EXPAT HEALTH INSURANCE CLAIMS

HOW TO CLAIM

HOW TO CLAIM FROM YOUR HEALTH INSURER

Each insurer may have slightly different rules about how their claims are processed, however they all work in a similar way. Many insurers allow you to login to a member area, and some provide you an area on their website to initiate a treatment guarantee or pre-certification process, the purpose of which is to pre-authorize claims for larger out-patient costs or in and day-patient treatments. Some insurers try to make this process as straightforward as possible, and offer expected claims processing times from 5 working days to up to 20 working days, and often any delays can be minimized by helping the insurer obtain the documentation they require from the medical provider and the insured member having treatment.

IN PATIENT & OUT PATIENT CLAIMS OVER $1,000

As soon as you are able to and ideally prior to having treatment you need to contact your insurer to initiate a process where your insurer and medical providers each verify information about your treatment and proposed treatment. This results in a pre-approval for the payment of your treatment and the issuance of a treatement guarantee letter or similar named document to the medical provider from the issuing insurer. This is often required from many medical providers prior to treatment, and helps you prevent any surprises on the day of treatment regarding payment. A hospital may also want to swipe your credit card or take a deposit to cover any treatment cost the insurer may not process as part of your insurance policies coverage. *Note it is up to the medical provider to accept any guarantee of payment letter provided by your insurer as the insurer cannot force them to accept it.

OUT-PATIENT CLAIMS

To submit an out-patient claim you need to submit a claim form to your insurer and attach supporting documents, including an original invoice showing the breakdown of the treatment performed and the associated costs, the original payment receipt showing the total payment for the treatment. Some insurance allow you to submit a photo or a scan of these documents if the treatment costs are under a certain total value, while others may require you to post the originals to their claims center for processing.

CLAIMS PROCESSING

Your administrators can be contacted via their contact details, to allow you to liaise with them to obtain feedback on the status of your claim. Some insurers also provide this update online via your member login area. Having received the required claim supporting documents they should be able to reimburse to you any due payment within a period of 5 to 20 working days depending upon the insurer.

I've always been healthy but since emigrating overseas I seem to be more prone to getting sick. One night I ate at a new Chinese restaurant that opened up close to my home. The meal was fine but that night I woke up in agony with wrenching stomach pains. I ran to the toilet and got sick and had a bad bout of diarrhea. I thought it was just a 24hour stomach bug so I went back to sleep but kept waking up periodically during the night with the same problems. I also felt very weak, with a fever and dehydration. I've had stomach bugs before and after going back to bed and waking up several more times during the night I realized that I should go to the hospital.

Upon arrival they weren't sure what was the problem and suspected a stomach bug. They gave me 3 liters of drips and some drugs over the course of an hour and sent me home expecting that it would clear soon after. My symptoms remained however so I went back to the hospital that morning. This time they took it more seriously and put me in a private room for observation. I ended up staying there for a week. They took stool samples and doctors examined my stomach to try to figure out what the problem was. In one sample they found blood, E.coli type 157 and some other bug.

E.coli can be dangerous for children and the elderly because it can shut your kidneys down! They told me that you get E.coli from eating feces! There's no medication which can fight this really so the best course of action is just to make sure you are kept hydrated. Slowly the stomach pains subsided and I got my strength back. The nurses really took great care of me and I was delighted to be in the comfort of a private room. Everything was paid for by direct-billing - I didn't pay a dime in medical expenses apart from the taxi fares to and from the hospital. I would never go without health insurance and I was relaxed knowing that I didn't have the added pressure of paying for medical expenses when going through such trauma.

How my expat health insurance helped

Covered costs for emergency treatment, private accommodation, prescription drugs, ultrasound, CT scan and specialist consultations.

Client's monthly premium cost: $213 Cost to client if uninsured: $6,500

I had been living in China for a several years and we had just finalized negotiation for a large project. We had worked day and night for a couple of weeks and had a meeting with one of our Chinese partners to go through some minor issues when I all of a sudden started sweating, felt very dizzy and also felt chest pains. I was soaking wet, the dizziness would not go away and my colleagues decided to drive me to the hospital.

A series of tests was conducted and I was admitted to a ward overnight. My company provided medical insurance but I had never used it and did not really understand how it worked. My diagnosis was exhaustion. Nothing serious, but I was amazed that my hospital bill almost led to a second night for choke treatment - USD 4,700 for one night with no medication, no surgery and no treatment.

As I did not have my insurance card with me, a colleague settled my bill and after contacting the insurer they asked us to fax the bill and reimbursement was done within a week to my colleague’s bank account! I have told this story to many of my friends and I realize most insurers require claim forms filled out by the treating doctor; but not with my insurer and I am very lucky to have such a simple process to make a claim!

How my expat health insurance helped

Covered costs for emergency in-patient treatment, specialist consultation fees, diagnostic tests including an MRI and private room hospital accommodation.

