Getting Care Under the Demonstration
If you have an emergency, go to the nearest emergency facility. Contact International SOS before leaving the facility, preferably within 24 hours or on the next business day, to coordinate continued care.
For all other services, you don't need a referral for routine, urgent, specialty or preventive care, but some services will require prior authorization. Contact International SOS if you have any questions about services requiring authorization.
Approved Demonstration Providers
All care received within the demonstration area must be received from Approved Demonstration Providers unless you request and receive a waiver from International SOS. If you don't get care from an Approved Demonstration Provider and you don't have a waiver, you're responsible for the full cost of care.
To find an approved provider:
At the time of your visit, Approved Demonstration Providers will ask you to fill out an agreement to pay your cost shares and deductibles. You can pay up front or may be billed afterwards.
If you are currently engaged in an ongoing episode of care with a non-approved provider when the demonstration begins, and you wish to continue care with that provider, submit a waiver request to International SOS.
Step-by-Step Process for Getting Care
- Find an Approved Demonstration Provider
- Call the approved provider to set up an appointment
- Check in at your appointment, fill out all documentation as requested, and get the care you need.
Approved Demonstration Providers can ask for up front payment of your applicable cost shares and deductibles. After the appointment, you and the Approved Demonstration Provider will recieve an explanation of benefits (EOB) showing the amount you're required to pay. If you didn't pay up front, the provider will follow up with you to collect your payment.
Certified Providers and Pharmacies
There are times when you will still be required to select providers from the Philippines Certified Provider List. If you live in a designated demonstration area, but get care outside of a demonstration area, you must select a certified provider. Additionally, pharmacies are not included in this demonstration, so you will continue to select certified pharmacies from the Philippines Certified Provider List.
To find a certified provider or pharmacy, search the Philippines Certified Provider List.
Note: All beneficiaries who travel to the Philippines must select providers and pharmacies from the Philippines Certified Provider List.