How To Use Your ISO Insurance Plan

The health insurance system in the U.S. can be confusing to figure out, especially for international students who are used to a different procedure in their home country. At ISO, we often are asked about the process of how to see a medical provider and get insurance to cover their medical bill.

With this, we wanted to prepare a step-by-step guide you can follow if you ever do need to utilize the insurance in the future.

Step 1 – Have your insurance documentation readily available

When you purchase your insurance with ISO, you will automatically be sent a confirmation email with your insurance documentation. It’s important to always have this available in an easily accessible place in case of emergency, whether it be on your phone/computer or on you personally if you print them out.

Become familiar with the information listed on the following documents:

• Insurance ID card
• Confirmation letter
• Plan brochure

Make sure to have access to this information for the next two steps. If you need access to these documents, you can download them at any time through your ISO account page. You can log in using your member ID/email and password here.

Step 2 - Find a provider and make appointment

Once you have your insurance information ready to go, you can then begin the process of trying to find a provider. All ISO plans provide access to 1-2 preferred provider organizations (PPO), which work with providers across the U.S. to provide discounted rates for medical services.

Your ISO plan either works with the Firsthealth/Multiplan or Cigna PPO network(s). You can review which network(s) your plan works with on your insurance ID card. To find in-network providers, you can login to your ISO account and reference the following link.

Once you find a provider through the link above, you should call them directly to try to make an appointment. Make sure to emphasize that your insurance plan works with the PPO network(s) your plan is set up with during the call.

Since ISO plans are PPO plans, you have the option to see a provider outside of your plan's networks. However, we strongly suggest seeing an in-network provider whenever possible as it will save you money on your visit.

Step 3 - Go in for the appointment

Once your appointment is set, all you need to worry about is showing up for your visit and following the doctor’s orders. Make sure to have at least your insurance ID card information available when you show up for the visit, as the provider will need to reference it to see where to submit claims.

ISO plans are not reimbursement plans, so typically you will not be asked to pay anything at the time of visit. However, if your plan has a copay, you will probably be asked to pay that amount before you leave your appointment. In rare occasions, providers will ask you to pay the full bill amount out of pocket and/or submit the claim on your own but you will be able to submit a claim for reimbursement. 

Step 4 - Submit claim if needed

Before/during your visit, you can ask the provider to confirm if you will need to pay anything at the time of visit or if you will need to submit a claim on your own. In the case you need to, you can follow the steps here to submit a claim.

For more on claims, reference the following link.

Step 5 - Wait for claim to process

Once the claim is submitted by either you or the provider, you should expect to wait around 10-20 business days before the claim will be processed.

Once the claim has completed processing, you should receive an Explanation of Benefits (EOB) from our claims department, SISCO Benefits. This will be sent both to your home address and directly to your email listed in your ISO account. This is why it’s always imperative to update your address/email through your ISO account if they ever change.

Once you receive this information, make sure to review it as our claims department may need to request additional information to process your claim. If you need to submit additional documentation, you can do so following the same steps as you did to submit the claim here.

If you needed to submit a claim for reimbursement, you should also receive a check from SISCO Benefits for the amount the insurance is supposed to cover either with or shortly after you receive the EOB.

Step 6 - Complete payment through provider

Once you receive the EOB from SISCO Benefits, you should be billed by the provider shortly after for the amount you are deemed responsible for on the EOB.

From there, you will need to complete your payment through the provider using the billing information they list on the bill they send you.