Client's monthly premium cost: $297 Cost to client if uninsured: $4,700

During my first year in Malaysia I had heard of Dengue but did not pay much attention to it. One day I developed fever and my body was aching. Just normal flu I thought but one of my Malaysian friends advised me to check if it was dengue or not and luckily enough I went to the hospital early. Upon arrival the doctor conducted a few tests and dengue was confirmed.

I was directly admitted to the hospital and asked if I had insurance which luckily I did. I called the emergency number on my insurance card and after some 4 hours the insurer had issued a treatment guarantee and arranged to settle the bill directly with the hospital.

On my forth day of admission the doctor told me that I would need to stay for at least another 4 days and that the hospital would contact my insurer. The treatment guarantee was extended without me having to do anything which felt good as I had very high fever at the time. After 8 days I was released from the hospital and I was asked to come back for a checkup a few days later. I am delighted that I went to the hospital early and that I had appropriate insurance cover that took care of my bills without any hassle.

How my expat health insurance helped

Paid for emergency in-patient treatment, specialist consultations, diagnostic tests, prescription drugs and follow up consultations.

Client's monthly premium cost: $164 Cost to client if uninsured: $1,700

I have been an expat for just over 30 years and fortunately my employers have always provided medical insurance for me. Up until recently I have rarely needed any treatment, (apart from the occasional bout of gout due to an extravagant and well deserved lifestyle). On return from a business trip, after a week or two, I experienced severe chest pains. My immediate thoughts were that the lifestyle has finally caught up with me and that I was having a heart attack, thank god I have insurance!

I got myself to the hospital emergency department who put me on drips and attached numerous electronic gadgets to my torso. After going through 6 liters of saline my blood pressure was still dropping and the Canadian doctor told me he was concerned as he was not a heart specialist.

After numerous more tests, x rays, etc I was diagnosed with Pericarditus, not a heart attack, which is a build up of fluid around the heart muscles. This can be treated by medicines but there is a danger that the liquid will continue to build and damage the heart, so a decision was made to move me to a heart hospital here in Beijing, where they could, if necessary, use a syringe and insert it through the chest directly into the affected area, then withdraw the fluid. No doctor in the first hospital had done this before hence the move to the heart hospital. I stayed in the heart hospital for 2 days and nights and had several nurses sit by my bedside at all times to monitor me (nice).

The medicines started to work and danger subsided, so I was moved back to the first hospital where the private accommodation along with the TV, DVD player, 24-hour menu, private shower and bathroom were welcomed. After 4 more days and continual monitoring, daily x rays, painkillers etc, I was allowed to go home. Unfortunately, the symptoms returned several days later, albeit not as badly as the first time, and I had to spend another 5 days in the hospital again. They were not letting me leave this time until absolutely certain it was all ok.

My insurance has no deductible so all I had to do was sign it off and go. The bill was astronomical and in fact I calculated that it was actually more than the previous 30 years’ premiums, all within a 3 week period. If I had no insurance I would have had to sell my house to pay the bill.

How my expat health insurance helped

Paid costs for intensive care treatment, x-ray and MRI scans, prescription drugs, transportation, 24/7 assistance, private accommodation and follow up specialist consultations.

Client's monthly premium cost: $491 Cost to client if uninsured: $31,840

In 2006 I was celebrating something in Beijing and in a moment had picked up a friend and jumped in the air. Upon landing I put my back out and was in pain. In the days that followed I did not feel anything during the day, but when sleeping had a lot of pain. I thought it would fix itself after a week or two and did not visit the hospital. Eventually I realised it would not fix itself and went to see Beijing United Family Hospital.

The General Doctor tried to fix my back over two visits, before referring me to a back specialist. I proceeded to have physio over the next six months until one day I had no pain. Since that day three years ago I have fortunately had no symptoms. Thankfully I have excellent international private medical insurance policy that provides out-patient cover with sufficiently high benefit limits, a Nil deductible and direct-billing at hospitals globally, and so did not have to pay and claim any of the bill.

The premium for my policy for my age was around USD165 / month, that is cheap considering my claim was for only simple treatment and already in excess of my annual premium. The premium is a small % of my annual income, but provides total piece of mind.

How my expat health insurance helped

Paid for GP consultations, specialist consultations, prescription drugs and physiotherapy.

Client's monthly premium cost: $165 Cost to client if uninsured: $4,000

I’ve been an expatriate for a number of years now and have been very glad of my medical insurance plan and the peace of mind it provides. I’m a keen sportsman and over the years have picked up a fair few knocks, broken bones, etc. When I first arrived in China I immediately got involved in sports and I saw a few people get injured. I then got talking to a few people who told me stories of some people not being insured and having to dip into their savings to cover the costs. I immediately got a good plan sorted out and I'm very happy I did.

I was playing football on a very cold day and collided with another player and my finger got caught in his jersey and I thought I dislocated it. When I went to the hospital I discovered that it had multiple breaks and tendon damage. Such a simple collision ended up with me having to have quite complex surgery and a bill running into tens of thousands. Luckily my insurance plan covered all of this plus the follow up treatment. Had I not had the plan in place I would have had a major expense. I’ll certainly not be without good medical cover.

