Instructions on what to do in a health emergency abroad
This guide will help you prepare for what to do in an emergency situation that ends up in hospitalization. Please read on to learn 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. If an emergency happens in your local region it is best to already know which hospital to go to. If you are in an unfamiliar place or outside of your country of residence, here is a list of global emergency numbers.
Gather the patient's 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:
Prescription medications, 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 act as your medical advocate if you are unable to. They can also help tremendously in 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 heard of patients abandoned in hospitals abroad without any way of knowing who their family or friends are, which can leave the doctors in a very tough situation during catastrophic claims.
Notify your insurance provider of your emergency. Call them, then email them. This should be one of the first things you do after stabilizing the patient. Some insurers will charge a penalty if they are not notified within 48 hours of the emergency.
Be prepared to pay your full deductible at the hospital. Some hospitals may also require a deposit regardless of your deductible status. Deposits have been more frequent since the Covid 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.
Your insurer will coordinate 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, and stating your medical event in order to keep a paper trail. Some insurers will deny notification due to improper record keeping by a hospital employee, and it can incur a penalty to you for their mistake. This will cover your bases and could save a lot of frustration later on.
Notify Expat Insurance of the emergency.
We can help coordinate benefits for your claims if there are any issues. Send a WhatsApp message to Claims Support: +52 1 415 167 0886
Office Phone: +1 (800) 577-4308
Before you leave the hospital, gather as many documents from the Claims Checklist as possible. They are much easier to collect before you leave. This is especially true if you are filing for reimbursement as the hospital would have already received their money and has less incentive to help you.
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 like to be treated in the event of an emergency. Most international insurance providers allow you to go to 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, and Reasonable rates. This means you can choose any hospital and the insurer will pay out benefits at that region's average rates. It is rare we see hospitals price out of these rates, but it does happen.
Try to avoid predatory tourist hospitals. These hospitals mostly prey on unknowing tourists and charge exorbitant rates for healthcare. Many of these hospitals are located in tourist hotspots, frequently on cruise routes taking in patients at a premium rate. If you look up local ex-pat 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 provider's network list. Request the list from email@example.com
In the United States, a network is almost always required to be used. Typically for doctor networks, we see either Aetna (Consult their Directory of Health Care Professionals here) or United Healthcare (consult their doctor directory here), but be sure to check your policy. For emergency hospitalizations, many times there is a separate hospital list you need to go to if you want to avoid penalties.
How do evacuations work?
There are different ways to be evacuated if you find yourself in that type of medical emergency. 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. Be sure to contact your credit card company before your travel to find out what they offer.
We personally have only seen this benefit being approved if you are in a remote region, or are approaching your policy's maximum annual limits.
We do have standalone plans with much more comprehensive evacuation benefits if it is important for you to be treated in your home country. Here are a few trusted providers:
- Air Med (specializes in evacuation and has its own fleet of aircraft for medical transport)
- TME Travel Insurance
- Medjet Assist
How do 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 if applicable.
What if the hospital doesn't accept insurance?
Private hospitals are not required 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 do 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 then file for reimbursement. Getting a second medical opinion from a different surgeon or hospital can many times resolve this issue.
What if the hospital won't let me leave after getting care?
In most jurisdictions, only police officers are allowed to legally detain a citizen. Despite this, many hospital administrators will imply or even state flat-out that 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 you were admitted.
In most countries, you should have already signed a contract for the amount owed. This legally-binding contract should be enough for you 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 requests 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 a certain number of hours, typically it's a 30-50% penalty on your approved amount if you do not notify the provider within 48-72 hours. Check your provider's conditions of coverage for your policy. If you are in a coma or for some reason cannot notify the insurer, they do make exceptions to this rule.