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AETNA International Medical Insurance Review

AETNA International Medical Insurance Overview

AETNA International is the overseas subsidiary of the US managed healthcare company AETNA and is one of the largest health insurance companies in the world. The company provides health insurance and other benefits to 800,000 people around the world (outside of the USA).

The company is a great choice if you do a lot of international travel as it has more than 1,000 employees working in offices across the globe. Customers have access to a host of health and well-being resources through Aetna Well-being, which is accessed through the Aetna Health Hub. Plus you can see all your health insurance details on the Aetna Health app.

Aetna traces its roots back to the incorporation of the Aetna Fire Insurance Company in Hartford Connecticut, USA in 1819. The company was named after Mount Etna on the east coast of Sicily, because “though surrounded by flame and smoke [it] is itself never consumed.” Aetna started offering health insurance in 1899.

Contact details

Aetna Global Benefits (Middle East) LLC

28th Floor

Media One Tower Building

Dubai Media City

PO BOX 6380, Dubai

Tel +971-4-438-7500/7600

Fax +971-4-428-7100

[email protected]

This office serves the whole of Africa, Middle East, Indian Sub-Continent, Indian Ocean.

Why buy Aetna

There are four Aetna Pioneer health care plans and a fifth offering optional extra cover, these are the Aetna Pioneer℠ 1750, 2500, 4000, 5000, and Aetna Pioneer℠ 5000+.

All the plans cover inpatient and daycare treatment, parent hospital accommodation, they also offer the following outpatient benefits: Outpatient post-hospitalization treatment (up to 90 days), outpatient surgical procedures, outpatient dental treatment for accidental damage following hospitalization, further benefits, emergency assistance services, local ambulance, cancer care, organ transplants, mortal remains, rehabilitation (from 30 to 120 days), and hospital cash USD 125 per night (up to 20 nights). All plans also offer non-emergency medical evacuation as an optional benefit. The largest difference between the plans is their overall limit.

Aetna Pioneer℠ 1750 has an overall plan limit of USD 1,750,000, emergency inpatient and daycare treatment up to USD 5,000, in-patient treatment of acute conditions for newborns (natural conception) of USD 150,000. The outpatient benefits include access to the Global Crisis Management Program advice line (powered by WorldAware), and covers durable medical equipment up to USD 1,000. There is an optional benefit of USD 1,500 for routine and major restorative dental treatment.

Aetna Pioneer℠ 2500 has an overall plan limit of USD 2,500,000, emergency inpatient and daycare treatment outside area of cover up to USD 15,000, in-patient treatment of acute conditions for newborns (natural conception) of USD 150,000, inpatient psychiatric treatment of USD 5,000 (up to 30 days). The outpatient benefits include outpatient consultations, treatment and tests including MRI up to USD 5,000, outpatient physiotherapy and outpatient complementary medicine both up to USD 1,500, outpatient traditional Chinese medicine up to USD 300, outpatient psychiatric treatment up to USD 1,000, emergency outpatient treatment outside area of cover up to USD 500, access to the Global Crisis Management Program advice line (powered by WorldAware), covers durable medical equipment up to USD 1,000, terminal care, chronic conditions and disease management are included, congenital abnormalities up to USD 25,000, HIV or AIDS up to 5,000. There is an optional benefit of USD 1,500 for routine and major restorative dental treatment.

Aetna Pioneer℠ 4000 has an overall plan limit of USD 4,000,000, emergency inpatient and daycare treatment up to USD 30,000, in-patient treatment of acute conditions for newborns (natural conception) of USD 150,000, inpatient psychiatric treatment of USD 10,000 (up to 30 days). The outpatient benefits include outpatient consultations, treatment and tests including MRI up to USD 15,000, outpatient physiotherapy and outpatient complementary medicine both up to USD 2,000, outpatient traditional Chinese medicine up to USD 750, outpatient psychiatric treatment up to USD 2,000, emergency outpatient treatment outside area of cover up to USD 500, access to the Global Crisis Management Program action response (powered by WorldAware), covers durable medical equipment up to USD 1,000, terminal care, chronic conditions and disease management are included, congenital abnormalities up to USD 50,000, HIV or AIDS up to 10,000, compassionate emergency visit, routine health checks up to USD 500.

