Medical Conditions and Cover – Watch Out for Policy Exclusions!

When you have an accident or fall ill you’ll want to know that you will have the full backing of your international private medical insurance (IPMI) plan to get you back on your feet as soon as possible. In most circumstances your policy will do just that but it’s important to think ahead when buying your policy to make sure you maximise your cover within the budget you have available.

The process of choosing your expat health insurance isn’t straightforward. There are many different insurers all offering a wide range of plans with different options. The cover permutations and combinations are almost endless. Insurers will provide the option of excluding certain benefit categories in exchange for lower premiums. Pregnancy is a good example that is usually clear cut – after all, if you are a man in your 40s looking for an individual insurance plan, you are not going to want pregnancy cover. Dental is another example, although we all have teeth so it’s a little trickier to decide if you really need that benefit!

In fact, international private medical insurance usually comes with clear choices to omit maternity, dental and even out-patient as options.

As a rule of thumb, buy the most comprehensive cover you can afford. That way you’ll limit your exposure if something unexpected does happen.

Cover limits

Of course, it’s not just about what is excluded from your policy, it’s also about how limited your cover is. One plan, for example, might have an overall annual payment limit of US$7,000,000 whereas a seemingly comparable plan may limit this to only US$3,000,000. Another may have a limited scope to pay out for prescription drugs compared to one that refunds this benefit in full. And a third plan may offer comprehensive cover for dental compared to one that’s severely limited.
Understanding when a policy won’t pay for a certain condition when buying your insurance is relatively easy. Understanding whether the policy you are considering is limited in the areas that are important to you can be very difficult when looking to compare plans yourself.

Time-based exclusions

Insurers may exclude cover on the basis of pre-existing conditions. If you request a policy and already have (or have had) a condition, the insurer may deny cover. What an insurer will decide to do is complicated and based on many factors. If you are in a large group plan, you may not be denied cover at all. If you have an individual policy and your condition is permanent, however, it may be very difficult for you to ever secure the insurance protection you need. Conditions from which you have recovered should be covered but there may be a time-lapse; the insurer may offer you that benefit but only after a set number of months have passed.

Exclusions through excesses

Excesses are important to. In a sense these are self-imposed cover limitations. If you take out a plan with a high excess – say US$500 per claim – you are effectively making it more difficult for you to make a claim; because you know you’ll be paying the first US$500 out of your own pocket. Of course, excesses give you the advantage of lower premiums. It’s often worthwhile for those on tight budgets to think of their cover in terms of insurance for major events. A policy with a very high excess, say thousands of US dollars, will mean that you have to pay for minor treatment but if a major event occurs, that will cost you hundreds of thousands, you’ll be covered.

Buying the right IPMI policy can be essential to your well-being. Buy the wrong cover and you could be very exposed. The trick is to pay a competitive premium for a policy that provides you with the precise benefits you need but not the cover you don’t. If this logic sounds as sensible to you as it does to us, jump onto My Matchmaker’s Selector tool and you might find it really helps.

David Eline

David Eline

Founder Rivier Expat

After experiencing the frustrations of expat healthcare firsthand, David built what was missing: a truly independent advisory service backed by a proprietary comparison engine that prioritizes quality over commissions.

His approach is refreshingly straightforward: diagnose your exact coverage needs, design a modular solution with genuine portability and deliver transparent advice without hidden agendas

Whether you’re a digital nomad bouncing between borders or a corporate executive relocating your family, David eliminates the administrative headaches and coverage gaps that plague international professionals.

👉 Connect with me on Linkedin

Health is your most important asset ❤️‍🩹

With just a few details, we’ll recommend a policy that precisely fits your protection needs from the world’s leading insurers. Finding the best value cover for clients is
our business!

Your Guide to Medical Insurance International

Explore medical insurance international, a vital asset for HNWIs. This guide explains how to secure elite global coverage for your health and lifestyle.

What Are Insurance Deductibles? A Strategic Guide for Managing Your Portfolio

Learn what are insurance deductibles, how they work, and tips to use them wisely to save money and protect your assets. Click to understand more!

What Is Coinsurance vs Copay? Key Differences Explained

Learn what is coinsurance vs copay and how these health insurance terms impact your costs. Discover which plan suits your financial needs today!

Health Insurance Cost Sharing Explained for Global Citizens

Master health insurance cost sharing. This guide explains deductibles, copays, and coinsurance for expats seeking optimal international healthcare coverage.

What is Comprehensive Medical Insurance? A Strategic Guide for Discerning Individuals

Learn what is comprehensive medical insurance and how it safeguards your health worldwide. A must-read for global citizens and high-net-worth individuals.

Secure Global Coverage with International Health Insurance

Learn how international health insurance safeguards your health worldwide. Get expert tips to choose the right coverage and stay protected globally.

Top 10 Best Countries for Remote Workers in 2025

Discover the best countries for remote workers in 2025. Find your ideal destination for productivity, safety, and quality of life. Click to learn more!

Your Definitive Guide to the Investment Banking Career Path

Explore the complete investment banking career path from Analyst to Managing Director. Learn about roles, salaries, promotions, and key skills for success.

International Business Insurance | A Strategic Imperative for Your Global Enterprise

Discover essential international business insurance to safeguard your global assets. Get expert strategies for reliable worldwide coverage.

A Strategic Guide to Medical Insurance for Visitors to Canada

Learn about medical insurance for visitor to Canada. Get essential coverage details, eligibility info, and costs to stay protected during your trip.