Questions regarding April Expat Insurance

[Sheryl]

2 hours ago, david_je said:

Thank you for sharing that. I had no pre-existing conditions excluded on my April policy. This past year I was treated for atrial fibrillation and had an ablation done that so far has restored sinus rhythm. (I did not make a claim with April for the ablation since I chose to do it outside zone of coverage of my policy.) Do you think that could lead to cardiovascular exclusion or some such if I switch to new insurer?

Absolutely will lead to an exclusion. The only question is how broad an exclusion. 

[SooKee]

This will likely be the last post before I come up with some kind of plan as this is becoming really exhausting but I post it for for others who may encounter similar issues with April this year.  Essentially two completely different stories from two different brokers and one of them not providing complete answers to both questions that I explicitly asked (e.g. a) is the region 2 change only for new business and, if so, b) what is the precise reason FROM APRIL (not broker hypothecation) for the 30% hike in premium this year).  Question b) seems to be the one that one broker is avoiding answering at all costs, I have a sneaking suspicion as to why.

AOC have said that the region 2 change most definitely applies to ALL policies from 1 April, not just renewals.  He said that April made this clear to ALL brokers, providing them with the 2024 policy terms and conditions (the document along with the policy that they will refer to if making a claim).  To quote the email:

"The general terms and conditions of 2024 (Attached again page 6), which is an annual update of the My Health International policies, is very clear and doesn't allow any doubt. Furthermore, all the brokers received this information in an email from April International about the change of zone for Thailand and other countries."

 

That document clearly states:

"For medical expenses and basic repatriation assistance:
Cover is provided on a year-round basis in the Country of destination/expatriation listed on your Membership certificate. Cover also applies in the Cover zone listed on your Membership certificate and in the lower zones.

6 zones of cover are available:

 

Zone 0: Bahamas (Islands), Puerto Rico, the United States and countries in zones 1, 2, 3, 4 and 5
Zone 1: China, Hong Kong, Japan, Singapore and countries in zones 2, 3, 4 and 5
Zone 2: Brazil, Chile, Costa Rica, Mexico, Saint Barthélémy, Saint Martin, Switzerland, the United Kingdom, Taiwan, Thailand, the United Arab Emirates and countries in zones 3, 4 and 5

etc etc etc"

 

Thus, the zone is determined solely by "the Country of destination/expatriation listed on your Membership certificate" NOT by whatever region is indicated on the renewal notice!

 

When I asked exactly what the reason was for the discrepancy he said "commercial reasons". Basically it was clear the change was not going to go down well and could lead to a loss of custom.  His explanation was much longer, but that is the gist.

 

AA World however said the exact opposite: 

 

"We have checked this with April International and I can confirm again in writing that Thailand switched to zone 2 in 2024 but it is only applied for new Business."

 

The second part of the email they have not so far answered, despite repeated attempts to get an answer.  It makes me wonder what question they asked April and how.  Maybe April is extending the muddying of the waters around this issue for customers by splitting hairs over wording.  Whatever they say though does not change the general terms and conditions in that

 

"Cover is provided on a year-round basis in the Country of destination/expatriation listed on your Membership certificate."

 

From what I can see, as far as April are concerned your cover will depend on the country listed on you certificate and that is Thailand, thus region 2, regardless of what play on words anyone is giving with regard to the region change.  That I suspect is the reason for the 30% price hike this year and the renewal notice "admin error" merely makes the change less obvious, "It's been a bad year for medical costs" isn't going to cut it.

 

 

[david_je]

20 hours ago, Sheryl said:

Absolutely will lead to an exclusion. The only question is how broad an exclusion. 

Would you consider that a compelling reason to stay with April then?

[david_je]

4 hours ago, SooKee said:

"The general terms and conditions of 2024 (Attached again page 6), which is an annual update of the My Health International policies, is very clear and doesn't allow any doubt. Furthermore, all the brokers received this information in an email from April International about the change of zone for Thailand and other countries."

 

That document clearly states:

"For medical expenses and basic repatriation assistance:
Cover is provided on a year-round basis in the Country of destination/expatriation listed on your Membership certificate. Cover also applies in the Cover zone listed on your Membership certificate and in the lower zones.

6 zones of cover are available:

 

Zone 0: Bahamas (Islands), Puerto Rico, the United States and countries in zones 1, 2, 3, 4 and 5
Zone 1: China, Hong Kong, Japan, Singapore and countries in zones 2, 3, 4 and 5
Zone 2: Brazil, Chile, Costa Rica, Mexico, Saint Barthélémy, Saint Martin, Switzerland, the United Kingdom, Taiwan, Thailand, the United Arab Emirates and countries in zones 3, 4 and 5

etc etc etc"

 

This is directly from April's 2024 general conditions, as relayed by the broker, correct? Are you able to post the whole document? April had told me that the general conditions for my policy renewal due in May have not changed from when I first joined, in 2022. Thanks.

