IPMI renewals are your annual “moment of truth”. Your insurer re-prices your policy, and you have a limited window to renew as-is, adjust the cover, or compare alternatives. If your premium rises, it doesn’t automatically mean your cover is “wrong” — increases often reflect age-banding, medical trend (healthcare inflation), the insurer’s portfolio claims experience, and where you live and travel. The practical question is: how do you keep your cover aligned with how you live now (countries, dependants, chronic care and real-world usage) without creating gaps or unwelcome surprises? This guide sets out practical IPMI renewal strategies: how renewal pricing typically works, what you may be able to change, when underwriting comes back into play, and how broker support can help you compare options in a compliance-safe way.
Use this as a quick sense-check before you open the renewal notice:
- Your current policy schedule (benefits, excess/deductible, area of cover and optional modules).
- Your renewal quotation and any renewal endorsements/changes (limits, wording, or terms).
- Any changes since last renewal: country of residence, travel pattern, dependants, employment status, and visa/residency requirements.
- A simple usage snapshot: what you claimed for (inpatient/outpatient/maternity/dental/physio) and what you didn’t use.
- Your “non-negotiables”: countries that must be covered, chronic care expectations, preferred providers, and a realistic budget limit.
- Renewal is your leverage point: plan design changes are often simplest at renewal, and many policies restrict benefit option changes mid-term.[8]
- Expect medical trend pressure: global healthcare costs are commonly projected to rise at around ~10% per year, which can feed through to premiums.[2]
- Age-banding matters: premium increases often include an age-related step at renewal rather than on your birthday.[6]
- Not all increases are “personal”: some insurers state renewal premiums are unaffected by previous claims (pricing is more portfolio-driven than based on individual claims experience).[10]
- “Negotiation” usually means options: you may be able to adjust the excess/deductible, limits, area of cover and optional modules — each may reduce premium, but each has trade-offs.[7]
- Underwriting can return: adding benefits, reducing cost-share, or adding a dependant may trigger fresh underwriting or new terms.[12]
- Broker support is practical: we can compare like-for-like, explain trade-offs, and help manage timing — but outcomes depend on insurer pricing, underwriting policy, medical inflation, portfolio experience and your circumstances.[12]
- Why renewal is the best time to review cover
- How insurers calculate premiums (age, claims history, medical trends)
- Options for negotiating renewals (deductible adjustments, benefit changes)
- When medical underwriting is revisited
- How brokers approach market comparison
- Checklist for your renewal review
- Mistakes to avoid
Why renewal is the best time to review cover
Renewal isn’t just a price change. It’s the point at which your insurer re-prices the risk for the next policy year, and you can decide whether your cover still fits your circumstances. If you take no action, many policies simply continue on the renewed terms once the premium is paid (some may auto-renew, depending on your payment set-up and the policy wording).
For most people, the gap between cover and real life develops gradually over the year. You move country, travel more (or less), add a partner or child, start regular prescriptions, or your expectations around outpatient access change. Renewal is often the cleanest opportunity to correct course because plan design changes frequently apply from the renewal date rather than mid-term.[8]
Think of renewal as a “policy fit” review
A practical way to check “fit” is to review four areas:
- Geography: where you live now, where you expect to travel, and whether high-cost regions are included in your area of cover.
- Household: dependants, pregnancy planning, education location (for example, where children board), and whether everyone’s details are up to date.
- Usage: what you actually used (and paid out-of-pocket) versus what you pay for but rarely claim on.
- Risk tolerance: what level of excess/deductible and co-insurance feels manageable if you have a year with higher medical costs.
A simple renewal timeline you can use
Notice periods vary by insurer and jurisdiction. A sensible approach is to plan backwards from the renewal date so you’re not forced into last-minute decisions.
- Pull your policy schedule and last year’s renewal documentation.
- List any changes (country, dependants, travel pattern, employer reimbursement).
- Capture a simple “usage snapshot”: inpatient vs outpatient vs routine add-ons.
- Tip: many insurers issue renewal terms around 45 days before renewal, so use this time to prepare before the paperwork lands.
- Look out for the renewal quote/terms (often issued around 45 days before renewal).
- Decide what you must keep (non-negotiables) versus what you could adjust.
- Request 2–3 clean “what-if” prices: higher excess/deductible, different area of cover, module changes.
- If comparing, start market quotes early enough to allow time for underwriting if you switch.
- Review the renewal documents for any changes to benefits, limits or wording (not just price).
- Confirm deadlines for requesting changes and paying the premium.
- If switching, don’t cancel existing cover until the new policy is confirmed as in force.
