At American Insurance for Expats, we have collected a list of the most commonly asked questions regarding our insurance coverage. If you have a question you do not see an answer to, please contact us at our toll free number of 1-888-461-2099, and we will discuss your specific questions with you. Since every person has a unique situation, it is always best to talk in person to make sure you are getting the best coverage possible.
What different plans do you offer and what are the differences?
Our primary underwriter is International Medical Group, and we primarily focus on three different types of health insurance:
International major medical: This insurance is meant for ex-patriots who are relocating and want a policy that will last until age 75 as long as continuous premium payments have been met. At age 75, applicants that applied before age 65 qualify for extended coverage. International major medical insurance requires a one time health questionnaire and underwriting. You can custom build a plan that is tailored specifically for you by choosing your areas of coverage, the deductible of your choice and the amount of coverage you need.
Mid-length policies: Mid length policies (Gold Plan) are intended for Missionaries, professional consultants or exchange students who will be living abroad for a few years, but intend to go back to their home country to receive domestic coverage. This type of insurance also requires a one time health questionnaire and is renewable for up to three years.
Short term health insurance: This coverage is designed for people who will be vacationing abroad for a specific amount of time and need coverage in case of a medical emergency such as an unexpected illness or accident. There is no underwriting for this type of policy. The application takes about 10 minutes to fill out and coverage can begin as soon as the next day.
What are the Deductible options?
Deductible options range from $250.00 US Dollars, to $10,000.00 US Dollars. The higher your deductible, the lower your premium.
What is the age limit for coverage?
If you have signed up for a health care policy before the age of 65, and maintain continuous coverage to age 75, you qualify for the Global Senior Plan which will stay with you as long as you are around. There is no health application for this policy as it is exclusively offered by IMG on the 75th birthday. If you have not signed up for coverage before your 65th birthday, than coverage terms on the 75th birthday. You can obtain short term travel insurance up to any age without a physical or health application.
Does this insurance work with Medicare?
Our international insurance works with Medicare in that Medicare will cover you in the United States, but does not cover you when you leave the country. Supplemental plans only cover you for up to 60 days with a limit of $50,000.00. If a member is already on Medicare, than the appropriate coverage area would be “Worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan”, for a significant savings. With national and international health care coverage, no matter where you are in the world (except for the countries excluded above) you will be covered. Treatment can begin in one country and continue on at home.
Is there coinsurance? If so, how does it work and what affect does it have on premiums?
After the deductible has been met, IMG will pay 80% of the next $5,000 of eligible expenses. Coinsurance is waived for PPO Network expenses. Coinsurance is waived for expenses incurred outside US and Canada. There is no affect on the premium.
Are there specific areas of coverage?
This insurance is global insurance, so it is worldwide coverage. The area coverage options are “Worldwide” or “Worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan”. There are no substitutions to the area coverage’s.
Is coverage just major medical or does it include minor medical with doctors for day to day issues and check ups, lab work, etc.?
There is an annual $250.00 allowance for “Adult Wellness”. Adult routine physical examinations are excluded under the Silver plan option, and for the first 12 months for the Gold, Gold Plus and Platinum plan options. Out-patient mental and nervous is excluded for the first 12 months on all plan options. In-patient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold, Gold Plus and Platinum plan options.
Does insurance pay direct to hospitals and doctors or does patient pay and get reimbursed?
In many cases, IMG works directly with the hospital or clinic, including those outside our independent Preferred Provider Organization (In U.S.), for payment of eligible medical expenses. To file a claim, complete a Claim Form and submit it with original itemized bills. In this case, you will be responsible for your deductible, coinsurance amounts and non-eligible expenses. You can also use IMG Interactive Claim Form. Microsoft Word is required to use the interactive form.
If a member has received treatment and needs to be reimbursed for out-of-pocket medical expenses, they should complete the Claim Form and submit the original itemized bills and paid receipts within 90 days. IMG will reimburse the eligible medical expenses after applying the deductible and coinsurance.
Please remember to submit bills and receipts as soon as they are received. Do not hold them until the end of the year. IMG will apply eligible medical expenses to your deductible and coinsurance throughout the year.
Please use the following address to send any information to the Claims Department:
International Medical Group
PO Box 88500
Indianapolis, IN 46208-0500
Are there a list of doctors and hospitals that are approved inside a Network, or can a person choose their own, at no additional cost?
Among the variety of services provided by IMG is the ability to quickly search for a hospital or doctor of a members choice. When seeking treatment in the U.S., members have access to the independent Preferred Provider Organization (PPO), a separately organized network of hundreds of thousands of established, highly qualified health care physicians and many well-recognized hospitals in the U.S. contracted by IMG. Additionally, to help locate health care providers outside the U.S., there is access to our International Provider AccessSM (IPA), a database of over 17,000 providers. However, when members are outside of the U.S., they may go to any doctor or hospital available to them at no additional cost.
