Originally Posted by
Tokar
A question: when they bill the PPO, do you get hit with the full billed rate or do you get the network discount rate for services? In other words, if you get hit with a $25,000 bill, no insurance you are paying $25,000, with my employer-based PPO plan there is a huge network discount that usually brings it down by over 50% before it even gets billed to me/my deductible. I'm just curious if this tourist PPO operates the same as an employer-based PPO plan.
The services will be billed as In Network/Out of Network just like an employer-based plan. Deductibles and rules are all the same. The only hiccup is the lack of Group#. The card you print out says "United Healthcare PPO" exactly like an employer-based card but where Group# is supposed to be it says "WorldTrips" instead of the number.
A problem we had 2 years ago was that United Healthcare approved and paid everything but somehow the intermediary "World Trips" caused problems with billing by withholding the approved payment from the Hospital and my mum was sent to collections. I had to call the Hospital, United Healthcare and the Collectors several times to get everything sorted over a year later. Once collections looked deeper into it they realized that it was not my mum's fault nor United Healthcare for non-payment.
Our experience this past winter, was If you buy the same plan again for a subsequent visit, any previous claims accumulate towards your lifetime max. However, previous claims did not seem to affect the premium. If you need to extend the coverage you can do so easily via the original website by adding as few as 1 day. Coverage also starts the day you purchase the plan. We plan on buying this same plan for subsequent visits as we have a decent selection of United Healthcare providers in our area.