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Retiring overseas? Ageing, stress and how to ensure a healthy life abroad

Whether it’s a planned retirement move to a home in the sun, or a sudden desire to embrace a beloved host country for the long term, many ponder spending their ‘golden years’ living internationally.

Retiring overseas? Ageing, stress and how to ensure a healthy life abroad
Moving abroad to enjoy your golden years can be incredibly fulfilling. Photo: Getty Images

Turning your dream of living overseas into reality can be intensely rewarding. However, it is important to understand the stresses that come with it, how stress exacerbates common health conditions, and how these can be mitigated to ensure a happy, fulfilling life. 

In partnership with Cigna, we discuss the significant factors to consider before making plans to live abroad permanently.

Let’s talk about ageing

As much as we’d like to ignore the fact, as we grow older we are at greater risk of health problems. So it’s worth understanding some common conditions.   

Cardiovascular Disease (CVD) is by far the biggest threat to both men and women as they age. It encompasses a range of common conditions, from strokes and heart attacks to vascular dementia. Taking the United Kingdom as an example, CVD is responsible for 160,000 deaths each year. More pressingly, it is the impact of CVD on survivors that has greater consequences – strokes are one of the leading causes of disability in the UK , with two-thirds of survivors leaving the hospital with some kind of disability.   

Be prepared for the unexpected, get an international health insurance quote

Cancer is another leading threat to both men and women as they age. With the UK again as an example, 147,407 Britons died from cancer in 2020, out of an average of 375,000 new cases each year. One-third of all cancer cases were diagnosed in those over the age of 75. Breast cancer was the most common cancer diagnosed in the UK between 2016 and 2018, followed by prostate, lung and bladder cancers. While the survivability rates for many cancers are rapidly increasing, treatment and surgery does mean loss of mobility and quality of life for many patients. 

Mobility issues are another serious health problem faced by many as they grow older. After the age of 40, the number of people in the UK who require assistance to move freely begins to rise exponentially. Whether caused by the degradation of joints or other, more complicated issues, a loss of mobility can limit how much of the world an individual can engage with. 

While these figures may seem frightening, it’s worth remembering that medical science has led to significant increases in global life expectancy. The chances of surviving a life-threatening illness today are greater than at any point in history. 

What matters, however, is quality of life. We want to enjoy our later years rather than be impaired by illness. Therefore, any factors we can identify to help us avoid developing illnesses are worth paying close attention to.

Recent research shows the surprising role stress plays in the development of age-related diseases. The good news? This is a factor we can largely control. 

Stress and the human body

We’re all familiar with the sensation of being stressed – a rush of adrenalin, a flush of irritability and a pounding head. 

When we’re stressed, the body’s sympathetic nervous system releases adrenaline, as well as hormones such as cortisol, to spur us into a ‘fight or flight’ response, and lead us out of a dangerous situation. While this was a useful tool for our ancient ancestors, in the modern world it can do more harm than good. 

Increasingly, science is uncovering the myriad effects that prolonged stress can have on the human body. We’ve known for a long time that stress can harm the heart and circulatory system – prolonged stress can lead to a more rapid heartbeat and higher blood pressure, doubling the chances of having a heart attack or stroke

Research has also uncovered the role of stress in the development of many kinds of cancer. It indicates that the brain’s release of hormones during periods of prolonged stress can activate cancer cells, leading to rapid tumour growth. 

Stress also impacts the body’s immune system. When a person experiences prolonged stress, hormones again can significantly reduce the number of lymphocytes, a kind of white blood cell, weakening the body’s defences against infection. 

So, for most of us, if we can reduce stress in our daily lives, we can lessen our chances of falling ill. There are a number of techniques, practices and habits that can help reduce the effect of stress. For people living overseas, however, this may be more of a challenge. 

Enjoy the life you’ve planned for yourself abroad and build a policy that meets your specific health needs

Stress and living abroad

The experience of living abroad carries with it its own stressors. 

Chief among these are communication difficulties. A lack of understanding of language and cultural mores can be a constant source of stress for internationals, in particular when it comes to resources that may be needed, such as healthcare.

A lack of access to friendly support networks can also be a major stressor. A significant proportion of expats are individuals, so asking for help or having interactions may be difficult. Making friends can take time, and bring its own anxieties. 

