A Guarantee of Payment (GOP) assures payment directly to a health care professional outside the U.S. for covered services. This helps prevent you from having to pay for services that would normally be covered under your plan. Please refer to your Policy Terms and Conditions if you are unsure how your plan settles costs outside of the U.S. Some of our plans settle claims outside the U.S. via reimbursement only.
Why is a GOP important?
• Using a guarantee of payment increases access to care around the world.
• Reduces out-of-pocket expenses at those health care professionals who do not, per normal practice, directly bill WellAway (Please note: you are responsible for any applicable coinsurance, deductible or copayments per your plan).
• Enables the hospital to bill us directly.
• Allows WellAway to consult on the services being rendered, providing you the best care possible.
Who is responsible for requesting a GOP?
• If a health care professional requests payment upfront, always ask them to contact WellAway per the normal process that they use to verify benefits and confirm payment by WellAway for urgent/emergency services on your behalf.
• If you are requesting a GOP for urgent/emergency Service, call the toll-free number on the back of your ID card. WellAway will verify benefits and confirm payment.
• If you are requesting a GOP for a service/procedure planned in the future through consultation with your health care professional, they should contact us per the normal process that they use to verify benefits and confirm payment by WellAway for any services on your behalf.
Within 48 hours of an emergency which requires an inpatient procedure, or if an inpatient procedure is planned or you require outpatient surgery, you must contact a ConciergeCare Counselor before services are rendered. This is essential so that we may provide the necessary information to guarantee the costs or to pay the provider and/or hospital. This includes conducting a medical review of the invoices to make sure that they are Usual, Reasonable and Customary Charges.
As the best health insurance in the USA for international students, WellAway provides comprehensive coverage and support, clearly guiding you on how to manage payment processes like a Guarantee of Payment (GOP) when required by healthcare providers.
This material is for informational purposes only and is subject to change. Please refer to your Policy Terms and Conditions for a complete description of the benefits, conditions, limitations and exclusions of coverage. Products and services may not be available in all jurisdictions and are expressly excluded where prohibited by applicable law.