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One of the first things to come to mind while purchasing a health insurance coverage plan is: ‘Which doctor’s services or hospital facilities can I avail within my policy?’ The answer to this question depends on:
- Type of plan you have (Comprehensive Preferred Provider Organization (PPO) type or Limited Coverage Plan)
- Area of coverage (In USA or Outside USA)
Types of Plans & Medical Providers
On a comprehensive coverage plan, you can visit the doctors or facilities listed within your PPO network and avail the advantage of direct billing to the insurance company. You can also take advantage of a preferred negotiated rate that is contracted upon by the healthcare provider and the insurance company. However, that does not mean that you cannot go to a doctor of your choice if he/she is not enlisted within the PPO network. You may visit any doctor of your choice, but the percentage paid for by the insurance company might be lower for some plans, if you choose a provider outside the network.
On a limited coverage plan, you can choose to visit any doctor. However, it is the discretion of the healthcare provider to opt for billing the insurance company directly or ask you to pay upfront. In the latter case, you will be reimbursed by the insurance company.
Area of Coverage & Medical Provider
Since the insurance companies providing these plans are based in the USA, the list of healthcare providers participating in PPO networks is much more exhaustive compared to other countries, where you may be eligible for coverage. Some plans do have tie ups with doctors in some countries outside the USA. However it is highly possible that if you are taking medical services outside the USA, you would need to pay upfront to the provider, and then get reimbursement from the insurance company in the USA.
Searching for Providers in the PPO Networks
If you are looking for visitors’ insurance in the USA, once you have decided which plan you want to purchase, follow these easy steps to get your best option:
- Search for the providers online here : http://www.visitorscoverage.com/support/
- Click on the ‘Find Providers’ link.
- Select the plan of your choice.
- Click on ‘Providers Directory’ on the plan page (This link will take you to the PPO network home page, where you can browse through participating providers by facility type or providers’ name by using your address or your zip code.)
If you need visitors’ insurance coverage outside the USA, you can obtain lists of doctors you by calling toll free travel assistance numbers provided on your ID card.
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