How to Claim Medical Insurance: Best Tips for an Easy Claim Process

The process to learn how to claim medical insurance while studying abroad is a tenacious process. Most information you receive online is generic, and getting offline information is challenging as you are living abroad. 

Therefore, we have prepared a guide that will help you understand how you can claim your insurance while living away from your country. 

Let’s get started!

How to Claim Insurance: Essential Documents Required for Insurance Claim Abroad

Understanding medical emergencies abroad can be challenging, especially when it comes to managing health insurance claims. That’s why knowing how to claim insurance while studying in a foreign country is crucial for a smooth reimbursement process. Being prepared at the time will make the difference, whether it’s a routine checkup or something emergency. 

The very first step in learning how to file insurance abroad is knowing the policy of your provider. Apart from that, you would also need the necessary documents that they ask for. While every insurer is different, there are some common documents required for the filing of an international insurance claim.

• Claim Form: It is the base of your insurance claim. You will get a downloadable form on your insurer’s website, and you need to fill it up with correct information such as personal information, policy number, treatment, and payment information. Also, please remember to sign and date it correctly before re-uploading.
• Medical Reports: Your medical reports are your doctor’s prescriptions, diagnosis reports, and discharge summaries. It will help your insurer get background knowledge and the evidence of treatment provided to you. 
• Invoices and Receipts: Your itemized bills and invoices will help your claim by proving that you have spent the quoted amount for your treatment. This will also work as your proof of payment, as your insurer would ask for proof to confirm that you have paid before reimbursement. 
• Copy of Passport and Visa Stamp: To confirm your whereabouts at the time of treatment, some insurers may need proof of travel.
• Prescriptions and Pharmacy Receipts: If medication was used, add copies of prescriptions with accompanying pharmacy receipts.

By collecting the insurance claim submission required documents promptly and keeping them organized, you stand a much better chance of having a successful and quick claim process. Please ensure to submit before the deadlines, as some insurers put a time limit for filing claims. 

Knowledge about insurance claims, while living abroad, isn’t about submitting your documents. It’s more about being fully informed of your rights and duties to claim your insurance. Taking the above steps helps you to save time and financially support you with any delays. 

In-network Hospitalization Claim Process

When you get admitted to an in-network hospital, the insurance claim process becomes easier and more efficient. Because the insurer already has a prior relationship with the healthcare provider, claims are settled through cashless treatment in most cases, saving you on out-of-pocket expenses. This arrangement also has a beneficial effect on the health insurance claim settlement ratio.

Here's a step-by-step breakdown of the process:

• Pre-authorization: Inform your insurer or TPA (Third Party Administrator) of the hospitalization. Request a pre-authorization form, preferably 48–72 hours before a scheduled admission or within 24 hours in case of an emergency.
• Verification: The request is checked by the insurer and confirmed as per your policy terms.
• Approval: After approval, the insurer will inform the hospital, and the treatment can go on without your having to pay in advance.
• Treatment and Documentation: The hospital deals directly with the insurer, processing all forms and notifications while you are in the hospital.
• Final Billing: Once the treatment is over, the hospital directly generates a bill to the insurer. For coverage, the insurer clears it and sends payment proof to the hospital.
• Exclusions or Excess Charges: Costs like deductibles and extra payables that are not included in your policy must be paid by you during discharge. 

With an in-network provider, claiming insurance is easier, as there is less paperwork involved and the convenience is better. So, while purchasing insurance, always check for the in-network hospitals for a smooth experience and help facilitate a better health insurance claim settlement ratio.

Out-of-network Hospitalization Claim Process

As compared to in-network care, out-of-network hospital stays mostly operate under a reimbursement process. This implies that you have to first pay the medical bills from your pocket and subsequently claim the same from your insurer. To avoid any loss of time, it's important to be aware of how to claim insurance and collect all the necessary documents for an insurance claim.

Here's the way the process usually goes:

• Pay First: Pay all treatment and hospital bills directly to the provider upon discharge.
• Collect Documentation: Ask for and store safely all applicable documents—itemized bills, prescriptions, medical reports, discharge summaries, etc.
• Get Proof of Payment: Obtain receipts and payment confirmations (such as card slips or bank statements) to substantiate your claim.
• Fill Claim Form: Fill out the form given by your insurer with accurate information regarding your treatment expenses. 
• Attach Mandatory Documents: Add all mandatory documents like medical records, bills, prescriptions, a copy of the passport, and insurance card.
• Submit to Insurer: After filling up the form, mail it to your insurer, keeping your vendor in CC within the time limit offered by the insurer. The period is usually 30 to 90 days from the treatment.
• Monitor Status: Now you just have to monitor your claim status to ensure speedy processing. Maintain clear communication during this time. 

Knowing how to claim insurance will improve your claim reimbursement process. Learn how to prepare the documents required for insurance claims accordingly, and read your policy carefully. It will give you a clear idea of your coverage limits, exclusions, and timeline before submitting the claim. 

FAQs

• Why do Insurers reject your claim?

There are 4 primary reasons why insurers reject your insurance claim:

• Your policy doesn’t cover your care
• You are past your insurance claim tenure date
• Your claim documentation is incomplete
• You left some information in your initial application

• What are the claim documents I would need from the hospital?

To successfully file a health insurance claim, collect the following documents from the hospital:

• Discharge documents
• Accurate hospital bills
• Receipts of payment
• Prescription from the doctor
• Test reports run at diagnostic centers
• Pharmacy bills
• Pre-authorization form (if applicable)
• Medical certificate (if required)

• How do I claim my international health insurance?

To claim your international health insurance, follow these steps:

• Get treatment: Visit a hospital or clinic abroad (in-network for cashless, or out-of-network for reimbursement).
• Collect documents: Keep all bills, medical reports, prescriptions, and payment receipts.
• Fill claim form: Complete your insurer’s claim form with accurate details.
• Submit documents: Send the form and supporting documents to your insurer within the claim window (usually 30–90 days).
• Follow up: Track your claim status and respond to any additional information requests.

Always check your insurer’s specific claim process and country coverage before traveling.

• What is a claim form?

A claim form is a document to formally request your insurer to reimburse or pay the money for your hospital charges. It contains the proof and details of your claim and why you need it. 

Concluding Thoughts

Whether it’s in-network or out-of-network, knowing how to claim medical insurance will always help you get reimbursed faster and easier. Therefore, there will be less rejection, and your claim journey will be smoother. This blog has shed light on the same, to ease your claim process.