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Heading abroad? Key health insurer terms you MUST know

If you're planning to move abroad, or are already living abroad in 2022, organising your international health insurance is one of the most complex, yet important, tasks on your to-do list. Which is not to mention the added urgency that even the tail-end of a pandemic creates.

Heading abroad? Key health insurer terms you MUST know

Adding to the complexity is the medical insurance legalese you’ll come across when trying to research your best options. Fortunately, many international insurance use similar terms that have the same meaning. Together with provider Cigna Global, we demystify some of the key terms you’ll encounter when choosing a policy. 

Important dates

Generally, insurance policies will be very specific about dates, for a variety of reasons that deal with processes and legal compliance. Coverage may not be included as soon as you sign up, so it’s important to know exactly when your coverage starts and ends, and the duration of time before your policy needs to be renewed. 

Annual renewal date  – This is the yearly anniversary of the policy’s start date.

End date – This is the date that a policy ends, as listed in the certificate of insurance

Initial start date – This is the first day that the treatment of a beneficiary is covered. 

Period of cover – This is usually a period of 12 months, during which a beneficiary is covered, including the start and the end date. 

Start date – The date on which a beneficiary’s coverage starts, as indicated on the certificate of insurance. 

Cigna Global demystifies international health insurance. Discover how to protect you and your family abroad

People and places

Insurance providers are also, obviously, very particular about exactly who is covered by their policies, and where they come from. This is for a variety of reasons regarding international agreements and local laws. On your end, however, it’s important to know what they’re talking about when they ask you who is to be covered, and where. 

Beneficiary – A beneficiary, or beneficiaries, is anybody named in your policy, or certificate of insurance, as being covered. This will usually be your spouse or family members and can include newborns. 

Country of habitual residence – This is the country that a beneficiary resides in, as listed in their application. For example. if you’re an American working abroad in Germany with a residence permit, your country of habitual residence would be Germany. 

Country of nationality – This is the country that a beneficiary is a citizen or permanent resident of, as listed in their application. Essentially, the country or countries that you have a passport(s) for. 

Selected area of coverage – This is the area in which treatment is covered. 

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Medical terms 

Medical terms constitute the area of most precise language within policy documents. It’s very important that you understand exactly which treatments are covered, as well as those that the provider may opt not to cover, such as in the case of certain pre-existing conditions. 

Congenital condition –  A congenital condition is any deformity, injury or illness that is present at the time of birth, such as cystic fibrosis or clubfoot. 

Evidence-based treatment – These are treatments that have been approved by specific statutory bodies or standards – in the case of Cigna Global, the National Institute for Health and Clinical Excellence and the International Clinical Guidelines.

Inpatient – An inpatient is a beneficiary admitted to a hospital overnight or longer for treatment – for example, for heart surgery or a similar intensive surgical treatment. 

Medically-necessary – These are those treatments and services that are recognised by the International Clinical Guidelines to be necessary for diagnosing and treating an illness or disease, as standard and orthodox procedure. That is to say, these are treatments and services that are not experimental or untested, or purely cosmetic in nature. 

Outpatient – An outpatient is a beneficiary who attends a hospital or clinic for treatment, for less than a day. Ingrown toenail procedure? That’s an outpatient treatment, and the beneficiary is classified as an outpatient. 

Pre-existing condition – A pre-existing condition is an injury or disease, under treatment or otherwise, that was already present before the start date of a beneficiary’s policy. These can include conditions such as high blood pressure, or asthma that were not present at birth, but developed over time. 

Other important terms

Some terms are very particular to insurance provider documentation, and you may not see them used in any other context. However, they are usually simply ‘legalese’ for rather simple and straightforward concepts, events or objects. 

Certificate of insurance – A document that lists all the important information about the policy, including beneficiaries, dates of validity and treatments or procedures are covered. 

Qualifying life event – These are those events that change the number of beneficiaries covered by a policy, and include births, deaths, adoptions, weddings and civil unions.

Special category data – This is specific data on a beneficiary’s age, race, sex and other affiliations, collected for the purposes of identifying them.

When looking for the right international health coverage, Cigna Global is worth considering for a number of reasons. They offer fully-customisable health coverage, with four levels of statutory cover available, and a broad range of premium contribution options. Cigna Global also offers a direct billing network with more than a million doctors, hospitals and clinics worldwide, meaning that you will easily be able to find treatment options that meet your needs. There’s no upper age limit for cover, and you’ll also enjoy an additional 180 days coverage, while you’re still in your home country, making it easy to transition at either end of your international stay. Finally, full cancer care is offered, including experimental treatments and procedures. 

