Is an Exercise Stress Test (EST) Really Necessary in Your Annual Check-Up? A Guide for Expats and Employers
For many expats and globally mobile employees, an annual health check-up is a valuable part of their employer-sponsored health insurance. But with a wide range of check-up packages available – and different tests included – it’s easy to get overwhelmed. One test that often causes confusion is the Exercise Stress Test (EST).
It’s sometimes referred to as a “fitness test,” but that’s not quite accurate. So, what is it, and do you really need it?
What Is an EST?
An Exercise Stress Test is a diagnostic test used to assess how your heart performs under physical stress. Typically, you’ll walk or run on a treadmill while your heart rate, breathing, and blood pressure are monitored. The aim is to detect issues like:
- Coronary artery disease (CAD)
- Irregular heart rhythms
- Exercise-induced symptoms (like chest pain or dizziness)
At hospitals like Bangkok Hospital, the EST is part of certain advanced check-up packages, often grouped under “executive” or “cardiac” plans. You can read more about their approach here.
Not for Everyone
While an EST can be a useful tool in the right context, it isn’t recommended as a standard screening test for everyone. In fact, the American College of Cardiology and many international guidelines suggest that it should only be used if:
- You have cardiovascular risk factors – such as high blood pressure, diabetes, smoking, family history
- You’re experiencing symptoms like chest pain, shortness of breath, or fatigue
- You’re at moderate or high risk of heart disease and plan to start vigorous exercise
In other words, if you’re healthy, and asymptomatic, a doctor probably wouldn’t recommend it.
The Cost Factor
Here’s where things get tricky. At many hospitals, including Bangkok Hospital, only the more expensive health check-up packages include an EST – usually ones priced above US$600. That’s over the typical US$500-600 annual wellness limit on most international health insurance plans.
In other words, by choosing a package with an EST just because it sounds useful, you may end up paying out-of-pocket for most or all of the cost.
We’ve seen cases where people bought a more expensive check-up package just to get the EST, thinking it was a general fitness test – only to find out later it wasn’t really necessary.
From Experience: ESTs Aren’t Fun
Having done an EST myself, I can tell you: they’re not exactly enjoyable. The test is specifically designed to stress your heart. You’ll likely be pushed to your physical limit to help the doctor assess how your cardiovascular system responds under pressure.
That makes sense if you need the data, but it’s not something to undergo lightly or just because it’s part of the “most expensive package.”
Smarter Use of Your Wellness Budget
If you’re an expat or an employer of expats, the takeaway is this:
- Choose wisely: Don’t be upsold into expensive check-ups just because they include more tests. More isn’t always better.
- Use your budget effectively: A US$400–$500 comprehensive check-up without an EST may offer better overall value.
- Ask your doctor: If you’re unsure whether you need an EST, consult a physician before booking the check-up.
- Talk to your broker: If your plan’s wellness limit doesn’t cover the check-up you want, a good broker can help renegotiate limits or identify hospitals offering better value.
How One World Cover Can Help
At One World Cover, we work with HR teams and global mobility managers to ensure their staff aren’t just using their wellness benefits – but using them wisely. That includes:
- Helping employers negotiate better health check-up packages that align with insurance limits
- Educating staff on what each test is for and whether it’s necessary
- Making sure staff understand the difference between preventive care and diagnostic testing
If you’re unsure whether your wellness benefit is being used effectively – or if your staff are being pushed into tests they don’t really need – get in touch. We’re here to help you get better value and better health outcomes.
To learn more please get in touch: [email protected] or click here to contact us.
