Once you secure a visitors insurance policy for your trip to the United States, it’s important to understand how to find hospitals or doctors that you can visit under your plan. This will be helpful in the event that you need to seek medical care during your travels, and want to use your travel insurance plan. Let’s explore which doctors and hospitals can be visited for those who are traveling to the United States with a visitors health insurance policy.
What You'll Learn in This Guide
- How travel insurance covers doctor visits and hospitalization
- Which medical facilities you can access based on your insurance plan type
- How to find providers within your insurance network
- Understanding the payment process at medical facilities
Does Visitors Insurance Cover Doctor Visits?
Depending on the reason for your visit, your doctor visit may be covered by your travel medical insurance plan. Typically, most visitors insurance plan’s will offer coverage for doctor’s visits if it is for an eligible new illness or injury that occurs during your travels. However, it is important to read through your plan’s coverage details to understand any exclusions and limitations.
Does Visitors Insurance Cover Hospitalization?
Most visitor insurance plans do offer coverage for hospitalization if it is for a new illness or injury that occurs during your travels. However, it is important to note that hospitalization coverage is only for eligible new illnesses and injuries which have occurred after the start date of your travel medical insurance policy, and for which an authorized physician writes off that hospitalization is necessary.
Which Doctors or Hospitals Can I Visit With Travel Insurance?
When deciding which doctor or hospital to visit, you should first look at your plan’s details to understand if you have a comprehensive travel insurance plan or a limited plan. The type of plan that you have will determine whether or not you should look for doctors or hospitals within the plan’s PPO network, or if you can visit any doctor or hospital you choose.
How Do Comprehensive Travel Insurance Plans Work? PPO Network
With a comprehensive visitors insurance plan, the doctors and hospitals in which you will receive the most coverage are within the visitors insurance PPO network. This gives you a wide range of hospitals and doctors to choose from for care, and you’ll have the advantage of a preferred negotiated rate that’s contracted upon by the healthcare provider and the insurance company.
You can also choose to go to any doctor or hospital of your choice, even if they aren’t within your insurance plan’s PPO network. In this instance, your insurance may pay a lower percentage of total eligible expenses and your medical bills could be higher in the absence of a preferred rate that a PPO network provider offers.
What Medical Options Do Limited Travel Insurance Plans Offer?
With a limited coverage plan, you can choose to visit any doctor or hospital of your liking. Limited plans do not typically have PPO networks and only pay a fixed amount per doctor’s visit or hospital visit.
Understanding Visitors Insurance PPO Networks
A PPO, or Preferred Provider Organization, is a network of healthcare providers, including doctors and hospitals, that have agreed to offer services at a discounted rate to insurance plan members. PPO networks provide flexibility and cost savings for those covered by the insurance.
What's the Difference Between In-Network and Out-of-Network Care?
In network insurance refers to using healthcare providers that are part of the insurance plan's network. Out of network insurance involves seeking medical services from providers outside the insurance plan's network.
How Can I Find Providers in My Insurance Plan's Network?
Visitors insurance PPO networks include a roster of healthcare providers, and understanding the list of PPO network providers is crucial. Check the availability of preferred doctors and hospitals in your travel destination.
Searching for Providers in PPO Networks
If you're looking for a provider in your plan’s PPO network, follow these easy steps:
- Find your visitor insurance plan listed on our Visitors Insurance Provider Directory page
- Click the PPO Network and Providers link for your specific plan
- Click the View Providers in the USA button
- Search for providers in your area view the PPO network’s website
How Payment Works at the Doctor or Hospital
How you pay during your visit to the hospital or doctor will depend upon a number of factors. Typically, it is the choice of the hospital or doctor you are visiting whether they want to collect payment from you upfront, or opt for direct billing.
What is Direct Billing?
Direct billing occurs when the healthcare provider bills the insurance company directly for your visit, rather than requiring the insured to pay upfront and out-of-pocket. Most doctors and hospitals within your insurance’s PPO network will offer direct billing. However, it’s important to be prepared and to understand that direct billing may not always be an option.
Additionally, make sure to note that even if your doctor or hospital offers direct billing, this doesn’t change whether or not your insurance will approve or deny your claim for eligible expenses, and you still need to file a claim with your visitors insurance company regardless. You will also still be responsible for any other terms of your policy including any deductibles or coinsurance.
What If I Need to Pay Out-of-Pocket?
If direct billing isn't available or you visit an out-of-network provider, you'll likely need to pay for services upfront and seek reimbursement.
If you paid upfront for your doctor or hospital visit, make sure to ask for an itemized bill of your visit, save any payment receipts and financial records of the transaction, and keep any doctor’s notes or prescriptions. You will need this information when you submit your claim to your insurance company, which will help you get reimbursed for any eligible costs.
How Do I File a Claim with My Visitors Insurance?
Regardless of whether you used direct billing or need to get reimbursement, you will need to file a claim with your insurance company. Filing a claim correctly is essential to receive reimbursement for covered medical expenses. Following the proper procedure helps ensure timely processing and minimizes the likelihood of claim denials.
To file a claim effectively:
- Obtain a claim form from your insurance company's website or customer service
- Complete all sections of the form accurately, including policy information and details of the medical treatment
- Gather supporting documentation, including:
- Itemized bills showing services provided and their costs
- Receipts proving payment
- Medical records with diagnosis and treatment information
- Physician's notes and prescriptions
- Any referrals or pre-authorizations
- Make copies of all documents for your records
- Submit the claim according to your insurance company's instructions (online, email, or mail)
- Note the claim submission date and any reference numbers provided
- Follow up regularly on the status of your claim if processing takes longer than expected
Most insurance companies have specific timeframes for claim submission, typically 30-90 days from the date of service. Filing promptly helps avoid denials based on late submission.