How my expat health insurance helped

Covered costs for GP and specialist consultations, specialist surgery, prescription drugs and follow up consultations.

Client's monthly premium cost: $312 Cost to client if uninsured: $13,755

Having been an expatriate for nearly 8 years for the first year or so I had no insurance. After hearing horror stories about people I knew being refused treatment if they couldn’t prove they were insured or could afford the treatment I decided to get a good policy that would cover my family so if something serious happened we wouldn’t need to worry about the bills. As it has turned out we haven’t needed the insurance for anything too serious but the plans we have had have also included cover for maternity, vaccinations, and health checks. This has been very useful as over the years if I would have had to pay for all of these myself then it would have cost more than our insurance premium.

My wife's pregnancy would have cost a small fortune if the insurer hadn’t covered it and then all the vaccinations and check-ups for our child would have quickly added up. Then when you look at needing some dental treatment – fillings and so on – the occasional visit during the year if we’re not feeling quite well and the health checks for my wife such as mammograms and smear tests; it's not long before your annual health costs could be in the thousands. I hadn’t really thought about the cost for all of these as in my country treatment is free – being abroad is a different story and from the people I know and my own experience – anyone who is an expatriate and doesn’t have cover is taking a big risk with both their health and their finances. I suppose over the years sometimes my premium has been more than my claims and in other years less – overall I’m sure it’s cost more than I’ve paid. I’ve been really happy and worry less through having the cover and to me it is about making sure my family is covered if something really serious was to happen. When I first became an expat I hadn’t really thought about medical costs but having lived in a few different countries with varying standards of care and costs – I won’t be without our cover.

How my expat health insurance helped

Over the course of roughly 7 years: paid for routine check-ups, vaccinations, routine pregnancy, ultrasound, GP consultations, prescription medication and treatment for common colds and flus.

Client's monthly premium cost: $550 Cost to client if uninsured: $20,000

After many years living a rich life as an expatriate in the Far-East I developed acid-reflux symptoms, including coughing acid into my wind-pipe while sleeping, resulting in many disturbed nights of sleep. This problem developed over time and upon realizing it was not going to fix itself, sought medical attention to deal with the problem in Jakarta.

The General Practitioner and Consultant provided excellent treatment, including a diagnostic endoscopy. Treatment was made in form of prescribed medication, which successfully treated the diagnosis of acid-reflux.

Having insurance gave me peace of mind as although the treatment costs on this occasion were relatively low, should they have been much larger my policy would have been there for me. I recommend anyone to take a policy, even if your budget only allows you to take a policy with a higher plan deductible – it’s an essential financial safety net.

How my expat health insurance helped

Covered cost of General Practitioner and specialist consultations, day-patient endoscopy procedure and out-patient medication.

Client's monthly premium cost: $100 Cost to client if uninsured: $1,500

My wife and I were expecting our first baby in Asia where I am based for a few years. Fortunately, we had the foresight to take out an international health insurance policy with maternity benefits, including elective cesareans. This benefit has a 12 month waiting period however this did not affect us as we took a maternity insurance policy 2 years prior to trying to have a child as we know we would be trying for a baby later when the time was right.

We were relocated via our company to Malaysia so the policy maternity insurance benefit limits adequately covered the costs at the hospitals in Kuala Lumpur. Our insurer worked with our hospital after we put them on contact regarding the bills and the whole thing was paid directly, which was very convenient and easy for us – allowing us to focus on the important matters and not insurance bills.

We plan to have further children so we of course will maintain the policy over the near years, and should we have to move country again our policy will be there for us to cover maternity costs wherever we may go. Anyone planning a family could benefit from taking a maternity insurance plan for their family and BrokerFish is by far the best company to help them. Their service to us has been both personal and prompt and they are always there for us should we have a question.

How my expat health insurance helped

Helped cover routine maternity costs including pre-natal checks, planned cesarean and newborn costs.

Client's monthly premium cost: $ Cost to client if uninsured: $

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Client's monthly premium cost: $ Cost to client if uninsured: $

After many years living a rich life as an expatriate in the Far-East I developed acid-reflux symptoms, including coughing acid into my wind-pipe while sleeping, resulting in many disturbed nights of sleep. This problem developed over time and upon realizing it was not going to fix itself, sought medical attention to deal with the problem in Jakarta.

The General Practitioner and Consultant provided excellent treatment, including a diagnostic endoscopy. Treatment was made in form of prescribed medication, which successfully treated the diagnosis of acid-reflux.

Having insurance gave me peace of mind as although the treatment costs on this occasion were relatively low, should they have been much larger my policy would have been there for me. I recommend anyone to take a policy, even if your budget only allows you to take a policy with a higher plan deductible – it’s an essential financial safety net.

How my expat health insurance helped

Covered cost of General Practitioner and specialist consultations, day-patient endoscopy procedure and out-patient medication.

Client's monthly premium cost: $100 Cost to client if uninsured: $1,500

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Kudos to you guys for taking steps to make insurance a more bearable user experience :]

PHILIP, Start-up Co-founder, CHINARating