It takes courage and imagination to consider going to school in Niger — particularly if it means being immersed in a new culture or doing research that can’t be done anywhere else. But that also means facing some unique bureaucratic challenges — perhaps none as important as getting access to quality healthcare. There is no such thing as a government run (mandated) student health insurance system like most students experience when they go abroad to countries in Europe or North America. That leaves the student and/or his/her family with the entire cost and burden of providing medical insurance during their time in Niger.
If you’re traveling to Niamey or other parts of Niger with a spouse and/or children, you are not only looking for a health plan; you are creating a safety net in a country with underdeveloped and often over-extended medical services. This article delves into the specifics of securing your family’s healthcare while attending school in Niger — from actual health insurers and real costs to the possibly life-or-death necessity of arranging a medical evacuation..
The Reality of Healthcare in Niger
to get an idea about the importance of having top-of-the-line insurance coverage you have to think about what Niger’s health care system looks like. The government-run hospitals suffer from a lack of essential medical supplies, a lack of medical specialists and their equipment, as well as the number of qualified medical professionals. Although there are some hospitals (like the National Hospital or Polyclinic Magori in Niamey) with a much better quality of medical care than others, these types of hospital facilities are few and far between.
Therefore, during a medical emergency the “standard of care” provided by the local healthcare system will typically fall short of international standards. Thus it is this factor that causes most families to rely on global expatriate plans (rather than local plans) in order to protect themselves against medical emergencies overseas. It is the ability of your plan to do more than simply pay for your care at the local hospital or clinic; it is also important to know that your plan can arrange for you to be flown back home to undergo treatment by a specialist surgeon if your condition becomes too complicated for the local medical staff to handle.
Top Insurance Providers for Families
Because there isn’t an “out-of-the-box” insurance option available through the U.S. Government, you will need to shop the global expatriate market. These companies provide what they call “modular” plans. Modular means that you can purchase additional coverage for your family members (your spouse and/or dependents), as well as coverage for yourself, at the same time, so you’re only purchasing one policy.
Here are 5 top choices:
1. Cigna Global
Cigna is typically the number one provider for working professionals and students due to its modular design. Their “Platinum” level of coverage has almost unlimited maximums of coverage (the highest level available). In a country like Niger, where there may be limited medical services available and you might have to pay cash up front for medical services, having access to a large established medical network (like Cigna) can help you avoid paying thousands of dollars out of pocket, then filing a claim and waiting weeks/months to receive reimbursement. Cigna also offers “direct billing,” where they pay the doctor/hospital directly.
2. Allianz Care
Allianz is known for being “student friendly,” however, their international health insurance options are just as comprehensive as Cigna’s. Allianz offers add-on policies for spouses and dependents that include maternity benefits (after a waiting period) and routine wellness exams for kids. Their online management system is very user-friendly for submitting claims remotely.
3. IMG (International Medical Group)
IMG provides a Student Secure plan, but for families IMG’s Global Medical Insurance would be better suited. This plan is best for longer term assignments (6 months+). IMG has a great deal of experience in providing insurance to individuals in high risk locations such as the Sahel region, and understands the common infectious diseases found in these areas.
4. April International
If you’re looking for flexibility in terms of plan design, April International provides several different levels of coverage including Emergency Only, Standard, Premium, and Extensive. Based on your assignment to Niger, I would recommend the Premium or Extensive levels. Some plans offered by April have unlimited maximums on certain provisions, which could give you a greater degree of comfort if you were to become ill and require ongoing medical treatment over a long period of time.
5. Bupa Global
If you have a budget that allows it, Bupa is the gold standard for quality and reliability. Bupa’s Elite plan provides the smoothest possible experience anywhere in the world, including Africa. One of the features of Bupa’s Elite plan that we find especially valuable is their Second Medical Opinion program. When you receive a diagnosis from a smaller clinic in Niger and you’d like to get confirmation of the diagnosis/treatment plan from a world class physician in London or Paris, this is the perfect solution.
The “Must-Haves”: Core Coverage for the Sahel
It is simple to become lost in the details of a lengthy policy document such as a 50-page document. When creating a policy for Niger, the top priority should be the four key areas below:
1. Medical Evacuation and Repatriation
The first item on your list should be MedEvac – This is the number one area of concern in your policy. Broken legs are easily treated in Niger, but heart attacks and cerebral malaria are life threatening due to lack of access to specialized medical care. The “MedEvac” clause will guarantee that your insurance company will pay for a private air ambulance to take you to South Africa or Europe if you need to be evacuated from Niger. If there isn’t a MedEvac clause, evacuating someone from Niger could cost you between $30,000 to $50,000.
2. Infectious Disease Coverage
Niger is located within a region plagued by malaria, cholera, and meningitis. Your policy must provide coverage for both inpatient and outpatient treatment for these illnesses without excessive deductible amounts. Make sure your policy also provides coverage for malaria preventative medication (prophylactic) since the cost for a family of three or four over multiple years can be expensive.
3. Direct Billing
Cash flow is important when working in a professional environment. You don’t want to be in a situation where you have to put a $10,000 hospital bill on a credit card before the insurance company pays your claim after multiple weeks. Check to see if your provider has a “Direct Settlement” agreement in place in Niamey so your hospital bills are paid directly by your insurance company.
4. Inpatient vs. Outpatient
While some students will attempt to save money by purchasing “Inpatient Only” coverage (only for hospitalizations), this is usually a bad decision for families. Children develop ear infections, fever and stomach flu and all of these visits to a private pediatrician in Niamey should be covered under an outpatient portion of your policy to keep your daily expenses predictable.
