser continues. "A leukaemia patient could easily run at £50,000 of cost in under 12 months.”

Set against these sums, iPMI looks good value.

“We are always looking at ways of reducing premiums, and recently introduced a new voluntary excess giving policyholders discounts of either 10%, 20%, 35% or 50%,” Purser says.

MediCare International does not cover pre-existing chronic conditions, except on some of its group plans.

Last summer, AXA PPP International introduced chronic conditions cover on its top two plans, Comprehensive and Prestige. This covers the costs of routine specialist consultations and diagnostic tests needed to monitor and control conditions such as asthma, raised blood pressure and diabetes.

AXA PPP International currently offers cover for 15 chronic conditions. From April, it will extend that to all chronic conditions, says Karen Teasdale, marketing operations manager.

“Individuals, SMEs and our large corporate clients can secure cover against the costs of recurrent, continuing or long-term treatment of chronic medical conditions," Teasdale says. "These plans offer an overall benefit allowance of £2m and £1.5m respectively.”

AXA PPP International does not cover pre-existing chronic conditions. Nor does Aviva. But the latter does offer routine maintenance of long-term chronic conditions as core cover on its International Solutions policies, both for corporate and individual clients, says Teresa Rogers, international business lead.

"Each member receives up to £15,000, €16,500 or $22,500 towards routine maintenance of chronic conditions," Rogers says. "Customers also receive up to £50,000, €55,000 or $75,000 towards treatment of acute phases of chronic conditions. This covers unexpected flair-ups of a chronic condition until it is stabilised."


Not every customer wants or needs routine cover for chronic conditions, Rogers says.

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