Wellaway

Thanks to International-Santé and WellAway for their support

Our family moved to the US in 1998, and until the end of 2017 we were covered by CFE and my employer's complementary insurance. Then as of January 2018 I retired. As I had no American health insurance, I looked for the possibilities available to my wife and myself, either an American ACA insurance (Obamacare), or a complementary insurance to the CFE that was also ACA compliant.That's when we had a stroke of luck: I found the International Santé website on the internet, and got in touch with Raphaël Reiter. The latter was remarkably helpful and through him we decided to take a contract from WellAway: Life Abroad / Premier 4500 starting January 2018. I went on US Medicare in October 2020 and our Premier 4500 contract ended. My wife then signed a second identical contract with WellAway for herself, which will continue until she goes on US Medicare.My wife and I are pleased with the choice of WellAway and this contract. Among the most positive aspects of WellAway is the service provided by PayerFusion (based in Florida and working with WellAway), which acts as a liaison between all the different players: the health care providers, the US insurer whose network and logistics WellAway uses (Aetna until mid-2020 and now United Health Care), the CFE and of course the insured. This service, which is called ConciergeCare, has helped us on multiple occasions, and in particular Valerie provided us with invaluable assistance in resolving a situation with the CFE in early 2019.Due to a cancer diagnosed in 2019 in my wife, we still tested some limits. For example a provider at one point asked us to pay over ,000 for chemotherapy for which they (wrongly) felt insurance reimbursements were insufficient, and playing on the fact that WellAway is an international company. ConciergeCare and WellAway's claims department helped, advised and covered us in this difficult case by intervening directly with the provider. Our experience with WellAway has also included occasional "glitches", especially when we switched from Aetna to UHC as our US partner in 2020, but everything has always been resolved with the help of ConciergeCare. Some providers also have trouble understanding the difference between WellAway and UHC, but again, with a little patience, everything is eventually resolved, so if we had to do it again, we would not hesitate to take out a WellAway policy. We have encouraged our children to take out individual CFE/WellAway policies through International Santé, which they have done.

Disorganized and limited coverage

The biggest problem with the Orbe Gold insurance I had for my whole family (two adults, two teenagers) is that the care is covered only up to the usual customary rates. No one explained to me what this meant when I chose this insurance. It is impossible to know in advance whether or not these "UCR" rates will be the actual rates charged by doctors and hospitals. In preparation for surgery, I tried to find out in advance about costs and reimbursements from the insurer and the hospital: I couldn't really know how much I would be covered. But despite the lack of transparency, I could see that I was at risk of having several thousand dollars out of pocket even though it was a small operation with local anesthesia, and absolutely medically necessary. It was after this experience that I decided to leave this insurer. Another example that gave me the bug: we go to a dermatologist and make sure that he is "in network". Big surprise when we received the bill: the insurer discount (which normally reduces the price of consultations by about 30-40%) was only a few cents, so the basic consultation was 0. When I tried after that to find out about these insurer discounts to choose other doctors, it was impossible for me to know in advance the amount of these discounts. Finally, this insurance has major problems with organization and management of the insured, especially since they switched from Aetna to United Healthcare. I was forced to have the insurer check to see if there was an error in my coverage, and very often they "forgot" to reimburse me as they were supposed to according to my contract. I am still waiting for dental reimbursements that they made a mistake on. If I didn't check, I would be paying out of pocket when it was covered! I have spent hours like this dealing with these insurance issues, what a waste of time! Their web portal is absolutely terrible, incomprehensible and full of bugs. They recently lost all my communications with them from last year! Their phone service is not bad at all, but again, what a waste of time. The worst thing is the opacity of the coverage and the risk of not being covered properly because of these "UCR".

I PREFER APRIL

Pb refusal to pay for dermatology consultation. Problem solved thanks to our broker HeathForExpats

Health insurance

a bad reimbursement, endless waits to answer an email, an unacceptable delay for reimbursements (optical: 2 months) for a contribution of more than 1800 per month (and we have to add the cfe) moreover, we had to leave the United States because of a visa problem after 9 months (so against our will) and wellaways refuses to terminate our contract (deduction made for the year..) and to reimburse us (one month to answer my request for cancellation) Insurance to be avoided..better to choose an American insurance