[david_je]

23 hours ago, SooKee said:

 If your renewal is due imminently, has your premium increased significantly or is it still within the 6-10% band?

I have Essential plan, $500 deductible. I started with $2966 premium in 2022, the year I turned 65; it rose to $3511 in 2023 and for upcoming renewal $4157. If I stay with April, thinking maybe go down to Basic plan and higher deductible.

[Sheryl]

3 hours ago, david_je said:

Would you consider that a compelling reason to stay with April then?

Up to you -- and also really depends on what sort of exclusions you would otherwise face. If only treatment of cardiac arrhyrhmias and rate is OK  you might opt to accept that but if it is all cardiac conditions, or anything related to AF (which would include stroke) then at that point I would stay wirh April.

 

 

[david_je]

Sheryl, Since I know you have done it, does it make any difference if I switch from AA World to AOC before or after I renew my April policy in May? How has your experience with AOC been so far?

Like you, I had used the old AA as broker. The company now listed as my broker on my policy and new premium notice is called Alliance Insurance Services, with an aa-world.com email and a Pattaya address and phone. I recall reading here that the old AA was no longer allowed to broker overseas policies and shifted to an India-based contact?

Thanks. 

 

[Sheryl]

8 hours ago, david_je said:

Sheryl, Since I know you have done it, does it make any difference if I switch from AA World to AOC before or after I renew my April policy in May? How has your experience with AOC been so far?

Like you, I had used the old AA as broker. The company now listed as my broker on my policy and new premium notice is called Alliance Insurance Services, with an aa-world.com email and a Pattaya address and phone. I recall reading here that the old AA was no longer allowed to broker overseas policies and shifted to an India-based contact?

Thanks. 

 

AA world is a different entity than AA and headquartered in India. 

 

AA in Thailand is not allowed to broker non-Thai policies. 

 

While you can complete the paperwork to change brokers at any time, the new nomination takes effect only at your next premium. AOC assurred me they would still represent my interests before then if and as needed but fortunately not thus far necessary. 

 

As a result I can't give much by way of feedback yet. 

[SooKee]

On 3/23/2024 at 2:25 PM, david_je said:

This is directly from April's 2024 general conditions, as relayed by the broker, correct? Are you able to post the whole document? April had told me that the general conditions for my policy renewal due in May have not changed from when I first joined, in 2022. Thanks.

 

It's a big document so probably not.  There is an awful lot of information in addition to just that too, way too much to post.  I would suggest the best thing is to contact a broker yourself who can provide you with all the information one might wish to consider  I can give you the email address of the broker I am discussing with at AOC if you wish (contact me by direct message if you need it).  As I say there is a lot of information, much of it not good.  As an aside, changing broker is easy, signature on form, copy of a utility bill and copy of passport.  I have found AOC very helpful and very thorough in terms of the information they provide, reasons for premium adjustments (both now and in the future!) and their overall helpfulness.

[Sheryl]

The online customer portal for April should have all relevant documents including general conditions

[SooKee]

10 hours ago, Sheryl said:

The online customer portal for April should have all relevant documents including general conditions

 

I expected it would too, however while you can access some documents from the April customer portal, your certificate and "Guide to your insurance cover" along with a direct debit mandate and some blurb about data protection, the document you actually want, "My Health International - General Conditions 2024", isn't one of them, in fact, I couldn't find it on their site at all (that said, I didn't spend much time trying to find it, better things to do).  Your broker SHOULD provide this document along with some others, with your renewal notice, needless to say, my current broker (now ex-broker) didn't! They provided JUST the renewal notice and vert little else after.  Bare minimum is probably being generous!

[david_je]

20 hours ago, SooKee said:

 

It's a big document so probably not.  There is an awful lot of information in addition to just that too, way too much to post.  I would suggest the best thing is to contact a broker yourself who can provide you with all the information one might wish to consider  I can give you the email address of the broker I am discussing with at AOC if you wish (contact me by direct message if you need it).  As I say there is a lot of information, much of it not good.  As an aside, changing broker is easy, signature on form, copy of a utility bill and copy of passport.  I have found AOC very helpful and very thorough in terms of the information they provide, reasons for premium adjustments (both now and in the future!) and their overall helpfulness.

I thought there may be a link or manageable pdf. Like you, I could not find on April website or portal.

Thanks.