Aetna Pioneer℠ 5000 has an overall plan limit of USD 5,000,000, emergency inpatient and daycare treatment up to USD 50,000, in-patient treatment of acute conditions for newborns (natural conception) and  inpatient psychiatric treatment are both fully covered. The outpatient benefits include outpatient consultations, treatment and tests including MRI up to USD 15,000, outpatient physiotherapy is fully covered, outpatient complementary medicine up to USD 4,000, outpatient traditional Chinese medicine up to USD 1,500, outpatient psychiatric treatment up to USD 10,000, emergency outpatient treatment outside area of cover up to USD 500, access to the Global Crisis Management Program action response (powered by WorldAware), covers durable medical equipment up to USD 2,000, terminal care, chronic conditions and disease management are included, congenital abnormalities up to USD 100,000, HIV or AIDS up to 15,000, compassionate emergency visit, routine health checks up to USD 1,000, sight and hearing examination up to USD 250.

Aetna Pioneer℠ 5000+ has an overall plan limit of USD 5,000,000, emergency inpatient and daycare treatment covered with Area 1, inpatient psychiatric treatment is fully covered. The outpatient benefits include outpatient consultations, treatment and tests including MRI up to USD 15,000, outpatient physiotherapy is fully covered, outpatient traditional Chinese medicine up to USD 1,500, outpatient psychiatric treatment up to USD 10,000, emergency outpatient treatment outside area of cover is covered with Area 1, access to the Global Crisis Management Program action response (powered by WorldAware), covers durable medical equipment up to USD 2,000, terminal care, chronic conditions and disease management are included, congenital abnormalities up to USD 100,000, HIV or AIDS up to 15,000, compassionate emergency visit, routine health checks up to USD 1,000, sight and hearing examination up to USD 250, newborn congenital abnormalities is fully covered.

Value added extras with Aetna International

As an Aetna International customer you get access health and well-being resources at Aetna Well-being. This includes discounts at a network of global gyms and fitness classes (without having to sign a contract) with their ClassPass membership, an extensive library of travel and health advice, and security alerts whether you’re home or abroad.

Aetna offers a number of services to promote mental health and well-being. Their Wysa app has more than 150 different digital self help tools, including an AI chatbot and human coaching when you’re ready. Their myStrength app has a number of online tools that help you with anxiety, depression, stress, substance use, chronic pain and sleep challenges. Peak is an app that allows you to hone your memory, focus, problem-solving skills and more. If you’re struggling to sleep, Aetna offer the Pzizz app that helps you fall asleep and wake up feeling fully refreshed. You can learn the psychological skills to manage stress with the emotional fitness game eQuoo.

Aetna customers who are trying to give up smoking get access to world’s most popular stop smoking app, Smoke Free. For those who struggle with neck or back pain Aetna’s Kaia app demonstrates therapeutic exercises designed by leading experts in pain treatment.

You will find more information about all these services at the Aetna International Health Hub.

How to make a claim

The easiest way to make a claim with Aetna International is online.

Before you make a claim, make sure you have:

  1. Registered for an Aetna International web account
  2. Your membership ID number, and have your contact details to hand
  3. Details about the health care provider you’ve seen, as well as the treatment, consultation or service you received
  4. Documents that support your claim. If you’re going to submit online (which is the fastest method) they should be in an electronic format (eg PDF)
  5. Your credit or debit card, or other preferred method of payment

To make the claim:

  1. Login to the Aetna International secure member website
  2. Click on the ‘Claims Center’ link at the top of the page
  3. Click start a ‘New Claim’ – you will automatically be given the correct claims form
  4. Fill in the form – all the important information will be saved for next time
  5. You can click ‘Copy Claim’ if you want to save time submitting a second, very similar claim
  6. Click ‘Upload Documents’ and attach the relevant documents
  7. Double check you have included everything you want to be paid for
  8. Click ‘Submit Claim’

FAQS

What is iPMI and do Aetna offer them?

International Private Medical Insurance (also known as iPMI) are health insurance policies for people working overseas. With Aetna’s iPMI you can travel and use their network of approved medical facilities.

Does Aetna offer direct settlement?

Many healthcare providers require the patient to prepay before a procedure or soon afterwards, which can be worrying if you are going to have expensive medical treatment. Customers who use medical facilities that are part of Aetna’s international network can have their bills paid by direct settlement. This means that the invoice will be paid directly by the Aetna, rather than you having to pay the bill and then claim back from Aetna.

How does preauthorization work?

Preauthorization (also known as precertification, authorization, certification, prior authorization, guarantee of payment (GOP), or letter of authorization (LOA)) is when your medical treatment and costs are checked and then approved by Aetna International before they take place. This makes sure that you are covered and not subject to any unexpected bills. The services that need preauthorization include:
A treatment or service that costs more than USD 500 (or the equivalent)
A medical evacuation
Inpatient admission and daycare treatment
Psychiatric treatment
Drug prescription lasting longer than three months
Providers in the Aetna International network will usually seek preauthorization on the patient’s behalf. If the provider is not going to do this or if it is not part of the approved Aetna International network, customers will have to arrange preauthorization by contacting Aetna International themselves.