International Travel Health Insurance - Pharmacy Rx Drugs Claim Process

Pharmacy Claim Process in International Medical Insurance

Are prescription drugs covered in the visitors insurance? How much is the co pay?

Visitors insurance covers prescription drugs just like any other medical expense. In fixed coverage plans, just like any other eligible expense, there is a sub-limit for prescription drugs as well. In comprehensive coverage plans, just like other medical expenses, there is no sub-limit for prescription drugs.

There is no concept of co pay for prescription drugs in short term plans. Please refer to the plan brochure or the policy wording for the coverage amounts and your responsibility.

Are over the counter medicines, blood pressure machines, birth control pills etc. covered in visitors insurance

No, they are not covered.

Is there a separate deductible?

No, for all covered expenses, you pay one cumulative deductible. If you have already satisfied your deductible visiting a doctor's office, for example, as long as you have already satisfied your deductible, you don't have to pay a separate deductible again for the prescription drugs.

Which pharmacies can I use?

You can go to any pharmacy you like. There is no PPO network in any of the visitors insurance plans.

How does the prescription drugs discount card work?

Some of the travel medical insurance plans provide a prescription drug discount card. When you go to the participating pharmacies, for covered drugs they give you a certain discount on your prescription(s). You will have to pay the rest of the amount and file for reimbursement. The insurance company will pay according to the terms of the particular plan.

For example, if you have purchased Patriot America Lite from IMG. Let's assume that your total Rx cost is $100 and they give you the discount of $30; you pay $70 and file a claim for $70. As long as it is a covered expense, and assuming that you have already met your deductible, IMG will pay you 80% of the $70 you paid back.

For those plans that don't provide a prescription drug discount card, it does not mean that prescription drugs are not covered. It just means that you don't get an additional discount.

When I went to the pharmacy, they didn't accept the insurance. How does it work? I had to pay up front, how do I get it reimbursed?

Pharmacies do not participate in the PPO network of any of the visitors insurance plans. Pharmacies do not have the set up with the visitors insurance companies for billing them directly. You will have to first pay and file for reimbursement.

For all the plans, present the original prescription from the provider to the pharmacy. In order to get prescription drugs from the pharmacy in the U.S., make sure that you have the prescription from the provider licensed to practice medicine in the U.S., as they don't accept foreign prescriptions.

In case of eligible IMG or WorldTrips plans, additionally present the Rx discount card and they will give you an instant discount. Pay to the pharmacy as if you have no insurance. You can file a claim for eligible expenses.

Follow the Claims Submission Process for reimbursement. In addition to the documents mentioned there, you must also send the copy of the prescription and the documents given by the pharmacy for each drug.

The pharmacy didn't accept the insurance card. What do I do?

The card you received after you purchased the insurance is for available health services and is not a prescription card. Pay the pharmacy as if you have no insurance and file for reimbursement as described above.

I ran out of my regular prescription drugs supply that I brought with me from my home country. Can I get it refilled in the U.S.?

In order to get prescription drugs from a U.S. pharmacy, you will need a prescription from a doctor licensed to practice medicine in the U.S. Therefore, you will have to visit the doctor, get an appropriate prescription and get it filled at the pharmacy of your choice.

However, none of the above expenses would be covered by any of the visitors insurance plans as they are not meant to cover pre-existing conditions. As you brought the medicines from your home country, the problem you have is obviously a pre-existing condition. Even any plan that covers any acute onset of a pre-existing condition would not cover such expenses as they are routine expenses and not really an acute onset of a pre-existing condition.

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