What is turn-around time for approval?
Every attempt will be made to process applications timely. The specific time frame depends largely on the type of coverage for which is being applied. If a member is applying for short-term vacation coverage, IMG will process the application and forward fulfillment materials within one business day. If a member is applying for coverage under the Global or Group series, IMG will process the application within three to four business days following the receipt of all required information. Fulfillment materials will be forwarded the same day coverage is approved.
Is a medical exam required?
There is no physical exam required for travel insurance. For a major medical policy, a physical examination is required to have been completed within the previous 2 years of application. If a physical has not been preformed within 2 years of the application date, then a current physical exam will need to be completed and submitted to the underwriter.
Is coverage permanent, in that as long the premium is paid (after having been accepted), they get automatic renewal?
If a member purchases the permanent health insurance, it is renewable up to age 75 so long as payments have been continuously paid. If a member signed up for insurance before the age of 65, than they qualify for the Global Senior Plan. If a member signed up after age 65, than the insurance terms at age 75.
Are pre-existing conditions accepted?
IMG provides flexible underwriting methods to extend coverage. An application may be underwritten by Standard Underwriting or the Flexible Underwriting Rider.
Standard Issuance – There are two levels of underwriting when all medical conditions have been disclosed and they have not been specifically excluded or restricted by a rider (subject to the foregoing limits and the other terms of the plan*).
The Silver, Gold and Gold Plus plan options provide a $50,000 lifetime benefit for eligible pre-existing conditions that existed at or prior to the effective date, subject to a maximum of $5,000 per period of coverage after coverage has been in effect for 24 continuous months. This benefit is payable whether or not the applicant has received consultation or treatment for the condition(s) during the 24-month period of continuous coverage.
The following illnesses which exist, manifest themselves, are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: acne, asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall bladder or gall stones and kidney stones, any condition of the breast, and any condition of the prostate.
On the Platinum plan option, conditions that are fully disclosed on the application and have not been excluded or restricted by a rider will be covered the same as any illness. Conditions, including any complications therefrom, that are not fully disclosed on the application will not be covered.
Flexible Underwriting Rider – Where you may have otherwise been declined for coverage, the Flexible Underwriting Rider allows IMG to extend coverage to the applicant. After 24 months of continuous coverage, a disclosed pre-existing condition which has not been specifically excluded by a rider will be covered as any other pre-existing condition so long as in that 24 month period no treatment has been received for that condition. If treatment has been sought or should have been sought, then the 24 month period starts over from the treatment date.
Other Exclusions & Limitations*
- Adult routine physical examinations are excluded under the Silver plan option, and for the first 12 months for the Gold, Gold Plus and Platinum plan options
- Out-patient mental and nervous is excluded for the first 12 months on all plan options
- In-patient mental and nervous is excluded under the Silver plan option and for the first 12 months for the Gold, Gold Plus and Platinum plan options
- Maternity, newborn and congenital care (unless the maternity rider or Platinum plan option is purchased – see Benefits page by clicking link above) Note: maternity expenses including prenatal, delivery, postnatal, newborn and congenital disorders are excluded when the pregnancy is a result of fertility treatment
- Organ transplants not specifically listed
- Devices to correct sight or hearing are excluded under the Silver, Gold and Gold Plus plan options
- Treatment or supplies not medically necessary
- Treatment not ordered or received by a physician
- Treatment by a relative or family member
- Treatment as a result of war, riot, or terrorism
- Treatment resulting from illegal activities
- Organized amateur or professional sports
- Services and treatment eligible for payment by any government or other insurance
- Investigational, experimental or research procedures
- Routine foot care
- Elective cosmetic or plastic surgery
- Drug and alcohol abuse treatment
- Speech therapy
- Custodial care
- Weight modification
- Treatment of impotency
- Contraceptive medication or treatment
- Persons HIV+ at effective date
Does a person have to be living a certain amount of time outside the U.S. (or Canada) in order to get permanent health care coverage?
The application process should be begin 30 days before leaving the United States or Canada, and the date of coverage will begin the date of departure. If a member is already living outside the country, than approval begins immediately. Travel insurance begins on the date requested.
Does the cost differ depending on how much time one spends in the U.S. or Canada?
To qualify for coverage, applicants have to be able to prove 6 months a year or longer were spent internationally. The six months do not need to be consecutive, and it does not matter how many countries you visit. There is not a price difference in regards to how many months are spent abroad.
Where can I find a quick quote?
You can find a quick quote here: https://www.americaninsuranceexpats.com/quick-quote.html#