ACCESSING HEALTHCARE

Transcription

1 ACCESSING HEALTHCARE in the United States

2 To provide you with a local and efficient service, we have selected Olympus Managed Health Care to administer your healthcare policy on our behalf within the USA. Allianz Partners members can call the Olympus multilingual Helpline, available 24/7 on: (+1) (toll-free from the USA). For your convenience, this number is also printed on the back of your Membership Card. Olympus will be able to confirm if you are covered for specific treatment in the USA under your Allianz Partners policy. Olympus will also deal directly with local medical providers to coordinate the direct settlement of all eligible costs. Outside the USA, Allianz Partners will look after your medical needs. HOW CAN I ACCESS HEALTHCARE IN THE USA? STEP 1 SELECT A MEDICAL PROVIDER You have 2 options: Search online on: Call the dedicated Allianz Partners Helpline at Olympus: (+1) (toll-free from the USA) You will be able to choose doctors, hospitals and other medical providers by zip code, provider name, facility, specialty or condition.

3 STEP 2 MAKE AN APPOINTMENT You have 2 options: Call Olympus to arrange the appointment for you. Contact the provider directly to schedule an appointment (please call Olympus to inform them of the details). If you call Olympus, they will check the details of your cover and verify if pre-authorization is required (if it is, they will start the process of obtaining it). They will also arrange the direct settlement of eligible costs. Please note that the providers might ask you the name of the insurance company, policy/id number and a phone number for insurance verification (this would be the Olympus Helpline). If the provider asks you to confirm the medical network that you have access to, please provide them with Olympus contact details. NOTE: for dental treatment, Dentemax is accessible if dental cover is included in your plan. STEP 3 VISIT THE MEDICAL PROVIDER Carry your Olympus Membership Card with you. Arrive at least 15 minutes before your appointment time. When visiting a doctor/hospital for the first time, you will be asked to complete a registration form and sign a document authorizing the release of your medical details.

4 STEP 4 TREATMENT PAYMENT Olympus normally arranges the direct settlement of eligible medical expenses. If you are asked to pay in advance, you have 2 options: Ask the medical provider to call Olympus to arrange the direct settlement. Pay for the visit and claim your medical costs from Allianz Partners. You should not have to pay for any treatment up front, unless costs relate to something not covered under your healthcare policy (please refer to your Table of Benefits and Benefit Guide for the details of your cover). If you pay for the visit, please send a completed Claim Form with all supporting documents to Allianz Partners (details on the form). The Claim Form can be downloaded from: Please keep a copy of all documents submitted to Allianz Partners for your records. If you have any queries in relation to a reimbursement claim, please call Allianz Partners on: (+1) (toll-free from the USA) or send an to: client.services@allianzworldwidecare.com

5 OBTAINING PRESCRIPTION DRUGS Caremark pharmacy card If your company chose to provide you with a Caremark pharmacy card, you will be able to get certain drugs and pharmacy products on a cashless basis. Present the card to your Caremark pharmacy and the pharmacy will confirm if there is any amount to be paid by you. Please ensure that the prescriptions you present have the date of birth of the person that the prescription is for. If you have any queries in relation to your Caremark card, please dial the toll-free number provided on the back of the card. To locate a Caremark network pharmacy use the Pharmacy Locator on the Olympus website: Discount pharmacy card Whether or not you have a Caremark card, you can also apply for a discount pharmacy card which can be used at any time when your prescription is not covered by your plan. To obtain your discount pharmacy card, simply go to: and click on Print Discount Card.

6 RECEIVING STATEMENTS OR INVOICES AT HOME After receiving a treatment in the USA you may receive a statement informing you of the amount your insurance company is being charged via direct settlement for the services you received. This statement is for your information only and no action is required unless the treatment described does not reflect the treatment you actually received. If this is the case, please contact us. You may receive an invoice at home if your provider is independent from your main hospital (e.g. laboratories, pathology, etc.) and do not hold details of your insurance policy. If you receive an invoice at home, please inform Olympus. You may be asked to send a copy of the statement to Olympus by fax to: (+1) or by to: awc@omhc.com Olympus will then liaise directly with the provider to settle all outstanding, eligible costs. ALLIANZ PARTNERS DEDICATED HELPLINE AT OLYMPUS: (+1) (toll-free from the USA) ALLIANZ PARTNERS TOLL-FREE NUMBER FROM THE USA: (+1) AWP Health & Life SA, acting through its Irish Branch, is a limited company governed by the French Insurance Code. Registered in France: No RCS Bobigny. Irish Branch registered in the Irish Companies Registration Office, registered No.: , address: 15 Joyce Way, Park West Business Campus, Nangor Road, Dublin 12, Ireland. Allianz Partners is a registered business name of AWP Health & Life SA.