At a time when we’re all starting to enjoy increased mobility, and working abroad becomes more and more common after the pandemic, it’s crucial that you are covered for any eventuality. Cigna Global is the natural choice for those looking for comprehensive coverage, no matter where their work takes them. 

Learn more about Cigna Global’s broad range of coverage options today, and ensure that your international stay is fully covered against illness or injury 

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HEALTH

How to get prescription medicines in Denmark

Are prescription drugs covered by Danish national healthcare? It's complicated.

How to get prescription medicines in Denmark

How prescriptions work in Denmark

You’ve seen your doctor and been given a prescription. Now what? 

Once your doctor inputs the details of your prescription into the Danish health system, your data is available to any pharmacy in the country with a quick scan of your yellow health card. 

All pharmacies in Denmark charge the same price for each medication, so there’s no need to shop around or commit to a single ‘home’ pharmacy — you can just swing into whichever is most convenient for you that day. 

There are also online pharmacies that can fill your prescriptions and deliver them by courier or mail, or arrange for pickup at a pharmacy or another location. Remember to only purchase from websites with the green EU logo, according to the Danish Medicines Agency. 

READ ALSO: What happens if you lose your Danish yellow health insurance card? 

Do you have to pay for prescription medicines in Denmark? 

Mostly, yes — as a rule, prescription medicines aren’t covered by the national healthcare system until you reach certain spending thresholds for the year. At that time, discounts will be applied to your future prescription medicine purchases based on how much you’ve already spent. 

The scheme is called ‘reimbursement,’ which can be slightly misleading — the discounts are applied at the pharmacy, so you don’t have to pay up front and wait for the Danish Medicine Agency to cut you a check. 

Your progress toward the reimbursement thresholds is tracked automatically by the Central Reimbursement Register (abbreviated CTR in Danish), which sums up purchases of reimbursable medications associated with your yellow card. Your current CTR total is given on your receipt from the pharmacy after you purchase a medication, and you can also track your spending on reimbursable medications here

Reimbursable prescription medications purchased in other EU/EEA countries can count toward your CTR. If you’ve bought prescriptions abroad, fill out this form to be reimbursed based on the price of the medicine in Denmark. 

READ MORE: Why does it take so long in Denmark to see a psychologist or therapist? 

What are the reimbursement thresholds for 2022 for adult patients? 

If you’re over 18, you’ll have to pay out of pocket for your first 1,020 kroner of prescription medications. 

Once you’ve spent 1,020 kroner, you’ll receive a 50 percent reimbursement on future reimbursable purchases, and your copay will be 50 percent. That increases to a 75 percent reimbursement after your CTR total hits 1,705 kroner (with a copay of 25 percent) and an 85 percent reimbursement (and copay of 15 percent) for CTR totals above 3,700. 

Remember, your CTR total is calculated by the price of the medications before the reimbursement is applied. (Even though you’ve only paid 50 percent of the cost of medications after you hit the first reimbursement threshold, the full price of the medication is added to your CTR total.)

After your CTR total reaches 20,091 kroner, you’ll receive 100 percent reimbursement on future medications.

Taken together, that means the most you can pay out of pocket for prescription medications in Denmark in 2022 is 4,320 kroner.

The Danish Medicines Agency provides a chart of the thresholds and an example patient’s yearly spending history and reimbursements here. 

READ ALSO: Are you eligible for Danish national healthcare while your residence permit is processing? 

What about reimbursements for children’s medications? 

For patients under 18, all applicable prescriptions have a minimum 60 percent reimbursement rate. That gets bumped up to 75 percent after a CTR total of 1,705 kroner, 85 percent after 3,700 kroner, and 100 percent after 24,628 kroner. 

Just like for adults, the maximum out-of-pocket costs for a child’s prescriptions in a year is 4,320 kroner. 

What if I know I’ll need more than 20,000 kroner of medications? 

If you have chronic conditions or a major health challenge and can tell at the beginning of the year that you’ll hit the CTR maximum, you can apply for an installment plan. 

Pick the pharmacy most convenient for you and request an installment plan — you’ll be able to pay the maximum yearly copay of 4,320 kroner in 12 monthly installments of 360 kroner. 

Generic versus name-brand drugs and reimbursement 

Different drugs with the same active ingredients are called synonymous — generally, if your doctor prescribes a name-brand drug and there’s a less expensive synonymous drug, your pharmacist will give you the option to choose. 

If you stick with the more expensive name-brand drug, you’re responsible for the cost difference and only the price of the generic drug will be added to your CTR total. 

There are sometimes good reasons for choosing a more expensive synonymous drug — if, for instance, you’re allergic to some of the added ingredients in the generic form, your doctor can apply for increased reimbursement on your behalf. 

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