Finally, there may be financial pressures – particularly for retirees, who likely have finite savings. Sudden disruptions to their lifestyle could mean a costly return to their home country, or a reduction in circumstances – in itself a major stressor. 

Stretch yourself: Staying active and connected to others can help vastly reduce stress levels. Photo: Getty Images

The most important consideration for older internationals 

As increasing numbers of people work, live and retire abroad, international health insurers are beginning to understand the role of stress for policyholders – in both recovery and prevention. Most insurers now actively address the stress experienced by internationals abroad through their coverage. 

Chiefly, many providers, such as Cigna Global, offer unlimited phone and online consultations with doctors, with clinical advice and prescriptions in the customer’s language. They also grant access to specialists and choice of hospitals within their network, giving clients peace of mind when it comes to serious illness.

Insurance providers, like Cigna Global, are also developing benefits tailored toward specific conditions, such as cancer. In such cases, in addition to treatment, telephone counselling and other disease-related costs, such as those for a wig, may be included. This provides needed support during a crisis, minimising the damage done by stress and boosting the chances of a full recovery. 

Finally, depending on the level of coverage, some insurers have deployed the use of dedicated services to give their policyholders advice on all areas of life abroad – from rubbish collections to family emergencies. A friendly voice acting as a guide means that many stressors faced by internationals can be minimised, if not eliminated. 

If you are planning to make a permanent move abroad, especially if you’re getting older, it’s important to consider how a potential insurer addresses the challenges of living abroad, and how it actively helps tackle stress. 

It is worth asking exactly what is offered in an international health insurance policy, beyond the coverage it has for illness and accidents. Does it offer consultations with a doctor in your language? What about counselling services? How will the policy offset the stresses of life abroad daily?

Important for retirees to know, if joining Cigna Global before the end of August, the company will upgrade their policy to include the highly-valued Vision and Dental add-on module for one year*, that covers eye tests, eyewear and a wide range of preventative, routine and major dental treatments. 

Enjoying your later years abroad can be a hugely rewarding and fulfilling experience. To make the most of it, make sure you invest in a policy that not only covers you for when you’re ill but also helps you stay fit, healthy and free of stress in the first place. 

Find out how Cigna can ensure you make the most of your life abroad, and request a quote for international health insurance today

*  – The free Vision and Dental policy upgrade is only applicable to new policies sold in August 2022 which will be eligible for 1 year free Vision and Dental cover. Premiums under $2k will not be eligible. Not applicable in conjunction with any other offer or discount.

Sources

Member comments

  1. Can someone explain why on The Local.DE all the stories are about, and from, the UK? Id didn’t sign up for The Local.UK

    The Italian and Spanish The Local are also mostly about Brexit and The UK folks living there and complaining how its not the same.

    Please, just news. Local to the country and focused on the country would be great.

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VISAS

What happens if you overstay your 90-day limit in Germany?

People visiting Germany from a non-EU country are often subject to the 90-day rule, which states that they can only stay for 90 days out of 180. But how strictly is this rule enforced - and what happens if you end up overstaying?

What happens if you overstay your 90-day limit in Germany?

Most people who’ve come to Germany for short leisure trips should be aware of the so-called ’90-day rule’. 

The applies to citizens of non-EU countries that have a visa waiver agreement with the European Union, including people from New Zealand, Australia, the United States, Canada, and – since Brexit – the United Kingdom. 

It also applies to people travelling in Germany on a Schengen Visa for tourism or business purposes. Though visa durations can vary depending on personal circumstances, the most common type of Schengen Visa issued allows people to stay in the free-travel area for up to 90 days out of 180. 

But while the rules may seem pretty clear-cut, it’s often not obvious what the consequences are for people who end up staying longer than they’re supposed to. Here’s a rundown of the current rules and how Germany applies them.

What exactly is the ’90-day rule’?

As we mentioned above, the 90-day rule dictates that people from certain non-EU countries can only stay in Schengen states for up to 90 days in every 180.

It applies to people visiting Germany for tourism, business or leisure activities from countries like the United States, Japan, Australia and Singapore, which have a visa waiver (i.e. visa-free travel) scheme in place. You can check if you’re eligible to enter Germany without a visa here.

The 90 days can be used all in one go or over the course of several different trips. However, the important thing to remember is that no more than 90 days should have been spent in Schengen within 180 days of first entering the travel zone. 

