Accessing Healthcare in the US

We’ve partner with Aetna and  Caremark to give you convenient access to high quality care in the USA.

 
When receiving  treatment in the US, simply show your membership card to the medical provider and make sure to check if the provider has  your most up to date policy details on their file. The provider will contact us to sort any paperwork related to your treatment. Make sure you attend a network provider, where we can pay your medical bills directly.

If your plan includes access to the Caremark’s pharmacy network, you can obtain certain drugs and pharmacy products at these US pharmacies on a cashless basis.

When your plan includes access to  the Caremark pharmacy network, this  information will show 
on your membership card.

Whether or not you have a Caremark card, you can also apply for a discount pharmacy card, which you can use for any prescription that is not covered by your plan.
If you have had to pay for a medical service that is a covered benefit under your insurance policy, you can submit and track your claims online via our MyHealth app or portal.
We know you might want more information about international health insurance, so we've put together a list of our most commonly-asked questions right here.
In-patient cover relates to all treatment which occurs when a member is an "in-patient" (staying overnight/for a period of time) in the hospital.  Out-patient claims (such as doctor visits, buying prescription drugs) would only be covered if an out-patient plan was bought together with the in-patient one. We have a range of different levels of cover for both in-patient and out-patient treatment.
We generally  cover pre-existing conditions (including pre-existing chronic conditions), unless we say otherwise in writing before policy inception. If your underwriting terms are moratorium or CPME/CTT (previously MORI), there will be a  24 months waiting period before claims for any pre-existing medical conditions may become eligible for cover. Once you’ve completed a continuous 24-month period after your start date, your pre-existing medical condition may be covered, provided that you’ve not had symptoms, needed or received treatment, medication, a special diet or advice, or had any other indications of the condition.

For further information, Please call our dedicated sales team
Co-payment is the percentage of the costs which you must pay. E.g. if a benefit has an 80% refund, this means that a co-payment of 20% applies, therefore we will pay 80% of the costs of each eligible treatment per insured person, per Insurance year. In the US this is known as co-insurance.
Deductible also referred to as ‘excess’ in health insurance, is the part of the cost that is payable by you and that we deduct from the amount we will pay. Where deductibles apply, they are payable per person per Insurance year, unless your Table of Benefits states otherwise. In the US this is known as co-pay.
An Urgent Care Center is a walk-in clinic where you can see a Primary Care Doctor without an appointment. Urgent Care Centers are convenient because they are usually open early in the morning until late in the evening, and often on weekends. Urgent Care Centers may also be equipped to perform X-rays and/or CT scans. Please note that specialists (cardiologist, ENT, GI, etc.) are not available through Urgent Care Centers.
If you have recently changed insurer or received an updated healthcare card from us, please ensure that you update your medical provider upon your next visit, advising them of your new insurance details. The details needed would include your Aetna ID number located on the front of your card and the Payor ID which can be found on the back.  This will prevent you from receiving medical bills as the provider will send them directly to us.

First, check if your plan covers the treatment you are seeking. The treatments that requires pre-approval are usually indicated with the numbers 1 and 2 in your Table of benefits. You can access your Table of Benefits via MyHealth Digital Services. Simply login via browser or use the MyHealth app and click on “My Benefits”.

If your treatment requires pre-approval , simply show your Membership card to your medical provider. You will be asked to sign a document authorizing the release of your medical details. Your medical provider will then automatically start the pre-approval process directly with us.

The pre-approval process helps us assess each case, organise everything with the hospital before your arrival and make direct payment of your hospital bill easier, where possible.
Providers are only authorized to charge you up front (before the medical service) for a co-payment or a deductible. Please contact us if providers to try to charge you after receiving your medical care.
You only need to notify us if you are going to have a service that requires our pre-approval. Your Table of Benefits, available on MyHealth, will confirm which benefits requires pre-approval.  Simply login via browser  and click on “My Benefits” - usually the benefits marked with a 1 or 2 requires our pre-approval. If you have any queries, please call us on 866-238-1399 (toll-free from the USA)

Always provide your insurance ID care to your healthcare provider so they can call us for any questions about your benefits.
It is very common that providers send a bill to patients instead of the insurance even though they have your insurance information. If that happens, please call 866-238-1399 (toll-free from the USA) so we can organise payment directly with the provider.
If that happens, please call 866-238-1399 (toll-free from the USA) and we will help you find an alternative provider.
Did you know that we have a support page for members