Reasons Your Insurer May Not Pay Out

You have taken out an international health insurance plan. You have had the misfortune of requiring health care. You don't
have to worry about the finances, after all your policy should cover you. However, when you contact your health insurance
provider you hear the words ‘sorry, you’re not covered’. Your heart sinks, especially if the medical bill is an extortionate
one. You feel cheated. You wonder why you aren’t covered. 




Unfortunately this is a scenario that often happens to a lot of people. It usually arises because they have not fully understood
the terms and conditions of their policy. This is why it is imperative to read every single word of your health insurance plan.
Keeping that in mind, let’s take a look at the various different reasons why your global medical insurance policy may not
cover you and how to avoid this from happening. 


You are still in the ‘waiting period’ phase of your policy


There are some health care benefits that are subject to a waiting period. If you are still in the waiting period phase your
insurer will not cover your treatment. Maternity care is a prime example of this. Almost all insurers will place a waiting
period on maternity care, which is typically between ten months and twelve months. This means that they will only cover any
maternity care and treatment once you have had your policy for this length of time. So, if you’re experiencing
your run-of-the-mill contractions, so you go to hospital and see care, and expect it to be covered.  However, if you have only
had your policy for five months, you will need to fund it yourself. The reason they do this is to make sure that you don’t
merely fall pregnant and then take out a global health insurance plan to cover this. If you are planning to start a family you
need to make sure you take out health insurance prior to falling pregnant. Maternity care is not the only benefit that is
subject to a waiting period. A lot of insurers place a six to nine month waiting period on dental care, whilst there is typically
a year waiting period for well-being cover and two years for any pre-existing conditions. 


You have exceeded the annual limit of your policy


All international health insurance policies will have an annual limit in place. This is the maximum sum of money an insurer
will agree to pay out on your policy per annum. Once you have exceeded this limit you will need to cover all health care and
treatment expenses for the remainder of the year. A lot of people get caught out with this because they opt for a low annual
limit. Unfortunately it is very easy for medical expenses to add up. Let’s say your local hospital does not provide you with the
treatment you require. You then have to take an air ambulance to another destination. Thus, the medical costs will include
medical support in your local hospital, the cost of the air ambulance and the cost of the medical treatment you received in
another country or city. This certainly wouldn’t be a small sum. This is why it is always a good idea to go for a policy with a
relatively high annual limit so that you can avoid scenarios like this. 


You have lied on your application


Individuals are often tempted to lie on their application. Those with pre-existing conditions may purposely exclude any
information about these so that they will be covered. There are even those that lie about their age so that they can secure
lower premiums. Nevertheless, if you lie, there is an extremely high chance that you will get caught out. Once the insurance
company looks into your medical history they will see that you have lied on your application. Once you lie your policy
essentially becomes invalid and thus you will not be covered.


You have received health care or treatment for a pre-existing condition that is not covered in your policy


Some international health insurance providers are reluctant to cover those that have pre-existing conditions. If your policy
does not cover your pre-existing condition and you have had any sort of health care or treatment that relates to your
condition you will have to fund it yourself. As touched upon in the former point, it is imperative to be honest about any
pre-existing conditions you have. If you find a quality global medical insurance provider it is likely that they will offer you
an alternative solution. For example, they may offer you a policy with higher premiums, as you are more likely to
require medical treatment than other policyholders are. A lot of insurers elect to provide a health insurance plan that
excludes the pre-existing condition. If you agree to this you will of course still have to fully fund any care or treatment
related to your condition. As mentioned earlier, a two-year waiting period is also another feasible option to consider.  


You haven’t paid the policy excess amount 


Excess is the sum of money you need to pay before your insurer will cover you. For example, if your excess is set a $400,
you will have to pay $400 towards the medical bill before your insurer covers the rest. This could either be $400 per
treatment or $400 per year depending on the specifics of your policy. A lot of policyholders opt for a high excess
international medical insurance plan. They do this in order to lower their premiums. However, some people make the
mistake of opting for such a high excess that when the time comes to pay it they are unable to afford to do so. If you
cannot pay your excess your insurer will not cover any of your medical bill. 


The treatment you need isn’t a covered benefit of your health plan


When selecting a worldwide medical insurance plan one of the key decisions you need to make is the level of cover you
require. Generally speaking you can choose between low cover policies, intermediate cover policies and high cover policies.
No matter what policy you opt for, it is vital to be fully aware of what you are covered for and what you are not covered
for. Just because you have a high cover policy does not mean you are going to be covered for literally every type of
treatment. By simply assuming you are covered you could find yourself in a position where you have a treatment that isn’t
covered in your health plan without even realising.


You received treatment at a hospital that is not covered in your network


Last but not least, when choosing an insurance plan another aspect you must consider is the network of hospitals, facilities
and doctors you are going to have access to. If you do not get your care or treatment at one of the hospitals listed in your
policy you will have to fund the bill yourself. 

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