Even when general inflation eases, healthcare costs can rise faster than everyday prices. For example, the IMF expected global headline inflation to fall to 5.8% in 2024 and 4.4% in 2025,[1] while global medical trend projections are often around ~10% for employer-sponsored plans (a widely used benchmark for healthcare cost pressure).[2] Renewal premiums may reflect this healthcare cost environment, alongside age, geography and portfolio claims experience.
Options for negotiating renewals (deductible adjustments, benefit changes)
In IPMI, “negotiating the renewal” rarely means bargaining over the insurer’s base rate. More often, it means: (1) asking the insurer to explain the increase; (2) requesting a review if something looks inconsistent; and (3) adjusting plan design to reach a premium you can realistically sustain.
This section gives you a structured way to explore changes — including typical trade-offs and risks — so you can decide what makes sense for your household. Your insurer will still need to approve changes, and some changes may trigger underwriting (covered in the next section).[12]
Start with your “non-negotiables”
Before changing anything, be clear on what you can’t compromise on. For example:
- Countries you must be covered in (residence, frequent business travel, close family location).
- Access to particular hospitals/clinics or a broad provider network.
- Chronic condition management (ongoing prescriptions, regular specialist reviews).
- Budget limits (what you can sustain for the next 12 months, not just the next monthly instalment).
Negotiation levers table (what you can change, trade-offs, risks)
| Negotiation lever (plan design) | What you change | Typical trade-off | Key risks / watch-outs |
|---|---|---|---|
| Deductible / excess | Increase the amount you pay before benefits apply. | Premium may reduce because you retain more of the “first layer” of cost.[7] | Higher out-of-pocket in a claim-heavy year; check whether it applies “per policy year” or “per condition”. Some insurers state the deductible applies per insurance year and can apply again across renewal if treatment spans years.[11] |
| Co-insurance / cost share | Increase your percentage share of eligible costs. | Premium may reduce, but you contribute more towards each eligible bill. | Can be costly on larger claims; confirm any out-of-pocket maximum and how it operates. |
| Area of cover | Remove high-cost regions or move to a narrower geographic scope. | Premium may reduce (sometimes significantly) because the insurer’s exposure changes.[9] | No cover in excluded countries; travel plans or a future move can reopen the question (and may require re-quoting and/or underwriting). |
| Optional modules | Remove add-ons such as outpatient, dental/optical, maternity, or wellness modules (where a modular plan applies). | Premium may reduce because optional cover is removed.[7] | Adding it back later may require underwriting and/or waiting periods; confirm module rules and effective dates. |
| Outpatient structure | Lower outpatient limits, add visit caps, or move to a “core inpatient + optional outpatient” structure. | Premium may reduce, but routine care becomes more out-of-pocket. | Outpatient is often where chronic care costs sit; a lower cap can be used up quickly if you need regular monitoring. |
| Provider network / routing | Move to a plan tier with a tighter provider network (where available). | Premium may reduce; the insurer is pricing for more managed care pathways. | Check whether preferred providers are in-network and what happens if you go out-of-network. |
| Payment frequency | Switch from monthly instalments to annual payment (or other available frequency options). | Total paid may reduce if the insurer applies an instalment charge or a discount for annual payment. | Cashflow impact; confirm what happens if payment fails (some policy rules allow suspension/cancellation after notice periods).[12] |
This table is a decision framework, not a guarantee. Pricing outcomes depend on insurer rating, underwriting rules, and what changes are permitted on your specific product.
How to request renewal options (a broker-safe approach)
If you want to explore options without creating confusion, keep your request structured:
- Ask the insurer to confirm what is driving the increase (age band, medical trend, geography, plan changes).
- Request two or three “what-if” quotations (for example: (A) same cover; (B) higher excess/deductible; (C) narrower area of cover).
- Ask whether any of those “what-if” changes would trigger underwriting or reset waiting periods.
- Ask for written confirmation of what changes, and when the changes take effect.
Renewal outcomes depend on insurer pricing, underwriting policy, portfolio claims experience, medical inflation and your individual circumstances. Often, the most practical way to manage an increase is to choose a plan design you can sustain, then sense-check that it still meets your real-world needs.
What to ask your insurer (renewal-focused)
- “Can you break down my increase into age-related change vs medical trend vs any plan changes?”
- “Have any benefit limits, definitions, or policy terms changed for the new period of cover?”
- “If I increase my excess/deductible, what premium change would apply?”
- “If I remove an optional module (e.g., outpatient), can I add it back later — and would underwriting apply?”
- “If treatment continues over the renewal date, how does the deductible/cost share apply across policy years?”[11]
- “What are the deadlines to accept renewal and to request benefit changes?”
When medical underwriting is revisited
Many policyholders assume renewal automatically means fresh medical underwriting. In practice, underwriting is more commonly revisited when you request certain changes, or where the insurer requires updated information under the policy terms.