As an example, if you enter Germany on the 1st of January and leave on June 30th, you can’t return until at least September. You should also note that moving to another Schengen country like France or Italy after your 90 days is up won’t cut it: the rule applies to time spent in the EU, so you will need to leave the Bloc entirely. 

People from countries without a visa waiver scheme can generally apply for a 90-day Schengen Visa. This generally has similar conditions to the visa waiver programme for Austrians, Brits, etc., but you would need to apply for another visa in order to return after the 180 days is up. 

If you plan to work or study in Germany or want to stay longer than 90 days, you’ll need to apply for visa. Nationals of certain countries, including the US and the UK, can apply for a visa while already in Germany, while others will have to apply for this before they travel.

You can find more details on moving to Germany from a third country in the following articles:

What consequences are there for overstayers?

If you spend more than 90 days in the EU or Schengen zone without a visa or residency permit then you are officially an overstayer. And unlike the pre-EU days when passport control consisted of a man in a booth with a rubber stamp, scanning of all passports on entry/exit of the EU makes it pretty easy to spot overstayers.

This is set to become even more stringent when the EES scheme comes into effect next year – full details on that HERE

The EU lists a range of possible penalties although in practice some countries are stricter than others.

A police officer at border control in Germany

A police officer at border control in Germany. Photo: picture alliance/dpa | Matthias Balk

Within the system, anyone who overstays can be subject to the following penalties:

Deportation – if you are found to have overstayed, countries are within their rights to either imprison you and deport you, or give you a certain number of days to leave. In practice, deportation is rare for people who aren’t working or claiming benefits: they are more likely to be advised of the situation and told to leave as soon as possible.

Fines – fines can be levied in addition to other penalties and vary according to country. In Germany, they will depend on a range of circumstances, such as how long your overstay, whether the overstay is deemed intentional and if you have any previous convictions. For cases that are deemed to be ‘administrative offences’ – i.e. overstaying out of negligence – a fine of up to €3,000 is possible. In criminal cases, courts can set fines on a case-by-case basis. They could decide to issue a fine based on the number of days you’ve overstayed (for example, €40 per day) but are also likely to consider any other aggravating or mitigating factors. 

Prison sentences – in extremely rare cases, people who overstay their visas in Germany can face up to a year in prison. However, this would generally involve aggravating factors like working for several months or committing another offence while in the country.

Entry ban – countries can impose a complete ban on re-entry, usually for three years although it can be longer. A complete ban is usually only put in place for people who have over-stayed for a significant amount of time.

READ ALSO: Does transit through Germany’s neighbours affect Brexit 90-day rule?

Difficulties returning to the Schengen area – even if you avoid all of the above penalties, the overstay alert on your passport will make it more difficult for you to return to the EU, and this applies to any EU or Schengen zone country, not just the one you over-stayed in. People who have this alert on their passport are likely to face extended checks at the border and may even be turned back. You will also likely encounter difficulties if you later apply for a visa or residency.

People who simply stay in an EU country without securing residency become undocumented immigrants and will not be able to access healthcare or social security provisions. If caught, they face deportation.

How is Germany enforcing the rules?

Compared to some other EU countries, Germany has a reputation for having especially strict immigration rules. Though they may not spot your overstay immediately while you’re still in the country, it’s likely to be picked up when you leave. 

This could have consequences for future visits or visa applications, or other consequences mentioned above. 

A woman passes through the automated passport control in EU

A woman passes through the automated passport control at Düsseldorf airport. Photo: picture alliance / dpa | Federico Gambarini

How can I avoid overstaying in Germany?

One of the best ways to avoid an accidental overstay in Germany is to have a firm grip on the rules. It’s worth remembering, for example, that the date you arrive counts as the first day of your stay, even if your flight lands just before midnight. The same goes for the date you leave: anytime after midnight counts as the next day, even if it’s in the early hours of the morning. 

If you’re planning to make multiple short trips to Schengen in the 180 day period, you can use this handy calculator to work out how many more days you are allowed to stay. 

Of course, unforeseen circumstances can occur, such as sudden illness or other problems affecting your ability to return home. In these circumstances, you should contact your nearest Foreigners’ Office (Ausländerbehörde) as soon as possible to see what options are available to you. In some cases, they may allow you to extend your time in Germany without treating it as an illegal overstay. 

READ ALSO: REVEALED: EU plans digital-only Schengen visa application process

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