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Should I over insure my family for Covid? Do I need a Covid cost strategy?

From a health perspective, Vietnam is among the most vulnerable countries to the Covid pandemic. Most medical equipment, biological products, vaccines, medicines… have to be imported because they are not being produced domestically. The purchase of vaccines is slow due to the acceptance of the manufacturer/ distributor. Healthcare has become the most expensive aspect in Vietnam. 

When you arrive in Vietnam, you must be prepared to face limited medical resources and the rising Covid cost.

New to Vietnam? Protecting your family without being overly insured

Vietnam government has imposed health insurance for Covid treatment. For expats, coming from a developed country into Vietnam, is the perfect time to review and save money on medical insurance.

1. A dangerous low level of healthcare in Vietnam

Entering a new country, protecting your family starts with knowing your health risks: not only personally but in terms of environmental risks. An overview of tropical diseases, hygiene, food, domestic risks, but also the main failures of local hospitals and medical systems.

  • Higher ‘environmental’ risks in Vietnam: just by looking at traffic accidents statistics of average 35 deaths/ day on the Vietnamese roads. Also witness the low level of hygiene, standards and safety rules both by professionals and individual Vietnamese. Any expat first impression is accrued risk.
  • Sub-par healthcare system and hospital standards: as in many poor countries, clinics are under equipped, over staffed but ‘under’ trained. The socialistic centralized management and 5-year planning for budgeting and staffing regardless of top-down style, hardly has KPI for patient experience and satisfaction. Under investment or badly allocated funds regularly make press headlines with scandals in graft, malpractice or deaths.
  • Famously missing/ failing medical specialties in Vietnam are: lacking ICU, cardio-vascular center, neuro surgery, burns, cancer oncology, blood bank, microsurgery, virology, state-of-the-art, neonatal care, lab testing (biopsy) etc… (*)
  • The medical workers are lowly paid and incentivized resulting in lack of training and motivation.

2. New Covid regulations in Vietnam on compulsory health insurance

During 2020, Covid disputes over who will pay the costs of medical treatment and quarantine have been raging. The argument goes: “if a government imposes a quarantine and a treatment in their chosen facility whilst not proven ill or Covid positive, why should I pay?”. The solution has been to make medical insurance cover for travelers and expatriates mandated by many countries that have opened their borders to visitors. You can arm yourself with travel medical insurance for unforeseen medical emergencies you may face abroad.

In Vietnam, under Official Letter No. 3949/ CV/ BCD dated 24 July, issued by the National Steering Committee for Covid Prevention and Control on: 

  • Health insurance and medical costs related to Covid treatments (if any) are to be borne by the individuals or organisations sponsoring their visa/ work permit;
  • Organisations that sponsor the experts’ visa/ work permit are responsible for ensuring the safety of Covid prevention and control of the experts.

Why do more countries, like Vietnam, impose mandatory medical insurance to enter the country?

The list of countries that require health insurance upon arrival had been gradually increasing over the years before the Covid pandemic began.

Negative experiences of unpaid medical bills by foreigners have caused hospitals and healthcare organizations to push for insurance requirements so that these incidents are less likely to happen.

Many countries have now implemented testing requirements, quarantines, and proof of health insurance that includes Covid treatment coverage upon their reopening.

See which countries require travel insurance, travel medical insurance, or Covid cost coverage for entry. Just Google ‘country Covid compulsory medical insurance’.

3. What is your alternative Plan B to get excellent medical treatment?

If you can not seek the best treatment in Vietnam, then where? In case of medical emergency or your much needed surgery is not available to international standards in any Vietnamese hospital, the famously missing/ failing medical specialties in Vietnam you will need to be evacuated to Thailand and Singapore in case of emergency accidental treatment to ‘the nearest place of Excellence’. 

This comes at a cost between $5,000 to $15,000 depending on the medical assistance you may need and the air ambulance medical equipment of the airplane, for the 2-hour flight. 

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Repatriation flights to your home country in the EU or America can cost between $50,000 to $125,000.

Thailand and Singapore are world class medical facilities in equipment, medical specialists and experience. For more than 30 years, they developed medical tourism for wealthy Asian and Middle East Emirates. They are second to none, Thailand being slightly cheaper but catching up as demand from all over the world has to be catered for. In 2015, Thailand was already treating 2.5Mio foreign patients. Singapore was the pioneering country in medical tourism, taken over by Thailand who could combine a much cheaper packaged solution for [treatment surgeries + rehabilitation/ recovery] in much cheaper hospitality 4/5* hotels for the patient and their accompanying family.

Successful occupancy attracting successful specialist medical practitioners, Thailand quickly overtook Singapore.

