I will be hosting my MIL for whom my wife wants to get travel insurance. The important part of the insurance is the medical part (not so much the travel disruption stuff). If we get it from my wife's home country (Colombia), the cost of the plans are cheaper (for similar max coverage levels) but the coverage process for any service involves first calling the customer support and getting their OK to do the medical treatment. It would appear the products you can buy locally in the US (for incoming travelers), while more expensive than the plans from Colombian companies, offer PPO network coverage. This would seem to imply that these plans operate akin to standard US healthcare plans, i.e. find a place that is in network, show your insurance card, get billed later after co-pays, no hassle, no phone calls.

Does anyone have any experience with plans bought internationally that operate as noted above (having to call in the visit first to receive OK) or the local for-immigrants-only plans that you can buy in the US?