International Patients and Insurance

International Insurance Companies Travel Medical Assistance

International Insurance Arrangements

For international patients, we have contracts with some major insurance companies that allow us to submit claims directly to the insurance company. Others may require that you pay the claim directly at the time of service and seek reimbursement from the insurance company when you return home.

International insurance can fall into one of several categories:

  • Insurance for intended medical treatment
  • Insurance for medical emergencies while traveling
  • Insurance for routine or minor medical situations while traveling
  • Special corporate arrangements with CIMA Hospital

Most people either rely on their primary health insurance or purchase trip-related accident and medical insurance. Whether you are traveling to obtain medical care or for pleasure, we encourage international travelers to contact your insurance company before you travel abroad to learn what conditions may apply.

In many cases, your primary insurance may only cover medical expenses outside your home country when you have an accident or have an unforeseen medical emergency. They often do not cover minor medical situations.  Other insurance plans, as noted above, require that you pay the bill to the hospital or provider and then seek reimbursement from the insurance company. In a medical emergency, these bills can grow quite large very quickly. Some insurance companies, particularly travel assistance companies and insurers, will offer a guarantee of payment to the hospital. This will help minimize the amount you have to pay immediately, but there can still be amounts you will need to pay before leaving the hospital.

Remember too, that your insurance company may have a deductible, co-payment or other amount that you are required to pay as part of receiving medical care. You may also have limitations on payment for certain kinds of services or out of network provisions that apply. Because we are outside of your home region as an international patient, it is difficult to know what those amounts are, so you may be required to pay an estimated amount that is greater than the actual amount for which your insurance company may ultimately decide you are responsible. You can work with your insurance company to be reimbursed for them under the terms of your insurance coverage; however, we ask that you understand those arrangements are outside our control.

Direct Employer/Company Contracts

We also have direct contracts with a growing number of companies based in the United States that enable their employees to receive medical care at Hospital CIMA and will pay the hospital directly for you. These arrangements are often simpler, more transparent and less expensive for you and your employer. For specific information, contact your employer or Hospital CIMA’s International Patient Office. For information about starting a direct contract, please contact us at [insert email address].

International Insurance Companies

The table below shows some of the companies with which we work, but your specific terms and conditions may create a different situation. We recommend that you contact us to determine what type of arrangement exists between with your particular insurance company and the hospital.

Company Country Type of Relationship

(Direct Bill/Pay and Seek Reimbursement)

AETNA (USA Domestic Plans) USA Pay and Seek Reimbursement
AETNA GLOBAL BENEFITS USA Direct Bill
AETNA INTERNATIONAL USA Direct Bill
AGEAS INSURANCE LTD ING Pay and Seek Reimbursement
BARMENIA HEALTH INSURANCE Germany Pay and Seek Reimbursement
BDAE HOLDING GmbH Germany Direct Bill
BEST DOCTORS USA Direct Bill
BLUE CROSS BLUE SHIELD USA Pay and Seek Reimbursement (Most plans)
CIGNA INTERNATIONAL USA Direct Bill
CIGNA US USA Pay and Seek Reimbursement
CLAL HEALTH INSURANCE COMPANY LTD Israel Pay and Seek Reimbursement
HAREL Israel Pay and Seek Reimbursement
HEALTH CARE INTERNATIONAL UK Direct Bill
METLIFE EXPATRIATE BENEFITS USA Direct Bill
US VETERANS AFFAIRS FOREIGN MEDICAL PROGRAM (FMP) USA Direct Bill
VETERANS AFFAIRS OF CANADA Canada Pay and Seek Reimbursement


Some insurance companies have established relationships with travel medical assistance companies. These companies provide services on behalf of your insurance company for you when something happens while you are traveling. Some of these companies also provide independent trip-related insurance for medical and related needs. In many cases, we are able to work with your travel medical assistance company on a direct basis to help manage the expenses associated with an unexpected hospital admission. Please let us know as soon as possible that you have benefits through a company that provides these benefits and services, so that we can determine the right arrangement for your situation.

Travel Medical Assistance Companies

The table below shows some of the travel medical assistance companies with which we work. It is not intended to be a complete list, and we are consistently updating it.  Consequently, the list is a guide but may not cover all companies or situations.

Company Country Type of Relationship

(Direct Bill/Pay and Seek Reimbursement)

