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You have taken out an international health insurance plan. You have had the misfortune of requiring health care. You don’t worry about the finances and you’re thinking after all your policy should cover you. However, when you contact your health insurance provider you hear the words ‘sorry, you’re not covered’. Your heart sinks, especially if the medical bill is an extortionate one. You feel cheated. You wonder why you aren’t covered.
Before you find yourself in this terrible situation, it’s important to really understand the insurance policy you have.
Learn What Your Insurance Covers & How Much It Pays For
Unfortunately this is a scenario that often happens to a lot of people. It usually arises because they have not fully understood the terms and conditions of their policy. This is why it is imperative to read every single word of your health insurance plan. Keeping that in mind, let’s take a look at the various different reasons why your global medical insurance policy may not cover you and how to avoid this from happening.
Check The Time Span Of The ‘Waiting period’ Phase of Your Policy
There are some health care benefits that are subject to a waiting period. If you are still in the waiting period phase your insurer will not cover your treatment. Maternity care is a prime example of this. Almost all insurers will place a waiting period on maternity care, which is typically between ten months and twelve months. This means that they will only cover any maternity care and treatment once you have had your policy for this length of time. Therefore, if you have only had your policy for five months and you require maternity care you will need to fund it yourself. The reason they do this is to make sure that you don’t merely fall pregnant and then take out a global health insurance plan to cover this. If you are planning to start a family you need to make sure you take out health insurance prior to falling pregnant. Maternity care is not the only benefit that is subject to a waiting period. A lot of insurers place a six to nine month waiting period on dental care, whilst there is typically a year waiting period for well-being cover and two years for any pre-existing conditions.
You have exceeded the annual limit of your policy
All international health insurance policies will have an annual limit in place. This is the maximum sum of money an insurer will agree to pay out on your policy per annum. Once you have exceeded this limit you will need to cover all health care and treatment expenses for the remainder of the year. A lot of people get caught out with this because they opt for a low annual limit. Unfortunately it is very easy for medical expenses to add up. Let’s say your local hospital does not provide you with the treatment you require. You then have to take an air ambulance to another destination. Thus, the medical costs will include medical support in your local hospital, the cost of the air ambulance and the cost of the medical treatment you received in another country or city. This certainly wouldn’t be a small sum. This is why it is always a good idea to go for a policy with a relatively high annual limit so that you can avoid scenarios like this.
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You have lied on your application
Individuals are often tempted to lie on their application. Those with pre-existing conditions may purposely exclude any information about these so that they will be covered. There are even those that lie about their age so that they can secure lower premiums. Nevertheless, if you lie, there is an extremely high chance that you will get caught out. Once the insurance company looks into your medical history they will see that you have lied on your application. Make sure you are upfront about any medication you’re taking. It’s also worth switching to something natural, and you can check out these Maca benefits for a good example. Ask your doctor about these types of alternatives. Once you lie your policy essentially becomes invalid and thus you will not be covered. Plus, you will be ruining your integrity so just don’t lie.
You have received health care or treatment for a pre-existing condition that is not covered in your policy
Some international health insurance providers are reluctant to cover those that have pre-existing conditions. If your policy does not cover your pre-existing condition and you have had any sort of health care or treatment that relates to your condition you will have to fund it yourself. As touched upon in the former point, it is imperative to be honest about any pre-existing conditions you have. If you find a quality global medical insurance provider it is likely that they will offer you an alternative solution. For example, they may offer you a policy with higher premiums, as you are more likely to require medical treatment than other policyholders are. A lot of insurers elect to provide a health insurance plan that excludes the pre-existing condition. If you agree to this you will of course still have to fully fund any care or treatment related to your condition. As mentioned earlier, a two-year waiting period is also another feasible option to consider.
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You haven’t paid the policy excess amount (aka “Deductible”)
Excess is the sum of money you need to pay before your insurer will cover you. For example, if your excess is set a £400, you will have to pay £400 towards the medical bill before your insurer covers the rest. This could either be £400 per treatment or £400 per year depending on the specifics of your policy. A lot of policyholders opt for a high excess international medical insurance plan. They do this in order to lower their premiums. However, some people make the mistake of opting for such a high excess that when the time comes to pay it they are unable to afford to do so. If you cannot pay your excess your insurer will not cover any of your medical bill. In the US, the insurance company will pay their part of the bill, but you are still required to pay the deductible to the treatment facility directly. If it is extremely high, most places will set up a monthly payment plan.
The treatment you need isn’t a covered benefit of your health plan
When selecting a worldwide medical insurance plan one of the key decisions you need to make is the level of cover you require. Generally speaking you can choose between low cover policies, intermediate cover policies and high cover policies. No matter what policy you opt for, it is vital to be fully aware of what you are covered for and what you are not covered for. Just because you have a high cover policy does not mean you are going to be covered for literally every type of treatment. By simply assuming you are covered you could find yourself in a position where you have a treatment that isn’t covered in your health plan without even realising.
You received treatment at a hospital that is not covered in your network
Last but not least, when choosing an insurance plan another aspect you must consider is the network of hospitals, facilities and doctors you are going to have access to. If you do not get your care or treatment at one of the hospitals listed in your policy you will have to fund the bill yourself. There are plenty of policies in the US that only cover a handful of doctors or hospitals. These are usually a little cheaper but the wait time to see these doctors can be ridiculously long and you might as well not even have insurance in these cases.
Hopefully you now have a better understanding of the main reasons why you may hear the dreaded words ‘sorry, you’re not covered’. To ensure this never happens, make sure you are fully aware of everything your policy entails, from annual limits, to benefits, to waiting periods. Moreover, never lie on your application, as it is extremely likely that it will come back to haunt you.
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