If your claim is denied, carefully review the explanation of benefits (EOB) to understand the reason. Common reasons for denial include missing documentation, services not covered by your policy, or pre-existing condition exclusions. You generally have the right to appeal denials if you believe they were made in error.
What Is the Best Place to Get Travel Insurance?
Getting travel insurance from a comparison site like VisitorsCoverage allows you to compare and contrast the best travel insurance plans on the market so you can get a plan that fits your coverage needs and budget.
Still need help? Finding the right provider for your needs may be a challenge. VisitorsCoverage is here to help if you have any questions or need any assistance. Don’t hesitate to reach out to our award-winning Customer Success Team or learn more about visitors insurance.
- What doctors you can visit: Getting a plan with a PPO network gives you access to a network of doctors that will accept your insurance and allow you to get treatment at a negotiated rate
- Choose the right plan type: Comprehensive plans offer percentage-based coverage with PPO networks, while limited plans pay limited, fixed amounts regardless of actual costs
- Use in-network providers when possible: With comprehensive plans, staying in-network significantly reduces your out-of-pocket expenses and can even allow the hospital to bill your insurance directly
- Prepare proper documentation: Keep all medical records, itemized bills, and payment receipts for efficient claim filing and maximum reimbursement
Frequently Asked Questions About PPO Networks and Finding a Doctor in the US
How can I find an in-network doctor during an emergency?
Before you or the person you’re purchasing a policy for arrives in the US, visit your PPO network’s website. Browse the directory to identify in-network doctors and hospitals near your intended location. This pre-planning will save you worry in an emergency.
However, if you are not near home or urgently need medical attention, your health and safety are the first priority. Go to the nearest doctor or hospital; you can figure out the in-network and out-of-network details later. Legally, all emergency rooms in the US will provide you service regardless of whether or not that hospital accepts your insurance, so you don’t need to worry about being denied care.
Which doctors in the US can my parents visit if they have diabetes, hypertension, or blood-pressure?
Luckily, there aren’t any restrictions on which doctor seniors or elderly parents with pre-existing conditions can visit. Just make sure you have a plan with pre-existing condition coverage and a strong PPO network. Here are some of the best plans with a strong PPO and pre-existing condition coverage for elderly parents:
Best Travel Medical Insurance with Most Coverage for Pre-Existing Conditions: INF Elite X
Best Overall Visitors Insurance with Pre-Existing Condition Coverage: Visitors Protect
Best Affordable Plan with Basic Pre-Existing Condition Coverage: INF Premier X
What happens if I need to see a specialist while I’m visiting the US?
If you need to see a specialist while traveling:
- Some plans may require a referral from a general physician first
- Specialist visits are typically covered under the same terms as general physician visits
- Try to find in-network specialists when possible
- Confirm coverage with your insurance company before making the appointment
Specialists tend to be more expensive than general practitioners, so using in-network providers becomes even more important to manage your costs.
Can I use my travel insurance for prescription medications?
Most comprehensive travel insurance plans cover prescription medications when:
- They're prescribed for a covered illness or injury that occurred during your trip
- They're prescribed by a licensed physician
- They're medically necessary for treatment
Coverage typically doesn't extend to:
- Refills of medications you were taking before your trip
- Over-the-counter medications
- Medications for pre-existing conditions (unless your plan includes pre-existing condition coverage)
Keep all receipts and documentation for prescribed medications when filing your claim.
What if there are no in-network providers where I'm traveling?
If you can't find an in-network provider in your area:
- Contact your insurance company's customer service for assistance
- They may be able to make special arrangements with local providers
- If no in-network options exist, your plan may adjust coverage to recognize the lack of available network providers
- Document all communication with your insurance company
Remember that in emergencies, you should always seek the nearest appropriate medical care, regardless of network status, then file a claim.
Are ambulance services covered by travel insurance?
Yes, travel insurance will cover ambulances and transportation during a medical emergency.
Most comprehensive travel insurance plans will cover medically necessary ambulance services:
- Ground ambulance transportation to the nearest appropriate medical facility
- Air ambulance services when medically necessary and authorized
- Water ambulance services in appropriate circumstances
Limited plans may have lower caps on ambulance coverage or might pay a fixed benefit regardless of actual cost.
Does travel insurance cover follow-up visits after initial treatment?
Most travel insurance plans cover medically necessary follow-up care for a covered injury or illness while you are still traveling and your policy is active.
Examples of covered follow-up care include:
- Post-operative check-ups
- Wound care and dressing changes
- Cast removal
- Suture removal
- Follow-up tests or assessments
However, coverage is limited to:
- Care received during the policy period while you are still traveling.
- Follow-up care that is directly related to a covered injury or illness.
- Medically necessary care (not preventive or routine care).
If you need follow-up care after returning home, your regular health insurance would generally cover it, not your travel insurance policy.
Are diagnostic tests and lab work covered by travel insurance?
Most comprehensive travel insurance plans cover diagnostic tests and lab work if a doctor orders them, they are medically necessary to treat a covered illness or injury, they are not for a pre-existing condition (unless you have a waiver), and they are not part of a routine check-up.
Common covered tests include blood tests, urinalysis, X-rays, CT scans, MRIs, ultrasounds, and other necessary diagnostic procedures.
Limited plans may pay a fixed amount for these tests, regardless of the actual cost.
