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How to claim – Unravelling the international health insurance claims process

How to claim – Unravelling the international health insurance claims process

16th August, 2013 Health Insurance

We know how important it is to deal with international health insurance claims as quickly and efficiently as possible. So we thought it would be useful to supply a guide on how to claim on your international health insurance plan.

 

Essentially, there are three types of claim:

–          In-patient or day-patient direct billing

–          Out-patient direct billing

–          Out-patient pay and claim

How to claim for in-patient or day-patient treatment

If you need to be admitted to hospital for day-patient or in-patient treatment, all you need to do is contact your international health insurance provider and they should place what is called a guarantee of payment with the medical provider, which means you don’t need to pay anything.

It is not recommended, although it is sometimes necessary, to pay for in-patient or day-patient treatment yourself and claim back your expenses where covered under your plan, as the bill can be very large.  Your international health insurance provider may also have been able to negotiate a better cost so it is always wiser to let the experts handle it for you.

The same process applies if you need emergency care.  Your international health insurance provider will have special protocols to move extremely quickly if there is an emergency.  Make sure someone calls the insurance provider as soon as it is reasonably possible.  It can be the person who needs treatment, a family member, friend or one of the medical staff.

How to claim for out-patient treatment via the out-patient direct billing network

If you choose a plan that covers out-patient treatment and you have a nil excess or have bought an additional option that allows you to access your international health insurer’s out-patient direct billing network, you can generally, access out-patient care from any medical practitioner on their list without paying anything.

All you need to do is check that what you want to seek treatment for is covered, make an appointment with the medical provider and when you arrive, present your membership card.  The medical provider might ask for some additional ID or ask you to complete some paperwork for their own admin; from then on there is nothing further for you to do.  The medical practitioner will send the bills directly to your health insurance provider.

How to claim for out-patient treatment when you have paid for medical treatment and need to claim back your expenses

If you don’t have access to an out-patient network or you just want to use a medical practitioner that is not part of your international health insurance provider’s network, you can seek medical treatment, pay for it and submit a claim to recover your covered expenses.

There a few important things you need to know about before you start:

–          As indicated, your insurance provider will only reimburse you for medical treatment that you are covered for.  So if dental treatment is not covered under your plan, do not submit a claim for a scale and polish because it will be declined.

–          If you have chosen a plan with an excess or deductible, you are liable for this cost first. Now Health operates a ‘per medical condition excess’, which means that if you have a USD 100 excess, this cost will need to be met by you before any claims will be paid for each medical condition you claim for.  For instance, if you see a doctor for a sprained ankle, which results in two GP appointments, some medication and a few physiotherapy sessions, when you submit your claim you will be reimbursed the full amount minus the USD 100 excess.

Different international health insurance providers have different ways of dealing with reimbursement claims.  When you buy your plan, look out for ones that make the process simple and ones that will pay back your expenses as quickly as possible.

Here are some pointers to help you navigate the process:

–          Find a pdf of the relevant claim form, preferably a writeable one so you can fill it in online

–          Make sure your international health insurance provider lets you submit your claims by email or online.  This speeds up the process and means you get your money back faster.

–          Look out for providers who offer online tracking and emails and/or SMS notifications.  Having access to all your claims information means you can find out the status of your claims when it suits you, avoiding phone calls to your insurance provider.

Any questions about health insurance claims?

We are always happy to answer your questions. If you’d like to know more about our claims process and how it affects you, feel free to join the conversation on Twitter, @now_health, or leave your question below in the comments box.

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Alison Massey

Group Marketing Director

Now Health International

Alison Massey is a 15-year digital marketing veteran, who has spent the last seven years using social media to help expats and soon to be expats find out what to expect from a life overseas. An expat living in Hong Kong herself, Alison is the Group Marketing Director of Now Health, the award-winning international health insurance provider.

Contact Alison Massey

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