ACTIVE CARE MANAGEMENT Canada Direct Bill
ADAC Germany Direct Bill
ALLIANZ GLOBAL ASSISTANCE CA Canada Direct Bill
ALLIANZ GLOBAL ASSISTANCE USA USA Direct Bill
ALLIANZ WORLDWIDE CARE Ireland Direct Bill
ALMEDA HO Pay and Seek Reimbursement
AMERICAN ASSIST TRAVEL PROTECTION USA Pay and Seek Reimbursement
ANWB ALARM CENTRALE HO Direct Bill
AP COMPANIES USA Pay and Seek Reimbursement
APRIL USA USA Pay and Seek Reimbursement
ASSISTANCE SERVICES OF THE AMERICAS, INC Mexico Direct Bill
ASSURED ASSISTANCE Canada Direct Bill
ATLAS EXPATRIATE BENEFITS USA Pay and Seek Reimbursement
AXA ASSISTANCE CANADA Canada Direct Bill
AXA ASSISTANCE COLUMBIA Columbia Pay and Seek Reimbursement
AXA ASSISTANCE GERMANY Germany Direct Bill
AXA ASSISTANCE ITALY S.A. Italy Direct Bill
AXA ASSISTANCE MEXICO S.A. de C.V. Mexico Pay and Seek Reimbursement
AXA ASSISTANCE USA USA Direct Bill
AXA TRAVEL INSURANCE CIPT UK Pay and Seek Reimbursement
CANASSISTANCE Canada Direct Bill
CEGA UK Direct Bill
CLICK TRAVEL PROTECTION (IATAI) USA Pay and Seek Reimbursement
CMN Canada Direct Bill
COMPAÑIA EUROPEA DE SEGUROS Spain Direct Bill
CORIS USA Pay and Seek Reimbursement
CULTURAL INSURANCE SERVICES INTERNATIONAL USA Direct Bill
DAVID SHIELD Israel Direct Bill
DEUTSCHE ASSISTANCE SERVICE GmbH Germany Direct Bill
DEUTSCHER RING Germany Direct Bill
DIE CONTINENTALE Germany Direct Bill
DKV (GLOBALITY HEALTH) Germany Direct Bill
EGK ASSISTANCE HO Direct Bill
EMERGENCY CORPORATION INTERNATIONAL USA Pay and Seek Reimbursement
EMERGENCY ASSISTANCE FACILITIES UK UK Pay and Seek Reimbursement
EMERGENCY ASSISTANCE JAPAN-H.S. INSURANCE CO., LTD USA Pay and Seek Reimbursement
EURO CENTER S.A. Brazil Direct Bill
EUROCROSS ASSISTANCE HO Direct Bill
EUROP ASSISTANCE ALEMANIE Germany Direct Bill
EUROPE ASSISTANCE ARGENTINA Argentina Direct Bill
EUROPE ASSISTACE C.R. Costa Rica Direct Bill
EUROP ASSISTANCE ESPAÑA Spain Direct Bill
EUROP ASSISTANCE RUSSIA Russia Direct Bill
EUROP ASSISTANCE USA USA Direct Bill
FALCK ASSISTANCE Denmark Direct Bill
FD SERVICE S.p.A. Italy Direct Bill
FIRST ASSIST UK Pay and Seek Reimbursement
FRONTIER MEDEX (Now United Healthcare Global SafeTrip) USA Direct Bill
FZOG CURACAO Curacao Pay and Seek Reimbursement
GENERALI INTERNACIONAL Guatemala Direct Bill
GEO BLUE  USA Direct Bill
GLOBAL ASSURANCE GROUP USA Direct Bill
GLOBAL BENEFITS GROUP USA Direct Bill
GLOBAL EXCEL MGMT INC Canada Direct Bill
GLOBAL MEDICAL MANAGEMENT INC. USA Direct Bill
GLOBAL RESPONSE UK Pay and Seek Reimbursement
GOUDA TRAVEL INSURANCE Denmark Direct Bill
GRUPPO FILO DIRETTO Italy Direct Bill
HALLESCHE Holland Direct Bill
HEALIX INTERNATIONAL UK Direct Bill
HEALTH SMART (HARBIN CLINIC) USA Pay and Seek Reimbursement
HEALTHWATCH S.A. Greece Pay and Seek Reimbursement
HENNER-GMC France Direct Bill
HTH WORLDWIDE INSURANCE SERVICE (GEO BLUE) USA Direct Bill
INTANA GLOBAL England Direct Bill
INTER PARTNER ASSISTANCE, S.A. Spain Pay and Seek Reimbursement
INTERMUTUELLES ASSISTANCE France Direct Bill
INTERNATIONAL DIVING ASSURANCE LTD – DAN EUROPE Malta Pay and Seek Reimbursement
INTERNATIONAL MEDICAL ASSISTANCE (IMA) Israel Pay and Seek Reimbursement
INTERNATIONAL MEDICAL GROUP (IMG) USA Direct Bill
INTERNATIONAL SOS USA Direct Bill
INTREPID ASSISTANCE Canada Pay and Seek Reimbursement
ISFAS Instituto Social de las Fuerzas Armadas Spain Pay and Seek Reimbursement
KEY INSURANCE UK Pay and Seek Reimbursement
LATIN AMERICA ASSISTANCE USA Pay and Seek Reimbursement
LLT CONSULTING WEAVILITY France Direct Bill
MAPFRE ASSISTANCE France Direct Bill
MAPFRE ASSISTANCE IRELAND Ireland Direct Bill
MD ABROAD USA Pay and Seek Reimbursement
