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Care Expatriate - Health insurance for expatriates

Care Expatriate - Health insurance for expatriates

FAQ


FAQ
FAQ application procedure
FAQ provision of services
FAQ Care Cash
Questions regarding provision of services
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What is the procedure if I need a doctor?

After having submitted an application you will receive treatment tickets with your certificate of insurance. These contain important information for doctors about your Care Expatriate international health care insurance cover. Please print out this treatment ticket and take it along to the doctor so that he can forward his bill to us. As, however, no contractual relationship exists between us and the doctor, bills may be sent to you or bills may have to be settled directly after treatment.

Does the Care Expatriate international health care insurance allow me to choose any doctor?

If you are feeling unwell and require medical treatment, your Care Expatriate international health insurance generally allows you to choose any doctor. In Germany you can choose from any of the registered, approved doctors and dentists and any other officially approved practitioners, who are able to carry out any medically necessary treatment and who have had recognized and sound training in their area of expertise. Outside of Germany you are free to choose a doctor or dentist officially recognized and approved in the respective country or any other officially approved practitioners, who are able to carry out any medically necessary treatment and who have had recognized and sound training in their area of expertise. Information about approved doctors outside of German is, for instance, available from embassies, consulates, Chambers of Commerce and other institutions.

I have received treatment from a doctor. What do I do next?

If you have consulted a doctor and have received a bill or have subsequently received a bill by post, please forward the original bill to the following address for verification: In order to process the bill we always require the name of the disease (diagnosis). Generally this will be specified on the bill. Please do, however, check the bill as a precaution and ask the doctor to add the diagnosis if he has not done so. X-ray and laboratory bills often do not state a diagnosis. In this case we also require the bill from the treating doctor, who arranged for the examination in order to verify the charge. Please notify us if you have not received the bill from the doctor in charge as yet. Please forward the bill when you receive it. We will then check your claim and will pay the costs reimbursable according to the respective tariff to the specified payment recipient.

Do I always have to provide originals of doctors´ bills or prescriptions?

Yes! We always need original doctors´ bills and prescriptions to check your claim for payment. Please state your insurance certificate number on the documents (this is specified on the treatment tickets, which you receive at the start of the policy). Please inform us if you have already settled the bill by writing this clearly on the bill or by separate letter. In this case we would reimburse the amount to the known account of the policyholder. Please inform us of your correct or changed bank details.

What are the maximum costs to be reimbursed by the Care Concept international health care insurance for outpatient or inpatient treatments?

The amount of costs to be reimbursed depends – apart from the contractual agreements – on whether and which assessment basis exists for settlement of a doctor´s bill in the visited country. In Germany, the treatment costs for work carried out by the professional are reimbursed to the contractually agreed extent, provided that the costs are billed in accordance with the respective applicable official fee structure for doctors (GOÄ) and dentists (GOZ), the Hospital Fee Act or any other applicable official or statutory assessment basis in its respective valid version. Outside of Germany, medical treatment expenses are reimbursed up to the contractually agreed amounts for the work provided by the medical professional, and which are charged and are appropriate given the local assessment basis (e.g. fee structure for doctors, remuneration agreements between doctors and statutory or private health insurance companies, etc.) of the country in which the insured is treated. Where no assessment basis exists for the country, the reimbursement of costs shall be in-line with appropriate fees generally charged in the country.

Can I contact Care Concept prior to any treatment?

If you are unsure or require advice you can contact us at any time. During office hours (Monday to Friday 8 am to 6 pm) you can reach the claims department team on: +49 228 97735-22. You can also contact us by email: . You will generally receive a reply with 24 hours from receipt of your email. Emails sent during the weekend or public holidays will be answered on the next working day, following the weekend or public holiday. But we can also be contacted outside of our office hours. You can reach our competent assistants on our 24-hr. hotline which is listed in your policy documents. Please use this phone number, in particular in emergencies.

I am in a NAFTA country (USA, Canada, Mexico) and have to consult a doctor. Is there anything I need to observe?

We also support you in NAFTA countries. The fee in NAFTA countries is generally agreed between you and the doctor, with prices varying considerably. It is therefore imperative that you contact

MedCare International Inc.
12480 West Atlantic Blvd, Suite 2, Coral Springs, FL 33071, USA,
tel.: +1 954.345.5650, Fax: +1 954.340.4245
e-mail: care-concept@medcareinternational.com, Internet: www.MedCareInternational.com

prior to consulting a doctor and, in particular, prior to any hospital treatment. MedCare will help you with finding a doctor, organizing medical assistance, answering questions about the health system and will offer you any other assistance and also issues cost absorption declarations after having checked the required services. Apart from finding a competent doctor you will thus also avoid any financial disadvantages.

When do I have to inform Care Concept of a hospital stay?

Hospital stays generally result in considerable costs. In order to minimize the cost risk for you and the insurance company, Care Concept AG must be informed immediately by phone or in writing of hospital stays in Germany and abroad and no later than 5 days after commencement of the treatment. An exception is the immunization of newborn babies or children where such immunization is mandatory due to statutory prevention programs.

Are vaccinations covered?

No, they are not covered. (Eine Ausnahme gilt nur dann, wenn es sich um Impfungen von Neugeborenen bzw. Kindern handelt und die Impfungen im Rahmen gesetzlicher Vorsorgeprogramme vorgesehen sind.)

Are there any outpatient or inpatient services for which an absorption of costs must be applied for from Care Concept prior to commencement of the treatment?