4. Who will pay for the medical costs in Vietnam, Thailand or Singapore hospitals?

In our experience, it is very difficult to plan for the cost of an accident or a sudden serious illness, those costs well above $5,000… because those are by definition unexpected. Most people would plan for a 3-to-5000$ emergency hospitalisation fund. As mentioned, in case of a serious medical condition, evacuation to Thailand is best recommended by international clinics specialists in Vietnam. 

Here are usually 3 possibilities we witnessed over time in Vietnam and Asean developing countries:

CROWDSOURCING: when you don’t have the money and collect it from friends and family. 

When you need to be hospitalised, usually following an accident or an emergency, and you have no money to pay for the bills, you face an “unfunded liability”. 

The upfront need is in the range of 5-to-$10,000 if an evacuation is involved and a delicate surgery or sophisticated state-of-the-art medical procedure is involved. 

Most times the crowdsourcing starts with immediate family -that is abroad and difficult to reach for immediate cash-, friends and more Facebook friends or GoFundMe.com’s begging to complete strangers. The average round reaches less than 50% of the immediate need of deposit to secure you a hospital theatre room in the hospital of your choice, with the best specialists. We can see many expatriates ending up in provincial cheapest state-owned hospitals.

NB. it is a myth that your government will pay for the Covid cost as citizen protection; to put it simply, your medical costs are not part of their responsibility. Their help, behind the scenes, consists in contacting your parents or siblings and enacting a guarantee of payment. The cash advance in Vietnam will be the result of your family member’s “frozen cash at their bank” or mortgage of their home or any asset they can seize to pay your hospital bills.

YOUR SAVINGS… are gone, and sometimes your assets too

Suppose you made the decision to self-pay or worse, you were ill-advised and your insurance does not cover for the sudden need of medical treatment. In emergency hospitalisation and you have to pay for it with your own money, then you face 3 uncertainties before you make a decision on spending some or all your savings or assets.

  • Where is the best and cheapest way to get treated and over with it?
  • How much can be the total cost including possible complications and rehabilitation?
  • How many months or years will you need financial provisions to completely recover?
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This is an utmost stressful situation while you are ill, you will need to constantly monitor the procedures and the mounting costs to check if you can afford the hospital, the tests, the specialists in the country you are being treated.

You return to your home country and your national social security pays

This seems to be a ‘free’ treatment solution as your safety net of your home country, gives you the appropriate treatment in top hospitals with the best specialist in your home language. Your family may reside in your parents or siblings house. Effectively, in most cases it comes at a loss of part -or all- you have built in your expatriation country. Be it your corporate job, your team and your reputation and expertise will be replaced. For partners and entrepreneurs, it is not rare that they need to sell in a rush -part or all- of their company or home to settle in your home country until your health condition allows you to return to ‘a new normal’: the dream life is gone.

Ideally and fortunately you were insured in Vietnam

Having the right health insurance in place is best for serious procedures and severe illness; it implies life changing decisions and huge costs to adjust. The keyword here is ‘the right insurance’ well thought in advance that is the proper solution to this sudden health issue.

Choosing the right insurance for your personal circumstances as described above, suitable for your lifestyle and budget, takes knowledge and experience. We use 5 professional criteria and personalized expatriate experience, to help you make the best choice.

The most important questions to answer are:

  • Security: do you have guaranteed renewal? Who is the regulatory authority?
  • Benefits: where can you take your treatment as per your needs/ choice? Over a long period if needed can you get elective treatment in Vietnam, Thailand, Singapore or your preferred home country?
  • Flexibility: what are the conditions and who decides on the cancellation of your policy? 

5. What happens after the critical illness; can it be expatriate life back to normal?

There are usually 3 scenarios, depending on the medical follow-up you need -if any- is available or not in the country of expatriation.

History shows 3 types of expatriate ending in case of critical illness, depending on the insurance arrangements the family put in place or not:

  • No provision to pay for treatment costs ending in a sub-standard treatment in a Vietnamese hospital for locals resulting in a long-term disability or an early death.
  • Not suitable provision, resulting in a repatriation to the expatriate home country for suitable treatment more or less costly to be repaid. Loss of what was built-in Asia or Vietnam, with no possibility to pay for suitable follow-up treatment if they return.
  • Expatriate properly insured -which does not mean overly insured at an expensive price-, back to a new normal with the peace-of-mind that medical costs are taken care of. All costs and related expenses for the treatment are paid for in the country you chose, but also all future costs at no increase to your insurance premiums apart from yearly inflation and aging. Whatever the insurer pays will not attract a corresponding increase of prices. Life comes back to a ‘new normal’ and medical bills are not a concern. 

Find all the information regarding our services to you. We will be pleased to answer your questions about the Covid cost strategy to help protect your family. 

Please contact us anytime for FREE Professional Review of your insurance arrangements.

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