11

I know that different doctors and hospitals work with varying number of insurance companies. However, I haven't seen any doctor or hospital listing that they accept any traveler insurance plans. Does it mean that most travel insurance are not accepted by any business? What are they good for then?

EDIT:

After reading the answer, I searched for the policy with fresh eyes. Here is a screenshot which explains the insurance mess: insurance mess: Disclaimer: I have no stakes in this business.

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    I think that you generally pay out-of-pocket and then get reimbursed. For big ticket items like evacuation, the insurance probably arranges and pays for it. – mkennedy Aug 23 '17 at 1:45
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    No, not in most cases. You would have to either pay cash and submit a claim or arrange payment directly with the travel insurance carrier. – Johns-305 Aug 23 '17 at 16:21
9

It's complicated, particularly in the US. But the way it usually works is that your travel insurance company has local arrangements with insurers in various countries, and the hospital/doctor will bill the local insurer, not the travel insurance company.

In any case, the best way to proceed is that if you need to go to the doctor/hospital and it's not a life-threatening emergency, you should first call the insurer and they'll identify a suitable provider for you.

Real-life anecdote: I was recently on a business trip to NYC and needed to see a doc. I called my travel insurance company's hotline, they found a suitable provider nearby (in this case CityMD) and arranged for their local US insurer, Cigna, to fax over proof of insurance (yes, this was in 2017). The whole process took 3 phone calls over 2 hours (!), and CityMD wouldn't take me in until the magic fax arrived... but once it did, all costs were covered and I didn't pay a penny for anything except the medicine I was prescribed.

Alternatively, they told me that I could pay out of pocket (which would have been ~US$200 in this case) and then file a claim with Cigna directly, but all things considered this was probably less hassle. (Although now I need to file a claim anyway for the $40 in antibiotics. Grumble.)

  • Thanks @jpatokal Although, regarding your US$200 estimate for out of pocket.:- There are lots of discounts given to insurance companies. If I want to get same procedure done out of pocket without insurance, I can easily end up paying 10 times of the cost which the insurance company would have to bear for exact same procedure from same location. – Asad Iqbal Aug 24 '17 at 12:09
  • Can you mention which travel insurance company did you use? And did you already know that it will be easily accepted here? – Asad Iqbal Aug 24 '17 at 12:10
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    @AsadIqbal I had heard the opposite—if you're willing to pay immediately, the hospital will cut you a discount as it saves them the trouble of pursuing the insurer? – Calchas Aug 24 '17 at 15:22
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    @Calchas you are right. But it is meager when compared to the discount which insurance companies get. npr.org/sections/health-shots/2014/11/15/364064088/… "Every hospital has its own master list of charges for different services. ... But insurance companies don't pay those listed charges. The listed charges are almost fiction. Instead, each insurer negotiates for lower prices with each hospital and doctor on every plan. The negotiated prices even can vary within an insurance company depending on which plan a patient has." – Asad Iqbal Aug 24 '17 at 18:20
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    @AsadIqbal CityMD said the out of pocket cost without insurance would have been $200. YMMV. Also, note that this was a walk-in doctor's clinic, not a hospital; emergency room charges in the US are famously expensive. – lambshaanxy Aug 24 '17 at 22:09

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