Support for Members

Under our plans, normally our insured members are free to choose the medical provider they prefer, as far as this is within their selected area of cover.

However, different arrangements may apply depending on the type of plan available to you: for example, your policy may be linked to the use of a specific medical provider network. Please check your Table of Benefits and your Membership Card to confirm if any medical network applies to your policy. If your plan is linked to a specific medical network, for your convenience you will find a list of medical providers included in your network within your Membership Pack.

If your policy is not linked to the use of a medical network, then you can choose the medical provider that you prefer.

In this case, if you need help locating a provider in your area, you can use our International Healthcare Provider Finder available via our MyHealth Digital Services.

It will allow you to search for hospitals, clinics, doctors and specialists on a country by country basis, with the ability to narrow down the search to specific regions and cities. You can also search under Medical Practitioner categories e.g. Internal Medicine, as well as on Specialism e.g. General Surgery, Neurosurgery or Traumatology etc.

You are not restricted to using the providers listed in this directory: the medical providers are available in our directory for your convenience only and we do not recommend, endorse or sponsor them, nor their inclusion in our directory implies that we have any agreements in place with them.

If your area of cover includes the USA and you are seeking a medical provider there, we recommend that you contact our third party administrator that we have appointed to administers your policy in the USA. Our third party administrator can assist you with locating a medical provider close to you and scheduling an appointment. The contact details of our third party administrator can be found on the back of your Membership Card.

First, check that your plan covers the treatment you are seeking. Your Table of Benefits will confirm which benefits are available to you, however, you can always call our Helpline if you have any queries. 

Normally planned in-patient treatments are subject to our Treatment Guarantee/Pre-authorization process for direct settlement of your medical bills. This process may be different depending on the insurance product available to you – for this reason, please check your Benefit Guide to confirm what process applies to your policy. 

For example, if you are covered under one of our standard International Healthcare Plans, the process requires that you submit a Treatment Guarantee Form in advance of treatment by following the process below:

1. Download a Treatment Guarantee Form (available here).
   
2. Send the completed form to us at least five working days before treatment. Scan and email, fax or post (details on the form).
   
3. We contact your medical provider directly to arrange settlement of your bills (where possible and where your costs are eligible for cover).

Please note that important terms and conditions are applicable to the medical claiming process. These terms and conditions may vary depending on the product available to you and on the type of insurance contract. We therefore advise you to check your Benefit Guide to confirm the claiming terms and conditions applicable to your policy with us.

You can access your Benefit Guide via MyHealth Digital Services. Simply login via browser  or use the MyHealth app, click on “My Policy” and select the “Documents” tab.

For convenience, we summarise below the terms and conditions that normally apply to standard policies in terms of medical claims:

1. You must submit all claims (via our MyHealth digital services) no later than six months after the end of the Insurance Year. If cover is cancelled during the Insurance Year, you should submit your claim no later than six months after the date that your cover ended. After this time we are not obliged to settle the claim
   
   
2. You must submit a separate claim for each person claiming and for each medical condition being claimed for. 
   
   
3. When you send us copies of supporting documents (e.g. medical receipts), please make sure you keep the originals. We have the right to request original supporting documentation/receipts for auditing purposes up to 12 months after settling your claims.
   
   We may also request proof of payment by you (e.g. bank or credit card statement) for medical bills you have paid. We advise that you keep copies of all correspondence with us as we cannot be held responsible for correspondence that fails to reach us for any reason outside of our control.
   
   
4. If the amount you are claiming is less than the deductible figure in your plan, you can either:
   - Collect all out-patient receipts until you reach an amount that exceeds this deductible figure.
   - Send us each claim every time you receive treatment. Once you reach the deductible amount, we’ll start reimbursing you.
   Attach all supporting receipts and/or invoices with your claim.
   
   
5. Please specify the currency you wish to be paid in. On rare occasions, we may not be able to make a payment in that currency due to international banking regulations. If this happens, we will identify a suitable alternative currency. If we have to make a conversion from one currency to another, we will use the exchange rate that applied on the date the invoices were issued, or on the date that we pay your claim. Please note that we reserve the right to choose which currency exchange rate to apply. 
   
   
6. We will only reimburse (within the limit of your policy) eligible costs after considering any Pre-Approval requirements, deductibles or co-payments outlined in the Table of Benefits. 
   
   
7. We will only reimburse charges that are reasonable and customary in accordance with standard and generally accepted medical procedures. If we consider a claim to be inappropriate, we reserve the right to decline your claim or reduce the amount we pay.
   
   
8. If you have to pay a deposit in advance of any medical treatment, we will reimburse this cost only after treatment has taken place. 
   
   
9.  You and your dependants agree to help us get all the information we need to process a claim. We have the right to access all medical records and to have direct discussions with the medical provider or the treating doctor. We may, at our own expense, request a medical examination by our doctors if we think it’s necessary. All information will be treated confidentially. We reserve the right to withhold benefits if you or your dependants do not support us in getting the information we need.

Starting with the 2019 tax year, you will not be penalized or fined for not having health insurance. Due to this change in federal tax policy, Allianz Care will not be sending 2019 IRS 1095-B tax forms to all members. However, you can request the form be sent to you as follows:

By telephone: 1 (857) 444-0638

By email: info.admin@allianzworldwidecare.com

By mail:
Allianz Care,
15 Joyce Way,
Parkwest Business Campus,
Nangor Road,
Dublin 12,
Ireland
 

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