Your coverage may not cover you the way your think READ the fine print
Some of the most popular and a few key phrases to look for in your Medical coverage.
- “only if you can’t be treated locally”
- “to the nearest facility”
- The transport is helicopter, no “fixed wing”. Don’t need fixed wing because they aren’t going far.
- NO MEDEVAC HELICOPTERS in Mexico.
- RV return is if the partner can’t drive it, so your husband has had a stroke, but you are licensed to drive that big rig, so guess what?
- The member will only be moved to another hospital when care at the first hospital is not adequate.
- Hospitalized for more than seven (7) consecutive days will bring whoever you want to your bedside.
- Arrange your return another medical facility nearby.
- First payer (The first of primary payer is the one that pays up to the limits of coverage)
- “Primary” means that the plan pays any bills first, without having to go through your home health insurance provider; “secondary” means the plan will only cover whatever you owe after you’ve filed a claim with your health insurance provider. You’ll typically get a bit more coverage per dollar with a secondary plan—but you’ll have to deal with more paperwork if you file a claim.
- IMPORTANT INFORMATION The following info is from a Travel Insurance questionnaire. Did You Know…If you do not disclose your medical history accurately and in-full as asked on the Health Option Questionnaire, and you have a claim totally unrelated to the undisclosed medical information, your claim will NOT be honoured. It is seen as a misrepresentation of your medical history, therefore putting you in a plan you otherwise would not have been eligible for at the time of purchase. The consequence of medical misrepresentation is your policy will rendered as null and void and no claim be honoured, regardless of the claim amount and medical emergency. EXAMPLE: You fall, break your leg, your past medical history shows you have a heart problem… but you did not answer ‘yes’ to the heart question. As a result, any charges relating to your broken leg will not be covered.
VERY GOOD INFO TO BE AWARE: The insurance company has pre-authorized the surgery but will not pay directly to the hospital since it is not in the USA. The hospital requires a guarantee of payment or payment in full before discharging patient.
The patient cannot walk and must be kept lying down therefore she cannot travel due to severity of the break (needs screws bars & other hardware). Her insurance says she needs to pay out of pocket for the surgery then submit bills when she returns to Las Vegas.
Needless to say she does not have $15-18,000.00 U.S. dollars for the surgery not does she have Medical Evac Insurance.
Trip cancellation coverage is what you need to qualify for a refund if something happens before the start of your trip
- Trip interruption coverage is what you need to qualify for a refund if something happens after the start of the trip.
- Be aware of the maximum benefit under your policy and the currency. Many travel insurance companies offer limited coverage in Canadian dollars, whereas most travel claims are settled in U.S. dollars.
- Every travel insurance policy has limitations and conditions. Ensure you understand the Pre-existing Condition Clause of your policy, and note that these conditions usually apply before your departure date, NOT when you purchased the policy. If you purchase an annual plan, these conditions apply to the departure date of each and every trip.
- Pre-existing conditions most insurance companies use one of two definitions to identify such conditions. Under the “objective standard” definition, a pre–existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan
- Copay: Your copay is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.
- Coinsurance: Coinsurance is a percentage of a medical charge that you pay, with the rest paid by your health insurance plan, after your deductible has been met. For example, if you have a 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.
- Arrange: We can arrange for a transfer to a more appropriate medical facility, even if an air ambulance is required.” Note that it says “arrange for,” not “pay for.”What you get is help in making arrangements; the cost of those arrangements goes right on your credit card bill, unless moving you is deemed “medically necessary.
United States residents or those with a USA mailing address
Don’t we always say, “Read the fine print?”
Traveling? What to do when facing a medical emergency?
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