Many agents’ websites claim that their Travel Medical Insurance plans are cashless or direct payment plans. This would mean that the traveler wouldn’t need to pay upfront and that the medical provider would bill the insurance company. However, when it comes to travel medical insurance plans, there is no guarantee for cashless transactions or direct pay.
The billing process depends on the service provider; the insurance company doesn’t control it. Most big hospitals & doctors directly bill to the insurance company. However, in exceptional cases patients may receive the bill from the provider.
Higher amounts are usually directly billed. For expensive medical services like surgery or hospitalization, the providers bill the insurance company directly. For routine services (mostly outpatient services) like general doctor consultations, you may be required to pay directly either in full or as per the applicable policy’s deductible or coinsurance.
Why Direct Pay can’t be Guaranteed in Travel Medical Insurance:
- Travel medical insurances are short-term emergency medical insurance plans and require claim submission and reimbursement.
- Different providers have different billing practices. They may or may not work with all insurance companies.
- Travel medical Insurance coverage is not as familiar to doctors or hospitals as mainstream domestic plans are. So, unless the bill amount is big, the hospitals or doctors won’t usually want to utilize their time to find out who and where to bill.
The Insurance company will pay for eligible covered expenses. Even though the billing process is at the medical provider’s discretion, a valid claim for a covered service would be paid by the insurance company, whether the bill comes from the doctor’s office or is sent by the traveler.
The insurance industry is regulated and insurance companies have to comply with the regulations. As long as the claim is in adherence to the policy stipulations, it should be paid.