Health Insurance

Please review our insurance resources for more detailed insurance information

What is a Co-Pay?

Although your insurance plan will pay most of your medical bill, they do require you, as the patient, to pay a small portion. This portion is called a co-pay. Under your insurance plan you will have a co-pay for every doctor’s office visit, a hospital stay, or other form of care. For every visit, you will pay the co-pay and the insurance will pay the remaining qualified expenses. If you visit an out-of-network doctor, you can expect a larger co-pay for each doctor’s office visit.

What is a Deductible?

This is the amount you must pay for medical expenses before the insurance company is obligated to pay – outside of the USA, this is also known as excess. Under your insurance policy you have a deductible for visiting the emergency room (unless you are kept in the hospital overnight, at which point the fee is waived). This means if the emergency room bill is less than your deductible, you will have to pay the entire bill; if it is more than your deductible, then you will only pay the deductible and the insurance company will pay the remaining amount of qualified expenses.

When I telephone the doctor to make an appointment and they request the name of my insurance, what do I tell them?

The plan utilizes the UnitedHealthcare Network, so when calling or talking with providers, please mention this name or show the provider a copy of your insurance ID card with the UnitedHealthcare logo on it for network recognition. Alternatively, or if any issues arise, please call the insurance company immediately for assistance. Please refer to your insurance ID card to confirm the name of your insurance company.

Note: Participants from CKM, SAYIT, and IEC must refer to their respective insurance plans for coverage details.

Can I go to any doctor?

Yes, you are free to visit any provider you wish, but it is not advisable to see doctors outside of the provider network. The benefit of staying within the preferred provider network is that bills and invoices may be settled directly without any payment (apart from your deductibles) on your part.

What does my insurance NOT cover?

Common exclusions on your insurance plan include pre-existing conditions, birth control pills, long-term treatment, and regular exams/check-ups. However, please log into your Student Zone for a copy of your insurance brochure that will contain a full listing of the plan exclusions.

What should I do if I feel like I want to harm myself?

While in the USA, your insurance plan includes access to DialCare, supporting you in your time of need. DialCare is a virtual and telephonic counseling service focused on providing safe, secure, and private means of seeking mental health assistance from licensed counselors. Some additional organizations that can assist are:

• • Suicide and Crisis Lifeline: 988
  • The Trevor Lifeline (LGBTQA): 1-866-488-7386
  • Treatment Referral Hotline (Substance Abuse): 1-800-662-4357
  • National Sexual Assault Hotline: 1-800-656-4673 or http://online.rainn.org
  • Crisis Text Line: Text Free in the US 741741

Should I go to a hospital emergency room?

We generally recommend that you visit a doctor’s office or urgent care clinic for treatment. You will likely have a shorter wait time, and urgent care clinics tend to be much less expensive than hospital emergency rooms. Generally, you should ONLY visit a hospital emergency room if you are experiencing a serious injury or a life-threatening illness.

What if I lose my insurance confirmation card?

Please visit your Student Zone to download your insurance ID card from the MyDocuments section.

Note: Participants from CKM, SAYIT, and IEC must refer to their respective insurance plans for coverage details.

What do I need to take with me when I go to the doctor’s office?

You should take with you:

• • Insurance confirmation card with your Individual Policy Number
  • Passport (to use as Identification)
  • DS-2019 Form (just in case they need to see it)

How/where do I get my individual insurance policy number?

Your insurance ID card contains both your Group ID (this is the same for all participants under the plan) and your certificate ID, which is unique to you and is your individual insurance policy number.

What is a claim form?

An insurance claim form is a form/application you must complete after going to the doctor in order for the insurance company to pay your medical bill. Download a claim form from your insurance plan’s Claims Center.

Who has to file a claim form?

All Work & Travel USA participants who receive medical treatment must file a claim form for each injury or illness.

When should I file the claim form?

You should file a claim form as soon as possible after going to the doctor’s office, urgent care center, or emergency room, and no later than 90 days after you received treatment. After 90 days, you will not be reimbursed for your medical expenses.

What does the insurance company need from me in order to process the refund?

To process a refund, you’ll need to submit signed and dated claim form and either the physician’s bill or a fully itemized statement of charges (a complete list of everything the doctor’s office has charged you) with the diagnosis written on the doctor’s letterhead.

If my medical provider sent the bill directly to the insurance claims department, do I still have to fill out a claim form?

Yes, but the bill and claim form do not have to be mailed in together. As long as the medical provider sent in the bill you only have to send in your claim form. However, sending both together may help to expedite payment of your bill.

How do I find out the status of a claim?

Through your MyIMG account, you can submit your claims, track the status, access your Explanation of Benefits, and more! We strongly recommend that you register for your MyIMG account as soon as your coverage starts. Alternatively, you may call/email your insurance company to check on your claim.

I received an unpaid bill from the doctor’s office I visited. What should I do?

First, call the doctor’s office to ask if they have submitted the bill to your insurance company. If they did not receive your correct insurance information, you may give them your insurance company’s details so that your claim can be processed. If the bill was submitted to the insurance company but has not yet been processed, please contact the insurance company directly in order to check on the status of your claim.

I am unhappy with the results of my insurance claim. What steps can I take?

If a claim has been processed and you are not happy with the results, you can request that the insurance company review the claim again. To do this, you can email an appeal to the insurance company to request another review.

What if I’m injured on the job?

All job-related injuries are covered by Workers’ Compensation insurance. Your employer should refer to their Workers’ Compensation policy.