Expat Maternity Insurance Claims: A Guide to Navigating the Claims Process While Living Abroad
For expats starting a family abroad, understanding how to file maternity insurance claims abroad is crucial to avoiding unnecessary out-of-pocket payments. You need to understand what services require pre-certifications and pre-authorizations so they can be claimed when you begin the claims process.
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Are you an expat family expecting a new family member? Are you looking to navigate through the claims process while living abroad? This article from Pacific Prime can answer all your questions and more.
In this guide, we will cover what you need to know about maternity insurance claims as an expat family living abroad.
What To Do Before the Maternity Insurance Claims Process
The most important thing when it comes to maternity insurance claims is to understand your policy details. Understanding what your policy covers, your deductibles, copays, and any pre-approval requirements is key to a smooth claims process.
As an expat abroad it is crucial that you go into your pregnancy journey with a thorough understanding of your maternity insurance so you can better plan for maternity. This can help you avoid unexpected costs and ensure that you don’t miss out on any benefits you have such as prenatal care.
Managing Pre-certifications / Pre-authorizations
Many maternity plans require pre-certifications or pre-authorizations for certain services and procedures such as maternity stays. It is important that you follow the process specified by your insurance provider to avoid unnecessary conflicts during the claims process.
Understanding Paying for Maternity Services for Expats
When paying for maternity services while under maternity insurance, you generally have 2 options: either pay out-of-pocket first and then submit a claim or you may have direct billing options where the service provider bills your insurer directly and you pay any outstanding amount afterward.
It is important to note that direct billing may not be available depending on your maternity insurance policy. Be sure to check if direct billing is available for your plan and if it is available in the country you choose to give birth in.
Maternity Insurance Claims Process for Expats
When starting your claims process, the most important thing is to be organized and prepared. Keeping any documents in an organized fashion will make it easier for you to submit the necessary documents to your insurer.
Here is an overview of the claims process for maternity insurance:
- Compile Required Documents: Start with compiling all the documentation related to your pregnancy and delivery, this includes bills, invoices, medical records, and any other additional information requested by your insurer.
- Sign and Submit Claim Forms: Once you have all the required documents ready, you can start completing claim forms from your insurer. Depending on your insurer, you will be able to send in your completed claim forms either by mail, online portal, or via mobile apps.
- Keep Track of Claims Status: Upon sending in your claim forms, you will be able to track the progress of your claim. During this stage, your insurer may want additional information or documents for you. This is why staying organized is essential during the claims process.
- Receive Claims Decision: Depending on your insurer, the wait time may vary but when you receive a claims decision, it will come with an explanation of the benefits you have claimed and how much is covered.
- Pay Outstanding Amounts (if any): The last thing to do to complete the claims process is to pay any outstanding amounts including deductibles or any co-pay options your plan has.
For expats who are looking for maternity insurance, here is a list of some of the common benefits covered by maternity insurance. Keep in mind that the exact coverage depends on the insurer and plan.
- Medically prescribed caesarian sections
- Normal deliveries
- Deliveries with complications (which complications are covered may vary)
- Deliveries following fertility treatments
- Hospital and/or home delivery costs
- Childbirth and newborn care (up to a certain limit)
Expat Maternity Insurance Claims Process Through a Broker Like Pacific Prime
Insurance brokers like Pacific Prime offer add-on services such as claims processing can help you process your claims. This is only available to those who secure maternity insurance with the broker.
When going through an insurance broker, you can simply contact your broker as soon as you need to file a maternity claim and they will guide you through the entire process, from collecting the necessary documents from you to submitting your claim to your insurer.
Getting Maternity Insurance as an Expat
Whether you’re planning your pregnancy abroad or otherwise, it is essential that you secure maternity insurance before your pregnancy due to the lengthy waiting periods. Securing the right maternity insurance ahead of time can offer you peace of mind during the stressful pregnancy journey.
When securing maternity insurance, there are several key factors you need to consider, these include the coverage limits, the area of coverage, a network of providers, prenatal and postnatal coverages, and the waiting periods.
Below are some of the key factors that you should consider when looking for maternity insurance that is right for your needs and requirements:
- Coverage Limits – Coverage limits are crucial in deciding whether or not a plan is right for you. Depending on your requirements, what you want and need in a policy may differ.
- Area of Coverage – As expats planning a pregnancy abroad, it is crucial that you check the geographical area of coverage for your policy. Certain plans may include restrictions on certain countries and regions.
- Network of Providers – If you have a preferred doctor, it is important to make sure that your preferred doctor is included in the policy’s network of providers so you can keep your preferred doctor.
- Prenatal & Postnatal Coverage – Whilst there are maternity plans that cover both prenatal and postnatal, there are also cases where they are offered as add-on benefits instead. Be sure to check whether these are covered or available as add-on benefits if you want them covered.
- Newborn Insurance – Newborn insurance is often available as a supplementary benefit for maternity insurance. It provides coverage on initial medical expenses for newborns including routine check-ups, vaccinations, and other necessary treatments or hospital stays.
- Deductibles and copayments – Deductibles and copayments are vital in securing a plan with optimal coverage whilst staying within budget.
- Customer Support and Claims Process – when finding a policy that is right for you, it is also important to look into the customer support and the claims process. Picking a policy from a reputable brand with an efficient claims process or direct pay will offer optimal convenience.
Frequently Asked Questions
What does maternity insurance cover?
Common services covered by maternity insurance include prenatal care, hospitalization fees for delivery, anesthesia, surgery costs, and postpartum care.
When should I file a maternity claim?
You can choose to file your maternity claims as you progress through your pregnancy journey, filing claims as you use different services or you can wait until after the delivery to claim them all at once. Some plans may offer direct billing which charges your insurer directly.
Are midwives and doulas covered by maternity insurance?
Whether midwives and doulas are covered depends on your maternity insurance policy. Midwives are generally covered if they are part of your insurer’s network of providers. Doulas are not commonly covered by maternity insurance.
Do maternity services need to be pre-approved?
There are a lot of insurers that will require pre-certifications or prior authorization for maternity services, especially for hospital admissions and certain prenatal tests and procedures if prenatal is covered. It is important to check your policy details to avoid unnecessary conflicts.
Conclusion
The maternity claims process abroad is generally the same as claims made locally, however, it is important that you do sufficient research when you plan your pregnancy abroad to ensure that your maternity insurance covers the country you choose to give birth.
It is crucial that you follow the process specified by your insurer and obtain any pre-certifications and pre-authorizations for certain procedures and services so that they can be claimed afterward.
If you want to save yourself from complicated and time-consuming maternity claims processes, secure your maternity insurance through insurance brokers, like Pacific Prime!
They can help save you from all the hassle as they guide you through the claims process and submit your claims for you.
Are you an expat looking to secure maternity insurance? Pacific Prime can help you! As a global insurance broker with over 20 years of experience in the insurance industry, our insurance experts can filter through all the different maternity insurance plans to find one that suits you.
Contact us today for impartial advice or an obligation-free quote!
If you are planning to start a family or welcome a family member abroad, check out our other maternity guides on “Expat Maternity Checklist: Essential Items to Prepare Before Baby Arrives Overseas” and “Expat Maternity Leave Benefits” for more maternity planning information.
Born and raised in the cultural melting pot that is Hong Kong, and having studied at an international school, Vista has developed a multicultural perspective that he uses in his writing and strives to connect to people of different backgrounds.
In his free time, Vista enjoys immersing himself in different worlds, from video games to light novels and movies. His hobbies help him expand his writing style by putting himself in the point-of-view of different people and characters.
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