|
5 Quick Tips . . . To
Help You Get The Most
From Your Insurance Contract |
1. Be aware of the
"Pre-Certification" provision of your contract.
Nearly all health insurance policies contain a
"Pre-Certification"
or "Pre-Notification" provision. Simply put, this says that you must notify the insurance company prior to surgery or other
major
medical procedures. (Some plans require that you contact the company prior to
seeking any medical care, except in the case of a medical emergency.) Read and
understand this provision.
Pre-Certification
or Pre-Notification enables the insurance company to be sure
you are receiving appropriate treatment, to coordinate all care, and to
pre-negotiate
fees and arrange for payment. Failure to contact your insurance company could
reduce or jeopardize your coverage, so
we emphasize that you and all family members be aware of this provision
in your insurance contract.
2. When in doubt,
don't hesitate to call your 24-hour assistance service.
All International insurance companies found
here offer 24-hour, worldwide assistance by telephone. Make several copies of
your 24-hour telephone
number and policy ID number and keep them handy at all times.
Most companies provide a telephone number for
you to
call collect if outside of the USA. In the
event of any major medical situation, or if you have a question or are simply
in doubt, do not hesitate to call.
3. Don't use a
hospital emergency room for non-emergency treatment, x-rays, or tests - unless
appropriate or authorized.
Hospital emergency facilities are often
convenient, especially after hours. But typically, your health insurance plan
will not pay for expenses incurred during a non-authorized hospital emergency
room visit which is not of an emergency nature. (See the health plan
exclusions.)
In a medical emergency, seek immediate
treatment at the nearest available 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 to see a doctor ASAP, call your assistance service first. If
the assistance service refers you to a medical facility, which 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.
4.
For US visitors, if you need to see
a doctor in the USA, always ask for either the "PPO Discount" or "Cash
Discount." You can expect to save 20% or more.
In the USA, you will rarely see a fee schedule
posted in a doctor's office. That's because fees and charges vary from
patient to patient, depending on the patient's insurance and how the bill will
be paid.
A "PPO" (Preferred Provider
Organization) is a network of "participating" doctors and hospitals who have
agreed to lower pre-negotiated fees in return for a large volume of business.
In order to control costs within the USA, most
Long-Term
or "Permanent" health insurance plans provide strong incentives (or
maybe require) that their contracted PPO medical network be used for all
covered medical treatment. Be sure you have the website for your plan's PPO,
so you can look-up a list of "providers" in your area whenever you wish.
Contact your insurance company if you have any questions.
If you are visiting or
immigrating to the USA and have a Temporary
health insurance plan, you might save 20% or more by asking prior to making
your appointment for the doctor's "PPO" or "Cash" discount.
Explain that you will pay cash or credit card at time of visit (most likely
anyhow, unless you have exceeded your deductible) and that you will file your
own claim with your insurance company. Most doctors' offices will happily
agree.
5. When receiving
treatment outside of the USA, request a fully itemized bill.
If receiving medical treatment in some
countries, especially in developing countries, you may not automatically
receive a bill in which all charges are fully itemized. This
could possibly 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.
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|
Who's Who In
Your Insurance Contract |
Here's a brief international insurance
"who's who." Knowing exactly who to contact and when can mean better
assistance and could help you to ensure maximum coverage.
1. Your Health Plan
Administrator:
contact for questions regarding premium payments,
renewals, benefits, new ID cards, claims filing, and all day-to-day administrative matters.
Many Administrators now have a dedicated
"client" page on their website, where clients are able to log-in and print-out
duplicate insurance IDs, renew their coverage, etc..
2.
24-Hour Worldwide Assistance Company:
for pre-certification, general medical guidance, or questions
regarding any medical situation. Also coordinates emergency medical
evacuation, repatriation, etc..
Today, most 24-hour Worldwide Assistance
Companies are owned by and operated "in-house" by the Health
Plan Administrators. Some companies have a separate telephone number for
24-hour Worldwide Assistance, while others use one telephone number for both
the Administrator (usually available 8 hours per day) and the 24-Hour
Assistance Company.
Your Insurance ID will contain your policy number, these
important
telephone numbers and other important information. Our advice to you is
always "when in doubt, call." From outside the USA, most companies
allow you to call "collect." (I am told that when doing so, it is
often
best to use an AT&T operator.)
3. Your
Independent Agent:
for questions while shopping, applying, and possibly
after the sale if needed. Per US Federal and State Laws, a licensed,
independent insurance agent has a fiduciary
obligation to you the client. (In other words, we work for you.)
For example, if you happen to experience a
claims dispute with your Health Plan
Administrator, we as your independent agent can and will openly assist
(see guarantees). Obviously we cannot
change the wording of your insurance policy, so always
be aware of your obligations under your policy as well (see
get the most).
Please note
that obtaining your international insurance here does not increase your premium
in any manner whatsoever (see lowest-rate
guarantee).
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Today, most health plan administrators
have websites where you can find policy details, contact information, and in
some cases, print-out a new insurance ID card. Here are links to the
plan Administrators found here. (All links are intended to open in a new Window.)
Administrator: Seven Corners, Inc. (SCI)
Website:
www.sevencorners.com
Long-term plans include
Reside Prime Worldwide and Reside
Worldwide. Temporary plans include Liaison International, Inbound USA,
Inbound Immigrant, and US Immigrant.
Administrator: Global Underwriters
Agency (GUA)
Website:
www.globalunderwriters.com
GUA plans include the Diplomat International, Diplomat America,
and Diplomat LT.
Administrator: HTH Worldwide (HTH)
Website:
www.hthtravelinsurance.com
Long-term plans include the Global Citizen and Global Citizen
EXP.
Administrator: MultiNational
Underwriters Inc. (MNUI)
Website:
www.mnui.com
Temporary plans include the Atlas International and Atlas America.
Rule of Thumb: When in doubt, never
hesitate to call your 24-hour assistance service. All plan
administrators allow you to call "collect" or provide an international
toll-free number.
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