Financial Planning: What Will It Cost?
International insurance budgeting is typically a culture shock for many people. Based upon a typical student family consisting of a primary student, the spouses, and one infant (typically in their late 20’s or early 30’s) you can expect to be charged as follows:
- Economy ($250-$350 USD per month) – these plans will generally include very high deductibles prior to insurance coverage kicking in and will likely only provide emergency and hospitalization coverage. Routine dental and maternity are rarely covered.
- Mid-Range ($400-$600 USD per month)- this tier offers the best value to most professional families with robust outpatient services, full medical evacuations and lower deductibles than economy tier.
- Premium ($700-$1000+ USD per month)- premium insurance plans such as Bupa or Cigna Platinum offer no deductible, higher maternity limits, and ‘wellness’ benefits, including yearly check-ups and vaccinations.
Note on maternity: if you plan to grow your family while living in Niger, please make sure that you secure insurance a minimum of 10 to 12 months in advance. Every international insurance company has an imposed waiting time (minimum of 9 months) for maternity benefits.
Practical Steps Before You Depart
Preparation is the Best Medicine. Complete this checklist before boarding that flight to Niamey so that you can document and protect your families’ health.
1. Vaccine Protocol
You will need a Yellow Fever vaccine to enter Niger. In addition to your “Yellow Card”, you will want to obtain the following vaccinations as well for long term residents:
- Hepatitis A and B
- Typhoid
- Meningitis (ACWY)
- Rabies (this is especially important for kids since they are likely to be playing with the local dogs.)
- Polio boosters
2. Find a Specialized Broker
Do not attempt to navigate the above process on your own. Utilize brokers such as Pacific Prime or AOC Insurance. Brokers do not charge a fee to you. They receive payment from the insurance companies. What they bring to the table is the ability to compare up to 5 different quotes side-by-side and provide you with information on which company has the quickest claims processing time in West Africa.
3. Document the Minimal Visa Requirements
Although Niger does not have a “Student Scheme”, the visa office may still request evidence of “repatriation insurance”. Ensure your insurance certificate contains language stating “Repatriation of Remains” and “Emergency Medical Evacuation” so that you are able to demonstrate to the immigration officials that you meet all requirements.
4. Get Your Local Contacts Set Up
Once you arrive at your destination, do not wait until there is an emergency situation to find a physician. Go visit the Polyclinic Magori or the CERC (Centre de Santé de Référence) in Niamey. Present yourself and ask if they accept your insurance and save their emergency contact numbers in your cell phone.
Navigating Local Risks
Niger is full of life, however, it takes a lot of awareness to stay safe. In addition to health issues, there are many other factors that may impact your overall well-being.
- Waterborne Illnesses: Cholera and Giardia are two types of waterborne illness that can occur from contaminated water. Fortunately, your insurance will cover treatment; however, prevention is always best. Consider investing in a good quality water filter at your home or stick to using bottled water.
- Petty Crime & Express Kidnappings: Petty thefts do happen in Niamey, as well as “Express Kidnappings” in specific areas. Choose a residence with good security, and consider purchasing an insurance policy with a “Crisis Response” addendum if you plan to travel into more rural areas of Niger to conduct your research.
- Heat: The Sahara desert is hot. Dehydration can become severe quickly. Ensure that your entire family adjusts gradually and consumes adequate amounts of electrolytes during the peak of the dry season.
Investing in Peace of Mind
Family relocation to Niger in pursuit of education represents a huge commitment on both a personal and familial level. This represents a significant investment in the future of all members of the family; and can represent a new chapter in your family’s history. That being said, this investment is only as secure as the health of the people relocating to Niger to pursue their educational goals.
When choosing to purchase a comprehensive, international expatriate plan from providers such as Cigna, Allianz or IMG, you remove the “what ifs” associated with studying abroad and ensure that a medical issue does not create a financial disaster or cause a premature end to your educational experience.
Although the monthly premium of $500 may appear high in comparison to local costs of living, it is a low price to pay for the peace of mind that your spouse and dependents will have access to the highest quality medical treatment available anywhere in the world.
References:
- Aetna International. (n.d.). International health insurance for individuals and families. https://www.aetnainternational.com
- Allianz Care. (n.d.). International student health insurance. https://www.allianzcare.com/en/personal-international-health-insurance/student-health-insurance.html
- AOC Insurance Broker. (n.d.). Niger expat health insurance guide. https://www.aoc-insurancebroker.com/niger-expat-health-insurance-guide
- April International. (n.d.). International student insurance: What does it cover? https://www.april-international.com/en/international-student-insurance/guide/what-does-international-student-health-insurance-cover
- AXA Global Healthcare. (n.d.). International health insurance for students. https://www.axaglobalhealthcare.com
- Bupa Global. (n.d.). International health insurance for families. https://www.bupaglobal.com
- Cigna Global. (n.d.). International health insurance for expats and students. https://www.cignaglobal.com
- International Insurance. (n.d.). Health insurance in Africa for expats and foreigners. https://www.internationalinsurance.com/africa/
- International Student Insurance. (n.d.). Student health insurance for international students. https://www.internationalstudentinsurance.com/student-health-insurance/
- IMG. (n.d.). International student health insurance. https://www.imglobal.com/international-student-insurance
- Pacific Prime. (n.d.). Niger health insurance for expats and locals. https://www.pacificprime.com/country/africa/niger-health-insurance/
- William Russell. (n.d.). Health insurance for expats in West Africa. https://www.william-russell.com/blog/health-insurance-expats-nigeria/
