Frequently Asked Questions (FAQs)
Using the Policy
What Should I Do if I Have a Medical Emergency?
Please seek treatment immediately at any medical facility. Once you are able, please notify, or have someone else notify:
For policies that started before 1 November 2022
(Phone +1 877 248 2197 free on Skype) within the following 48 hours.
Aetna’s assistance staff will work with the medical provider to pay your bill.
I’ve Paid For Treatment; How Do I Submit a Claim?
You can submit a claim electronically.
For more details on how to submit a claim please click here.
What Treatment Requires Preauthorization?
Members are required to obtain prior approval from your insurer 5-7 days, when possible, before commencing the following treatments or procedures:
a) Planned inpatient or daypatient treatment (hospitalization)
b) Any pregnancy or childbirth treatment
c) Planned surgery
e) Psychiatric treatment – inpatient, daypatient, and outpatient
f) Home nursing charges
g) Planned inpatient, day patient or outpatient MRI, CT & PET scans
For policies that started before 1 November 2022
You can find more information on filing for a preauthorization here.
For policies that started after 1 November 2022
You can find more information on filing for a pre-approval here.
How Do I Obtain Pre-Authorization for Treatment Like a Planned Inpatient Surgery, a CT Scan, or an MRI?
For policies that started before 1 November 2022:
You can arrange pre-authorization for treatment by contacting the Aetna Member Services number +1 877 248 2197
Which Doctors or Hospitals Can I Use?
If you are outside the USA, you can go to the hospital or doctor of your choice.
In the USA, if you are with Aetna or Allianz, you can seek treatment within Aetna’s Network of Approved Providers.
What Else Comes With My Policy?
Talent Trust policies come with resources to help you have the greatest impact in your calling. We understand that the challenges of mission life can limit the impact of a missionary’s ministry. We provide resources to stay physical, mental, and financially healthy, so you can thrive as long as needed in your calling.
You can see how these different resources can help you here.
Making a Claim
How Long Will It Take for My Claim to Be Paid?
Most claims are paid within 15 business days of receipt. In 2020 85% of claims were processed within 5 days.
Can My Insurance Pay My Medical Provider Directly?
For treatment within the United States, all eligible treatment received within Aetna’s Preferred Provider Network can be settled directly by Aetna or Allianz.
For treatment outside of the United States, all daypatient and inpatient treatment, as well as any outpatient treatment costing US$1,000 or more, can be settled directly by Aetna or Allianz.
Please note that in some remote locations some medical providers may not accept direct settlement. However, Aetna and Allianz have partners in most countries.
How Do I Get Aetna To Pay My Bill With the Hospital?
Which Claims Do Not Affect My No Claims Bonus (NCB)?
- Wellness benefits
- Vaccinations benefits
- Routine Dental option
- Vision Care option
- Travel option
- Extended Compassionate Travel option
You can also speak to Virtual Healthcare doctors and this does not affect your NCB.
What/Who is Covered
What is Covered by My Policy?
Your Policy Legal Wording contains complete details on your covered benefits. This is emailed to you when you sign up and at your renewal. Please refer to this document for specific information about your benefits.
If you would like help determining what would be covered in a specific situation, please contact us, and we will be happy to go through this with you.
Am I Covered for COVID-19?
Yes, members are covered for COVID-19 treatment provided they did not have COVID19 before joining the policy, and they are not entering a country against a governmental or WHO (World Health Organization) travel ban. Our plans cover COVID19 medical treatment in full, including diagnostic tests, hospitalization, and ICU.
Please note our policies do not cover government-mandated testing or quarantine for travel purposes.
Am I Covered if I Travel Away from My Country or Area of Residence?
Yes, your policy will cover you when you are travelling. Please note that some of our policies have restrictions on where you are covered, and what you are covered for.
Will the Pregnancy Benefits Cover a Caesarian Section and an Evacuation to the Nearest Capable Hospital if That Is Prescribed?
What is an Excess?
An excess is an amount a member pays for expenses before any benefits are paid by a policy. A policy excess is applied for each new medical condition. In the case of a condition that spans 2 or more policy years, the excess will only be applied once.
What is the Difference Between an Excess and a Deductible?
A deductible is applied once per policy year and will be applied for all bills that year. All claims that you make in a policy year will go towards meeting your deductible. An excess is applied against each medical condition. Each new condition will have its own excess that will need to be met before the policy will begin to cover expenses. In the case of a condition that spans 2 or more policy years, the excess will only be applied once.
|1 per person per policy year||1 per person per condition|
|Resets each policy year||Resets each new condition|
|Multiple conditions in a policy year fall under a single deductible||Conditions that go over multiple years fall under a single excess|
Please Can You Give Me an Example of How the Policy Excess Works?
In the event that a member broke their leg, all treatment associated with that broken leg, including setting the bone, putting the leg in a cast, doctors visits, rehabilitation, any medication for pain or infection, etc. would be classed as being associated with that one condition, and so one excess would be applied. The member would pay their excess, and the insurance would pay for all other subsequent eligible* treatment.
If the member subsequently had appendicitis and had to have his appendix removed, this would be classed as an unrelated condition to the broken leg, and all treatment associated with this condition would have a new excess applied to it, and once this was paid all eligible treatment would be covered by the policy**.
* as defined in the policy legal wording
** Note, treatment in the USA may incur an additional 20% co-insurance.
What Benefits Do Not Have an Excess/Deductible?
Standard benefits not subject to an excess or deductible:
a. Hospital Cash
b. Mortal Remains
c. Emergency Transportation
e. Evacuation & Additional Travel Expenses
f. Well-Child Care
g. Wellness Benefit
Optional benefits not subject to a policy excess or deductible:
a. Routine Dental Treatment,
b. Compassionate Travel
c. Vision Care
What is Co-Insurance?
Co-insurance is a concept that US plans use where a member is required to pay a percentage of the cost of their treatment. Under the Omega policy, if a member requires treatment within the United States, they will be liable for 20% of medical charges after the excess when they seek treatment at an Aetna PPO medical facility. The co-insurance is generally limited, please see your policy wording for your co-insurance limit.
When not undertaken within the Aetna PPO network, treatment within the United States will be subject to a 40% co-insurance and will not be subject to the co-insurance limit.
Please refer to your policy for detail of when a co-insurance would apply.
Is Talent Trust Only for Missionaries and Church Workers?
Yes, Talent Trust only covers those in full-time church or mission service. We recognize that some people may travel to certain countries that require them to be there under an alternate capacity. You are eligible for cover as long as your primary reason for relocating is to let people know about Jesus.
Do I Need a Medical Exam Before Enrolling?
No, we ask some basic medical questions, but no medical exam is necessary.
Can Emergency Air-ambulance Flights Get into Places Like Nepal or Cambodia?
Yes, an air-ambulance flight can normally get into these countries. Some countries are more complicated to arrange transport out of, so please inform the Aetna medical teams as soon as possible if you have a possible medical emergency developing.
Is There a Limit to the Number of Days That I Can Be Resident in My Home Country?
No, you are not limited to the amount of time you spend in your home country. Please note that some policies do have limits on cover in certain countries. We do not recommend that you use a policy that has limits on cover in your home country.