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Follow our step-by-step guide to navigate overseas healthcare with confidence:
1. Pre-certification Process
Initial Contact: Your referring specialist should complete an Overseas Care Referral Form then contact OTH to provide the details of your overseas care needs, before making any appointments. You can contact us via email at overseascare@argus.bm or 1-800-720-7315 or (441) 298-0429 and we will respond within 24-48 business hours to confirm your health plan eligibility, guide you through the next steps, and inform you of any additional requirements
2. Care Coordination and Travel Planning
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Appointment Scheduling: OTH will assist with coordinating all the necessary medical appointments, including pre-operative consultations, surgeries, and post-operative care.
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Proactive Network Solutions: To help reduce claims and out-of-pocket expenses, we have partnered with United HealthCare to provide access to hospitals and health care facilities that offer high-quality care at negotiated rates. See ‘Healthcare Networks Explained’ below to better understand your options.
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Logistical Support: OTH will help you to navigate the logistical details of your travel. Please note that you will be reimbursed for the hotel stay, based on your daily allowance, upon completion of care.
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Plan Confirmation: Before you travel, you will receive a Confirmation of Coverage via email that includes medical appointment dates, prescription information, and travel information
3. During Treatment
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Hospital Admission: OTH ensures a seamless hospital admission process by providing all necessary documentation.
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Patient Advocacy: We are available throughout your treatment to address any immediate needs or concerns, arrange second opinions, guide you through the available care and facility options and explain what is happening at each stage.
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CVS Pharmacy Benefit: Using your CVS Caremark card, you have convenient access to a network of more than 68,000 participating retail pharmacies (both CVS and non-CVS pharmacies).
4. Post-Treatment Support
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Transition back home: Within 24 hours of your return to Bermuda, OTH will follow up to ensure you arrived safely.
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Local Continuation of Care: Within 48 hours of completion of care, OTH will obtain your medical records, share your results with local specialists and your GP, or connect you with a local Thrive. Case Management representative (if needed) who will assist with follow-up appointments and local care coordination.
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Cost Management: Any out-of-pocket costs incurred during your travel can be reimbursed through the Argus Vantage online portal where you can ‘submit a claim’ using the Health dashboard.
Healthcare Networks Explained
By familiarising yourself with these terms and processes, you can plan your overseas healthcare more efficiently and cost-effectively:
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In-Network: These are healthcare providers or facilities that either have direct contracts with Argus or are pre-approved to offer services at negotiated rates. Utilising in-network providers usually means lower out-of-pocket costs for you.
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Preferred Provider Network (‘PPN’): This designated healthcare network offers services at discounted rates, based on specialty. It includes many of the facilities within the In-Network contracts. The PPN also provides the maximum daily allowance stipend for hotel and food.
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Out-of-Network: These are providers or facilities that either do not have contracts with Argus or were not pre-approved to provide services. Using out-of-network providers typically results in higher out-of-pocket expenses, as they do not adhere to the negotiated rates of in-network providers.
To confirm the network that supports your health plan, please review your Schedule of Benefits, as some overseas care benefits and networks may differ per plan.
To view your Schedule of Benefits, log in to your Vantage account, or to search for a provider CLICK HERE.
With this information, you're better prepared to handle your healthcare needs while abroad. We're here to support you every step of the way, ensuring you receive the care you need.
For additional assistance or inquiries, you can reach us at: 1-800-720-7315 or (441) 298-0429 or email overseascare@argus.bm