Common triggers: “risk-increasing” changes
As a general rule, changes that increase the insurer’s exposure are more likely to prompt underwriting review. Examples may include:
- Adding optional modules or upgrading the level of cover (where a modular plan applies).[12]
- Reducing your excess/deductible or cost share (you’re asking the insurer to pay a greater share).[8]
- Adding a dependant (particularly where not added within any required newborn timelines).
- Expanding the area of cover to include higher-cost countries (if handled as a re-quote).
For example, some policy rules state that coverage options can’t be changed at your request during the period of cover and can only be changed at renewal. They also note that if you want to add/remove options or reduce your excess/deductible or cost share, the insurer may ask you to complete a new application (i.e. underwriting may be reopened).[8]
“Risk-reducing” changes can be simpler
Changes that reduce the insurer’s exposure can be easier to approve (still subject to the policy rules). Examples often include increasing your excess/deductible or removing optional cover. Some membership guides note that premiums may be lower if you add/increase a deductible or remove an option, and higher if you remove/reduce a deductible or add options (reflecting the underlying risk change).[7]
Renewal terms can still change (even if you don’t request changes)
Insurers typically reserve the right to review premiums each period of cover and to inform you of charges for the next period.[12] Some policy rules also allow insurers to apply updated restrictions or exclusions for the new period of cover (subject to the contract terms and acceptance).[12]
This is why it’s worth treating renewal documents as more than a payment request. Look out for:
- Changes to benefits, limits or definitions (including outpatient caps, mental health definitions, maternity waiting periods).
- New endorsements, special exclusions, or changes to cost share/excess/deductibles.
- Changes to how you access care (network rules, pre-authorisation requirements, provider lists).
When you ask us to support you at renewal, we focus on avoiding unintended underwriting triggers. We’ll map what you want to change against what the insurer treats as a re-underwrite, then structure options so you can make decisions with fewer surprises. We can’t influence underwriting decisions, but we can help you approach changes in a clear, well-documented way.
How brokers approach market comparison
Market comparison is a tool, not a threat. If your renewal still represents fair value for what you need, staying put can be sensible. If the renewal no longer fits your needs or budget, comparing alternatives helps you understand whether different plan designs might suit you better.
What “like-for-like” really means
A proper comparison is not just “premium vs premium”. We typically compare:
- Core benefits: inpatient/day-patient scope, oncology, ICU limits, emergency cover.
- Outpatient structure: cap levels, access to specialists, diagnostics, therapy limits, prescription limits.
- Geography: area of cover and any restrictions for high-cost countries.
- Cost sharing: excess/deductible structure, co-insurance, out-of-pocket maximums, per-year vs per-condition mechanics.
- Policy mechanics: pre-authorisation, direct settlement networks, claims administration, service requirements.
- Underwriting implications: what switching could mean given your medical history and any ongoing treatment.
What brokers do (and don’t do) at renewal
- Clarify what changed: price only vs terms/limits as well.
- Model plan design “what-ifs” (excess/deductible, area of cover, modules).
- Prepare a shortlist of options based on your non-negotiables.
- No guarantee of lower premiums.
- No guarantee of improved underwriting terms.
- No guarantee that switching will be available or appropriate.
- What you gain/lose by changing excess/deductible or area of cover.
- Whether outpatient caps create a risk for chronic care costs.
- Timing risks (renewal deadlines, underwriting delays).
Retention-focused comparison: staying vs switching
If you’re already insured, a renewal review should usually answer three questions:
- Is the renewed policy still fit for purpose? (countries, household, expected usage)
- Is there a plan design adjustment that improves value? (premium vs cover balance)
- If switching, what is the underwriting risk? (exclusions, loadings, waiting periods)
Questions to ask your broker (renewal comparison)
- “Can you compare my renewal with alternatives on a like-for-like basis, including cost share and outpatient caps?”
- “If I switch, what underwriting questions are likely to be most relevant given the last 12 months?”
- “Can you show me two or three plan designs (not just insurers) that meet my budget?”
- “What are realistic timescales to secure a new policy before the renewal date?”
- “Which changes are easily reversible later, and which could be difficult to undo?”
Checklist for your renewal review
This is the practical heart of IPMI renewal strategy: get the right information, ask the right questions, and make changes in an order that avoids gaps. Use the timeline below and the document checklist to stay organised.
Renewal review timeline (actionable steps)
- 90 days before: Gather your policy schedule, table of benefits, last renewal paperwork, and any endorsements. Note your renewal date and payment method. List any changes in circumstances.
- 60 days before: Request “what-if” quotations (excess/deductible, area of cover, modules). If comparing, start market quotes now. Identify changes that may trigger underwriting.
- 30 days before: Review the renewal offer line by line. Confirm deadlines. Finalise decisions and documentation. If switching, ensure new cover is confirmed before cancelling existing cover.
