How other countries view issues pertaining to insurance of expatriates

While many other countries require foreigner visitors to have an expatriate insurance plan in order to be issued an initial visa, Japan has no such precondition.


Expatriate health insurance & the Schengen Visa . . .

International or expatriate health insurance (also known as visa insurance), is a type of private health insurance plan that also covers particular situations expatriates might encounter while living away from their native home. Such a plan, for instance, will typically pay benefits for international clinics, coverage in more than one country, medical or political evacuation, and repatriation of remains in the event of death. Many countries require foreign visitors (both short- and long-term) to have this type of coverage before they are allowed to enter.

In recent years, travel to many European countries has been made easier with the adoption of the Schengen Agreement and the Schengen Visa. Named for the town in which it was signed (Schengen, Luxembourg), the accord creates a borderless travel zone among the member countries. With a single Schengen Visa, you can travel to all countries in the Schengen Area, which include Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Holland, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden and Switzerland. In order to obtain a Schengen Visa, you must show proof of insurance that meets the following criteria:

  • The insurance company must have a representative office in Europe;
  • The policy must include medical evacuation/repatriation coverage of at least US$37,500; and
  • The insurance coverage must be valid for the duration of your stay in the Schengen countries.

It is interesting to note that these countries all require evacuation/repatriation coverage, an important feature that none of the Japanese social or national insurance plans offer. And why should they? The social health insurance was designed for Japan's citizens, not the foreign community. Nothing wrong with that. But to force non-Japanese on social health insurance when they may want or need expatriate coverage is not in anyone's best interests. For a non-Japanese married into a Japanese family that has a cemetery plot and who wants to be buried here when he or she dies, social health insurance might be the way to go. But for most expatriates, this shoe does not fit.

Indeed, Japanese embassies and consulates do not require foreign visitors to have any type of insurance whatsoever to enter this country. What happens to the unfortunate traveler on a flight to Japan who has no insurance coverage and suddenly becomes seriously sick or injured or, even worse, loses his or her life? Will they receive no aid? Certainly, perish the thought. But who, then, will pay the expense?


25 countries in Europe require visa
applicants to have private expatriate insurance
Others have recognized the need . . .

Many nations will not grant visas to visitors or foreign residents without proof of some form of visa insurance. China has socialized medicine, yet expatriates there must have private insurance. The same holds true for Dubai and numerous other countries. In Australia, expatriates can enroll in that nation's public health program, hold onto their own private plan or participate in both. Many areas around the world have awakened to the important realization that it is indeed in the best interest of all concerned for foreign visitors to have health care protection before arriving inside their borders.

For the individual, a quality international health insurance plan will provide coverage for the unique needs and special circumstances faced by expatriates, not to mention the peace of mind that such protection can bring. Considering these things, and the new Immigration guidelines set to go into effect in April 2010, a disconcerting question inevitably arises: do the Japanese authorities really want us to have insurance for the purpose it was originally intended? Do they really care about our protection and coverage?

It is certainly clear that everyone is well aware of the need for quality health care. The point here, however, is that forcing all foreign residents to accept one of the social health plans is really in no one's best interest. Those benefits most important to expatriates will not be covered, thereby forcing many to choose from a small handful of unattractive options. They can either: 1) try to afford a private insurance policy in addition to the government's social plan, 2) leave Japan, or 3) go underground. Many places around the world have understood that their populations (both natural and foreign) are best served by their foreign residents having access to private health insurance, coverage that is designed specifically with their unique needs in mind. Hopefully, Japan's government will come to this realization, as well.