MD MEDICUS ASSISTANCE SERVICE GmbH South Africa Direct Bill
MEDAIRE USA Direct Bill
MEDBRICK Canada Direct Bill
MEDCARE INTERNATIONAL, INC USA Pay and Seek Reimbursement
MEDGATE Switzerland Pay and Seek Reimbursement
MEDIC AIR INTERNATIONAL France Direct Bill
MEDICALL AG Switzerland Pay and Seek Reimbursement
MEDICOS Y AUDITORES S.A.S. Columbia Pay and Seek Reimbursement
MEDIPAC  ASSIST UK Pay and Seek Reimbursement
MONDIAL ASSISTANCE, S.R.O South Africa Direct Bill
MORGAN WHITE USA Direct Bill
MOS MEDICAL HELPLINE GmbH South Africa Pay and Seek Reimbursement
MSH INTERNATIONAL USA Direct Bill
MUTAS Belgium Direct Bill
MUTUAIDE ASSISTANCE France Pay and Seek Reimbursement
NET SERVICES TRAVEL ASSISTANCE SLNE Spain Pay and Seek Reimbursement
NORDIC HEALTHCARE Denmark Pay and Seek Reimbursement
NORFOLK MOBILITY BENEFITS USA Pay and Seek Reimbursement
NORTHCOTT GLOBAL SOLUTIONS UK Direct Bill
NORTHERN LIGHT USA Pay and Seek Reimbursement
OHRA Holland Pay and Seek Reimbursement
OLYMPUS USA Direct Bill
ON CALL INTERNATIONAL USA Pay and Seek Reimbursement
ONE WORLD ASSIST USA Pay and Seek Reimbursement
OPTIMUN GLOBAL UK Direct Bill
PA GROUP ADMINISTRATION USA Direct Bill
PANAMA ASISTENCIA S.A. Panama Pay and Seek Reimbursement
PAN AMERICAN MEXICO COMPAÑIA DE SEGUROS S.A DE C.V Mexico Pay and Seek Reimbursement
PAYER FUSION USA Pay and Seek Reimbursement
PERIDOT GLOBAL USA Pay and Seek Reimbursement
PROFESSIONAL CLAIMS ADMINISTRATORS INC USA Pay and Seek Reimbursement
PRONTO ASSISTANCE SERVIZI Italy Pay and Seek Reimbursement
QUALITY HEALTH MANAGEMENT USA Direct Bill
QUALITY TRAVEL ASSISTANCE USA Direct Bill
RACC Serveis Medics, S.A. NIF: A60705910 Spain Direct Bill
ROLLAND ASSISTANCE GmbH South Africa Direct Bill
SEGUROS DE OCCIDENTE Guatemala Direct Bill
SEGUROS G&T GUATEMALA Guatemala Direct Bill
SEVEN CORNERS USA Direct Bill
SIGMA ASSISTEL Canada Direct Bill
SOMPO JAPAN INSURANCE INC. Japan Pay and Seek Reimbursement
SOS DINAMARCA Denmark Direct Bill
SOS INTERNATIONAL AMSTERDAM Holland Direct Bill
SOS SEGUROS Y REASEGUROS S.A. Spain Direct Bill
SPECIALTY ASSIST UK Direct Bill
SUNMED INTERNATIONAL USA Direct Bill
TIC TRAVEL INSURANCE Canada Pay and Seek Reimbursement
TMCA GROUP CORP USA Direct Bill
TOURING CLUB SUIZO Switzerland Pay and Seek Reimbursement
TRAVEL AND MEDICAL ASSISTANCE (TMA) UK Pay and Seek Reimbursement
TRAVEL GUARD USA Pay and Seek Reimbursement
TURIEN Y CO ASSURADEUREN Holland Pay and Seek Reimbursement
TYROL AIR AMBULANCE Ges.m.b.H. Austria Pay and Seek Reimbursement
UNITED HEALTHCARE GLOBAL SOLUTIONS USA Direct Bill
UNIVERSAL ASSISTANCE USA Pay and Seek Reimbursement
USA MEDICAL SERVICES USA Direct Bill
VUMI GROUP USA Direct Bill
WORLD TRAVEL ASSIST USA Pay and Seek Reimbursement
WORLDWIDE MEDICAL ASSURANCE, LTD. CORP. Panama Direct Bill
WSIB (WORKPALCE SAFETY AND INSURANCE BOARD) Canada Pay and Seek Reimbursement
WTP ASSIST Canada Pay and Seek Reimbursement

IMPORTANT NOTICE FOR US CITIZENS

Please be aware that Hospital CIMA does not accept Medicare or Medicaid as a form of insurance payment. In general, these plans do not provide any benefits for travelers outside the United States, even for emergency medical situations.  

We strongly encourage US citizens traveling abroad purchase travel medical insurance that covers the costs of medical care, both on a routine and an emergency basis, and that includes the costs of emergency medical evacuation. We hope that no one ever needs that insurance; however, we regularly see patients who are experiencing both the stress of an emergency medical situation and the discovery that their health insurance coverage is not as broad as they thought it was.