- 7–14 days before: Confirm payment and policy documents for the new policy year. Store digital copies and key contact details.
Documents to pull together
- Your policy schedule and table of benefits.
- Your renewal notice and any new endorsements or updated terms for the next policy year.
- A simple claims/usage summary (even if it’s just your own notes: what you used, and where you paid out-of-pocket).
- If switching: relevant medical records for any ongoing or recent treatment (so you can answer underwriting questions accurately).
- Travel/residency clarity: your country of residence and expected travel countries for the next 12 months.
Renewal questions (copy/paste)
- Higher excess/deductible quotations.[7]
- Module removal/adjustment (e.g., outpatient/dental/maternity).
- Area of cover adjustment (and what it removes).
- Payment frequency options and any associated fees (if applicable).
Broker perspective tips (neutral, practical)
- Don’t start with “cheapest”. Start with the cover you need, then adjust plan design to fit budget.
- Keep scenarios simple. Two or three clean “what-if” quotations are usually easier to compare than lots of small tweaks.
- Protect continuity. If switching insurers, plan timing carefully so you don’t create a gap in cover.
- Document decisions. Keep written confirmation of requested changes and the effective date.
- Assume variation. Underwriting, pricing and renewal rules vary by insurer and jurisdiction; verify anything that matters before you act.
Mistakes to avoid
The biggest renewal problems usually come down to timing and assumptions. A close second is making a “cost” decision that creates an access-to-care problem later.
1) Treating the renewal notice as “just a bill”
Renewal documents can include changes to benefits, limits, definitions and process rules — not just the premium. Read them line by line and flag anything that looks new or unclear.
2) Making changes without checking underwriting impact
Risk-increasing changes can trigger underwriting and new terms (including restrictions/exclusions), depending on the policy rules.[12] Before requesting upgrades, confirm the process and timescales so you don’t end up “pending” close to renewal.
3) Cutting the wrong benefit to save premium
Reducing outpatient cover can look attractive until you have a year of repeated diagnostics, specialist reviews, or long-term prescriptions. If you’re managing a chronic condition, be cautious with outpatient caps and therapy limits.
4) Missing the excess/deductible mechanics
Deductibles can apply per person and per insurance year, and some insurers explain that if treatment continues across the renewal date, the annual deductible may apply in each insurance year.[11] That detail can make a meaningful difference to your expected out-of-pocket costs around renewal.
5) Leaving market comparison too late
If you plan to compare or switch, start early enough to allow for underwriting, document requests and approvals. Leaving it to the final week can mean you effectively have to accept the renewal because it’s the only option that can be confirmed in time.
6) Cancelling existing cover before the new policy is in force
If you are switching, avoid gaps. Confirm the new policy has been accepted and is active before cancelling the existing policy. If you’re unsure, ask your broker to help with timings and paperwork.
If a premium increase feels uncomfortable, step back and separate “price pressure” from “cover fit”. A sound renewal decision usually balances: (1) where you need cover; (2) what you need covered; (3) how much risk you can retain via excess/cost share; and (4) underwriting implications if you switch.
Get Started
If you already have IPMI and want a renewal-focused review, start here: Already Covered (Review my existing policy). We’ll help you interpret the renewal, model plan design options (excess/deductible, area of cover, modules), and compare market alternatives where appropriate.
If you want to compare or replace cover, you can request a new quote here: Get a quote. For common renewal questions and definitions, our FAQ may also help.
Note: we provide broker support and clarity, not guarantees. Renewal pricing and underwriting outcomes depend on insurer rules, portfolio experience, medical trend and your individual circumstances.[12]
Points to verify
The items below commonly vary by insurer, product and jurisdiction. Check your policy wording and renewal notice before acting.
- Notice period and deadlines: how far in advance renewal terms are issued; cut-off dates for requesting changes and making payment.
- Mid-term change rules: whether you can change modules, excess/deductible/cost share, or area of cover during the policy year, or only at renewal.[8]
- Underwriting triggers: which changes require a new application/medical questionnaire (e.g., adding modules, reducing excess/deductible or cost share, adding dependants).[12]
- Ongoing treatment across renewal: how deductibles/cost share apply if treatment spans two insurance years.[11]
- Area of cover changes: whether changing geography is treated as a new quote; how emergency cover works outside your area of cover.
- Optional module rules: waiting periods, whether adding later is permitted, and whether exclusions can apply to new modules.
- Payment failure mechanics: what happens if an instalment fails (suspension/cancellation timing and reinstatement rules).[12]
- Currency rules: which currency premiums are due in, and whether currency factors are referenced in pricing explanations.[5]
- Renewability and age limits: whether the plan has an upper age limit or whether it can continue while eligibility criteria are met (product-dependent).[10]
