Insurance claims

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1. Finding a provider outside the US
2. Hospitalization - Emergency situations
3. Pre-certification for Special Treatments
4. Universal RX Pharmacy Discount Card
5. Insurance Terms and Conditions

Finding a provider in the US:

Your insurance plan is contracted to the independent U.S. Preferred Provider Organization (PPO). This PPO network is organized and administered by The First Health Network and includes hundreds of thousands of established, highly qualified health care physicians and many well-recognized hospitals in the U.S. To search for a medical care provider within the independent Preferred Provider Organization network, please contact the Service Center toll-free at:

1.800.628.4664

Or use the Online PPO directory at: www.imglobal.com to access a list of providers and facilities within the PPO network. The Online PPO directory is updated on a routine basis however changes may be made between updates. To ensure that the physician you have selected is in the network, please contact the physician’s office to confirm his/her participation.

Finding a provider outside the US:

If you are seeking treatment outside the U.S., you have access to the International Provider AccessSM (IPA) (www.imglobal.com), a database that includes more than 16,000 highly qualified physicians and facilities that encompass a comprehensive array of specialties to handle any health care emergency.

In case you need help or cannot find a physician next to your location, please contact the Service Center at:

+44 (0) 1444 465555
or
+1.317. 655.4500 (Worldwide Collect)

Free choice of doctors and hospitals:

With your insurance plan you may seek treatment with the hospital or doctor of your choice. However, it is highly recommended to choose a doctor as described above (Finding a provider in the US / Finding a provider outside the US), in order to avoid out of-pocket costs, that may apply, if you choose a doctor outside the PPO network.

Out-patient Treatment

In case of out-patient treatment always call the Service Center prior to treatment at 1.800.628.4664

A. Direct Billing

In many cases IMG works directly with the hospital or clinic, for payment of eligible medical expenses. To be eligible to have a claim paid in this fashion, you or the provider must complete a Claim Form and submit it with original itemized bills. In this case, you will be responsible for direct payment of your deductible and non-eligible expenses and charges.

B. Reimbursement

If you have received treatment and need to be reimbursed for out-of-pocket medical expenses, complete the Claim Form and submit your original itemized bills and paid receipts within 180 days. We will reimburse your eligible medical expenses after applying the deductible.

Hospitalization - Emergency situations

Each hospital admission MUST be pre-certified for medical necessity, which means you or the attending physician must call the following number prior to admittance to a hospital or performance of a surgery:

In the US & Canada: 1.800.628.4664 (toll-free) or 1.317.655.4500 Outside the US & Canada: +1.317.655.4500 (call collect if necessary)

In case of an Emergency Admission, the pre-certification call must be made within 48 hours of the admission, or as soon as reasonably possible. If a hospital admission or a surgery is not pre-certified, eligible claims and expenses will be reduced by 50%.

Pre-certification for Special Treatments

The following treatments and/or supplies must always be pre-certified for medical necessity:

• Inpatient Treatment and/or supplies of any kind
• Any Surgery or Surgical procedure
• Durable Medical Equipment
• Computerized Axial Tomography (CAT Scan)
• Magnetic Resonance Imaging (MRI)

In case of any of the above mentioned treatments, please call IMG for pre-certification:

In the US & Canada: 1.800.628.4664 (toll-free) or 1.317.655.4500 Outside the US: +1.317.655.4500 (collect if necessary) email: acm@imglobal.com

Please note: if your treatment was not pre-certified, eligible claims and expenses will be reduced by 50%.

Universal RX Pharmacy Discount Card

The following treatments and/or supplies must always be pre-certified for medical necessity:

• Inpatient Treatment and/or supplies of any kind
• Any Surgery or Surgical procedure
• Durable Medical Equipment
• Computerized Axial Tomography (CAT Scan)
• Magnetic Resonance Imaging (MRI)

In case of any of the above mentioned treatments, please call IMG for pre-certification:

In the US & Canada: 1.800.628.4664 (toll-free) or 1.317.655.4500 Outside the US: +1.317.655.4500 (collect if necessary) email: acm@imglobal.com

Please note: if your treatment was not pre-certified, eligible claims and expenses will be reduced by 50%.

Insurance Terms and Conditions

The list of Cover and Benefits forms part of the Certificate of Insurance where the complete terms for the insurance policy are stated.

For a detailed representation, including all restrictions and exemptions from coverage, please read the detailed insurance terms and conditions in the Certificate of Insurance available within this My Insurance area, which will be provided with your insurance confirmation card.

Global Choices Network

We are glad to be affiliated and associated with the following organisations: Find out more about Global Choices affiliations