A guide to health emergencies - This guide will help you prepare for what to do in an emergency situation and tips to properly utilize your insurance.
Most urgent steps to resolve:
Get the person that is hurt to a hospital immediately.
Either call an ambulance, or coordinate transportation to their hospital of choice. It is best to have one in mind you trust ahead of time if your in a local region. Here is a list of global emergency numbers.
Gather the patients medical records if you have them.
Doctors abroad will not have access to your medical history, these can be vital for diagnosing an issue quickly.
Other items that can be helpful:
Prescriptions, phone chargers, identification, warm clothing, pillow, spare change of clothes, pen and paper to help document important facts (things can be hard to remember when stressed), laptop and charger.
Notify someone you trust of your emergency.
They can help tremendously for managing your affairs such as pets left at home, coordinating family members, or helping doctors identify who can make critical medical decisions for the patient. We have had many clients abandoned in hospitals abroad without anyway of knowing who their family or friends are, which can leave the doctors in a very tough situation during catastrophic claims.
Be prepared to pay your full deductible at the hospital, some hospitals can also require a deposit. Deposits have been more frequent during the pandemic. If you are asked to put a deposit down, we recommend asking if they can put a hold on a credit card for a deposit amount to be released when the insurer pays their portion to the hospital.
Notify the insurance provider of your emergency. Call them, then email them.
They will begin coordinating with the hospital to verify you have active coverage, and will begin the process of setting up a direct payment for the rest of your bill if it will exceed your deductible. We also highly recommend emailing them of your medical event as well for a paper trail. Some insurers sometimes will deny notification due to improper record keeping by an employee, and it can incur you a penalty for their mistake. This will cover your bases and save a lot of frustration later on.
Notify us of the emergency
We can help coordinate benefits for your claims if there are any issues. WhatsApp: +52 1 415 167 0886
Office Phone: +1 (800) 577-4308
Before you leave the hospital, gather as many claim documents as possible. They are much easier to gather before you leave. This is especially true if you are filing for a reimbursement as the hospital would have already received their money.
Advice for Global Claims
How to choose a hospital, and is it in network?
It is best to know ahead of time where you would want to be treated in the event of an emergency.
For most international insurance providers, they allow you to choose your hospital of choice. If you have doubts, call your insurance provider, and they may have a local hospital they are familiar with. Most insurers work off what's called the UCR: Usual, Customary, Reasonable rates. This means you can choose any hospital and the insurer will pay out benefits in that region's average rates. It is rare we see hospitals out of these rates, but it does happen.
Try to avoid predatory tourist hospitals. These hospitals mostly prey on unknowing tourists charging exorbitant rates for healthcare. Many of these hospitals are located in tourist hotpots, frequently on cruise routes taking in evacuations at a premium rate. If you look up local expat Facebook groups or ask around to locals, you should be able to find a good private hospital that people trust.
If your plan does utilize a network, consult the insurance providers network list.
In the United States, a network is almost always requred to be used. Typically for doctor networks we see either Aetna or United Healthcare used, but be sure to check your policy. For emergency hospitalizations, many times there is a seperate hospital list you need to go to if you want to avoid penalties.
How do evacuations work?
Many credit cards, travel plans, or health insurance plans will have evacuation benefits, but they typically only evacuate you to the nearest medical facility that is adequate to treat you. We personally have only seen this benefits being approved if you are in a remote region, or are approaching your policy maximum annual limits.
We do have standalone plans with much more comprehensive evacuation benefits if it important for you to be treated in your home country. Here are two trusted providers.
How to I plan follow up care?
Please contact us to do a pre-certification with your insurer for any follow up treatments. This will allow the insurer to see if the treatment is medically necessary, within your benefits, and also attempt to set up a direct pay with the provider.
What if the hospital doesn't accept insurance?
Private hospitals do not have to accept insurance policies, and many times hospital relations can change depending on how busy they are or what their current outstanding claims are with that insurer. We have also seen hospitals in more remote regions of the world that only accept cash deposits. We don't see this issue frequently, but try to go to larger more established hospitals to avoid this. Many times you can call them ahead of time to see if they accept domestic or international insurance policies.
If you are in this situation, you will either need to go to a different hospital, or pay for care out of pocket and file for a reimbursement. Getting a second medical opinion from a different surgeon or hospital can many times resolve this issue.
What if the hospital wont let me leave after getting care?
In most jurisdictions, it is against the law to detain a citizen unless they are a police officer. Despite this, many hospital administrators will imply you can't leave without the bill being paid in full, even if they agreed to accept the direct pay arrangement from your insurance before getting admitted.
In most countries you should have already signed a contract for the amount owed, which should be enough to leave the hospital. Inform them that the insurance provider will pay the remainder of the bill and that you wish to leave. Our clients in Mexico experience this the most often, we generally suggest calling the police if you continue being illegally detained.
It is in your best interest to have the insurer deal with larger bills above your deductible and copay. If they accept insurance, the hospital's billing department should work with the insurer to satisfy document request directly. In our experience, it can be much harder to get documents from hospitals after they have gotten their money.
What if I forget to notify the insurance provider?
Most insurance providers will have a penalty if you do not notify them within xx hours, typically its a 30-50% penalty on your approved if not notified within 48-72 hours. Check your providers conditions of coverage for their policy. If you are in a coma or for some reason cannot notify the insurer, they do make exceptions to this rule.