Tips for Accessing Health Care Abroad
For those who choose to live abroad, international health insurance is one of the first priorities that you will want to check off your to-do list. Assuming that you have purchased a high quality plan with us, here are some basic guidelines which can help should you need to use your coverage.
Choose a Medical Center and Physicians Within Your Provider Network
In the event of an unexpected medical incident, most people do not have the time to research which in-network doctor they need to be seeing. You may find that there is a medical center conveniently located near your home or office. However, using a health care provider that is out of your insurance company’s network may result in increased fees and delayed payment of claims.
The advantage of going to a facility within a network is that your provider (doctor) can bill the insurance company directly (The insurance company pays the provider). Otherwise, you would have to pay the provider yourself (out of your own pocket). When you pay out of your own pocket, you can submit a claim to the insurance company later but it will take some time for your to be reimbursed, especially if the medical documents have to be translated.
We recommend that as soon as you have settled into your new home, you take the time to research which doctors, clinics and centers have a partnership with your insurer. When you have time to do this leisurely, it is a simple process, and easier to tackle if a language barrier is involved. Since most insurance companies provide an online directory of their network domestically and internationally.
Communicate with Insurance Company Plan Administrators
Should you need to use your international health insurance, make sure you have your plan documents on hand and readily available. Health care providers are much more likely to provide you with care if you can show confirmation that you have insurance to cover the costs. At a minimum, carry your insurance cards with you at all times. It is highly recommended that you also have the 24 hour emergency assistance hotline provided by your insurance company. This number is to be used for emergency situations when you need to find a doctor, have a question clarified or pre-notify your insurance company of treatment. Always call your insurance company before receiving treatment – when possible. They have experts
in international medical care trained for situations like these, rely on their expertise to help you get through a tough time.
If you are not able to call right away, call as soon as possible to notify the insurance company of potential claims.
If you find yourself in a complicated situation it is also a good idea to have correspondence in writing. documenting your communication with doctors and the insurance company in writing will limit potential misunderstandings and confusion in the future. If you find yourself dealing with an incident over the phone, make it a point to request the name of whom you are speaking with and a direct extension, this way you are able to contact the individual you were previously working with.
Keep all Bills, Records, and Documents
Should you need medical care abroad, make sure you record and document everything. You want to have all the records you can get for both your own personal medical history but also for potential claims you might have to fill with your insurer. Specifically, make sure you ask for and receive an explanation of diagnosis from your doctor or a “Physician’s Statement”.
It is imperative that you request some form or receipt for any treatment that you receive. This can often times become an issue if you are asked to pay up front and then later try to request a refund or reimbursement. If there is no documentation, the insurance company will not have a way to verify that the payment was made.
Make Sure Information is Accurate
Surprisingly, one of the most frequent problems with filing a claim is that the documentation of the medical expense does not have the correct name of the person filing the claim. This may happen because of language and cultural differences, but it is something to watch out for. Make sure documentation of your expenses has your name on it and, if possible, your insurance policy number. It is important to tie the medical expenses to you personally as best you can.
Pre-Certification of Medical Benefits
In some cases, typically before you are admitted to a hospital or undergo major surgery, you will get certain expenses approved by the insurance company. This process is called pre-certification. It is to your benefit, and to the benefit of the insurance company, to work together to get pre-certified before you incur major expenses.