Yes! In order to provide unnecessary cost risks for you and the insurance company, a cost acceptance confirmation must be obtained from Advigon Versicherung AG or Care Concept in writing (email, fax or post) prior to treatment for the following services, provided that these are covered by insurance according to the chosen tariff:

  • Diagnostic examinations including imaging methods such as, in particular, magnetic resonance (MRT),
  • computer (CT),
  • positron emission (PET) and computer positron emission tomography CT-PET,
  • oncology,
  • oncological treatments,
  • palliative care,
  • partial inpatient/day clinic treatment,
  • medically required follow-on treatment (rehabilitation measures),
  • outpatient treatments,
  • medical transportation or repatriation,
  • repatriation in the event of death
Are there any dental services for which the absorption of cost must be applied for from Care Concept prior to commencement of the treatment?

Yes! A cost acceptance confirmation must be applied for in the event of the requirement of dentures, even where dentures are required as a result of an accident. In this case, the dentist must prepare a "treatment and cost schedule" for the planned measures. Please forward the original within 2 weeks with your full insurance certificate number to the following address:
We will check the treatment and cost schedule as quickly as possible upon receipt and will inform you of whether all or some of the calculated costs will be paid by us or whether we require further information or documents from you or the dentist.

Does the Care Expatriate international health care insurance include hygienist services and check-ups?

Yes, hygienist services and annual check-ups are included in all tariff levels of Care Expatriate.

What does the term artificial teeth refer to?

Artificial teeth refers to prosthetic measures, including pivot teeth (pegged crowns), insert fillings, cap crowns (also for single teeth) and orthodontic treatments.

Screening examinations are included?
Yes, screening examinations aimed at early detection of disease are included in our products "Care Expatriate Comfort" and "Care Expatriate Premium": max. €250.00 (Care Expatriate Comfort), max. €500.00 (Care Expatriate Premium) per insurance year.
Is treatment costs arising settled directly with the physician or the hospital by Care Concept AG?

During a stay in Germany, any treatment costs arising may be settled directly with the physician or the hospital. Should the biller be adamant about sending the bill to you, you may forward it to us for refund purposes. In this case, please note on the physician’s bill whether we should refund the costs to the physician or, if you paid in advance, to you

How does refund for prescriptions and lab bills work?

Prescriptions and lab bills must always be submitted together with the physician’s bill. Please note your policy number on every individual document.

Do documents (physicians’ bills, prescriptions) need to be provided in a certain language?

One of the advantages of the service provided by Care Concept AG is the multilingual skills of our employees. With many languages – e.g. Chinese, English, Spanish, Arabic, Russian, French, Turkish, Portuguese and German – we cover a big part of the languages used internationally and, when necessary, we can have our employees conduct foreign correspondence. This has, of course, major advantages for all those involved in the process. However, we do prefer to conduct the procedure in German or English and kindly request that you make use of this if possible and inform the physician treating you.

What information do doctor´s bills/prescriptions have to contain?

Doctor´s bills/prescriptions should be issued in the language of the country in which the insured is staying and shall be made out in the official currency of this country. They must also contain the name of the treated person, the exact name of the illness and information about the services provided by the treating doctor including type, location and period of treatment.

The invoiced amount is lower than the agreed excess. Do I still have to submit doctors´/laboratory bills/prescriptions?

Where an excess has been agreed, this amount is generally deducted from the first applications for reimbursement. As the excess does, however, not apply to each insurance claim but to all insurance claims during an insurance year, bills (originals) should also be submitted if the amount of the doctors´, laboratory or other medical bill or prescriptions is lower than the excess. We will check the bills submitted by you and will inform you of the amount of cost reimbursable according to the tariff that will be offset against your excess and what (residual) amount will then “only” be offset, where applicable, against future bills. It is therefore always advantageous to submit original bills.

When can I expect reimbursement of the costs?

Once the originals of all required information and documents have been submitted and examined, all payments to be made according to the tariff shall be paid to the nominated recipient within 10 working days.

To whom are reimbursable costs paid?

Unless we receive another payment order from you we shall transfer the reimbursable amount to your nominated account. We can also settle the bill directly with the doctor if you notify us accordingly. Please also inform us of the complete bank details of the treating doctor unless these are provided on the submitted bill(s). For international payment transactions we require the international sort code (BIC/Swift Code) and the international account number (IBAN) as well as the name of the bank, at which the treating doctor maintains his account.

Is there a deadline by which bills have to be submitted? Can I also submit bills when I am back in Germany or in my home country?

No, there is generally no deadline by which bills have to be submitted. You can therefore also submit any invoices for checking after you have returned from your stay abroad.
Please do, however, observe the following:
Claims generally become time-barred within three years from the end of the year in which the claim for payments can be asserted. Where you or the treating doctor only submit the bill after expiration of this period, claims can no longer be effectively asserted. There may also be queries arising during the verification of a claim or further medical documents may be required. Where a claim can no longer be checked or no longer be fully checked because of the elapsed time, this could be disadvantageous for you, as the insurer may not have to provide any or parts of the insurance benefits. We therefore recommend to generally submit doctor´s bills and recipes as soon as possible, at least, however, 2 weeks after receiving these documents.

Does the excess reduce (proportionally) if the duration of the policy is less than one year?

No, also for policies with durations of less than one year, the agreed excess will be offset in full against the reimbursable insurance benefits.


Download FAQ (provision of services questions)

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Please note that the English translation is for convenience only. The legally binding version is the German one.


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