[david_je]

20 hours ago, SooKee said:

 I can give you the email address of the broker I am discussing with at AOC if you wish (contact me by direct message if you need it).  

Tried to DM but system says you cannot receive. Thanks.

[Sheryl]

The General Conditions are on the customer portal. Just click on "My Documents".

 

Mine shows only from 2023 but that may be because my 2024-2025 premium is not yet due/posted.

[david_je]

12 hours ago, Sheryl said:

The General Conditions are on the customer portal. Just click on "My Documents".

 

Mine shows only from 2023 but that may be because my 2024-2025 premium is not yet due/posted.

My "My Docs" only shows insurance cert, notice on personal data and paying premium. Is it hidden somewhere in there? Thanks.

[SooKee]

14 hours ago, Sheryl said:

The General Conditions are on the customer portal. Just click on "My Documents".

 

Mine shows only from 2023 but that may be because my 2024-2025 premium is not yet due/posted.

 

As I said, for me it's not (probably why I posted that it wasn't in the first place), I say again the ONLY documents showing for me under My Documents are:

My Insurance Certificate

Insurance Card

Guide to your insurance cover (this is not general conditions)

Information notice - the processing of your personal data (GDPR)

SEPA Direct Debit Mandate

 

It may be that what you see under My Documents is not the same, it wouldn't surprise me given the shambles that is April administration.

 

[SooKee]

21 hours ago, david_je said:

Tried to DM but system says you cannot receive. Thanks.

 

I just sent you a DM.

[SooKee]

By way of a final update, and given the time constraints, I plan to renew my April policy for 2024/25 as a stop-gap with an increased deductible then take a more leisurely approach to finding a new provider with my new broker, AOC.  At the moment New Health International are looking favourite but AOC will also start handling policies from AXA later in the year, that's another option too, there may be others.

 

Having asked AA World to get a specific answer from April about the reason for my premium increase if, as they said,  that the zone change is NOT affecting renewals (the exact opposite of AOC), they eventually sent me an April one page flyer (a typical insurance company blah blah blah document) about all the things that MIGHT influence premium increases.  Nobody seems able (more likely willing) to provide a specific answer to a very specific question.  For the industry standard 10% or so increase the pamphlet would probably cut it but for a 30% hike I'd expect a better and more detailed explanation.  The region change is not mentioned anywhere at all!  

 

It does seem that region change is a topic that April seem keen to avoid, at least insofar providing customers with any information about it.  Thailand is however listed as being in region 2 in the 2024 General conditions and there's a specific example given in another document, a help sheet for choosing zones of cover, both of which were supplied by a broker that I wasn't even with at the time.  Neither of these documents had been supplied to me by April or anyone else and were part of a bundle of 4 documents that AOC advised me should be supplied by a broker along with the renewal notice under the European Distribution Directive.  Doing the bare minimum seems to be the order of the day in some cases and even April didn't send me the documents when they emailed my renewal notice directly, nor did they make any reference to their existence!

 

 

IMO it's definitely worth discussing with a reputable broker, one able and willing to provide more than superficial replies, in order to get the full low down on the current situation with April and, for instance, exactly how the costs of the region change (in total about 40% I'm told) for Thailand will be recouped.

[Sheryl]

12 hours ago, david_je said:

My "My Docs" only shows insurance cert, notice on personal data and paying premium. Is it hidden somewhere in there? Thanks.

Very odd. This is how mine looks:

[SooKee]

It seems that even what customers see on their portals is different! "Guide to your insurance cover" downloads a completely different document to General Conditions a document that, for some customers, is very elusive!!

 

 

[david_je]

On 3/28/2024 at 1:34 PM, SooKee said:

By way of a final update, and given the time constraints, I plan to renew my April policy for 2024/25 as a stop-gap with an increased deductible then take a more leisurely approach to finding a new provider with my new broker, AOC.  At the moment New Health International are looking favourite but AOC will also start handling policies from AXA later in the year, that's another option too, there may be others.

 

Having asked AA World to get a specific answer from April about the reason for my premium increase if, as they said,  that the zone change is NOT affecting renewals (the exact opposite of AOC), they eventually sent me an April one page flyer (a typical insurance company blah blah blah document) about all the things that MIGHT influence premium increases.  

I plan to also switch from AA World to AOC. Did you originally receive a premium notice with AA World listed as broker, then switch to AOC, then had April send new invoice with AOC listed as broker before you paid? Any need to notify AA World of switch?

When I asked April about my premium increase, they only sent a short doc called "Understanding how your
health insurance is changing" about general trends that could influence increases. Is that the same doc you got from broker? Maybe insurance cos. do not as a rule discuss individual increases.

