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MARINE HEALTH INSURANCE 101

Growing demand leads to top notch international health insurance being available for the first time in the marine industry

You barely have to turn the page in a newspaper or magazine these days to see that globalization is at the epicenter of the new world order. As global lifestyles emerge, the demand for comprehensive major medical insurance has grown rapidly. In response to this demand, a new generation of superior health plans is now available to serve the marine market. This is a positive development for the marine industry which has historically had limited choice when it comes to coverage. Existing insurance options have often missed the mark because of limited benefits, long waiting periods, harsh exclusions, pre-certification penalties, lack of portability and other constraints.

Well built for the long haul

Insurance regulators have historically encountered international health plans primarily in the form of surplus lines products. These plans are technically not a health insurance policy. Nevertheless, surplus lines plans have been the only renewable health option available to the marine industry up until now. The Florida Department of Financial Services recently approved the sale of a new health insurance plan to serve people with global health insurance needs. Florida joins more than 40 other states in approving a health plan geared for people with a global lifestyle. Benefits are available inside and outside of the United States with no cap on time spent in any one place. The new generation of plans respond whether you spend the majority of the year sailing the eastern seaboard or most of your time in the Mediterranean or Caribbean.

Admitted Health Insurance vs. Non-Admitted, Surplus Coverage

Comparing surplus coverage to true health insurance is a little like comparing a small pleasure craft hull to that of a long range expedition yacht. They are built very differently with far reaching consequences. Your personal health and financial security could hang in the balance.

Admitted health insurance advantages include:

Critical Protection- You are protected under US insurance laws and oversight. U.S insurance laws are strict and have long favored the health care consumer. This means that policy language must meet the plain English definition. Policy wording, plan definitions, exclusions, state mandates for coverage, claims process, claims turnaround times, formal appeals process all must meet regulatory muster.

Ongoing Coverage Rights- An admitted plan can be kept even after your employment ends. US insurance laws have stepped up to ensure portability and renew ability of coverage. This is designed so that people do not suddenly find themselves out of a job and uninsurable. Admitted plans can be kept after employment ends whether you were covered under a group or individual policy.

Medical Provider Networks- Larger networks tend to be available in the United States with fewer billing issues for members. In addition, contracted doctors and hospitals are available in overseas ports. These providers are set up in many instances to bill the insurance company directly. Providers are profiled, contracted and members can review their biographical information.

Better Benefits- Admitted benefits tend to be broader and deeper with few waiting periods or low limits on medical conditions. The table below illustrates some of the major differences between an admitted health plan and a non admitted surplus plan.

Coverage Considerations Admitted Health Insurance Non-Admitted Surplus Insurance
Must conform to U.S. health insurance laws
Unlimited time can be spent in or out of the U.S.
Pre-existing conditions coverage available*
Covers appendicitis, kidney stones, gall stones, breast disorders in the initial 6 month period and beyond
Substance abuse benefits included
Transplants covered to policy maximum
Terrorism covered worldwide with no excluded countries
Preventive services covered with no waiting period
Pre-certification is not required when seeking care
Alcohol related injuries and illnesses are covered
Amateur sail boat racing covered to policy maximum
Deductible waived for physician office visits
Wellness benefits covered with no waiting period
Cashless access to physicians outside U.S. -180 countries
Access to 700,000 contracted providers in the U.S.

*References individual products sold. Subject to prior credible health insurance. Chart is meant as a general guideline of individual products offered. Some benefits and services may vary by insurer.

Calmer seas are ahead and the waters are patrolled frequently

Navigating health insurance just got a lot smoother. An industry with an appetite for the best can now enjoy superior health insurance. As always, it is a good idea to do your home work. Always ensure that you read the fine print rather than just scanning a benefit schedule. Ask your broker or insurance company to send you a sample policy so you can get the complete picture.