Claims handling

If you're enrolled in one of the EXPAT plans with the BDAE GROUP, you're essentially paying for insurance coverage, hoping you never need it. Nobody wants to use insurance, but sometimes it's necessary. You're part of a group of insured individuals that mainly comes into play for specific situations. However, you're still in this group because there's a chance you might face a costly illness in the future, and in that unfortunate event, the group will help cover your expenses.

To ensure a quick and smooth process for reimbursing your medical bills in such a situation, we kindly ask you to read our tips and frequently asked questions on this page. The more you work with us, the faster we can assist you.

Thank you for your cooperation!

• As soon as we have received your invoices, we will send you a confirmation email. Next, our billing service team will review the matter, taking into account any relevant medical history. Ideally, a decision will be made promptly regarding whether the invoices are eligible for reimbursement according to the insurance terms or not.
• You can easily upload invoices up to a value of 1,000 euros using the Service-Portal or the Web-Upload feature.
• If the costs are eligible for reimbursement, we typically transfer the money to you within 14 days after sending the billing statement.
• In some cases, we may need to gather additional information regarding your medical history from you and/or your treating physicians. If we contact one of your doctors, we will require a current signed release of medical confidentiality from you. Otherwise, we will not receive any information from the doctor, and the invoice review cannot be completed. Unfortunately, there are occasional delays on the part of doctors in responding to our inquiries.
• Once we have received all the necessary information and documents, we will assess the eligibility of the invoices, and we will inform you in writing about the reimbursement decision.
• For mail from abroad: If you submit original medical documents such as invoices, doctor's reports, or laboratory reports from abroad, please always include our EORI number DE295600038415981 on the envelope. This facilitates customs clearance, and the documents can be delivered more quickly.

Dental invoices must always include details of the treated tooth, the specific procedures performed, and a breakdown of costs included in the invoice amount. Our policies cover composite fillings. Depending on the policy, annual check-ups are covered, but preventive treatments such as tartar removal and teeth cleaning are not covered.

If you want to make sure your dental treatment costs are covered, ask your dentist to create a treatment plan that lists all the expected expenses. We will review this plan and give you written confirmation of how much we will pay. Just remember to check your specific policy for details on dental prosthetics, waiting periods, and maximum reimbursements.

For questions and basic information about the reimbursement process, please feel free to visit the designated website https://bdae.globalexcel.com, which is also noted on your insurance card and in the information sheet.

There, you will also find some explanatory videos that describe the US healthcare system and explain how the reimbursement process works in the USA.

Cost reimbursements often come with the potential for conflicts, which is regrettable. In the best-case scenario, our customers receive what they consider to be a given – the reimbursement of their expenses. In principle, we must conduct claims settlement according to the very specific guidelines of our underwriters. These guidelines are based on two criteria:

• The total number of claims must remain within a range in a private sector company that protects its existence and, in turn, the community of policyholders.
• The goal is to protect the interests of all policyholders because if premiums need to be increased due to economic reasons, it affects all policyholders negatively.

Of course, you will receive the benefits specified in the contract from us.

A significant portion of our insurance products excludes coverage for pre-existing conditions and existing treatment needs in accordance with the General Insurance Terms and Conditions (GTC). Pre-existing conditions are predictable risks that incur costs. If there is suspicion of pre-existing conditions, we must be able to rule out that our suspicion is justified. What does this mean?

If you have a medical condition or health issues before the insurance coverage begins, even if you haven't sought medical treatment for them, it is considered an existing treatment need before the insurance coverage starts. According to the General Insurance Terms and Conditions (GTC), the costs associated with this illness and any resulting conditions would not be eligible for reimbursement.

If an illness that already existed before the start of the insurance but did not cause you any complaints is only diagnosed for the first time after the start of the insurance, this is considered a new illness and the costs are reimbursable. In the case of illnesses that are known to take a chronic course, although they do not bear the suffix "chronic" (e.g. allergies), it must be checked exactly when the illness first occurred or when it was diagnosed by the doctor.