Thanks.

[traveldan]

On 1/28/2024 at 5:56 PM, bubblegum said:

Don't bother they are a disaster.

If you have any details or experiences about April being a disaster, please share.  It could help people like me, who are shopping for international medical insurance.  Thank you.

Oops never mind.  I see your later comments where you gave details.  Thank you!
 

[traveldan]

On 3/15/2024 at 4:07 PM, Y Chang said:

...

 

When I posted my inquiry regarding April insurance, I also explored other options.  What I noticed was that there is a big jump of ~40% or more when hitting the 65/66 years old age band.  For the other AseanNow members who might be interested, the table below includes a few examples to illustrate this jump:

 

...

 

When comparing to April International, it's worth noting:

- Pacific Cross Thai has no real limit on how high they can raise your premium.  Their pricing formula is based on your medical history and the group of people who enrolled when you did.  They also have a much less favorable Pre-Existing Conditions rule, which lets them deny coverage for any pre-existing condition (even ones you couldn't have known about) Contrast to IMG & CIGNA pre-existing condition rules.

- IMG is EU based🙂 & truly international, but it's overall coverage limits are Life-Time and not Annual like April International.  That difference lets IMG significantly reduce their risk and pass on savings to customers.  But if you got an expensive chronic disease, you might regret choosing IMG? 

- I don't know much about AXA yet. It looks interesting. Google results seem to show AXA SwitchCare is a Thailand based policy.  Personally, I'd pay more for EU/UK legal rules (and hopefully handling disputes in English).

Anyone considering these policies, should probably compare future premium estimates to April's MyHealth Thailand policy.

[Sheryl]

My recent experience with April (international not April Thailand) when I needed spine surgery:

 

- received pre-approval/Guarantee of Payment within 48 hours of the hospital submitting the forms

 

- 580k baht directly paid to the hospital. I paid only my chosen $500 deductible and the difference between room charge (room only, excluding meals and nursing)  and the $75/night allowance for a single room.

 

- over another 80k reimbursed for outatient care before & after the surgery (including MRIs,  Xrays, preop labs etc)

 

In addition I was reimbursed about 45k for an epidural injection considered a day surgery. (I could have had it directly paid to the hospital but opted not to as I was in a lot of pain so didn't want to bother with the pre-approval process; pre approval is not required for hospitiizations costing less than $2,000). 

 

Reimbursements were pretty fast. Maybe 10- 14 days on average.

 

 

- 

[david_je]

4 hours ago, Sheryl said:

My recent experience with April (international not April Thailand) when I needed spine surgery:

 

- received pre-approval/Guarantee of Payment within 48 hours of the hospital submitting the forms

 

- 580k baht directly paid to the hospital. I paid only my chosen $500 deductible and the difference between room charge (room only, excluding meals and nursing)  and the $75/night allowance for a single room.

 

- over another 80k reimbursed for outatient care before & after the surgery (including MRIs,  Xrays, preop labs etc)

 

In addition I was reimbursed about 45k for an epidural injection considered a day surgery. (I could have had it directly paid to the hospital but opted not to as I was in a lot of pain so didn't want to bother with the pre-approval process; pre approval is not required for hospitiizations costing less than $2,000). 

 

Reimbursements were pretty fast. Maybe 10- 14 days on zverage.

 

 

- 

I am also April Intl customer, so thank you for helpful and encouraging post. And wish you a speedy recovery.

[david_je]

On 8/23/2024 at 7:37 AM, Sheryl said:

My recent experience with April (international not April Thailand) when I needed spine surgery:

 

- received pre-approval/Guarantee of Payment within 48 hours of the hospital submitting the forms

 

- 580k baht directly paid to the hospital. I paid only my chosen $500 deductible and the difference between room charge (room only, excluding meals and nursing)  and the $75/night allowance for a single room.

 

- over another 80k reimbursed for outatient care before & after the surgery (including MRIs,  Xrays, preop labs etc)

 

In addition I was reimbursed about 45k for an epidural injection considered a day surgery. (I could have had it directly paid to the hospital but opted not to as I was in a lot of pain so didn't want to bother with the pre-approval process; pre approval is not required for hospitiizations costing less than $2,000). 

 

Reimbursements were pretty fast. Maybe 10- 14 days on average.

 

 

- 

Wondering if you needed/got help from AOC on this, and if so, how that went.

[Sheryl]

1 hour ago, david_je said:

Wondering if you needed/got help from AOC on this, and if so, how that went.

Out of some 10 odd claims, needed their help on just one. 

 

They were able to resolve the problem in  a day.