U.S. government: Coronavirus (COVID-19) information
CDC: Coronavirus (COVID-19) Travel Advice
Tokio Marine HCC-MIS: How Coronavirus Affects Your Coverage
If You Purchased Your Atlas Policy on Or After July 15, 2020 : Your plan will cover eligible medical expenses resulting from COVID-19/SARS-CoV-2.
How to use Atlas Travel Medical Insurance to pay medical bills in the U.S.?
Atlas Travel Medical Insurance Atlas America plan is a visitor health insurance policy designed to provide medical and travel benefits, as well as emergency travel assistance to take the risk out of international travelers visiting the USA. Atlas America insurance is available to individuals, families, and groups from over 180 countries. You get access to quality care and are protected against the costs that can incur from unexpected medical and/ or travel emergencies.
Atlas America insurance provides worldwide coverage including the United States. If you become ill or are injured during your visit to the U.S., you are free to go to the health care providers of your choice.
With Atlas Travel Medical Insurance, you have access to a large Preferred Provider Organization (PPO) network. Health care providers in the PPO network can submit your medical bills directly to the insurance company for payment. More about how to pay in-network medical providers?
You can use health care providers who are outside of your PPO network. Usually you pay for medical expenses at the time of service and then file a claim to HCC-MIS to request reimbursement. You may incur higher out-of-pocket costs.
How to pay out-of-network health care providers?
When seeking medical treatment within the U.S., you are free to choose health care providers. Atlas Travel Medical Insurance does not restricts your choice of hospital, physician or other medical service provider.
Once you choose a medical provider, you may schedule an appointment or go directly to the health facility if it’s an emergency. You are not required to obtain a pre-approval from the insurance company before you visit a hospital or doctor. There's no need to get referrals to see a specialist.
Out-of-network health care providers do not have direct billing arrangement with HCC-MIS. Usually you pay for medical treatment at the time of service, then file a claim to HCC-MIS to request reimbursement for eligible expenses that are covered by your insurance policy.
Out-of-network health care providers set their own fees for medical services provided. You may incur additional out-of-pocket costs. Atlas Travel Medical Insurance pays usual, reasonable and customary expenses for claims incurred outside the PPO network within the U.S.. If your health care providers charge more than reasonable and customary fees for services rendered, you will need to pay the excess charge.
Usual, Reasonable and Customary means the lesser of the following:
- One and a half times (150%) of the charges payable under the United States Medicare program, for claims incurred outside the PPO network within the U.S., or
- Most common charge for similar services, medicines or supplies within the area in which the charge is incurred, so long as those charges are reasonable. What is defined as usual, reasonable and customary charges will be determined by us. In determining whether a charge is usual, reasonable and customary, we may consider one or more of the following factors: the level of skill, extent of training, and experience required to perform the procedure or service; the length of time required to perform the procedure or services as compared to the length of time required to perform other similar services; the severity or nature of the illness or injury being treated; the amount charged for the same or comparable services, medicines or supplies in the locality; the amount charged for the same or comparable services, medicines or supplies in other parts of the country; the cost to the provider of providing the service, medicine or supply; such other factors we, in the reasonable exercise of discretion, determine are appropriate.
If you pay for medical treatment at the time of service, you should collect all medical provider names, addresses, receipts, invoices and medical records. Each of your medical providers should provide you the original itemized bills that document what medical services are provided to you and the cost for each service. The insurance company will request these documents as proof of claim.
How to file a claim for reimbursement of medical expenses?
After your medical treatment, you need to submit a completed Claimant’s Statement and Authorization Form , your proof of claim including the original itemized bills from your medical providers, original receipts for any expenses paid by you, your medical records, along with other requested documents to Tokio Marine HCC-MIS Group.
Your Claimant’s Statement and Authorization provides HCC-MIS with information to evaluate your claim, also allows HCC-MIS to request medical records from your medical providers. Be sure to keep a copy of all submitted documents for your records.
More about How to Complete and Submit a Claimant's Statement and Authorization Form?
The claims examiner at HCC-MIS will review your medical records and expenses to determine whether to pay or deny the claim(s). The claims examiner may request more information from you or your medical provider(s). Tokio Marine HCC–MIS Group will complete the claims process once they have all the necessary information.
If the claim is deemed eligible, the insurance company will reimburse eligible medical expenses to you. You may have to meet your deductible before your insurance plan begins to pay the cost of your medical bills. It is your own responsibility to pay for medical expenses that are not covered by your insurance plan.
You will receive an Explanation Of Benefit letter from HCC-MIS that tells you if your claim is paid or denied. During the claim process, you may visit Client Zone to check your claim status.
Find out more about the claims process at Tokio Marine HCC-MIS Group Claims Resource Center.