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What is the claims procedure for expatriate health insurance

 

Question: 
If for example you go see a doctor for some reason (medical problem), do I have to pay and then I will be reimbursed. How does it work. Thank you

Answer: 
Making a claim can often be one of the most confusing aspects of international health insurance for policyholders. At Pacific Prime we are dedicated to providing you the comprehensive support which you require to ensure that all claims are handled in a timely and efficient manner. The range of Insurance Companies which we choose to work with have some of the best claims processes in the industry, giving you the peace-of-mind in knowing that your healthcare is always in safe hands.

There are typically two types of claims that can be made under an expat medical insurance policy, these are; In-patient or Out-patient.

Out-Patient

Out-patient treatment is any medical care which does not require an overnight stay in a hospital or similar healthcare facility. Typical out-patient procedures are usually visits to the Doctors (GP’s) office for check ups, or ambulatory surgery for minor conditions. In many cases your health insurance policy will allow you to access an extensive international network of medical facilities with whom your insurance company has created a direct settlement network.

If you are using a healthcare provider within your plans network then you will often not have to do anything more than supply you doctor with a copy of your insurance details or membership card, and your insurance provider will cover the cost of the treatment minus any deductibles applicable on the policy.

However, as international health insurance plans allow you to seek treatment with the doctor of your choice you may often receive healthcare outside of the insurance providers direct settlement network. If this is the case, then you will typically be required to pay for the treatment out-of-pocket and submit a claim for reimbursement from the insurance company.

In-Patient

When receiving in-patient treatment you will normally spend one or more nights in a hospital or similar healthcare facility. Typically, in cases of in-patient treatment, you will be aware prior to admittance to hospital, that you will be requiring said treatment, in which case you should notify your insurer as soon as possible. Once the insurance company has been notified they will then make arrangements with the healthcare provider to cover the payment of the treatment minus any policy deductibles.

In some cases, such as emergency situations, it may not be possible to contact your insurance provider prior to being admitted for treatment. In this case you should make arrangements for your insurer to be contacted as soon as possible, in order to ensure that settlement of the claim is made in a speedy manner.



For more information about various claims procedures, or to receive a free comprehensive international health insurance quote, please contact us today.


 
   
     

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