# expat health insurance Mondassur???



## kirikara (Jan 21, 2009)

Hi all,
so I have been comparing options for health insurance..
This is for the case of someone moving to the states without a job that provides health insurance.

I have been looking at several companies that offers expat health insurance and comparing that with what Blue Cross, cigna and the likes offer..

Here is what I found: 
It seems that expat health insurance are WAY better than what the US insurances offer for cheaper if you are in the market for some really good coverage.
coverage is often 90 to 100%, no deductible, copays are smaller, they cover accupuncture, etc..

a few caveat though, is that with the new law taking slowly taking effect, the US insurance don't have max coverage anymore, while the expat ones still do for now. 
Also, you need to pay upfront and then get reimbursed (except for big hospital bills etc..). But you might be able to combine that with a cash discount at your doctor.

After doing a bunch of comparisons, I found 2 plans that look pretty good Mondassur first expat premium plan and ASFE indice 60.
*
Mondassur* is the cheapest by far, though it does not cover as well (90% for routine stuff) but ASFE is better if planning to have a baby/high cost.
*Does anyone have experience with them?
*
I would go with Blue Cross again, but they are quoting $730 monthly for a plan that not as really much better (and sometime less good) than the mondassur plan costing $280.


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## Montserrat Cano (Mar 26, 2013)

I would just ask as specialist health broker, who may be able to do some research to you according to your specific needs for free. For instance, Medibroker. com


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## kirikara (Jan 21, 2009)

Montserrat Cano said:


> I would just ask as specialist health broker, who may be able to do some research to you according to your specific needs for free. For instance, Medibroker. com


Not sure what you mean... Are you just advertising your services?
I dont need to find more plans, I wanted to get feedback from people using these plans in the US...


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## Montserrat Cano (Mar 26, 2013)

OK, I just thought it might be useful to you. Good luck with your move to US, though!


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## Crawford (Jan 23, 2011)

Picked up on the necessity to pay up front for medical costs and then get reimbursed.

Would you have the several tens of thousands of dollars if you were hospitalized for instance? 

Sorry, don't have any experience of these expat policies, but if the one is quoting you only 280 dollars a month I would have deep reservations as to what it could provide.


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## kirikara (Jan 21, 2009)

Nope, anything that is major medical at the hospital or above $1000 for certain procedures is paid directly by the insurance to the provider. No money upfront. Like any US company, you need approval for major surgeries and such.

Actually, I dug deep in our BCBS insurance when we lived in the US because , being french, I was freaking out at the little coverage we had and had trouble understanding how it all works. I feel pretty well versed now and I am glad I did.
Now obviously, for $280 a month those plans are not the best in the world, but it is also one of the cheapest I found and there are plenty way better plan that are still lots better than BCBS and lots cheaper ($500 vs $730)..

to sum up here is what that plan offered:

A *yearly* max coverage of 500.000 euros. if something is extremely wrong that could be an issue. Now, again, there are lots of other better options if this is a concern. My pre-obamacare BCBS was a *life* max of $1M so it does not concern me too much given the cost. I would probably upgrade to a better plan within a couple years though.
No maximum out of pocket.
Dr visits are covered up to a max, that is fairly low (100 euros for a MD, 130 for a specialist) but according to my previous bills, it is still comes out cheaper than with the $40/$50 copay I had if you average it out.

However:
it covers 100% of hospitalisation (inc related labs/pharmaetc..), no deductible. AND 90% of most everything (routine medicine, labs, pharmacy, etc.) even covers a bit of cost of accupuncture. There are maximums per charges like labs and xrays etc.. are covered at 800euros max per 'act'

It also covers some dental, some vision/glasses (better than any US independant coverage) AND maternity after 10 months of subscription up to 4000euros/6000euros.

Obviously if you have a chronic condition with expesnive test labs and medication, that could end up being expensive with the 10% that adds with no max OOP ever.


But basically, what I am finding out is that it is worth looking into the expat insurance if you are going to be on your own, without employer coverage.
You might be able to pick a plan that suits your needs better. It gives more choice and flexibility.

With some digging , i found lots of good plans for specific situations.
Like the *Ambassade plan from April *that covers maternity without limits 100%, right off the bat, and can cost at little as $300/400 a month.
That is the cost of the maternity rider ALONE on BCBS, and you have to pay it for 12 months before it kicks in! 

