Here is part two of our series on how to use your international employer group medical insurance while in the U.S. and throughout our wonderful globe!
Ask Doug – About International Employer Group Insurance is a series of videos created by Good Neighbor Insurance, here in Gilbert, Arizona – https://www.gninsurance.com. Almost every week, we get great phone calls and emails from our clients around the world about their international employer insurance coverage – https://www.gninsurance.com/group-health.
Good Neighbor Insurance (GNI) provides international and U.S. group health insurance and comprehensive insurance options for employers, for profit, non-profits, international small businesses, social good organizations and agencies, NGOs, and mission organizations and agencies. We provide insurance solutions for social entrepreneurs and international businesses both large and small.
We offer International Group Health insurance (for paid overseas staff, 1099 workers, volunteers, foreign nationals, short-term projects/teams) from a variety of top-rated carriers.
We feel these videos will provide you valuable information. However, our international insurance agents are here anytime to connect with them via email or phone for more detailed information on your international employer group medical insurance.
The Difference Between Annual Wellness and Preventative Benefits versus Sick Benefits on your International Group Employer Medical Insurance
Joey and Sally called in to our Good Neighbor Insurance office here in Gilbert Arizona last month. Joey could not understand why the ultrasound his wife, Sally, had for her breast was not covered as her annual preventative check, which has no out of pocket (100% paid for by their international insurance policy), but rather was being applied to their family deductible.
It turns out that the mammogram, taken a week earlier, showed that Sally had a lump and her doctor requested an ultrasound to be performed at her earliest opportunity. The subsequent ultrasound was then ordered to determine whether this lump was something to be concerned about or not. Because there was a symptom, this lump, it was no longer in the preventative category and thus was coded by the medical facility as a non-annual preventative check-up procedure or also called a diagnostic test.
Even for myself, Joey and Sally, when I went for my annual wellness and preventative checkup, I had to pay an office co-pay for a prescription that is filled annually. Why did I have to pay my office visit co-pay during my annual wellness and preventative checkup? Because I was doing two things during one office visit. I was getting my annual preventative and wellness checkup which cost me nothing out-of-pocket for that visit. However, my second reason I was seeing my doctor to write another annual prescription out for this certain Rx. That second reason caused me to have to pay, my office visit copay.
Joey and Sally, this follow up test with the ultrasound has now moved from being coded as an annual wellness and preventative checkup to now being a diagnostic test. Therefore, this and any other diagnostic test will be subject to your deductible and co-insurance (once the deductible has been met).
Now let’s chat about in-network and out-of-network just for a second, Joey and Sally. When you are going in for your annual wellness and preventative checkup, and nothing comes up that needs to be investigated more, than your office visit is covered at 100% and not subject to a deductible. However, there is an exception to this if you are in the U.S. for your annual wellness and preventative checkup.
Out-of-Network – In the U.S., if you go to out-of-network medical providers for your annual wellness and preventative checkup, then sometimes your deductible is applied as well as your out-of-network co-insurance.
Please avoid using out-of-network medical providers, if at all possible. There are two ways to avoid this from happening. First, when in the U.S., stay in your network of medical providers. The second way to avoid going to an out-of-network provider is by having your annual wellness and preventative checkup done outside the U.S., where any western style medical facility will be in your in-network of providers.
Key note to remember pertaining to immunizations, especially for your children Joey and Sally. Usually immunizations, especially for children, are covered at 100% as part of your annual wellness and preventative checkups. But please keep in mind, that you cannot expect any and all immunizations to fall under your annual wellness and preventative checkup. Sometimes travel immunizations are not covered. There are certain immunizations, dependent on a person’s age, that are covered under your annual wellness and preventative checkup. Other immunizations are not.
Here are two ways to find out what immunizations are part of your annual wellness and preventative checkup. First: Check the benefit chart of your policy. If you aren’t sure about a specific one, you can e-mail Customer Service or us here at Good Neighbor Insurance. Second: You may also check out the CDC schedule: https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html
There are tests and lab work that need to be ordered by your physician and there is a schedule as to at what age some of them should be done. If you have a family history of certain disease, exceptions to the schedule can be made. Here is a great web site to provide more information on what wellness and preventative checkup benefits will be provided by age group – https://www.publichealth.org/public-awareness/preventive-care-schedule/adults.
We do recommend that each year, you and your family take advantage of the annual wellness and preventative benefits offered by your international employer group insurance, Joey and Sally. This is one of the best ways to catch any possible medical conditions while they are more easily treatable and you have the best outcome.
Ask Doug – Who should you call in a medical emergency on your international employer group medical insurance?
Hannah called our GNI office, https://www.gninsurance.com, this past week and had great questions on what she needs to do if her family has a medical emergency and needed to connect with her international employer medical insurance. She and her family have just arrived to serve in eastern Indonesia with a local social good organization. Being 8 hours away, by a bumpy jeep ride, to the nearest hospital, Hannah wanted to know who she should call to ask for help from her international medical insurance if she or one of her family members needed to be medically evacuated to the nearest and best medical hospital.
Karen and her team, at Good Neighbor Insurance group department –https://www.gninsurance.com/group-health, was able to share on the phone what Hannah should do if she needs to call her international employer medical insurance in case of a medical emergency. Karen said – Hannah, besides calling 911 or the equivalent in your country of service, your next call should be the Customer Care, Customer Service or Member Services of your international employer medical insurance which is on your medical ID card.
Your medical ID card has an emergency phone number that you may call. These phones are monitored 24/7 and they will take collect calls. If you have to leave a message, be sure to leave your phone number. Please also include your telephone country code, if you are outside of the U.S.
We at Good Neighbor – https://www.gninsurance.com/group-health, here in Gilbert Arizona, are at your service also, Hannah. However, we do not monitor our phones 24/7. We work regular office hours, so are therefore unavailable evenings or week-ends. If unexpectedly you are unable to reach your international employer medical insurance company, we will be happy to reach out on your behalf. Please provide a phone number that we can pass on to your international employer medical insurance company so that they can reach you. Relying only on e-mail can be tricky, it doesn’t allow for the back and forth questions and answers that you would have on a phone call. And the e-mails from your insurance company may end up in your junk mail folder.
Your mobile app can be very helpful too in finding nearby medical providers that your insurance company may already have a direct billing relationship. You may also communicate with your international employer medical insurance company via their mobile app…