Using Your Insurance... Get the Most
Here are some tips to help you get the most from your international travel insurance.
Understand the "Pre-Certification" provision (very important).
Most travel health insurance policies contain a "Pre-Certification" or "Pre-Notification" provision. Simply put, this says that you must notify the insurance company prior to scheduled surgery, inpatient testing, or other large anticipated medical expense. Failure to do so jeopardizes your coverage substantially, so we emphasis that you be aware of this provision.
"Pre-Certification" enables the insurance company to be sure you are receiving adequate and appropriate treatment, to coordinate all care, and to pre-negotiate fees and arrange for payment.
Copy all 24-hour telephone numbers, along with your policy ID number and keep this information handy at all times. As a rule of thumb, with regard to any medical situation, if in doubt . . . call your plan's 24-hour worldwide assistance service.
From outside the USA, most companies allow you to call "collect." When doing so, we are told it is usually best to use an AT&T operator if possible.
In a medical emergency, seek treatment immediately. Then, you or someone should contact your insurance company as soon as possible.
When receiving treatment outside the USA, always request a fully itemized bill.
If receiving medical treatment overseas, especially in developing countries, you may not receive a bill in which all charges are fully itemized. This will create a problem when you file the claim with the insurance company. Always request a fully itemized bill, which might help you later in the claims process.
Avoid use a hospital emergency room for Non-Emergency treatment.
Hospital emergency facilities are sometimes convenient, especially after normal business hours. But typically, your travel health insurance will not pay for expenses incurred during a non-authorized hospital emergency room visit which is not of an emergency nature. (See your plan exclusions.) (In a true medical emergency, seek immediate treatment at the nearest facility.)
Here is a general definition of a medical emergency; a medical condition manifesting itself by acute signs or symptoms which could reasonably result in placing the Insured Person’s life or limb in danger if medical attention is not provided within 24 hours. Usually, the symptoms are sudden and unexpected.
If it is not a medical emergency, but you want treatment ASAP, one option is to call your 24-hour assistance service first. If the assistance service refers you to a medical facility that also happens to be an emergency facility, then you can reasonably expect to be covered without question. (If this occurs, it's a good idea to make note of the time and to whom you spoke.) The assistance company may then call the medical facility on your behalf to arrange for treatment and to pre-negotiate fees.
For all insurance obtained here, you enjoy three (3) levels of assistance. Knowing "who's who" can mean better and faster assistance for you, if or when needed.
1. Your Travel Insurance Plan "Administrator"
Contact your plan administrator for questions regarding;
- premium payments,
- new ID cards,
- claims filing,
- misc. administrative matters.
When people refer to the "insurance company," they are really referring to the "insurance plan administrator." For all practical purposes, a policy holder will never communicate directly with the insurer or policy "underwriter."
Today, most administrative matters are best handled via the Internet, where you have an e-mail trail. Claim forms and insurance IDs are readily available online or by e-mail. Here are the Websites of the insurance Administrators whose plans are offered here:
Seven Corners, Inc. http://www.sevencorners.com (Liaison Majestic, Liaison International)
HTH Worldwide http://www.hthtravelinsurance.com (TravelGap Excursion)
Global Underwriters Agency http://www.globalunderwriters.com (Diplomat Plans)
2. Your 24-Hour Worldwide Assistance Company
Contact 24-hour assistance for pre-certification, medical guidance, or questions regarding any medical situation. When in doubt, don't hesitate to call. Most accept collect calls from overseas.
Today, most 24-hour Worldwide Assistance Companies are owned by and operated "in-house" by the larger insurance Administrators. Some companies have a separate telephone number for 24-hour Worldwide Assistance, while others use one telephone number for both the Administrator and the Assistance Company.
Your insurance Confirmation/ID will contain your policy number and the 24/7 Assistance company telephone number.
3. Your Independent Insurance Agent (that's us)
For questions while shopping and during the application process. Also, in the event of a possible claims dispute (with the Administrator), we can openly offer guidance.
Per USA Federal and State Laws, as a licensed independent agency, we have a "fiduciary obligation" to you the client. We work for you (Independence Guarantee).
Please note that obtaining your international insurance here does not alter your cost in any manner (Lowest-Rate Guarantee), but it does give you with an extra level of service if needed.
If you need to file a travel health insurance claim, complete instructions are contained in your insurance policy. In most cases, you'll also find instructions and forms at your plan administrator's Website.
Suggestions on Filing a Claim
Notify the plan administrator of your claim as soon as practical from the date of your illness or injury, or within 90 days. A claim form is normally included with your insurance policy and ID card. You may also obtain a claim form through your insurance plan administrator, by going to their Website calling or e-mailing.
Read your policy for instructions on filing a claim. When completing a claim form, be sure your personal information and policy number are clear and readable. Be sure the form is signed and dated.
Attach your original medical bill. If properly itemized, this bill will usually contain the medical information that your insurance company needs. Keep copies of everything.
Tip: When receiving treatment outside of the USA, always ask for an itemized bill. (Not all doctors or clinics outside the USA will think about this when preparing your bill.)
What to Expect Next
Upon receiving your claim, the administrator should promptly send you a written notice verifying receipt. You will sometimes be asked for additional information about your health history, such as the full names of all doctors seen during the past year. When this occurs, the company is making sure that your claim is not related to a "pre-existing condition" (see your policy for definitions and exclusions).
Respond promptly and keep copies. Be sure that your name and policy number are clearly printed on all correspondence. (Remember, it is other humans who are reading your handwriting.)
Tip: Sometimes, a doctor's office can be slow to respond to an insurance company's request for medical information. A polite call to your doctor's office may help to speed up this process, and your claim payment.
USA-Style Insurance for International Health & Travel Insurance Needs.