Another plan that looked decent was *ASFE MSH* one, the premium "*indice 60*".
You are covered for 900,000 euros per year, so over a $1M.
Everything is pretty much covered 100% without deductible but within limits.
Like accupucnture coverage is max 200 euros per visit, 1500 euros per year.
Labs and scans/etc,,.. done outside of major hospital (24h+) is covered at 1000 euros daily max. MD visits are limited at 130 euros after 5 visits/yr, and Specialist 180 euros after 5 visits/yr.
You have some visions and dental included in that too.
the cost?I was quoted about $460 a month. Still cheaper than BCBS and way better coverage. They work with the Aetna network where you dont pay anything, they work directly with them.

One caveat: on all the expat plans it looks like any "prosthesis" which I am guessing includes knee surgery or the like, would get terrible coverage. This one covers 4000 euros per hospital stay. that seems very little to me? Though I don't know if that is just for the actual knee part of the whole surgery.

Based on that info, it all sounds pretty good., or at least not worse that what I was used to with BCBS in Illinois but cheaper monthly cost for what is considered a "premium"plan in the US. but I would love to hear real life feedback on these plans.


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## kirikara (Jan 21, 2009)

BTW, i do have all the detailed coverage for each plan. It is fairly well explained. but like with any insurance, it is what is NOT on there that matters. 
Hence my request for feedback.


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## twostep (Apr 3, 2008)

It sounds like you will need to deal with providers accepting patients with this insurance. Have you checked who in your area will take new patients?


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## kirikara (Jan 21, 2009)

twostep said:


> It sounds like you will need to deal with providers accepting patients with this insurance. Have you checked who in your area will take new patients?


That is a good point. With the Ambassade/April they work with Aetna so that is easy to check and a fairly big netowrk. I will double check.

But with Mondassur, they only told me they work with GAN insurances, which will mean nothing to my local providers. So I better check on that.

I did like the fact that you pay upfront for routine stuff, because you might be able to save on medical cost that way, plus I always ended up checking my bills anyway, so might as well take care of the paperwork. Plus that means I can go anywhere I want for routine.
But I will check and get back to all of you on that.
With all the research I am doing, I feel like that should be helpful for somebody else too!


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## twostep (Apr 3, 2008)

kirikara said:


> That is a good point. With the Ambassade/April they work with Aetna so that is easy to check and a fairly big netowrk. I will double check.
> 
> But with Mondassur, they only told me they work with GAN insurances, which will mean nothing to my local providers. So I better check on that.
> 
> ...


Reimbursement does not necessarily mean you send in the bill and the check is in the mail:>)


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## kirikara (Jan 21, 2009)

Well i did ask the question, and you send in your bill and they pay within 3 business day by wire transfer.
Except for ER stuff, i woul definitely check ahead and get my ducks in a row/
But then again, with BSBS, it was always the lottery. I would go to the doctor and never know what got billed, how much it would cost in the end etc..
At least with this one, it puts you in a situation to ask the questions and get answers since you are the one paying. Most time when you ask your dr how much isomething not major cost, it is answered by:
approx we will charge X, but i cant tell you for sure, and you will need to check with your insurance. And then you ask your insurance, and they tell you, you wont know until we see the final bill. That happened at the dermatologist. Was left with a surprise $680 bill.

Now, we all know, these are insurance companies we are talking about..
But the problem would be similar with any insurance. Although it would not be mine.. I can see that makes quite a difference.

I did hear some good feedback from french people using them in China, but it does not tell me how well they do in the US> the system being so different.
So far, their customer service has been nothing but great. but they are still waiting for me to purchase so.. that only tells me that they don't suck 100%. LOL.

I double checked with them, and no they dont have a notion of network for this plan. Which makes sense given how they work. I know my local providers will take it, since i will be handled like a cash patient. what is harder to figure out is with the hospital bill or getting an IRM or such things..
I asked for more info, and basically you go get the quote from the hospital and then get it authorized. With the authorization, they also confirm the coverage.

This whole health insurance thing, is really such a crap shoot..I am pretty diligent( compared to your average consumer )with my research, but in the end, with this system it seems that there is ALWAYS a risk:

-with the US insurance: that it wont be covered or the best specialist is not in network plus you will a nice bill either way with the deductible and OOP costs.
-with the expat insurance: that they won't cover enough or give some kind of authorization issue.


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## twostep (Apr 3, 2008)

Kirikara this sound too labor and cash intensive for me. We had our share of unexpected emergencies lately:>)


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