Should You Rely on Public Healthcare and Travel Insurance for Expat Staff?
In some countries, expat employers are required to enroll staff in the local national health insurance system. This is common across Europe and in a few Asian markets like Japan and Taiwan. When the public healthcare system is reliable, high-quality, and accessible, it may seem logical to rely on it – and then purchase a travel insurance policy for the 1–2 months per year when staff travel abroad.
It’s an approach that, on the surface, might offer significant cost savings. But is it truly enough?
Public Healthcare + Travel Insurance: A Viable Strategy?
In theory, yes – but only in very specific situations. If:
- Public healthcare is high quality and accessible,
- Your staff are comfortable using local public hospitals,
- You only want coverage for emergencies while traveling…
…then this model might make sense.
But in reality, the situation is more complex. Let’s break it down.
Not All Public Healthcare Systems Are Truly Accessible for Expats
Thinking about Asia, while national health systems in Japan and Taiwan are world-renowned, expats in most other regions will likely face:
- Language barriers
- Cultural discomfort
- Limitations in the availability of certain medications or treatments
In China employers are required to purchase social insurance for expats in most cities and provinces – but virtually no expats rely on the public system, even though its being paid for. Language, access, and quality concerns (rightly or wrongly) mean that in practice, international staff often seek care at costly private medical facilities or outside China.
The same is true in many other countries where public healthcare may not be aligned with expat expectations.
Travel Insurance ≠ Health Insurance
As we wrote in a previous article: Travel insurance is not a substitute for health insurance. It’s designed for emergencies only, not ongoing care.
READ MORE >> Should Expat Employers Limit International Health Insurance to One Country and Use Travel Insurance for the Rest?
Relying on travel insurance means accepting:
- Limited cover for pre-existing conditions
- No access to care for chronic or long-term illnesses
- No cancer treatment coverage
- Limitations (though not always) on care in a member’s home country
Some travel plans do offer home-country coverage (contact us if you are looking for such a plan), but they are the exception, not the rule – and still fall short of true health coverage.
What Are You Really Trying to Achieve?
Before making any decisions, you need to ask:
What do we want to support/offer as an employer?
If your goal is simply to protect staff in case of a medical emergency while traveling, then travel insurance may suffice. But if you want to:
- Support chronic condition care,
- Ensure continuity of treatment,
- Allow staff to access care in their home country or while traveling,
- Provide cancer treatment or specialized services…
…then you’ll need international health insurance – not travel cover.
There Are Hybrid Options – But Only If You Know Where to Look
Some insurers (though not the usual suspects like Cigna, Allianz, or Bupa) will allow employers to purchase a health insurance plan with a non-standard area of cover to exclude cover in the country where you staff are typically resident/working for the majority of the year. This allows:
- Lower overall premiums
- Continued support for chronic and serious conditions abroad
- Full coverage outside of the country of expat residence without resorting to travel insurance
For example:
- If your staff are based in Japan and are enrolled in the national health system, you might exclude Japan from the coverage area (because public care is sufficient there) while still covering them worldwide elsewhere.
- This ensures full benefits for pre-existing conditions, cancer care, and chronic illnesses while keeping costs down.
At One World Cover, we work with a wide range of insurers that can provide non-standard coverage areas to suit your team’s specific needs.
Remember: Medications and Waiting Periods Still Matter
Even in excellent public systems like those in Europe, Japan, or Taiwan, staff might not:
- Have access to specific medications
- Be able to see specialists quickly
- Get approval for certain high-cost procedures in a timely manner
Offering international cover – even with a restricted geographic scope – can ensure staff have the option to seek care abroad if needed, whether in their home country or a center of medical excellence.
Final Takeaway: Match Your Coverage to Your Goals
If you’re trying to save costs, it’s worth reviewing everything. But you must:
- Decide what kind of care you want to support
- Be realistic about what public systems and travel plans can offer
- Have alternatives in place for the services you choose not to cover
If you do want to make a shift – such as dropping cover in the USA or excluding the staff’s country of residence – you must ensure that:
- The alternative is viable and clearly communicated
- It can be confidently recommended
- Staff can actually use the alternative in practice
Our team at One World Cover is happy to help you explore these options and create a solution that balances cost control with your duty of care as an employer. If you’re facing budget constraints, let’s explore the right options together – ones that safeguard your people and your reputation.
To learn more please get in touch: [email protected] or click here to contact us.
