Discover why your medical network matters more than your premium when living abroad.
Choosing a private health plan isn’t only about the benefits. The strength of the medical network behind your plan can often determine things like:
These are all vital factors in any healthcare journey that become even more critical when you're living abroad and navigating an unfamiliar environment.
A medical network is a group of expertly curated healthcare providers that an insurance company or Third-Party Administrator (TPA) have contractually partnered with, and will typically include:
These partnerships between healthcare providers and medical insurers typically set out:
For those with private health insurance, a medical network makes it easier to use your health plan to find and access reliable care and treatment.
Your insurer has already done the due diligence on the quality and capabilities of the providers in their network, meaning you can have confidence in attending any facility to get the attention you need. This is particularly vital when you’re unwell and unfamiliar with the local healthcare system, especially if you’re living in a country where the quality of the facilities can vary widely.
The rates your insurer negotiates with network providers protect you from inflated charges and ensure you almost always know what your out-of-pocket expenses, if any, will be before you start treatment. In contrast, out-of-network providers may charge you more than local market norms, and reimbursement caps may result in higher out-of-pocket costs.
Direct billing removes the burden of paying sometimes significant sums upfront then waiting for reimbursement, as well as ensuring you avoid paperwork and currency conversion issues, all crucial if you’re in unfamiliar surroundings or facing a complex treatment plan.
Claims flow more smoothly when insurers and medical providers have alignment on benefits and medical necessity criteria, and when providers know what to submit for swift claim processing.
In addition to the integrated pathways we mentioned earlier, medical networks also often include second medical opinion services and case management frameworks for complex diagnoses or treatment plans. This coordination improves communication between providers and enhances continuity of care, making the journey from diagnosis and specialist consultations through to care, rehabilitation and recovery as smooth as possible.
Your insurer will conduct ongoing provider credential checks and outcome monitoring, ensuring that your network provides the safest and most comprehensive level of care.
Whether you’re an expat based in one location or a globally mobile individual, a broad international network makes it easy for you to access reliable care in multiple countries under consistent rules and processes. This allows you to accept projects in new markets or travel regionally with peace of mind for you and your family.
Leading insurers’ medical networks these days are managed digitally, meaning you can typically do the following, and often much more, directly from your smartphone:
When you require care, your medical network turns your health plan into a treatment pathway, so you can focus on getting better rather than worrying about paperwork.
In general, the purpose of a medical network is to ensure you can get the treatment you need, when you need it, with as little stress or uncertainty as possible. In the long term, a medical network can also provide the added benefit of controlling costs, which can support more stable premiums over time.
Here’s how it typically works:
Depending on your health plan, you may have a range of options when it comes to electing for in-network or out-of-network care.
Direct billing – sometimes called cashless treatment – means the medical provider invoices your insurer directly for eligible services. To access direct billing facilities, you will typically need to present your membership card and pay any applicable deductible (excess) or co-pay/co-insurance. Direct billing can be particularly useful when you need unexpected care, although you may still need to get pre-authorisation for some treatments.
Note that direct billing applies only to eligible benefits, treatments and conditions. If a service isn’t covered for direct billing, the provider may ask you to pay at the point of care. You’ll still be able to submit a claim, although check if you require pre-authorisation before undergoing any treatment you pay for to ensure you won’t be paying out of pocket. You will also remain responsible for paying any deductible, co-pay / co-insurance, or for any treatment costs that exceed your plan limits.
Planned hospital admissions, high-cost imaging or diagnostics, and specific treatments may require pre-authorisation, which is when your insurer will assess whether the care and treatment you're seeking is medically necessary and eligible under your plan. Pre-authorisation helps you avoid surprise medical bills, while your insurer can also give providers certainty by providing guarantees of payment before you begin treatment.
Learn more: What is pre-authorisation?
Some medical networks use specific pathways. For example, your care pathway may involve consulting a general practitioner first or using a specific diagnostic centre before starting treatment. Such pathways can help you receive the treatment you require more efficiently, enable better coordination of your care, and keep costs predictable and stable.
Robust medical networks provide you with 24/7 assistance teams who can direct you to the most suitable facility should you need care or treatment. If appropriate care isn't available locally, your health plan may include medical evacuation, allowing your medical network to arrange transportation to a suitable facility elsewhere.
You'll only appreciate and unlock the value of your medical network if you know how to utilise it effectively. Ensure you can use your medical network effectively by:
Even with access to a comprehensive medical network, there may be times when seeing an out-of-network provider is necessary, such as if you need to visit a unique specialist or your family doctor, or are in a remote location a significant distance away from your nearest in-network facility.
If you elect for out-of-network care or attend an out-of-network facility out of necessity, you should consider the following:
Our private health plans and medical network are designed to provide our members with ease of use and access to the best possible levels of care, offering:
Beyond your plan benefits and policy features, your medical network is the backbone of your insurance plan. A strong medical network helps you access quality care efficiently, controls both your premium and your out-of-pocket costs through negotiated rates, simplifies how you use your plan and seek treatment with direct billing, and supports you through coordinated pathways and treatment plans.
When choosing an international health insurance plan, pay close attention to the usability of your medical network; it’s the critical factor that transforms your insurance plan from a document into tangible, world-class healthcare when you and your family need it most.
Note that health insurance benefits, limits and processes may vary by plan and sometimes by region. Always refer to your certificate of insurance so you fully understand how your private health plan works for you.