Travel insurance demands Medicaid direct claim denial, how do I receive proof?
Hello,
My grandmother who received medicaid and medicare in US visited Israel and unfortunately had to go to an Israeli hospital to get treatment. Her travel insurance won't pay because they demand claim denial from medicaid. How can I prove that Medicaid will not cover Israeli medical services?
Thank you
Expert Answer
Neither Medicare nor Medicaid covers medical care received outside the United States (except for some rare exceptions on the border). The travel insurance companies know this perfectly well, but it is typical of insurance companies to make a claim difficult, knowing that some people will not follow through and therefore the company will not have to pay some claims that it should pay.
In your grandmother's situation, you may have to submit copies of her Israel medical bills to both Medicare and Medicaid, seeking coverage and payment, and then wait until you receive a formal written denial of coverage from each program. When she has those written denials of coverage, she can then submit them to her travel insurance company and demand payment under her policy.
You may be able to short-circuit this process by speaking to a claims adjuster for the travel insurance company. You may get lucky and find a sympathetic ear from someone who can tell you whether the medical bills alone -- showing that they are from outside the U.S. -- might be enough for your grandmother to get payment.